In manual BP measurement with a stethoscope, where should the cuff be placed and where should the stethoscope be positioned?

• A. Cuff on upper arm over brachial artery; stethoscope over brachial artery just distal to cuff
• B. Cuff on forearm; stethoscope over radial artery
• C. Cuff on upper arm over carotid artery; stethoscope over neck
• D. Cuff on upper arm over ulnar artery; stethoscope over palm

Answer: (A)

Manual BP measurement relies on compressing the brachial artery with a cuff and listening for Korotkoff sounds as the cuff deflates. The cuff should be placed on the upper arm with the bladder centered over the brachial artery, about 2–3 cm above the elbow crease. The stethoscope belongs over the brachial artery just distal to the cuff, in the antecubital fossa, so you can hear the sounds produced as the artery is gradually released from pressure. Placing the cuff on the forearm or the stethoscope over other arteries (carotid, radial, ulnar, or in the palm) either misses the artery under the cuff or poses safety and accuracy issues, leading to unreliable readings. This setup ensures the artery under the cuff is properly occluded and the Korotkoff sounds are heard clearly.