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Physiology Lessons for use with the Biopac Student Lab

PC running Windows ® 98SE, Me, 2000 Pro, XP Pro/Home/Media

Manual Revision PL3.7.0

081006

Richard Pflanzer, Ph.D.

Associate Professor Indiana University School of Medicine Purdue University School of Science

J.C. Uyehara, Ph.D.

Biologist BIOPAC Systems, Inc.

William McMullen

Vice President BIOPAC Systems, Inc.

BIOPAC Systems, Inc.

42 Aero Camino, Goleta, CA 93117 (805) 685-0066, Fax (805) 685-0067 Email: info@biopac.com Web Site: http://www.biopac.com

© BIOPAC Systems, Inc.

Web Site: http://www.biopac.com © BIOPAC Systems, Inc. Lesson 7 ECG & PULSE Mechanical Action of the

Lesson 7

ECG & PULSE

Mechanical Action of the Heart Peripheral Pressure Pulse Plethysmography

BIOPAC Systems, Inc. Lesson 7 ECG & PULSE Mechanical Action of the Heart Peripheral Pressure Pulse
BIOPAC Systems, Inc. Lesson 7 ECG & PULSE Mechanical Action of the Heart Peripheral Pressure Pulse

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Biopac Student Lab

I.

INTRODUCTION

The primary purpose of the heart is to pump blood throughout the body. To pump blood, the heart has a rhythmical sequence of both electrical and mechanical events, the cardiac cycle. The electrical activity, recorded as an electrocardiogram (ECG), initiates the mechanical activity of the heart (contraction and relaxation of atria and ventricles). When the heart chambers contract, they pump blood to the next section of the cardiovascular system. This lesson will focus on the actions of the left ventricle, which pumps blood to the systemic circulatory system, producing a pulse.

During the cardiac cycle the electrical activity of the ventricles, as represented by the QRS complex of the ECG, precedes the mechanical event of ventricular muscle contraction (ventricular systole). Within the range of normal resting heart rates, systole begins at the time of the R wave peak and ends at the end of the T wave. The T wave, which represents repolarization of the ventricles, occurs during the time the ventricles are in systole. Ventricular diastole, a period of relaxation of ventricular muscles, begins at the end of systole and lasts until the next R wave peak. Since each cardiac cycle contains one period of ventricular systole immediately followed by one period of ventricular diastole, the duration of one cardiac cycle, or heartbeat, can be measured as the time between successive R waves. (Fig 7.1) In the ECG cycle, electrical activity precedes and initiates mechanical activity.

activity precedes and initiates mechanical activity. Fig. 7.1 Contraction of the ventricles (ventricular systole)

Fig. 7.1

Contraction of the ventricles (ventricular systole) pushes a volume of blood (stroke volume) into arteries. From the left ventricle, the blood goes into the aorta and throughout the rest of the body. Each section of blood “bumps” the downstream, neighboring section of blood to facilitate blood flow. The aorta and other arteries have muscular walls, which allow the arterial walls to expand slightly to receive the volume of blood during systole and then, elastic recoil of the arteries helps to continue “pushing” the blood through the rest of the system. The arterial pressure throughout the cardiac cycle is the main force for blood flow.

The pumping action of the ventricles also initiates a pressure wave that is transmitted via the arterial walls. The pressure increases with systole and decreases with diastole. The stiffness of the vessel walls helps transmit the pressure wave. The stiffer the walls, the faster the transmission of the pressure wave, but the more work is required by the heart to move the same blood volume.

When the pressure wave is transmitted to the periphery, e.g., fingertip, there is a pulse of increased blood volume. The tissues and organs change in volume as blood vessels dilate or constrict and as pulses of blood pass through the blood vessels during each cardiac cycle. Changes in blood volume of organs may be brought about by the autonomic nervous system acting on the cardiovascular system, environmental factors (such as temperature), metabolic activity of an organ, and a variety of other variables.

For example, temperature regulation involves controlling blood flow to the skin; when heat needs to be conserved, blood flow to the skin is minimized and when excess heat is being generated, the opposite occurs.

Lesson 7: ECG & Pulse

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The actual blood flow is slower than the transmission of the pressure wave. The aorta has the fastest blood flow in the body at approximately 40-50 cm/sec (approximately 1 mile per hour) whereas the speed of the pressure wave can be much faster.

The travelling speed of the pressure wave from the heart to the periphery can be affected by many interrelated factors, including the heart’s ability to contract strongly, blood pressure, the relative elasticity of the arteries, and the diameters of systemic arteries and arterioles. These factors change in response to body positions, sympathetic nervous system input, emotions, etc. For example, the travelling speed of the pressure wave has been shown to correlate with sympathetic influence and systolic blood pressure.

The study of blood volume changes within an organ by using volume displacement techniques is known as plethysmography. In this lesson, you will simultaneously record the ECG and subsequent pulse. One type of transducer used in plethysmography operates by converting light energy to electrical energy and thus is called a photoelectric transducer. The photoelectric transducer works by shining a beam of light through the skin and measuring the amount of light that is reflected. Blood absorbs light in a manner proportional to blood volume. The greater the blood volume, the greater the light absorption, and vice-versa. The photoelectric transducer converts the reflected light into electrical signals, which can then be processed and displayed by the recorder.

II. EXPERIMENTAL OBJECTIVES

1)

To become familiar with the principle of plethysmography and its usefulness in qualitatively assessing peripheral changes in blood volume.

2)

To observe and record changes in peripheral blood volume and pressure pulse under a variety of both experimental and physiological conditions.

3)

To determine the approximate speed of the pressure pulse wave travelling between the heart and the finger.

4)

To illustrate the electrical activity associated with normal cardiac activity and how it relates to the flow of blood throughout the body.

III. MATERIALS

BIOPAC electrode lead set (SS2L)

BIOPAC disposable vinyl electrodes (EL503), 3 electrodes per subject

BIOPAC pulse plethysmograph (SS4LA or SS4L)

Ruler or Measuring Tape

Ice water or Warm water in plastic bucket

BIOPAC electrode gel (GEL1) and abrasive pad (ELPAD) or Skin cleanser or alcohol prep

Computer system

Biopac Student Lab 3.7 for PC running Windows

BIOPAC acquisition unit (MP35/30)

BIOPAC wall transformer (AC100A)

BIOPAC serial cable (CBLSERA) or USB cable (USB1W) if using a USB port

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Biopac Student Lab

IV. EXPERIMENTAL METHODS

For further explanation, use the online support options under the Help Menu.

A. SET UP

 

FAST TRACK Set Up

1. Turn the computer ON.

2. Make sure the BIOPAC MP35/30 unit is turned OFF.

3. Plug the equipment in as follows:

 

Electrode lead (SS2L) — CH 1

Pulse transducer (SS4LA) or

Pulse transducer (SS4L) — CH 2

4. Turn the MP35/30 Data Acquisition Unit ON.

5. Place three electrodes on the Subject (Fig. 7.3).

 

Set Up continues…

DETAILED EXPLANATION OF SET UP STEPS

The desktop should appear on the monitor. If it does not appear, ask the laboratory instructor for assistance.

Pulse Transducer (SS4LA or SS4L) plugs into CHannel 2 Electrode Lead (SS2L) plugs into CHannel
Pulse Transducer (SS4LA or SS4L)
plugs into CHannel 2
Electrode Lead (SS2L)
plugs into CHannel 1
Fig. 7.2
2 Electrode Lead (SS2L) plugs into CHannel 1 Fig. 7.2 one on right forearm (just above

one on right forearm (just above wrist)

one on inside right leg (just above ankle bone)

one on inside left leg (just above ankle bone)

Fig. 7.3

- One electrode on the medial surface of the right leg, just above the ankle bone

- One electrode on the medial surface of the left leg, just above the ankle bone

- One electrode on the right anterior forearm just above the wrist (same side of arm as the palm of hand).

Note: For optimal electrode adhesion, the electrodes should be placed on the skin at least 5 minutes before the start of the Calibration procedure.

Lesson 7: ECG & Pulse

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6. Attach the first electrode lead set (SS2L) to the electrodes, following the color code (Fig. 7.4).

7. Clean the window of the sensor.

8. Wrap the pulse transducer (SS4L) around the tip of your index finger (Fig. 7.5) on the right hand with the electrode/lead attached.

Set Up continues…

right leg left leg BLACK lead RED lead (ground)
right leg
left leg
BLACK lead
RED lead
(ground)

right forearm

WHITE lead

Fig. 7.4 Each of the pinch connectors on the end of the electrode cable needs to be attached to a specific electrode. The electrode cables are each a different color. Follow Fig. 7.4 to ensure that you connect each cable to the proper electrode.

The pinch connectors work like a small clothespin, but will only latch onto the nipple of the electrode from one side of the connector.

When the electrode cable is connected properly, the LEAD II electrode configuration will be established.

It is a good idea to clean the window of the sensor before each use. This will prevent any oil or dirt on the window from interfering with the signal. Use a soft cloth or other non- abrasive material to wipe it clean.

On the hand of the right arm with electrode positioned in Steps 5 & 6, position the transducer so that the sensor is on the bottom of your fingertip (the part without the fingernail). Wrap the Velcro ® tape around your finger so the transducer fits snugly, but not so that blood circulation is cut off—it’s a fine line between tight and too tight.

Sensor attaches to bottom of fingertip

tight and too tight. Sensor attaches to bottom of fingertip Velcro strap wraps around finger Fig.

Velcro strap

wraps around

finger

Fig. 7.5 Figure demonstrates sensor position only — attach to the hand used for electrode/lead placement

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Biopac Student Lab

9. Have the Subject sit down with forearms supported and relax.

10. Start the BIOPAC Student Lab Program.

11. Choose Lesson 7 (L07-ECG&P-1).

12. Type in your filename.

13. Click OK.

END OF SET UP

Position the electrode cables such that they are not pulling on the electrodes or the transducer. Connect the electrode cable clip (where the cable meets the three individual colored wires) to a convenient location (can be on the Subject’s clothes). This will relieve cable strain. The Subject should not be in contact with nearby metal objects (faucets, pipes, etc.), and should remove any wrist or ankle bracelets.

Use a unique identifier.

This ends the Set Up procedure.

Lesson 7: ECG & Pulse

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B.

CALIBRATION

The Calibration procedure establishes the hardware’s internal parameters (such as gain, offset, and scaling) and is critical for optimum performance. Pay close attention to the Calibration procedure.

 

FAST TRACK Calibration

1. Double check the electrodes, and make sure the Subject is relaxed.

2. Click Calibrate.

 

3. Wait for the calibration procedure to stop.

4. Check the calibration data:

 

If similar, proceed to Data Recording.

If different, Redo Calibration.

 

END OF CALIBRATION

 

DETAILED EXPLANATION OF CALIBRATION STEPS

Make sure the electrodes adhere securely to the skin. If they are being pulled up, you will not get a good ECG signal.

The Subject must be relaxed during the Calibration procedure. The Subject’s arms and legs need to be relaxed so that the muscle (EMG) signal does not corrupt the ECG signal.

The Calibrate button is in the upper left corner of the Setup window. This will start the calibration recording.

The Subject needs to remain relaxed throughout Calibration.

The calibration procedure will stop automatically after 8 seconds.

At the end of the 8-sec calibration recording, the screen should resemble Fig. 7.6.

calibration recording, the screen should resemble Fig. 7.6. Fig. 7.6 There should be a greatly reduced

Fig. 7.6

There should be a greatly reduced ECG waveform with a relatively flat baseline in the upper band. There should be wavelike forms in the pulse band. If your data resembles Fig. 7.6, proceed to the Data Recording section.

If the data shows any large spikes, jitter, or large baseline drifts, or if you have a flat line instead of a clear signal on the pulse channel, then you should redo the calibration by clicking Redo Calibration and repeating the entire calibration sequence.

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Biopac Student Lab

C. RECORDING LESSON DATA

FAST TRACK Recording

1. Prepare for the recording and have the Subject sit down in a chair and relax, with arms on the armrests.

Recording continues…

DETAILED EXPLANATION OF RECORDING STEPS

You will record ECG on one channel and indirect pulse pressure on another channel with the Subject in three conditions: Arm relaxed, Temperature change, and Arm up. The Subject will perform tasks in the intervals between recordings.

In order to work efficiently, read this entire section so you will know what to do for each recording segment.

The Subject should remain in a seated position and continue to relax while you review the lesson.

Check the last line of the journal and note the total amount of time available for the recording. Stop each recording segment as soon as possible so you don’t use an excessive amount of time (time is memory).

Hints for obtaining optimal data:

To minimize muscle (EMG) corruption of the ECG signal and baseline drift:

a) The Subject should keep still during all of the recording segments because the recording from the pulse transducer is sensitive to motion and the ECG recording is sensitive to EMG artifact.

b) The Subject should be in a relaxed state for each recording segment.

c) Initially, the Subject’s forearms should be supported on armrests.

d) After the Subject has repositioned his/her forearm, check to make sure that the cable is not pulling on the pulse transducer.

e) The recording should be suspended before the Subject prepares for the next recording segment.

f) Make sure electrodes do not “peel up.”

Lesson 7: ECG & Pulse

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Segment 1

2. Click Record.

3. Record for 15 seconds.

4. Click Suspend.

5. Review the data on the screen.

If correct, go to Step 6.

If incorrect, click Redo.

Recording continues…

When you click Record, the recording will begin and an append marker labeled “Seated and relaxed” will automatically be inserted.

Subject is seated in chair, with arms relaxed on the armrests (seconds 0-15).

The recording should halt, giving you time to review the data and prepare for the next recording segment.

If all went well, your data should look similar to Fig. 7.7 and you can proceed to Step 6.

d look similar to Fig. 7.7 and you can proceed to Step 6. Fig. 7.7 End

Fig. 7.7 End of Segment 1, Arm relaxed

The data would be incorrect if:

a) The Suspend button was pressed prematurely.

b) An electrode peeled up causing a large baseline drift, spike, or loss of signal.

c) The Subject has too much muscle (EMG) artifact.

If incorrect, you should redo the recording by clicking Redo and repeating Steps 2-5. Note that once you press Redo, the data you have just recorded will be erased.

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Biopac Student Lab

Segment 2

6. Subject remains seated and sticks the left, non-recording hand in a plastic bucket filled with warm or cold water.

 

WARNING The container for the water must not be metal, as this poses the potential danger of bypassing the electrical isolation of the Biopac Student Lab.

7. Click Resume.

 

8. Record for 30 seconds.

9. Click Suspend.

10. Review the data on the screen.

 

If correct, and more segments are required, go to Step 11.

If incorrect, click Redo.

 

Recording continues…

 

When you click Resume, the recording will continue and an append marker labeled “Seated, one hand in water” will be automatically inserted

Subject remains sitting with hand in water (seconds 16-45).

The recording should halt, giving you time to review the data and prepare for the next recording segment.

If all went well, your data should look similar to Fig. 7.8 and you can proceed to Step 11.

d look similar to Fig. 7.8 and you can proceed to Step 11. Fig. 7.8 End

Fig. 7.8 End of Segment 2, One hand in water

The data would be incorrect for the reasons in Step 5.

If incorrect, you should redo the recording by clicking Redo and repeating Steps 6-10. Note that once you press Redo, the data you have just recorded will be erased.

Lesson 7: ECG & Pulse

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Segment 3

11. Subject remains seated, raises the right hand (with transducer attached), extends the arm above the head, and holds that position.

12. Click Resume.

 

13. Record for 60 seconds.

14. Click Suspend.

15. Review the data on the screen.

 

If correct, go to Step 16.

If incorrect, click Redo.

16. Click Done.

 

17. Remove the electrodes and the transducer.

   

END OF RECORDING

Subject’s right hand (with transducer attached) should remain raised with arm extended above the head for the duration of the recording.

When you click Resume, the recording will continue and an append marker labeled “Seated, arm raised above head” will be automatically inserted.

Subject remains seated with arm extended above head (seconds

46-105).

The recording should halt.

If all went well, your data should look similar to the Fig. 7.9 and

you can proceed to Step 16.

Note: The recording will vary greatly with different Subjects. When the hand is raised above the head, there may not be enough blood pressure at the fingertips to overcome the pressure of the Pulse Transducer strap. In such cases, switch Subjects.

Pulse Trans ducer strap. In such cases, switch Subjects . Fig. 7.9 End of Segment 3,

Fig. 7.9 End of Segment 3, Arm raised above head The data would be incorrect for the reasons in Step 5.

If incorrect, you should redo the recording by clicking Redo and

repeating Steps 11-15. Note that once you press Redo, the data you have just recorded will be erased.

A pop-up window with options will appear. Make your choice,

and continue as directed. If choosing the “Record from another Subject” option:

a) Attach electrodes and transducer per Set Up Steps 5-7, have the new Subject sit and relax, and continue the entire lesson from Set Up Step 10.

b) Each person will need to use a unique file name.

Remove the electrode cable pinch connectors, and peel off the electrodes. Throw out the electrodes (BIOPAC electrodes are not reusable). Wash the electrode gel residue from the skin, using soap and water. The electrodes may leave a slight ring on the skin for a few hours. This is normal, and does not indicate that anything is wrong.

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Biopac Student Lab

V. DATA ANALYSIS

 

FAST TRACK Data Analysis

 

1. Enter the Review Saved Data mode.

 

Note Channel Number (CH) designation:

 

Channel

Displays

CH 1

ECG

CH 40

Pulse

2. Setup your display window for optimal viewing of the entire recording.

3. Set up the measurement boxes as follows:

 
 

Channel

Measurement

CH 1

ΔT (time interval)

CH 1

BPM (rate)

CH 1

p-p

CH 40

p-p

4. Zoom in on a small section of the Segment 1 data.

 

5. Using the I-Beam cursor, select the area between two successive R waves (one cardiac cycle).

 

Data Analysis continues…

 

DETAILED EXPLANATION OF DATA ANALYSIS STEPS

Enter Review Saved Data mode from the Lessons menu.

The data window should come up the same as Fig. 7.10.

menu. The data window should come up the same as Fig. 7.10. Fig 7.10 The following

Fig 7.10

The following tools help you adjust the data window:

Autoscale horizontal Autoscale waveforms Zoom Tool

Horizontal(Time) Scroll Bar Vertical (Amplitude) Scroll Bar Zoom Previous

Grids — turn Grids ON and OFF by choosing Preferences from the File menu. The measurement boxes are above the marker region in the data window. Each measurement has three sections: channel number, measurement type, and result. The first two sections are pull- down menus that are activated when you click on them.

Brief definition of measurements:

ΔT: The Delta Time measurement is the difference in time between the end and beginning of the selected area.

BPM: The Beats Per Minute measurement first calculates the difference in time between the end and beginning of the area selected by the I-Beam tool (same as ΔT), then divides this value into 60 seconds/minute. Because BPM only uses the time measurement of the selected area for its calculation, the BPM value is not specific to a particular channel.

p-p: finds the maximum value in the selected area and subtracts the minimum value found in the selected area.

The “selected area” is the area selected by the I-beam tool (including the endpoints).

Be sure to zoom in far enough so that you can easily measure the intervals between peaks, approximately 4 cardiac cycles.

Try to go from R wave peak to R wave peak as precisely as possible (Fig 7.11 follows).

Note:

Lesson 7: ECG & Pulse

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A

6. Repeat the above measurements for each of the data segments.

 
 

A

7. Using the I-Beam cursor, select the area between two successive pulse peaks (one cardiac cycle).

 
 

A

8. Repeat the above measurements for each of the data segments.

 
 

A

9. Select individual pulse peaks for each segment and determine their amplitudes.

 

B

10. Using the I-beam cursor, select the interval between the R-wave and pulse peak.

 

C

11. Save or print the data file.

 

12. Exit the program.

 

END OF DATA ANALYSIS

12. Exit the program.   END OF DATA ANALYSIS Fig. 7.11 Fig. 7.12 Use the p-p

Fig. 7.11

Exit the program.   END OF DATA ANALYSIS Fig. 7.11 Fig. 7.12 Use the p-p [CH

Fig. 7.12

Use the p-p [CH 40] measurements.

Important: Measure the first pulse peak after the recording resumed. The body’s homeostatic regulation of blood pressure and volume occurs quickly. The increase or decrease in your results will be dependent on the timing of your data relative to the speed of physiological adjustments.

data relative to the speed of physiological adjustments. Fig. 7.13 Record the time interval ( Δ

Fig. 7.13

Record the time interval (ΔT) between the two peaks.

You may save the data to a drive, save notes that are in the journal, or print the data file.

END OF LESSON 7

Complete the Lesson 7 Data Report that follows.

Biopac Student Lab

Lesson 7: ECG & Pulse

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Lesson 7: ECG & Pulse

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Lesson 7

ECG & Pulse

Mechanical Action of the Heart, Peripheral Pressure Pulse, and Plethysmography

DATA REPORT

Student’s Name:

Lab Section:

 

Date:

I. Data and Calculations

Subject Profile

Name

Height

Age

Weight

Gender:

Male

or

Female

A. Comparison of ECG with Pulse Plethysmogram (Segments 1-3)

Complete Table 7.1 with data from three cycles from each segment and calculate the Means.

Table 7.1

Condition

Measurement

Channel

Cycle I

Cycle 2

Cycle 3

Mean

Arm Relaxed

R-R Interval

ΔT

CH 1

       

Segment 1

Heart Rate

BPM

CH 1

       

Pulse Interval

ΔT

CH 1

       

Pulse Rate

BPM

CH 1

       

Temp. Change

R-R Interval

ΔT

CH 1

       

Segment 2

Heart Rate

BPM

CH 1

       

Pulse Interval

ΔT

CH 1

       

Pulse Rate

BPM

CH 1

       

Arm Up

R-R Interval

ΔT

CH 1

       

Segment 3

Heart Rate

BPM

CH 1

       

Pulse Interval

ΔT

CH 1

       

Pulse Rate

BPM

CH 1

       

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Biopac Student Lab

B. Relative Volume Changes (Segments 1-3)

Complete Table 7.2 with data from each recording segment.

Table 7.2

Measurement

Arm Resting

Segment 1

Temperatur

e

Segment 2

Arm Up

Segment 3

QRS Amplitude

CH1 p-p

Relative Pulse Amplitude (mV) CH 40 p-p

C. Calculation of Pulse Speed

Distance between Subject’s sternum and shoulder?

Distance between Subject’s shoulder and fingertip?

Total distance?

cm

cm

cm

Data from Segment 1 of the recording (measure with I-beam)

Time between R-wave and Pulse peak?

Speed?

secs

cm/sec

Data from Segment 3 of the recording (measure with I-beam)

Time between R-wave and Pulse peak?

II.

Speed?

Questions

secs

cm/sec

D. Referring to data in table 7.1, are the values of heart rate and pulse rate similar for each condition? Yes / No

Explain why the values might differ or be similar.

E. Referring to Table 7.2 data, how much did the amplitude of the QRS complex change between conditions?

Extreme temp – Arm Resting?

Arm up – Arm Resting?

mV

mV

Lesson 7: ECG & Pulse

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F. Referring to Table 7.2 data, how much did the pulse amplitude change between arm positions?

Extreme temp – Arm Resting?

Arm up – Arm Resting?

mV

mV

G. Referring to Table 7.2 data, does the amplitude of the QRS complex change with the pulse amplitudes? Why or why not?

H. Describe one mechanism that causes changes in blood volume to your fingertip.

I. Referring to data from section C of this report, how would you explain the difference in speed, if any?

J. Which components of the cardiac cycle (atrial systole and diastole, ventricular systole and diastole) are discernible in the pulse tracing?

K. Would you expect the calculated pulse wave velocities of other students to be very close if not the same as yours? Why or why not?

L. Explain any amplitude or frequency changes that occurred with arm position.