Supplementary Notes for the Vital signs:

Blood Pressure:

• Palpation Method:  this method uses palpation of a pulse distal to the blood pressure cuff to estimate the systolic blood pressure. The video demonstrates this method on the radial pulse.

• Stethoscope Usage: Most physicians use the diaphragm when measuring the blood pressure.  (Dr. Ross mentions use of the bell in the video.)

• Korotkoff sounds:  FYI. During the auscultatory portion of blood pressure measurement, the examiner listens for low pitched sounds produced by turbulent flow in the vessel being using for the measurement of the blood pressure.  These sounds are Korotkoff sounds. 

  • There are five phases of Korotkoff sounds

  1. gradually increasing tapping sounds (the systolic pressure)

  2. tapping followed by murmurs

  3. tapping, but no murmur

  4. abrupt muffling and decreasing sound intensity

  5.  complete loss of sounds (the diastolic pressure).

Pulse and Respiratory Rates:

• Pulse:  The pulse rate and heart rate may be different if there are events in the heart that are not transmitted distally. Paroxysmal Atrial Contractions (PAC) and Paroxysmal Ventricular Contractions (PVC) could produce such a difference.