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45 Cards in this Set

  • Front
  • Back
Everyday cardiac rhythm
Normal Sinus Rhythm
Any rhythm that is not a normal sinus rhythm
Arrhythmia

(also dysrhythmia)
True or False:
All arrythmias are abnormal and potentially dangerous.
False.
Some are quite normal and frequently occur in healthy individuals.
foremost clinical manifestation of a possible arrhythimia
palpitations
an awareness of one's own heartbeat
palpitations
Name two symptoms of possible decreased cardiac function secondary to an arrhythmia.
light-headedness
syncope
hypoxic chest pain
angina
This term refers to an abrupt, fatal arrhythmia.
sudden death
What is the mnemonic used to remember arrhythmogenic factors to be considered whenever encountering a patient with an arryhythmia?
HIS DEBS
Name the factors to be considered when encountering a patient with an arrhythmia.
Hypoxia
Ischemia/Irritability
Sympathetic Stimulation
Drugs
Electrolyte disturbances
Bradycardia
Stretch (enlargement)
When an arrhythmia is suspected, it is standard practice to run a long tracing of a single or multiple leads called what?
a rhythm strip
an ambulatory device worn by a patient that provides a complete record of the patient's rhythm activity
Holter monitor
(ambulatory monitor)
a monitor worn by a patient that is activated when palpitations are experienced
event monitor
Name the five basic types of arrhythmias.
arrhythmias of sinus origin
ectopic rhythms
reentrant arrhythmias
conduction blocks
preexitation syndromes
sinus rhythm in excess of 100 beats per minute
sinus tachycardia
sinus rhythm below 60 beats per minute
sinus bradycardia
Name the most common rhythm seen in the early stages of acute myocardial infarction.
sinus bradycardia
Name the rhythm that is a normal phenomenon, reflecting a variation in heartrate with inspiration and expiration.
sinus arrhythmia
This occurs when the sinus node stops firing.
sinus arrest
prolonged electrical inactivity
asystole
Which myocardial cells have the inherent ability to function as pacemakers?
Virtually all myocardial cells have the ability to function as pacemakers.
Which pacemaker ordinarily drives the heart?
The fastest pacemaker drives the heart. Under normal circumstances, the fastest pacemaker is the sinus node.
rescue beats that originate outside the sinus node when sinus arrest occurs
escape beats
typical firing rate of the sinus node
60 to 100 beats per minute
typical firing rate of atrial pacemakers
60 to 75 beats per minute
typical firing rate of junctional pacemakers
40 to 60 beats per minute
typical firing rate of ventricular pacemakers
30 to 45 beats per minute
Of all the available escape mechanisms from sinus arrest, name the most common one.
junctional escape
With junctional escape, where does depolarization originate?
AV node
True or False:
In most cases, retrograde P-waves are seen in a junctional rhythm.
False.
Most often there are no P-waves at all, but in some cases a retrograde P-wave may be seen.
What is the mean electrical axis of a retrograde P-wave with respect to a normal P-wave?
reversed 180 degrees
Why are retrograde P-waves most often not seen in junctional rhythms?
They are masked by the more prominent QRS complexes.
True or False:
Sinus arrest and sinus exit block are usually not distiguishable on EKG.
True.
Sinus arrest is a failure of sinus depolarization, whereas sinus exit block is a failure of current delivery to the surrounding tissue. Since sinus node firing is not visible, the two conditions are usually indistinguishable on EKG.
True or False:
Transient sinus arrest and sinus exit block can sometimes be distinguished on EKG.
True.
Resumption of transient sinus arrest is usually random, whereas resumption of exit block is usually sinchronized with the underlying sinus rate.
abnormal rhythms that orginate outside of the sinus node
ectopic rhythms
difference between escape beats and ectopic rhythms
Ectopic rhythms are sustained, whereas escape beats refer to one or a few rescue beats.
True or False:
Ectopic rhythms often arise from enhanced automaticity of a nonsinus site.
True.
True or False:
Any of the pacemakers scattered throughout the heart can be stimulated to depolarized faster than and override the heart's normal pacemaker.
True.
Name one of the most common causes of enhanced automaticity.
digitalis toxicity
Is enhanced automaticity a disorder of impulse formation or impulse transmission?
impulse formation
Is reentry a disorder of impulse formation or impulse transmission?
impulse transmission
Name the phenomenon in which electrical current spins as if in a closed racetrack to provide a source of electrical activation that can override the sinus mechanism and run the heart.
reentry loop
an uninterrupted, revolving circuit often setup by a delay or block through one side of parallel conduction pathways
reentry loop
Four Questions for assessing any rhythm disturbance on EKG
(1) Are Normal P Waves Present?

(2) Are the QRS Complexes Narrow or Wide?

(3) What is the Relationship Between the P Waves and the QRS Complexes?

(4) Is the Rhythm Regular or Irregular?
All clinically important arrythmias fall into which two categories of origin?
(1) ectopic
(2) reentrant