Sphygmomanometer

Sphygmomanometer with aneroid manometer and stethoscope

Sphygmomanometer (tonometer) - a device for measuring blood pressure. It consists of a cuff that is placed on the patient's arm, a device for inflating air into the cuff, and a pressure gauge that measures the air pressure in the cuff. Also, the sphygmomanometer is equipped with either a stethoscope or an electronic device that records air pulsations in the cuff.

The method for recording blood pressure, which underlies the operation of the tonometer, was invented in 1881 by the German physicist Siegfried Karl Ritter von Basch ( On him.), improved to be safe for the patient by Scipio Riva-Rocci ( in Italian) in 1896. Both inventions used measurement using a mercury manometer; in 1905, the measurement was improved to modern look, with pressure assessment by sound method.

Blood pressure measurement

Blood pressure measurement
1-tonometer cuff
2-stethoscope

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Synonyms

See what a “Sphygmomanometer” is in other dictionaries: Sphygmomanometer...

Spelling dictionary-reference book Exist., number of synonyms: 4 pressure gauge (12) sphygmomanometer automatic (1) tonometer ...

Synonym dictionary - (from the Greek sphygmos pulse and manometer) a device for measuring blood pressure ...

Big Encyclopedic Dictionary SPHYGMOMANOMETER, an instrument used to measure BLOOD PRESSURE. The device consists of an inflating rubber “sleeve” connected to a column of mercury with a graduated scale. The “sleeve” is wrapped around the forearm and inflated, providing... Scientific and technical

encyclopedic Dictionary - (from the Greek sphygmós blood pulsation, pulse and Manometer, a device for indirect measurement of blood pressure. Based on the type of manometer, S. are divided into mercury, or Riva Rocci devices (named after the Italian pediatrician S. Riva Rocci, who created S. in ... ... Big

- (gr. sphygmos heartbeat + pressure gauge) apparatus for measuring blood pressure (see also tonometer). New dictionary of foreign words. by EdwART, 2009. sphygmomanometer [gr. pulse beat + pressure gauge] – a device for measuring blood pressure.… … Dictionary of foreign words of the Russian language

- (from the Greek sphygmos pulse and manometer), a device for measuring blood pressure. * * * SPHYGMOMANOMETER SPHYGMOMANOMETER (from the Greek sphygmos pulse and pressure gauge (see MANOMETER)), a device for measuring blood pressure ... encyclopedic Dictionary

sphygmomanometer- kraujospūdžio matuoklis statusas T sritis Standartizacija ir metrologija apibrėžtis Arterinio kraujospūdžio matuoklis. atitikmenys: engl. sphygmomanometer; sphygmometer vok. Sphygmomanometer, n rus. sphygmomanometer, m pranc. sphygmomanomètre, m;… … Penkiakalbis aiškinamasis metrologijos terminų žodynas

- (sphygmo + manometer) a device for measuring blood pressure using the indirect method according to Korotkov, which is a type of manometer ... Big medical dictionary

- (from the Greek sphygmos blood pulsation, pulse, manos rare, loose and .... meter) honey. a device for measuring pressure in the artery of a limb by applying an external pressure using an inflated pneumatic cuffs If ext. pressure more pressure… … Big Encyclopedic Polytechnic Dictionary

How does a mechanical, semi-automatic, automatic, wrist tonometer measure pressure?

Tonometer This is a device that measures blood pressure. Typically, a tonometer is a cuff that must be placed on the arm of the person whose pressure you want to know. A device is connected to the cuff for pumping air into it and a pressure gauge, which determines what pressure is in the cuff.

Tonometers are:

• mechanical
• semi-automatic
• automatic

Mechanical tonometer.

A mechanical tonometer is equipped with a stethoscope or phonendoscope, and an automatic and semi-automatic tonometer is equipped with a special electronic device for recording air fluctuations in the cuff.

When the pressure is measured using a mechanical tonometer, a cuff is put on the area of ​​the right or left arm from the elbow to the shoulder, and then air is pumped into it using a special bulb until the pressure of this air is higher than the upper pressure. Then, applying the phonendoscope to the inside of the elbow, you need to slowly deflate the air from the cuff. When the air pressure in the cuff decreases to the level of systolic pressure, so-called clicks can be heard in the stethoscope. The lower pressure corresponds to the readings at the moment the clicks stop or suddenly weaken.

Thus, the tonometer is designed so that the cuff compresses the artery when the pressure in it exceeds the blood pressure. And when, on the contrary, the blood pressure becomes greater than the pressure in the cuff, the artery straightens with characteristic clicks that can be heard when air is pumped into the cuff and smoothly released by placing the phonendoscope on the radial artery.

Semi-automatic and automatic blood pressure monitors.

A semi-automatic blood pressure monitor works on the same principle, but does not require a stethoscope to measure blood pressure. The built-in electronics itself will determine when the artery straightens, based on bursts of air pressure in the cuff itself. The semi-automatic tonometer kit includes a bulb for inflating air, and it is released automatically. The tonometer, which pumps and releases air independently, is automatic.

Blood pressure monitoring devices play an important role in the consistent and reliable diagnosis of hypertension. Such devices are always available in several modifications, including those for independent use at home. In this case, the process of measuring pressure can occur differently depending on the type of tonometer.

What determines the accuracy of tonometer readings? This indicator depends on how much the pressure in the cuff decreases during the period of time between clicks (usually 1 second). Obviously, if you deflate their cuff too quickly, the measurement will not be accurate.

Wrist blood pressure monitors are also designed, with the only difference that during measurement the body of the device is located on the wrist, and the cuff is fastened over the arm. In this case, blood pressure is measured at the radial artery on the inside of the wrist. This tonometer is somewhat less accurate, since the artery on the wrist is thinner, it has lower blood pressure, and accordingly the amplitude of air fluctuations in the cuff is lower. For a reliable measurement, a mandatory condition must be met - the hand with the tonometer must be in the area of ​​the heart or measured in a lying position.
The convenience and ease of use of such tonometers has led to the fact that they can now be freely purchased at the nearest pharmacy and even via the Internet. To measure blood pressure using an automatic tonometer, you do not need special medical knowledge or professional qualification. In addition to automatic air supply to the cuff, many tonometers have additional functions such as memory for the last few measurements, automatic shutdown of the device, average pressure calculations, arrhythmia detection, and pulse counting.

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So..... What is a blood pressure monitor?

Tonometer is a device for measuring human blood pressure, designed to help prevent cardiovascular diseases, primarily arterial hypertension (or more simply, hypertension).

High blood pressure, or hypertension, already occurs in more than 20% of people inhabiting our planet, and is present in more than half of all older people. According to experts, by the mid-twenties of the 21st century, the total number of people with high blood pressure will approach 1.5-1.6 billion people. According to WHO estimates, high blood pressure is in third place among other causes of mortality, and a sharp increase in mortality from hypertension is expected in the coming years.

Regular measurement of blood pressure should become a mandatory rule in the life of every person, as the first step to prevent hypertension. IN last years A disease such as arterial hypertension has become quite “younger.” All more people not only older, but also middle-aged, and even young people show signs of this disease.

Like any other disease, high blood pressure is better prevented than treated later. The most important condition for this is commitment to healthy image life, absence of bad habits, playing sports, healthy eating. If the above is not implemented by a person sufficiently, or there is a genetic predisposition, there is a risk of disease. It can develop gradually and unnoticed by the person himself. Most people at first do not feel high blood pressure at all, do not notice its consequences and, as a result, do not go to the doctor for help. It is diagnosis and regular monitoring of your blood pressure that becomes the first and important step in the fight against this disease. Identified problems in the early stages, at the very beginning of the disease, make it possible to combat it most effectively, and ultimately prolong a person’s life.

What types of blood pressure monitors are there and which one is better to choose?

Modern, “household” blood pressure monitors are mechanical and electronic(automatic and semi-automatic).

Mechanical tonometers. Principle of operation.

The auscultatory method of measuring blood pressure was discovered more than 100 years ago by Russian doctor Nikolai Sergeevich Korotkov. In November 1905, N.S. Korotkov developed a sound method for determining blood pressure. The method for measuring blood pressure was presented in just 281 words - less than a page of text in the News of the Imperial Military Medical Academy in St. Petersburg. But these 281 words made the name of Nikolai Sergeevich immortal. The auscultatory method was named after its discoverer, the Korotkoff method. This method is the only official method of non-invasive blood pressure measurement, approved by the World Health Organization in 1935, and has not fundamentally changed for more than a century. It was based on Korotkov’s discovery of the correspondence of characteristic sound tones from the process of decompression of the human brachial artery. By first squeezing the brachial artery, the doctor sought to stop the blood flow through it, then gradually reducing the pressure in the cuff, using a phonendoscope, he determined by ear the beginning of the appearance of the first tones, which indicated the upper, or systolic, pressure in the artery. When the pressure in the cuff decreased to the level of diastolic pressure, the characteristic sound tones stopped - blood began to flow into the arteries unhindered. Nikolai Sergeevich determined the values ​​of systolic and diastolic pressure using a mercury manometer.

So, in order to measure pressure with a mechanical tonometer, you need to manually pump air into a cuff attached to the patient’s shoulder using a bulb. Then, slowly unscrewing (opening) the valve, begin to bleed air from the cuff while simultaneously listening with a phonendoscope for the beginning and end of the characteristic tones. The beginning of the appearance of tones and their end will correspond to the levels of upper and lower blood pressure. These values ​​are read from a dial gauge built into the device.

Measurement accuracy with mechanical tonometers.

Measuring your blood pressure yourself using mechanical tonometers is often problematic. Professionals (health workers) are well trained in this. An ordinary person often makes several typical mistakes when self-diagnosis using a mechanical tonometer. Usually this is the creation of excess pressure in the cuff, or incorrect determination of the beginning and end of tones, untimely and unsmooth decompression of air from the cuff. In addition, the accuracy of the measurement is greatly influenced by the presence of extraneous noise in the room. The results can also be affected by incorrect placement of the phonendoscope. Therefore, in order for a mechanical tonometer to show an accurate result, the patient must be specially trained to measure correctly, or entrust the measurement process to a professional.

Electronic blood pressure monitors.

Based on the method of supplying air to the cuff, electronic tonometers are divided into semi-automatic (air is pumped into the cuff using a bulb) and automatic (air is pumped into the cuff by a compressor). Automatic blood pressure monitors are “shoulder” (the cuff is attached to the upper arm of a person’s arm) and “wrist” (the cuff is attached to the wrist).

Electronic tonometers were created specifically for self-measurement of blood pressure by an ordinary person, and not by a specialist. Their work was based on the oscillometric method of measuring blood pressure. With this method, air is also pumped into a cuff that is attached to a person’s shoulder or wrist, blocking the blood flow through the artery. Fluctuations in blood pressure in the arm artery, or oscillations, cause the air inside the cuff to oscillate. These air vibrations are captured by the device's sensor and then processed by a special processor. At the same time, the processor monitors the correct inflation of the cuff, the compressor inside the automatic tonometer pumps exactly as much air into the cuff as is necessary for an accurate measurement, and when air is released from the cuff, an oscillogram is analyzed, based on the results of which the tonometer determines the systolic (upper) and diastolic (lower) ) patient's pressure. The processors of modern electronic tonometers have various intelligent measurement technologies. Different manufacturers have different names, but all are designed to increase the accuracy of the measurement, thanks to the processing of many parameters, including pulse, correct dosing of air when injected into the cuff, and quick processing of the results obtained by the sensors. After measurement, the values ​​of the upper and lower blood pressure are displayed on the device display, the values ​​of the measured pulse are also displayed there, and additionally, if the device has such a function, an indication of the presence of arrhythmia and other parameters.

Thus, the use of the oscillometric measurement method, i.e. the use of electronic tonometers allows even inexperienced people who do not have special skills in use and measurement to carry out accurate pressure measurements for themselves and their loved ones.

Automatic tonometers can be powered by batteries or an AC adapter; more than half of the automatic tonometers have an AC adapter included. If necessary, a network adapter can be purchased separately. In addition, with increasing class of the device, additional functions appear, such as the presence of measurement memory for one or several users, display backlight, WHO scale indication, sound alarm, the ability to connect the tonometer to a computer to transfer measurement data to special monitoring programs, built-in electronic clock, voice support and other functions. The range of models of automatic tonometers is extremely wide: from affordable economy models costing from 1,600 rubles to real premium class computer terminals for blood pressure diagnostics costing more than 10,000 rubles.

Semi-automatic blood pressure monitors

A separate type of electronic tonometers are semi-automatic. Unlike an automatic one, when using a semi-automatic tonometer, the user must independently pump air into the cuff (as in mechanical tonometers), but the results are analyzed by the microprocessor of the electronic unit (as in automatic tonometers). Actually, a semi-automatic machine differs from a full automatic machine in the absence of a compressor. This tonometer is easy to use; due to the absence of a compressor, it consumes little electricity, which makes it convenient - the battery life lasts for several months.

Semi-automatic electronic devices do not eliminate the need to self-inflate the cuff, which can lead to an overestimation of readings by 10-15 mmHg. Semi-automatic devices can be recommended to a greater extent for people with low blood pressure and those who can independently pump air correctly using a bulb. Due to its low price, a semi-automatic blood pressure monitor can also serve as a good addition to a car first aid kit.

If, due to high blood pressure, it is difficult for an elderly patient to correctly inflate the bulb on their own, then it is advisable to use an automatic tonometer to obtain the correct data.

Automatic blood pressure monitors on the wrist.

Wrist blood pressure monitors are usually small in size and provide a comfortable feeling during measurement. The accuracy of wrist blood pressure monitors depends on individual characteristics person. Not all manufacturers recommend them for elderly people due to the peculiarities of the condition of blood vessels in the wrist area. But there are also those who do not set such age restrictions.

Wrist tonometers are designed to monitor pressure in conditions where any other is of little use or inconvenient: while traveling, in public places, outside the home, in the gym during training, etc. Wrist tonometers are convenient due to their lightness, small size and better tolerance of measurements by patients with high level pressure. It must be remembered that the accuracy of measurement with a wrist tonometer directly depends on the correct position of the hand during measurement relative to the level of the heart. Consistently correct measurement results with a wrist tonometer are achieved by strictly following the instructions for use.

What devices to use at home.

To measure blood pressure at home, you can use any devices: mechanical, semi-automatic and automatic.

It should be remembered that in all household tonometers (both mechanical and electronic), the cuffs are consumables. Over time, depending on the operating mode, insufficiently careful operation, random mechanical impacts, etc. cuffs may become unusable. Typically, the average service life of cuffs is several years, but with intensive daily use, after 2 years the cuff will need to be replaced, because the quality of measurements depends on the integrity of the cuff. All tonometer manufacturers supply the market with additional cuffs as a separate accessory. There is a wide variety of cuffs, because they are designed for different models of tonometers from different manufacturers.

In addition, there are special cuffs (for example, for infants or adolescents, special thigh cuffs), as well as cuffs with an increased size. Some manufacturers also offer universal cuffs that are suitable for devices from different manufacturers. Spare cuffs for any tonometer models are always in stock, and you can easily purchase them.

It is reliably known that palpating the pulse was known back in Ancient Egypt However, the actual measurement of blood pressure was not practiced until the 18th century. The history of blood pressure measuring instruments began in 1773 with the experiments of the English scientist and researcher Stephan Hales, who tried to measure the blood pressure of a horse.

During his experiments, Hales tied a rope around the animal's left femoral artery, punctured it, and inserted a copper tube connected to a glass test tube into the puncture. After the rope was loosened, the blood rose and fell in the test tube after each pulse beat. The Hales tube, of course, cannot be called the first tonometer, but it began a new direction in medical diagnostics. One of the greatest physiologists of the 19th century, Johann Müller, would later say: “The discovery of blood pressure was more important than the discovery of blood.”

The first breakthrough in the field of blood pressure measurement after Hales was made by the Frenchman Jean Louis Marie Poiseuille almost a hundred years later (in 1828). He was the first in history to use a mercury manometer to measure pressure. In this case, the pressure gauge was connected to a cannula, which was inserted directly into the artery.

The first device to measure blood pressure without puncturing an artery was the sphygmograph (1855) by Carl von Vierordt, which determined the strength of external pressure required to completely stop blood flow in the radial artery. Five years later, the design of Vierordt's sphygmograph was significantly modified by Etienne Marey. Marey's sphygmograph recorded changes in pulse graphically and was widely used in medicine.

For the first time, human blood pressure was measured by the surgeon Favre in 1856. He obtained accurate numerical data by connecting the artery directly to a mercury manometer during surgery. In the femoral artery the pressure was 120 mm Hg, in the bronchial artery - 115-120 mm Hg.

In 1881, the Austrian physician Samuel Z. C. R. von Basch invented the sphygmomanometer, which became the great-grandfather of modern tonometers. The principle of its operation was as follows: a hollow rubber bag with water was placed on the area of ​​pulsation of the artery, which pressed on the artery until the pulsation completely stopped. The force of pressure created by the bag was read by a mercury manometer, thus measuring the person's systolic pressure.

In 1896, the Italian S. Riva-Rocci developed a method for measuring blood pressure that remains relevant to this day. The device he invented, which worked according to a new method, looked, in essence, the same as a modern tonometer - a hollow rubber bag was placed in a cuff made of inextensible material, wrapped around the shoulder and inflated with a rubber bulb. The cuff was connected to a pressure gauge.

The pressure in the cuff was increased until the pulsation disappeared, then the compression was slightly weakened and the pressure gauge value at which the pulsation resumed corresponded to the blood pressure level. The device had the only drawback - the cuff was too narrow (5 cm), due to which areas of high pressure appeared and the measurement results were inaccurate. In 1901, this defect was corrected by Heinrich von Recklinghausen, who increased the width of the cuff to 12 cm.

In 1905, the famous Russian surgeon Nikolai Sergeevich Korotkov gave a presentation at the Imperial Military Medical Academy in St. Petersburg. In a short speech of 280 words, he introduced the audible method he developed for determining systolic and diastolic pressure, which forever changed the approach to diagnosing human blood pressure.

Korotkov suggested listening with a stethoscope to the sounds (tones) that appear in the artery below the Riva-Rocci sleeve compressing the shoulder. When the first sound appears, the pressure gauge shows the level of systolic pressure, and when the sounds disappear, the level of diastolic pressure. Without exaggeration, we can say that Korotkov’s report determined the history of the development of tonometers for decades to come, since his method still underlies the work of tonometers.

For more than 50 years, a mechanical tonometer operating according to the Korotkoff method was the only measuring instrument to determine blood pressure levels and has been used by doctors around the world. Only in 1965, the American therapist Seymour London invented an automatic blood pressure monitor, in which the stethoscope was replaced by a microphone and a rubber bulb by a compressor.

The new device inflated the cuff itself and “listened” to the tones, determining the pressure. To confirm the accuracy of the measurement, Seymour and his wife performed a massive double (mechanical and automatic) blood pressure measurement at the American Medical Association convention. After 400 measurements, no statistically significant differences were found between the readings of mechanical and automatic tonometers. In 1966, Seymour patented his device in the USA, Germany, France and Italy.

Although simply taking the pulse was used in ancient Egypt, directly measuring blood pressure was not practiced in medicine until the 18th century. The starting point in the history of pressure measuring instruments is 1773, when an English scientist and researcher Stephan Hales published the results of his experiments measuring blood pressure in horses.

During these experiments, the left femoral artery of the animal (previously tied with a rope) was punctured, and a copper tube was inserted into the puncture, which was connected to a glass test tube. After untying the rope, the blood rose and fell in the test tube with each pulse beat. Of course, the Hales tube cannot be called the first tonometer, but it became the harbinger of a whole trend in medical diagnostics. Later, one of the greatest physiologists of the 19th century, Johann Muller, would say: “The discovery of blood pressure is more important than the discovery of blood.”

The first significant breakthrough in blood pressure measurement after Hales was made by a French doctor Jean Louis Marie Poiseuille almost a hundred years later. In 1828, he used a mercury manometer for the first time in history to measure pressure. The pressure gauge was connected to a cannula, which was inserted directly into the artery.

The first non-invasive device for measuring blood pressure was the sphygmograph (1855) by Carl von Vierordt, who proposed to measure the force of external pressure required to stop blood flow in the radial artery. The design of Vierordt's device was significantly modified by Etienne Marey in 1860. Marey's sphygmograph graphically recorded changes in the pulse and was widely used among doctors of that time.

It's interesting that:

The first numerical measurement of human blood pressure was made by the surgeon Favre in 1856. During the operation, he connected the artery directly to a mercury manometer and thus obtained accurate data. The pressure in the femoral artery was 120 mm Hg, the pressure in the bronchial artery was 115-120 mm Hg.

The great-grandfather of modern tonometers is the sphygmomanometer, which was invented in 1881 by the Austrian physician Samuel Siegfried Carl Ritter von Basch. The principle of its operation was simple - a rubber bag with water was placed at the site of pulsation of the artery, which pressed on the artery until the pulsation stopped. The pressure created by the bag was read by a mercury manometer, and thus the systolic pressure was measured.

In 1896 Scipione Riva-Rocci introduced a method for measuring blood pressure that is still relevant today. The device he invented was easy to use and safe for the patient. In essence, it looked the same as modern blood pressure monitors - a hollow rubber bag placed in a cuff of inextensible material, wrapped around the shoulder and inflated with a rubber bulb.

The cuff pressure, as read by a mercury manometer, was increased until pulsation disappeared. When the pressure was slightly relieved, the level of mercury in the manometer fell, and the value at which the pulsation resumed corresponded to the systolic pressure. The only drawback of the device was that the cuff was too narrow (5 cm), which created areas of increased pressure, as a result of which the measurement results were slightly overestimated. In 1901, this defect was corrected by Heinrich von Recklinghausen, who increased the width of the cuff to 12 cm.

In 1905, at the Imperial Military Medical Academy in St. Petersburg, a surgeon Nikolai Sergeevich Korotkov made his famous report on sound method for determining systolic and diastolic pressure using the Riva Rocci sleeve.

The essence of the method was listening with a stethoscope to sounds (tones) that appear in the artery below the Riva-Rocci sleeve, squeezing the shoulder. The pressure gauge value at which the first sound appears corresponds to systolic pressure, and the value corresponding to the disappearance of sounds indicates diastolic pressure. Without exaggeration, we can say that the 280 words of Korotkov’s report determined the further history of the development of tonometers, since the method he proposed still underlies the operation of pressure measuring devices.

For more than 50 years, a tonometer, working on the principle of listening to “Korotkoff sounds,” was the only device for measuring blood pressure and was used by doctors all over the world. Only in 1965, the American doctor Seymour London invented an automatic blood pressure monitor, in which the rubber bulb was replaced by a compressor and the stethoscope by a microphone.

The new device itself pumped air into the cuff and “listened” to the tones, determining the pressure. To confirm the accuracy of the measurements, Seymour and his wife performed massive double blood pressure measurements (mechanical and automatic) at the American Medical Association convention. More than 400 measurements did not reveal statistically significant differences between measurements using a mechanical tonometer and its automatic counterpart. In 1966, the new device was patented in the USA, France, Germany and Italy.