Lung and Blood Pressure - Assignment Example

Lung and Blood Pressure xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx Name xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx Course xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx Instructor xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx Date LUNG FUNCTION Introduction Lungs are body organs which allow the body to breathe and located in the chest inside the rib cage to prevent them from any interference. They are two of them working and they work together so as to function accurately (Cappuccio et al ,2004). This therefore means that they are very vital in sustaining life. They not only provide a means for transfer of oxygen from air into the blood and the removal of carbon dioxide, but they are also very vital in metabolism and detoxifying a wide of substances and protect against agents and environmental pollutions (Wensley , Pickering & Silverman, 2000). Pulmonary function tests are the tests done on lungs and are used to measure the amount of air entering the lungs, strength of muscles in the respiratory system, how much air is exited from the lungs and at what speed as well as efficiency of the lungs in transporting oxygen in the entire body (Miller, Crapo & Hankinson, 2005). The amount of air entering and leaving the lungs and the speed of the air moving out of the lungs are measured using a spirometer (Enright, Beck & Sherrill, 2004). This spirometer is a portable with breathing tubes and a calibration syringe. It has an inbuilt computer that is capable of analyzing the expiratory curves, calculate the pulmonary parameters and in the long run determine the acceptability of the tests. A strip chart is provided which is aimed at providing a hard copy record (Wanger, Clausen & Coates, 2005). The ATS recommends that a spirometer have accuracy for FVC and FEV1 of at least 3% of reading or 50 mm (Rytila, Helin & Kinnula, 2008). to improve its accuracy, a digital shaft encoder is used to convert the volume displacement to a digital signal, replacing the analog potentiometer. Aims Showing how a Spirometer measures the peak expiratory flow rate, showing the difference between pulmonary capacities and pulmonary volumes. And finally, determine the differences between peak expiratory flow rates in males and females. Method The first issue to handle was the sex, age and height of the students, for it is important so that FEV1 and FVC can be compared with the predicted normal values. Then, a clean, disposable one way mouthpiece was attached to the spirometer, and then the student was asked to breathe in as deeply as possible or have a full inspiration. Moreover the students were instructed to hold their breath just long enough to seal their lips. They were also instructed not to purse their lips as if blowing a trumpet. Also they were allowed to blow the breath out as hard and as fast as possible. The results appearing in the display were recorded. The results were recorded and keyed in the website. Many electronic spirometers measures even the expiratory flow plotted against the volume of air exhaled Results for electronic spirometer experiment Name/ Parameter Jhan Abdullah Abdulhadi Meshal Mohammed FEV1 4.44 2.91 3.90 3.54 3.01 FVC 4.41 2.90 3.85 3.52 3.00 PEV 615 537 697 601 653 FER 100 100 101 100 100 Pic1: Spectrometer readings Males Females 670 470 530 470 620 350 620 460 720 510 510 540 600 330 600 500 450 440 580 400 540 280 680 490 550 440 610 440 590 455 660 410 450 410 450 250 680 420 550 450 700 470 480 510 Pic 2: Peak flow results for males and females. Scatter diagram representing a comparison of males and female. Discussion A measure of the maximum speed of air leaving the lungs as indicated by the peak flow meter is referred to as peak expiratory flow (Miller, Hankinson & Brusasco, 2005). It is worth noting that peak flow readings differ depending on factors such as sex, height, age and health of the students or patients (Boffin et al, 2006). This experiment was aimed at determining the differences in peak flows between males and females and the results showed differences in the readings. Males have large volume of lung which are very elastic and this they can not match with females (Wanger, Clausen & Coates, 2005). Exercising increases lung volume and alveolar strength giving chance to large amounts of air into the lungs (Miller, Hankinson & Brusasco, 2005). Moreover, male lungs have more power and better coordination which can be attributed to exercises and training during sports and other muscle involving activities. Most importantly, many of the male students are exposed to cigarettes which have a direct effect on increased peak respiratory flow rate (Johns et al, 2006). On the other hand, females have low PEFR ranging between 280 and 540L/min and males range between 450 and 720L/ min. this is determined by the alveolar pressure which in men is higher than in females (Miller, Hankinson & Brusasco, 2005). The volume of the lungs which is determined by the elastic property of the lungs and by the power and coordination of expiratory muscles in increased by exercises which are mostly associated with males (Miller, Hankinson & Brusasco, 2005). This means that males generate higher alveolar pressures than females and this therefore means that males achieve higher values of PEF than females (Cooper, 2005). Residence of an individual also plays part in determination of pulmonary volume and capacity. It is also worth noting that, Individuals living in high altitude areas are more vulnerable to conditions such as altitude sickness which comes due to inefficient expulsion of carbon dioxide from the lungs (Chavannes, Schermer & Akkermans, 2004). Amount of air that is taken into the lungs with each inhalation or the amount the leave is referred to as pulmonary volume. On the other hand pulmonary capacity refers to the maximum amount of air that can be contained in the lungs at any given time. It is worth noting that there are factors that affect pulmonary volume and capacity with the inclusion of nutrition, height, hormones activities, sleep among other factors (Walker et al, 2006). It has been proven that tall individuals have large lung volumes hence parameters such as FEV 1 and FVC are high. Moreover, FEV1 and PEFR in those involved in sports are high in comparison to controls (Wanger, Clausen & Coates, 2005). Conclusively, the experiment was successful and all the data collected was adedquatley recorded and stored. The aims of the practical were realized and for instance, it was clear that men have large volume of lung which are very elastic and this they can not match with females. And therefore their volumes vary. Exercising increases lung volume and alveolar strength giving chance to large amounts of air into the lungs. Moreover, male lungs have more power and better coordination which can be attributed to exercises and training during sports and other muscle involving activities. However, males are exposed to various lifestyles like smoking and this directly affect their increased peak respiratory flow rate. And finally, females have low PEFR ranging between 280 and 540L/min and males range between 450 and 720L/ min References Boffin N, Van der Stighelen V, Paulus D, Van Royen P.2006 Use of office spirometers in Flemish general practice: results of a telephone survey. Monaldi Arch Chest Dis 65:128-32. Chavannes N, Schermer T, Akkermans R, 2004 Impact of spirometry on GPs' diagnostic differentiation and decision-making. Respir Med; 98(11):1124-30. Cooper BG 2005. Limitations to spirometry being performed in “the office.” Chronic Respir Dis ;2:113-15. Enright PL, Beck KC, Sherrill DL. 2004. Repeatability of spirometry in 18,000 adult patients. Am J Respir Crit Care Med;169:235–8 Johns DP, Burton D, Walters JAE, Wood-Baker R.2006 National survey of spirometer ownership and usage in general practice in Australia. Respirology;11:292-8. Miller, M.,R., Crapo R, Hankinson. 2005. General considerations for lung function testing. Eur Respir J; 26: 153–161. Miller MR, Hankinson J, Brusasco ., 2005Standardisation of spirometry. Eur Respir J; 26: 319–338. Rytila P, Helin T, Kinnula V. 2008. The use of microspirometry in detecting lowered FEV1 values in current or former cigarette smokers. Prim Care Resp J; 17(4):232-7. Walker PP, Mitchell P, Diamantea F, Warburton CJ, Davies L.2006 Effect of primarycare spirometry on the diagnosis and management of COPD. Eur Respir J ; 28(5):945-52. Wensley D, Pickering D, Silverman M. 2000 Can peak expiratory flow be measured accurately during a forced vital capacity manoeuvre? Eur Respir J.;16:673–6 Wanger, J, Clausen J., L, Coates, A, 2005. Standardisation of the measurement of lung volumes. Eur Respir J ; 26: 511–522. Introduction The heart works as a double pump whereby the right heart receives blood which has come from the body and pumps it to the lungs through the pulmonary artery (Cappuccio et al, 2004). The blood then returns to the left heart through the pulmonary vein, it then pumps it through the artery/aorta which branches out to the whole body through various arteries. Pulse is the rhythmic expansion and contraction of the artery caused by the impact of blood pumped by the heart (Chiolero et al, 2000). Blood pressure is the force exerted on the wall of a blood vessel as the heart pumps it and then relaxes. This is referred to as Arterial blood pressure (Lu & Mukkamala, 2006). The degree of force when the heart is pumping is known as systolic blood pressure and finally the degree of force when the heart relaxed is diastolic blood pressure. When the blood pressure changes, there is a risk of illness or even death. Heart rate is the number of beats per minute of the heart (BPM). It’s determined by factors which are intrinsic to the heart as well as the pathways from the brain and the hormonal signals from the adrenal gland (Bojorges-Valdez et al, 2007). The heart rates are for moving the blood around the entire body. The blood vessels exert pressure on the blood which is determined by their elasticity. The elasticity of the blood vessels is limited by the build up of lipid deposits in the walls of the vessels and decreases with the presence of certain lifestyle factors like diet and age (Sinha & Reid, 2007). Blood pressure is measured non invasively and is reported in pressure units of mmHg and a typically normal blood pressure for a young person is about 120/80 (SBP/DBP) which is the same case in this test (Shah et al, 2005). Aims This task is aimed at making sure that students understand; How an electronic blood pressure meter works so as to measure blood pressure, determine the blood measurements for males and females and finally to make a comparison of the blood pressure of both women and men. To achieve, there was a provision of an electronic blood pressure meter. Procedure for Electronic measuring device Before carrying out this practice, the students were subjected to a series of instructions that were aimed at getting the most accurate results. They included making sure that the patients were comfortable by ensuring that the environment is conducive, there are no acute anxiety or stressor pain, no tight clothing on the forearms, ensuring that they sat in most comfortable postures for at least 5 minutes before the task and that their hands were at the level of the heart and legs touching the floor. Then the cuff was selected according to the appropriate size of the students arm circumference. The O/I start button so as to turn the unit on so as to start the required measurements. The cuff is inflated automatically around the arm and as there was an increase in pressure, the tightening of the cuff was felt around the arm. After a few seconds, the measurements started with deflating and as the cuff deflates the heart symbol flashes at every heartbeat. After the measurement is complete, the arm cuff completely deflates and there were clear values of the systolic pressure, diastolic pressure and pulse which were accurately recorded. Finally, after a few minutes, approximately 2-3 hours, the measurements were repeated 2 more time and the mean value taken. It is worth noting that, blood pressure in measure in millimetres of mercury/mmHg. Results Blood Pressure ‘ Pulse Malem Female 70 86 80 94 82 103 86 104 90 90 84 115 96 83 74 114 80 113 80 109 96 87 105 114 134 97 108 109 73 91.6 71 81.3 90 109 86 75 75 104 83.3 90 72 62 92 97 74 91 114 122 Graphical illustration of males blood pressure and Pulse rate Graphical illustration of females blood pressure and Pulse rate In the results, the average blood pressure = 134/79mmHg (Males) = 121/77mmHg (Females) The pulse pressure = systolic pressure-Diastolic pressure = 121mmHg-77mmHg=44mmHg (females) = 134mmHg-79mmHg=55mmHg (Males) The mean arterial pressure = DP+1/3 (SP-DP) =77+1/3(44) =91.7mmHg In males = 79+1/3(56) = 97.7mmHg Discussion From the results, there is a gender associated differences in blood pressure in humans. This in most cases is associated with the interaction between sex hormones and the kidneys (Lurbe & Parati, 2008). It has been found that, both endogenous and exogenous female sex hormones influence the systematic and renal hemodynamic response to salt (Kang & Miller, 2003). Men have higher BP level as compared to women. This therefore means that, men are at higher risk of cardiovascular complications. The kidney plays a very big role in determining and regulating BP. The systolic blood pressure of female reaches a plateau at about 14 years and remain constant throughout the early reproductive years, however, the mean systolic blood pressure of males rises until the age of 20 and therefore, the systolic blood pressure is greater in males than in females (Echeverria et al, 2003). The difference in diastolic blood pressure between males and females tend to be smaller. During adolescent however, women have slightly higher diastolic blood pressures on the average than males. But their heart rate has not been found to differ. It is clear that there is no correlation between blood pressure and pulse rate (Zhu et al, 2005). Measurement of heart rate does not indicate high or low blood pressure however, when a person is involved in an activity like exercising, the pulse rate is high as compared to when one is relaxing (Baltatu et al, 2003) A decrease in renal sodium excretion can lead to long term increase in BP and development of hypertension. Rennin angiotensin system is also key as hormonal system regulating BP and modulating the pressure natriuresis relationship (Barbagallo et al, 2001). It has been proved that, gender differences in various components of the rennin angiotensin cascade that explains clearly the gender BP difference. Exogenous female sex hormones administered for oral contraception is said to stimulate angiotensinogen production which may lead an increase in BP in some women (Chiolero et al, 2000). Irrespective of whether women are using contraceptives, the renal hemodynamic response to salt is also modulated by female sex hormones. These hormones also affect the regulation of sodium excretion. The increased salt sensitivity in menopausal women strongly encourages the use of diuretics in hypertensive women (Stergiou et al, 2000). Conclusion The practical on blood pressure was a success and data accurately recorded. Moreover, the students learned how to use electronic blood pressure gadget. The aims of the experiments were well met especially in determining the difference in blood pressure for males and females. The results showed that males tend to have high blood pressure compared to females. Reasons for this were given in the discussion which includes kidney activities and sex hormones that affect both male and female.. References Barbagallo M, Doninbues L.,J, Licata G, Ruggero R, Lewanczuk R.,Z, Pang, P.,K, Resnick, L.,M 2001. Effect of testosterone on intracellular Ca__ in vascular smooth muscle cells. Am J Hypertens ;14:1273– 1275. Baltatu O, Cayla C, Iliescu R, Andreev D, Bader M .2003. Abolition of end-organ damage by antiandrogen treatment in female hypertensive transgenic rats. Hypertension;41:830–833. Bojorges-Valdez, E. R., Echeverria, J. C., Valdes-Cristerna, R., and Pena, M. A. 2007. Scaling patterns of heart rate variability data. Physiol Meas ;28:721-730. Cappuccio FP, Kerry SM, Forbes L, Donald A.,2004. Blood pressure control by home monitoring: meta-analysis of randomised trials. BMJ ; 329: 145-48. Castiglioni, P., Parati, G., Civijian, A., Quintin, L., and Di Rienzo, M. 2009. Local Scale Exponents of Blood Pressure and Heart Rate Variability by Detrended Fluctuation Analysis: Effects of Posture, Exercise and Ageing. IEEE Trans Biomed Eng ;56:675-684. Chiolero A, Maillard M, Nussberger J, Brunner HR, Burnier M .2000. Proximal sodium reabsorption: an independant determinant of blood pressure response to salt. Hypertension 2000;36:631–637. Echeverria, J. C., Woolfson, M. S., Crowe, J. A., Hayes- Gill, B. R., Croaker, G. D., and Vyas, H .2003. Interpretation of heart rate variability via detrended fluctuation analysis and alphabeta filter. Chaos 2003;13:467-475. Hinojosa-Laborde C, Lange, D., L, Haywood, J., R. 2000 Role of female sex hormones in the development and reversal of Dahl hypertension. Hypertension;35:484–489. Kang A.,K, Miller, J.,A 2003 Impact of gender on renal disease: the role of the renin angiotensin system. Clin Invest Med ;26:38–44. Lurbe E, Parati G.2008. Out-of-office blood pressure measurement in children and adolescents. J Hypertens; 26:1536–1539. Lu Z and Mukkamala R. 2006 Continuous cardiac output monitoring by invasive and noninvasive peripheral blood pressure waveform analysis. J Appl Physiol 101: 98–608. Shah M, Hasselblad V, Stevenson LW, Binanay C, O’Conner CM, Sopko G, and Califf RM. 2005. Impact of the pulmonary artery catheter in critically ill patients. JAMA 294: 1664–1670. Stergiou ,G.,S, Thomopoulou, G.,C, Skeva, II, & Mountokalakis, T.,D.2000. Home blood pressure normalcy: the Didima study. Am J Hypertens ; 13:678-685. Sinha MD, Reid CJ.2007.. Evaluation of blood pressure in children. Curr Opin Nephrol Hypertens; 16:577–584. Zhu W, Huang X, He J, Li M, Neubauer H.2005. Arterial intima-media thickening and endothelial dysfunction in obese Chinese children. Eur J Pediatr; 164:337 344. Read More