Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
57 Cards in this Set
- Front
- Back
|
how is max heart rate determined?
|
220 - pts age
|
|
|
how is target heart rate determined?
|
(X %) x (HR Max - Resting HR) + Resting HR
|
|
|
Systole
definition |
: period of cardiac contraction
|
|
|
Diastole
definition |
period of cardiac relaxation or refilling
|
|
|
Korticoffs Sounds
which are we interested in as PTAs? |
Phase I- first clear sound (systolic BP)
Phase V- sound disappears, second diastolic pressure |
|
|
what are the four chambers of the heart?
|
2 atriums and 2 ventricles
|
|
|
what is the primary job of the atrium?
|
receives blood from the veins
|
|
|
what is the primary job of the ventricles?
|
ejects blood into the arteries
|
|
|
What is the R side of the heart responsible for?
|
brings the systemic circulation to the lungs
|
|
|
What is the L side of the heart responsible for?
|
Bringing the blood from the lungs to the systemic circulation
|
|
|
Order of blood flow from the systemic circulation into the heart..
|
-the SVC, IVC and intrinsic veins deposit venous blood into the R atrium
-blood moves to the R ventricle via the tricuspid valve -the R ventricle projects the blood through the pulmonary valve into the pulmonary arteries (only arteries to carry unoxygenated blood) to the lungs |
|
|
order of blood flow from the pulmonary vein
|
-the pulmonary vein (only vein to carry oxygenated blood) returns the -blood to the L atrium
blood is passed to the L ventricle via the mitral valve -blood is ejected from the L ventricle through the aortic valve into main artery of the body, the aorta -to the systemic circulation |
|
|
where does the normal pathway of excitation begin in the heart?
|
begins with the S-A Node in the wall of the R atrium
|
|
|
where does the electrical wave from the S-A node spread to?
|
spreads throughout the 2 atria resulting in a contraction
|
|
|
what can be found at the lower part of the 2 atria?
|
The Atrio-Ventricle Node (A-V Node)
|
|
|
what is the electrical pathway to the ventricles called?
|
Bundle of His
|
|
|
what becomes of each Bundle of His
|
Each bundle becomes an interlacing network called the Perkinje System which spreads outward through the ventricular musculature. The electrical wave is brought to the ventricles via this network resulting in a contraction
|
|
|
what is the basic cardiac cycle?
|
-initiation of the heart beat by the SA node
-contraction of the atria -wave moves through the AV bundle -contraction of the ventricles |
|
|
Electrocardiogram
definition |
a graphic recording of the electrical activity of the heart; a recording of voltage changes at the body surface which were produced by electrical activity within the heart.
|
|
|
what part of the heart cycle is the P Wave associated with?
|
atrial depolarization (contraction of the atria)
|
|
|
what part of the heart cycle does the QRS Complex correspond to?
|
ventricular depolarization (contraction of the ventricles)
|
|
|
what part of the heart cycle does the T wave correspond to?
|
ventricular repolarization
|
|
|
what is the P-R INTERVAL?
|
from the beginning of the P to the beginning of the QRS. It is the time it takes from the beginning of atrial contraction to the beginning of ventricular contraction.
|
|
|
what is the U WAVE?
|
it is usually not present, it follows the T wave and is thought to be associated with late repolarization of papillary muscles.
|
|
|
how long does an EKG last with a normal heart rate?
|
0.5-0.6 seconds
|
|
|
with a 3 lead system for an ECG how should the red, white, and blck wires be placed.
|
"Red Right. Smoke above fire. Black on left"
|
|
|
Arrhythmia
defintion |
arrhythmia's are changes in electrical activity of the heart that occur at an abnormal time in the cardiac cycle. An arrhythmia may be either an abnormal time interval between consecutive cardiac cycles (disorder of rhythm) or within a single cardiac cycle (disorder of excitation conduction).
|
|
|
Arrhythmia's are thought to occur due to 3 reasons, what are they?
|
1. development of ectopic foci (abnormal pacemaker)
2. re-entry-the electric signal not completing a normal circuit, but rather looping back upon itself. 3. development of abnormal excitation conduction pathways. |
|
|
what is the clinical importance of an Arrhythmia?
|
Arrhythmia's reduce the ability of the heart to pump blood. When the ability to pump blood is severely diminished, blood flow to the tissues is diminished and tissue damage occurs
|
|
|
information gained from the ECG can be used to make inferences concerning what?
|
cardiac function
|
|
|
Changes in the P wave
the P Wave may be inverted, what might this suggest? |
atrial pacemaker other than the SA Node
|
|
|
Changes in the P wave
if the P Wave is larger or biphaisc, what might this suggest? |
hypertrophied atria
|
|
|
Changes in the P wave
if the PR Interval is longer, what might this suggest? |
excessive delay of excitation of the AV node
|
|
|
Changes in the QRS complex
if there is a widened or bizarre QRS Complex, what might this suggest? |
aberrant ventricular conduction
|
|
|
what are the steps to interpreting an ECG?
|
-calculate rate
-examine rhythm to determine -regular and irregular i-dentify P waves -evaluate P-R interval for duration and relationship of P-wave to QRS complex -Eval QRS complex for shape and duration -identify extra waves or complexes (arrhythmia's) -determine clinical significance of arrhythmia |
|
|
how long is the normal P-R Interval?
|
between .12-.20 (3-5 small boxes)
|
|
|
what does a shorter than normal P-R Interval indicate?
|
A shorter than normal P-R interval indicates increased A-V conduction or an atrial impulse that does not originate in the S-A node
|
|
|
what does a longer than normal P-R Interval indicate?
|
A longer than normal P-R interval indicates a slowing of conduction from the S-A node into the A-V junction
|
|
|
what does a prolonged P-R Interval define?
|
. A prolonged P-R interval defines A-V heart block. Heart blocks are defined as first, second or third degree
|
|
|
what do irregularities between QRS Complexes indicate?
|
Irregularities indicate bundle branch blocks or problems in ventricular conduction
|
|
|
What HR determines BRADYCARDIA
what are common causes of BRADYCARDIA? |
Slow rate (<60/mm) otherwise normal
Causes: parasympathetic stimulation, MI, drug intoxication's, high performance athletes |
|
|
what HR determines TACHYCARDIA?
common causes of TACHYCARDIA? |
Rapid rate (>100/mm) otherwise normal, on occasion T wave is modified by P wave of the following beat
Causes: fever, excitement, exercise, heart failure, sympathetic stimulation, drug intoxication's, pain, and compensation for hypovolemia |
|
|
Premature Atrial Contractions (PAC)
where is the ectopic focus? |
The ectopic focus is not in the SA node, the P wave will be normal or abnormal depending on the location of the focus. The T wave may be modified by the P wave of the following beat. This is an irregular rhythm.
|
|
|
Premature Atrial Contractions (PAC)
common causes |
Causes: caffeine, alcohol, stress, emotional extremes, sympathetic nervous system stimulation, and heart disease or Ml. Patients who have PACs report palpitations or skipping a beat
|
|
|
Atrial Flutter
main idea? how does it look on an ECG? |
The atrial waves are so rapid (@300/min) that the AV node cannot transmit every pulse to the ventricles. The ventricle will respond to every 2nd, 3rd .4th etc. flutter wave thus resulting in a 2:1, 3:1,4:1 AV block with the atrial flutter
- like little humps among the P Wave (think of a butterfly) |
|
|
Atrial Flutter
common causes of? |
valvular heart disease, R heart failure, Ml, and CAD.
|
|
|
Atrial Fibrillation
main idea |
The irritable focus is so rapid (>350) that there are no consistent P waves. The T wave may be modified by the fibrillatory line. The ventricular rhythm is usually irregular
|
|
|
Atrial Fibrillation
what kind of pattern? common causes? |
sawtooth pattern
- MI, pulmonary embolus, HTN, CAD, cardiac valvular stenosis, and many more. |
|
|
1st Degree A-V Block
main idea |
Impairment of conduction through the A-V node. Prolonged (>0.20 seconds) PR interval
|
|
|
2nd Degree A-V Block
main idea |
The impairment of conduction is greater so that some of the impulses from the atria fail to get through to activate the ventricles. This results in "dropped beats". Irregular ventricular rhythm
|
|
|
3rd Degree A-V Block
main idea |
No impulses from the atria reach the ventricles. The atria and ventricles will have separate pace makers
|
|
|
Premature Ventricular Contraction (PVC)
main idea |
Premature beats. The P wave may be present but unrelated to the PVC. The QRS is usually widened abnormal and of increased amplitude. The T wave is usually inverted. (there are special types of PVCs called bigeminy and trigeminy and refer the location and frequency of PVCs.
|
|
|
Premature Ventricular Contraction (PVC)
key point of BIGEMINY |
irregularity is every other beat
|
|
|
Premature Ventricular Contraction (PVC)
key point of TRIGEMINY |
irregularity is ever 3rd beat
|
|
|
Premature Ventricular Contraction (PVC)
common causes |
MI, ischemia, electrolyte imbalance, drug toxicity, acidosis, pain, COPD, gall bladder involvement, and sympathetic nervous system stimulation.
|
|
|
Ventricular Tachycardia
main idea |
A most dangerous rhythm which requires prompt correction. It is a rapid recurrence of ventricular premature contractions with no normal beats in between. The P wave may be absent or unidentifiable, the QRS is usually widened and abnormal , and the T wave is usually inverted. HR is usually 150-250 bpm. Cardiac output may be severely diminished, and Vfib may follow. Causes: same as PVCs
|
|
|
Ventricular Fibrillation
main idea |
This may occur spontaneously or as a sequel to Vtach. The pattern is bizarre with totally disorganized electrical activity of the ventricles. Cardiac output is essentially zero. No pulse is audible or palpable, and death is imminent without immediate defibrillation or CPR.
Causes: same as PVCs and Vtach, but also may occur spontaneously. |
