LAB EXERCISE

CARDIOVASCULAR RESPONSES
TO CHANGES IN POSTURE AND TO EXERCISE
(Martini p.708-715, 730-747)

Work in groups of 4

Objectives:

 Determine heart rate by palpating radial pulse

 Describe and account for pulse rates determined by radial and carotid palpation
 Describe and account for the differences in pulse rate between lying down, standing and following
exercise
 Describe and account for differences in these changes between a trained athlete and a sedentary
person
 Determine arterial blood pressure using a sphygmomanometer
 Define systolic pressure, diastolic pressure, pulse pressure, mean arterial pressure
 Differentiate between factors determining systolic pressure and factors determining diastolic pres-
sure
 Describe and account for the changes in systolic and diastolic pressure that occur on standing up
(from a reclining position) and on following exercise

SAFETY PROCEDURES
 Students volunteering as subjects should be physically fit.
 Students with cardiovascular problems should abstain to volunteer.
 For this exercise subjects should wear flat comfortable shoes (they will be climbing on and off a
laboratory stool), and garments with sleeves that can be rolled up well above the elbow (they will be
using a blood pressure cuff).

In exercise the increased energy requirements of active muscles necessitate increased delivery of oxygen and
nutrients to them. This is brought about by appropriate adjustments in the cardiovascular and respiratory
systems. Standing up also requires changes in these systems as a result of the effects of gravity.

This exercise explores how and why cardiovascular parameters change in adapting to the erect position and to
exercise.

I. PROCEDURE TO DETERMINE HEART RATE AND BLOOD PRESSURE (Martini p. 736)

A. Determining Heart Rate by Palpating the Radial Pulse

Place your fingertips (not thumb) over the radial artery in the ventrolateral region of the subject's wrist.
Count the exact number of pulses in exactly 30 seconds. Record. Multiply by 2 to have the number of
heartbeats per minute. Repeat the count twice and record. Average the three values.

B. Determining Blood Pressure by Using the Sphygmomanometer

The sphygmomanometer is the device used routinely to measure blood pressure. It consists of an
inflatable rubber cuff connected by rubber hoses to a hand pump and to a pressure gauge (manometer)
graduated in millimeters of mercury (mmHg). The cuff is wrapped around the upper arm snuggly (but not
tightly enough to obstruct venous flow), with the lower margin about 2.5 cm above the antecubital space
and with the rubber bag over the inner aspect of the arm. When the bag is inflated to a pressure greater
than the systolic pressure the brachial artery is occluded and blood ceases flowing in it.

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To determine the approximate systolic pressure, proceed as follows. Palpate the radial artery and, while
feeling the pulse, quickly raise the pressure within the cuff in steps of about 5 mmHg until the radial pulse
disappears. The pressure at this point is the systolic pressure. Do not keep the pressure elevated for any
longer than is necessary to make the reading. Deflate the cuff and allow the circulation to return to
normal.

Determine the position of the brachial artery in the antecubital space by palpation. Place the bell of the
stethoscope over it and quickly raise the cuff pressure about 30 mmHg above the systolic pressure. Then
release the pressure gradually, at a rate of about 2-3 mmHg per second, by opening the screw-type value
adjacent to the hand pump. Listen for the Korotkoff Sounds described below.

At rest, the blood normally flows through the arteries in laminar flow. That is, the fluid in the center part
of the stream moves faster than the fluid in the peripheral layers, and there is very little transverse flow or
mixing between the two layers (turbulence). Under these conditions the artery is silent when auscultated.
When the sphygmomanometer bag is inflated to a pressure above the systolic pressure, the flow of blood is
stopped and the artery is also silent.

As the pressure in the bag is released gradually through the levels between systolic and diastolic pressure,
the blood is pushed through between the walls of the flattened and compressed artery in a turbulent flow
pattern. The layers of blood are mixed by eddies flowing at angles to the main stream, and the turbulence
sets up vibrations in the arterial wall which are heard as sounds in the stethoscope. These are the sounds
of Korotkoff.

In practice, as the pressure in the cuff is permitted to fall gradually from above systolic, no sound is heard.
Note the pressure at which the first 'snapping' sound is heard. This is the systolic pressure. As the
pressure in the bag is reduced further the sound first becomes quieter, then changes to a louder tapping.
With still further decreases in pressure, the sound changes again from a tapping sound to a muffled or
blowing noise. The pressure at which this change occurs should be recorded as the diastolic pressure.
Further reduction in cuff pressure leads to the total disappearance of any sound. If the systolic pressure is
determined to be l20 mmHg and the diastolic 80 mmHg, the blood pressure is recorded as l20/80.

The pulse pressure is the difference between systolic and diastolic pressures, in this case l20 - 80
= 40 mm Hg.

The mean arterial pressure is calculated as diastolic pressure + l/3 pulse pressure, in this case 80
+ (l/3 x 40) = 93 mm Hg.

Notes:
(l) In some instances, especially in elderly people with arteriosclerosis, there may be a silent period
(auscultatory gap) between the systolic pressure, when snapping sounds are first heard, and the loud
tapping phase. This can lead to errors in recording systolic pressure if the manometer is not pumped up
high enough before letting it fall. For this reason systolic pressure determination by the auscultatory
method should always be checked by palpating the radial pulse.

(2) It is often difficult to determine the exact point when the sound changes from a tapping to a muffled
sound. In such cases, the pressure when the sound disappears should be recorded as diastolic pressure.
Both values are sometimes recorded, eg. l20/85/75 (systolic pressure is l20 mmHg). Check by palpation
of the radial pulse.

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II. EFFECTS OF POSTURE AND EXERCISE ON HEART RATE AND BLOOD PRESSURE

NOTE: Measure heart rate and blood pressure simultaneously. One student is the subject, the second
determines heart rate, the third determines blood pressure and the fourth records the values and does the
calculations. Record results in the space provided.

A. Sitting

EXERCISE A
Equipment:
 stopwatch (or watch with second hand)
 sphygmomanometer
 stethoscope

The subject should be seated comfortably for this count. Practice recording heart rate and blood
pressure simultaneously: one student records heart rate, another one records blood pressure.

Heart Rate.
Count the exact number of pulses in exactly 30 seconds. Repeat the count twice and record. Average the
three values. Multiply by 2 to have the number of heart beats per minute.

Sitting heart rate 1st 2nd 3rd Average

Radial pulse (30 second
count)
Sitting heart rate (beats/min)
(average x 2) =

Blood Pressure.
Practice determining your partner's blood pressure by the auscultatory method while she is sitting
comfortably (check against palpatory method) until you record 3 successive readings that are in close
agreement. Record these below. Leave the cuff in place but uninflated.

Sitting Blood Pressure (mmHg) 1st 2nd 3rd Average

Systolic
Diastolic
Calculate, using average values:
Pulse pressure (= systolic - diastolic)
Mean pressure (= diastolic + 1/3 pulse press)

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B. Reclining

EXERCISE B
Equipment:
 stopwatch (or watch with second hand)
 sphygmomanometer
 stethoscope

Prior to this test the subject should lie down on a laboratory bench with eyes closed and relax completely
for a period of 5 minutes before heart rate and blood pressure are determined.

Heart Rate.
Locate the carotid pulse by placing your thumb and fingers on either side of the neck just below and in
front of the angle of the jaw. Make 3 counts palpating the carotid pulse and 3 counts palpating the radial
pulse, alternating counts between the two locations. Count carefully - there is usually a small but
noticeable difference. Record and average your observations below.

DO NOT make these counts simultaneously. If you do the counts will be identical.

Reclining heart rate - carotid pulse 1st 2nd 3rd Average

Reclining carotid pulse (30 sec)
Average reclining heart rate (carotid) (beats/min)
=
Reclining heart rate - radial pulse 1st 2nd 3rd Average
Reclining radial pulse (30 sec)
Average reclining heart rate (radial) (beats/min)
=

Blood Pressure.
Make 3 determinations of systolic and diastolic pressures by the auscultatory method. The arm should be
level with the trunk. Determine mean values.

Reclining Blood Pressure (mmHg) 1st 2nd 3rd Average

Systolic
Diastolic
Calculate, using average values:
Pulse pressure (= systolic - diastolic)
Mean pressure (= diastolic + 1/3 pulse press)

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The subject has to keep lying down. DO NOT STAND UP before your two lab mates are ready to
take resting heart rate and blood pressure measurements before exercise for Exercise C.

C. Standing

EXERCISE C
Equipment:
 stopwatch (or watch with second hand)
 sphygmomanometer
 stethoscope

Leaving the cuff in place, the subject should stand up, and heart rate and blood pressure should be
determined immediately. Count pulses for heart rate measurements for 15 seconds only (multiply by 4 for
minute counts). Repeat blood pressure and heart rate measurements at 2 and 5 minutes after standing up.
In each case record simultaneously heart rate, systolic and diastolic pressures, and calculate pulse and
mean pressures. Stand "easy" in the intervals between counts, not absolutely still.

Heart Rate.
Immediate standing Heart rate 1st 2nd 3rd Average
Immediately standing radial pulse (15 sec)
Immediately standing heart rate (average x 4) =

The subject should remain on her/his feet, "standing easy". At 2 and 5 minutes make 3 15-second counts
of the radial pulse and average.

2 minutes after standing Heart rate 1st 2nd 3rd Average

2 minutes after standing radial pulse (15 sec)
2 minutes after standing heart rate (average x 4) =

5 minutes after standing Heart rate 1st 2nd 3rd Average

5 minutes after standing radial pulse (15 sec)
5 minutes after standing heart rate (average x 4) =

Blood Pressure.
Make 1 determination of systolic and diastolic pressure immediately after standing up and at 2 and 5
minutes.

Standing blood pressure Systolic Diastolic Pulse Mean

Immediately on standing

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 2 minutes after standing
5 minutes after standing

Note: if you miss a blood pressure reading or are late taking the blood pressure, simply note the time that
the blood pressure was actually taken.

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D. Exercise

The goal of EXERCISE D is to determine what cardiovascular adjustments take place during and after
exercise. Heart rate and blood pressure will be recorded before exercise, immediately after exercise and
during the recovery (while sitting). The measurements recorded immediately after exercise illustrate
what happens during exercise.

EXERCISE D
Equipment:
 stopwatch (or watch with second hand)
 sphygmomanometer
 stethoscope

While sitting, record pre exercise heart rate and blood pressure measurements. The subject should then
run up and down the stairs for 5 minutes. Post exercise measurements should also be done while sitting.

Heart Rate.
Be prepared to make 15 second counts of the radial pulse before exercising, immediately after
the exercise is completed and at 30 second intervals thereafter for a total of two minutes. Make
one 15 second count of the radial pulse at 4 and 6 minutes after completion of exercise.
Calculate heart rate from each of these counts.
Radial Pulse 15 sec count Heart Rate (beats/min)
Before exercise
Immediately after exercising
30 seconds after exercising
60 seconds after exercising
90 seconds after exercising
120 seconds after exercising
4 minutes after exercising
6 minutes after exercising

Blood Pressure.
Record blood pressures before exercising, immediately after completing the exercise and at intervals of 2,
4, and 6 minutes after completion. Calculate pulse and mean pressures.

Systolic Diastolic Pulse Mean

Before exercise
Immediately after
exercising
2 minutes after exercising
4 minutes after exercising
6 minutes after exercising
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E. Effects of Standing Still on Cardiovascular Performance

EXERCISE E
Equipment:
 stopwatch (or watch with second hand)
 sphygmomanometer
 stethoscope

The subject again lies down, closes her eyes and relaxes completely. Check heart rate at 1 minute intervals
until counts are consistent. Count the radial pulse for 15 seconds, record below and calculate.
Determine systolic and diastolic blood pressure, record below, and calculate pulse and mean pressures.

The subject then stands up with her back to the wall and remains absolutely still. Don't move your feet - or
even wiggle your toes. Record Heart Rate (count the radial pulse for 15 seconds) and Blood Pressure
immediately after standing up, 1-minute after standing up, and at 2-minute intervals thereafter for a period
of 15 minutes. Record below. If the subject feels faint or dizzy, the experiment should be terminated
immediately, and she should lie down again to recover.

Radial pulse Heart rate Blood Pressure (mmHg)

15 sec count (beats/min)
Systolic Diastolic Pulse Mean
RECLINING
0
1
TIME 3
AFTER 5
STANDING 7
(min.) 9
11
13
15

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NAME & section #: ________________________________________

EXERCISE 4: CARDIOVASCULAR RESPONSES

TO EXERCISE

INTRODUCTION
State the purpose of this exercise

MATERIALS AND METHODS

See the lab manual.

RESULTS.
Use separate pages.

CARDIOVASCULAR EFFECTS OF POSTURE AND EXERCISE.

1. Tabulate your results.
2. Illustrate your results with three graphs.

Cardiovascular effects of standing up from a reclining position: on the same page make two graphs: one
graph will show changes in heart rate and the second one, changes in blood pressure (systolic, diastolic and
mean arterial pressures). On this same page, describe your results in no more than 5 lines.
Cardiovascular adjustments during exercise and recovery: on the same page make two graphs: one graph
will show changes in heart rate and the second one, changes in blood pressure (systolic, diastolic and mean
arterial pressures). On this same page, describe your results in no more than 5 lines.
Cardiovascular effects of standing still: on the same page make two graphs: one graph will show changes
in heart rate and the second one, changes in blood pressure (systolic, diastolic and mean arterial pressures).
On this same page, describe your results in no more than 5 lines.

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DISCUSSION.
Use the spaces provided below. Do not use extra pages.

1) Explain why the heart rate differs depending on whether one palpates the carotid or the radial
pulse. Which of these is the most normal value?

2) Explain the changes that occur in heart rate and blood pressure when one stands up from a
reclining position.

3) How is the response (heart rate and blood pressure) on standing up altered if one stands very still?
Explain. Why does fainting can occur if one stands still for a longer time? How does fainting
"correct" the situation?

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4) Outline the mechanisms that are responsible for the changes in heart rate and blood pressure that
are observed during exercise. Focus on the changes in blood flow through tissues during exercise (what is
the stimulus for this change and the effect on heart rate and blood pressure).
Note: the measurements recorded immediately after exercise illustrate what happens during exercise.

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