Lena Torres
Korotkoff sounds are named after Nikolai Korotkov, a Russian physician who discovered them in 1905. They are the sounds that medical personnel listen for when taking blood pressure using a non-invasive procedure. These sounds are heard through a stethoscope or a doppler that is placed distal to the blood pressure cuff. The five phases of Korotkoff sounds are used to define systolic and diastolic pressures.
| Characteristics | Values |
|---|---|
| Phase 1 | Onset of faint, repetitive, clear, sharp tapping sounds which gradually increase in intensity for at least two consecutive beats |
| Phase 2 | Sounds soften and become swishing, wooshing, murmurs and longer and less intense |
| Phase 3 | Return of sharper sounds, which become crisper and louder again |
| Phase 4 | Sounds become muffled, soft, blowing and difficult to distinguish |
| Phase 5 | Complete disappearance of sounds |
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What You'll Learn
- Korotkoff sounds are heard when a blood pressure cuff changes the flow of blood through the artery
- They are named after Nikolai Korotkov, a Russian physician who discovered them in 1905
- The five phases of Korotkoff sounds are heard in sequential order
- The second and third Korotkoff sounds have no known clinical significance
- Korotkoff sounds are used to define systolic (high value) and diastolic (low value) pressures
Korotkoff sounds are heard when a blood pressure cuff changes the flow of blood through the artery
Korotkoff sounds are named after Nikolai Korotkov, a Russian physician who discovered them in 1905. They refer to the series of five distinct sounds heard when a blood pressure cuff changes the flow of blood through the artery. These sounds are produced by blood flow dynamics as the cuff pressure fluctuates relative to the arterial pressure.
When a blood pressure cuff is placed around the upper arm and inflated to a pressure above the systolic pressure, the cuff pressure is higher than the pressure produced by the heart, temporarily occluding blood flow. Normally, blood flows smoothly through the arteries, and no sound is produced. However, when the pressure in the cuff is equal to or slightly lower than the systolic blood pressure, blood begins to pass through the upper arm in spurts, creating turbulence and an audible sound, marking the first Korotkoff sound.
As the pressure in the cuff is gradually lowered, it alternates between being higher and lower than the arterial pressure, resulting in continuous turbulence and thumping sounds, which correspond to the second and third Korotkoff sounds. These sounds are of varying intensity and quality, with the third sound being described as "thumping."
The fourth Korotkoff sound occurs when the cuff pressure is within 10 mm Hg above the diastolic blood pressure and is characterized as "muting." Finally, the fifth Korotkoff sound is silence, indicating that the cuff pressure has dropped below the diastolic pressure, and blood flow has returned to its smooth, laminar state, producing no audible sound.
It is important to note that the second and third Korotkoff sounds have no known clinical significance. Traditionally, systolic blood pressure was considered the pressure at the first Korotkoff sound, and diastolic blood pressure was associated with the fourth sound. However, there has been a shift towards using the fifth Korotkoff sound (silence) as the indicator of diastolic pressure as it is more reproducible.
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They are named after Nikolai Korotkov, a Russian physician who discovered them in 1905
Korotkoff sounds are the sounds that medical personnel listen for when taking blood pressure using a non-invasive procedure. They are named after Nikolai Korotkov, a Russian physician who discovered them in 1905.
Nikolai Sergeyevich Korotkov was born in 1874 in Kursk, Russia, to a merchant family. He attended the Kursk Gymnasium (secondary school) and went on to study medicine at Kharkiv University in 1893. He transferred to Moscow University in 1895 and graduated with distinction in 1898. During his time at Moscow University, Korotkov served as a resident intern to Professor Alexander Bobrov at the surgical clinic.
In 1900, Korotkov was granted leave to serve with the Russian military forces in the Boxer Rebellion in China. He travelled extensively during this time, through Irkutsk to Vladivostok and then returning to Moscow via Japan, Singapore, Ceylon, and the Suez Canal. For his efforts in treating the sick and wounded soldiers, he was honoured with the Order of St. Anna.
Upon his return, Korotkov shifted his focus to academic pursuits. In 1903, he joined the Military Medical Academy in St. Petersburg as an assistant surgeon under Professor Sergey Fedorov. During the Russo-Japanese War from 1904 to 1905, he served as a senior surgeon in Harbin, Manchuria, in charge of the Second St. George's Unit of the Red Cross. It was during this time that he made his groundbreaking discovery of the auscultatory method for measuring arterial blood pressure.
Korotkov's technique, now known as the Korotkoff method, involves using a sphygmomanometer (blood pressure cuff) and a stethoscope to listen for the sounds of blood flow in the brachial artery. By inflating the cuff and compressing the brachial artery, the blood flow becomes turbulent and produces audible sounds. These sounds, known as Korotkoff sounds, are broken down into five phases that occur in sequential order.
The discovery of Korotkoff sounds revolutionized blood pressure measurement, and the Korotkoff method is still considered the "gold standard" for its accuracy and ease of use even today.
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The five phases of Korotkoff sounds are heard in sequential order
Korotkoff sounds are named after Nikolai Korotkov, a Russian physician who discovered them in 1905. They refer to the series of five distinct sounds heard through a stethoscope over the brachial artery during blood pressure measurement. These sounds are produced by blood flow dynamics as the cuff pressure fluctuates relative to the arterial pressure.
Phase 1
The first phase of Korotkoff sounds is characterised by the onset of faint, repetitive, clear tapping sounds. These sounds gradually increase in intensity for at least two consecutive beats and coincide with the systolic blood pressure. This phase marks the first appearance of audible sounds, indicating that the pressure in the cuff is equal to the systolic blood pressure.
Phase 2
In the second phase, the sounds become softer and acquire a swishing or whooshing quality. They are less intense and resemble intermittent murmurs. The artery stays open for longer periods compared to Phase 1.
Phase 3
The third phase is marked by the return of sharper and crisper sounds. These sounds become louder and clearer again, regaining or even exceeding the intensity of Phase 1. The artery spends more time open than closed during each pressure pulse.
Phase 4
In the fourth phase, the sounds become increasingly difficult to distinguish. They are described as softer, blowing, and muffled, with a decreasing intensity that eventually fades away. This phase occurs when the cuff pressure equals the diastolic pressure.
Phase 5
The fifth and final phase is characterised by the complete disappearance of all sounds. This silence indicates that the cuff pressure has dropped below the diastolic pressure, and the artery remains permanently open.
It is important to note that the second and third Korotkoff sounds have no known clinical significance. Additionally, there may be an auscultatory gap where sounds disappear temporarily between Phases II and III.
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The second and third Korotkoff sounds have no known clinical significance
Korotkoff sounds are pulsatile circulatory sounds heard during the measurement of blood pressure. They are named after Nikolai Korotkov, a Russian physician who discovered them in 1905. Korotkov described five types of Korotkoff sounds, which are heard in sequential order.
The first Korotkoff sound is a snapping sound first heard at systolic pressure. The second sound is a murmur heard for most of the area between systolic and diastolic pressures. The third sound is described as "thumping" and occurs at a pressure within 10 mm Hg above diastolic blood pressure. The fourth sound is described as "muting" and also occurs at a pressure within 10 mm Hg above diastolic blood pressure. The fifth Korotkoff sound is silence, indicating the diastolic pressure.
In adults, the fifth Korotkoff sound is used as an indicator of diastolic blood pressure. However, there is some controversy in the paediatric population, where the fourth or fifth Korotkoff sound can be used. If the fifth sound is undetectable, the fourth sound is used.
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Korotkoff sounds are used to define systolic (high value) and diastolic (low value) pressures
Korotkoff sounds are pulsatile circulatory sounds heard upon auscultation of the brachial artery. They are named after Nikolai Korotkov, a Russian physician who discovered them in 1905. Korotkov described five types of Korotkoff sounds, which are used to define systolic (high value) and diastolic (low value) pressures.
The first Korotkoff sound is a snapping sound first heard at systolic pressure. It is described as the first appearance of faint, repetitive, clear tapping sounds, which gradually increase in intensity for at least two consecutive beats. As the pressure in the cuff is the same as the pressure produced by the heart, some blood is able to pass through the upper arm when the pressure in the artery rises during systole. This blood flows in spurts, resulting in turbulence that produces an audible sound.
The second and third Korotkoff sounds have no known clinical significance. They are heard when the pressure in the cuff is between systolic and diastolic. The second sounds are described as murmurs, while the third sounds are sharper and more intense.
The fourth Korotkoff sound is traditionally used to indicate diastolic pressure. It is described as the abrupt muffling of sounds, which become soft and blowing in quality. However, there has been a move towards using the fifth Korotkoff sound, or silence, as the indicator of diastolic pressure, as it is felt to be more reproducible.
In paediatrics, there is some controversy over whether the fourth or fifth Korotkoff sound should be used to indicate diastolic pressure. It is recommended to use the fifth sound, as in adults, but if this is undetectable, the fourth sound should be used.
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