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How Do Blood Pressure Tests Work, And What Do Those Numbers Mean?

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Getting your blood pressure taken is a standard part of most visits to the doctor, but the details might seem mysterious—so read on.

What It Is

Blood pressure (BP) is the force exerted by circulating blood on the walls of the arteries as it's pumped from the heart. When we talk about it, we're usually referring specifically to the pressure as measured on the upper arm at the brachial artery.

Average blood pressure varies from person to person and is influenced by a number of factors, including age, gender, diet, stress, exercise and alcohol use. For an individual, blood pressure changes over the course of the day and even varies during a single heartbeat between a systolic (maximum) pressure, when the heart beats and pumps blood and the ventricles are contracting, and a diastolic (minimum) pressure, when the heart is at rest between beats and the ventricles are filled with blood.

That arm band the doctor uses to measure your BP is called a sphygmomanometer (from the Greek sphygmus ("pulse") + the scientific term manometer (pressure meter). The instrument consists of an inflatable cuff, a measuring unit and, for manual models, an inflation bulb and valve. The pressure of the cuff used to be measured on manual sphygmomanometers by observing a mercury column in the measuring unit and reading the BP as millimeters of mercury (mmHg). The risk of mercury leaks has led to the increased use of aneroid manual and even digital sphygmomanometers, but the mercury ones are still considered more accurate. Even if a mercury column isn't used, mmHg is still the unit of measurement for BP.

How It's Measured

During an exam, the cuff is placed around the upper arm at roughly the same height as the heart and inflated with the bulb until the artery is closed. Using the stethoscope, the doctor slowly releases the pressure in the cuff and listens. What they're listening for are the Korotkoff sounds, named for the Russian physician who described them in 1905. The first Korotkoff sound occurs when the pressure of the cuff is the same as the pressure produced by the heart and only some blood is able to pass through the upper arm in spurts, resulting in turbulence and an audible whooshing or pounding sound. The doctor records the pressure at which this sound is heard as the systolic blood pressure.

As the pressure in the cuff is further released, the sound changes in quality, becomes quieter (running through the second, third, and fourth Korotkoff sounds) and, when the cuff stops restricting blood flow enough to allow smooth flow with no turbulence, stops altogether. This silence is the fifth Korotkoff sound and the pressure at which it happens is recorded as the diastolic blood pressure.

The fraction that the doctor records as your blood pressure is the systolic pressure over the diastolic pressure, giving you the measure of both the pressure when your heart is exerting maximum pressure and when it's relaxed.

According to the American Heart Association, blood pressure readings break down like this:

Normal Blood Pressure: 120 systolic pressure and 80 diastolic pressure or less

Prehypertension:120-139 systolic pressure or 80-89 diastolic pressure

High Blood Pressure (Hypertension) Stage 1: 140-159 systolic pressure or 90-99 diastolic pressure

High Blood Pressure Stage 2: 160+ systolic pressure or 100+ diastolic pressure

Hypertensive Crisis (emergency care needed): 180+ systolic pressure or 110+ diastolic pressure

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Big Questions
Where Is the Hottest Place on Earth?
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The summer of 2017 will go down as an endurance test of sorts for the people of Phoenix, Arizona. The National Weather Service issued an extreme heat warning, and planes were grounded as a result of temperatures exceeding 120 degrees. (Heat affects air density, which in turn affects a plane’s lift.)

Despite those dire measures, Phoenix is not the hottest place on Earth. And it’s not even close.

That dubious honor was bestowed on the Lut Desert in Iran in 2005, when land temperatures were recorded at a staggering 159.3 degrees Fahrenheit. The remote area was off the grid—literally—for many years until satellites began to measure temperatures in areas that were either not well trafficked on foot or not measured with the proper instruments. Lut also measured record temperatures in 2004, 2006, 2007, and 2009.

Before satellites registered Lut as a contender, one of the hottest areas on Earth was thought to be El Azizia, Libya, where a 1922 measurement of 136 degrees stood as a record for decades. (Winds blowing from the nearby Sahara Desert contributed to the oppressive heat.)

While the World Meteorological Organization (WMO) acknowledged this reading as the hottest on record for years, they later declared that instrumentation problems and other concerns led to new doubts about the accuracy.

Naturally, declaring the hottest place on Earth might be about more than just a single isolated reading. If it’s consistency we’re after, then the appropriately-named Death Valley in California, where temperatures are consistently 90 degrees or above for roughly half the year and at least 100 degrees for 140 days annually, has to be a contender. A blistering temperature of 134 degrees was recorded there in 1913.

Both Death Valley and Libya were measured using air temperature readings, while Lut was taken from a land reading, making all three pretty valid contenders. These are not urban areas, and paving the hottest place on Earth with sidewalks would be a very, very bad idea. Temperatures as low as 95 degrees can cause blacktop and pavement to reach skin-scorching temperatures of 141 degrees.

There are always additional factors to consider beyond a temperature number, however. In 2015, Bandar Mahshahr in Iran recorded temperatures of 115 degrees but a heat index—what it feels like outside when accounting for significant humidity—of an astounding 163 degrees. That thought might be one of the few things able to cool Phoenix residents off.

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Big Questions
How Does Autopilot Work on an Airplane?
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How does autopilot work on an airplane?

Joe Shelton:

David Micklewhyte’s answer is a good one. There are essentially a few types of features that different autopilots have. Some autopilots only have some of these features, while the more powerful autopilots do it all.

  • Heading Hold: There’s a small indicator that the pilot can set on the desired heading and the airplane will fly that heading. This feature doesn’t take the need for wind correction to desired routing into account; that’s left to the pilot.
  • Heading and Navigation: In addition to holding a heading, this version will take an electronic navigation input (e.g. GPS or VOR) and will follow (fly) that navigation reference. It’s sort of like an automated car in that it follows the navigator’s input and the pilot monitors.
  • Altitude Hold: Again, in addition to the above, a desired altitude can be set and the aircraft will fly at that altitude. Some autopilots have the capability for the pilot to select a desired altitude and a climb or descent rate and the aircraft will automatically climb or descend to that altitude and then hold the altitude.
  • Instrument Approaches: Autopilots with this capability will fly preprogrammed instrument approaches to the point where the pilot either takes control and lands or has the autopilot execute a missed approach.

The autopilot is a powerful computer that takes input from either the pilot or a navigation device and essentially does what it is told to do. GPS navigators, for example, can have a full flight plan entered from departure to destination, and the autopilot will follow the navigator’s guidance.

These are the majority of the controls on the autopilot installed in my airplane:

HDG Knob = Heading knob (Used to set the desired heading)

AP = Autopilot (Pressing this turns the autopilot on)

FD = Flight Director (A form of navigational display that the pilot uses)

HDG = Heading (Tells the autopilot to fly the heading set by the Heading Knob)

NAV = Tells the autopilot to follow the input from the selected navigator

APR = Tells the autopilot to fly the chosen approach

ALT = Tells the autopilot to manage the altitude, controlled by the following:

VS = Vertical Speed (Tells the autopilot to climb or descend at the chosen rate)

Nose UP / Nose DN = Sets the climb/descent rate in feet per minute

FLC = Flight Level Change (An easy manual way to set the autopilot)

ALT Knob = Used to enter the desired altitude

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