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114 Cards in this Set
- Front
- Back
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What is the impulse that tells the heart to beat?
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Electrical
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What is the beat that responds to the electrical stimulation, resulting in pumping of blood?
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Mechanical
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The heart has two types of cells, what is the electrical cell called?
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conductive
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The mechanical cell of the heart is also called the.......
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Contracting cells
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After the electrical cells initiate the impulse and condut it throught the heart, which cells respond by contracting and pumping blood?
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Mechanical Cells
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You can not have a mechanical response, if you dont first get an .............
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eletrical stimulus
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After the electrical cells have discharged their stimuli, the mechanical cells are expected to do what?
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contract
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Without and electrical response the mechanical cells can't be expected to.......
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contract
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For complete assessment of cardiac function, we must examine bothe the......
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Electrical and Mechanical Functions
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As part of our assessment of mechanical function, we use _________, ________, _______ to determine if the heart is pumping adequately
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Blood Pressure, Pulse, perfusion parameters
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During assessment, how would we evaluate the heart's electrical activity?
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Monitor the electrocardiogram (EKG) tracing
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If the heart muscle is not able to contract in response to electrical stimulus, you could have a problem with what?
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The Mechanical Response
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If you had a functioning electrical system but a failing heart muscle, you could very likely see a viable EKG tracing but the patient might not have what?
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palpable pulses or blood pressure
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To evaluate a patient's cardiac function, you must assess the mechanical function by examing what?
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Pulses and Blood Pressure
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To evaluates a patients cardiac electrical function, what should you assess?
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The EKG tracing
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The term dysrhthmia and arrhythmia are both used to refer to patterns of what?
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electrical activity within the heart.
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Arrhythmias are graphic representation of the hearts what?
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Electrical activity
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The term electrocardiography is given to the study of arrhythmias because arrhythimias are manifestations of what?
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Electrical activity within the heart
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What 2 electrolytes provide electrical charges in the heart?
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Sodium (Na+) and potassium (K+)
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When the cell is in a resting state, where is most of the potassium?
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Inside the Cell
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If the cell is in a resting state, where is the sodium?
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Outside the cell
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Which has a higher charge, sodium or potassium?
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Sodium
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Is the inside of the cell negative or positive during the resting state?
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Negative
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During the resting state, which is positive, the inside of the cell or the outside of the cell?
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The outside
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In order for an electrical current to form, how do the charges have to correlate with each other?
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There must be a difference between the electrical charges
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In the resting cell the charges are......
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balanced
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What does balanced cells indicate?
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No electricity is flowing
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When the cells are resting, what state are they in?
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polarized state
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What is a polarized state?
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The cell charges are balanced and ready for action
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The electrical cells in the heart are unique in that they have a property called what?
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automaticity
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What does automaticity mean?
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The electrical cells in the heart can discharge an electrical current without and external stimulus
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What can the unique cardiac cells do to electrolytes?
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They are able to modify their membranes and pull sodium into the cell while potassium exits.
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When Cardiac cell alter their membrane and pull sodium into the cell, while releasing the K+ what happens?
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formation of an electrical current
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When the two chemicals change places, the electricity flows how?
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In a wave-like motion throughout the heart.
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What is the wave of electrical flow from the cardiac cells called?
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depolarization, and is how the stimulus flows through the heart.
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What is depolirization?
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refers to the process of electrical discharge and flow of electricity
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After the cell depolarizes, the positive and negative electrical charges will .....
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again return to their original positions around the cell, and the cell will prepare itself for another discharge
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The process that follows depolarization, wheen the cell charges are returning to their original state is called
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repolarization
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Repolarization occurs _______ depolarization
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after
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Sodium Pump
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The swapping of chemical in the cardiac cell that causes and electrical charge resulting in the initiation of an electrical flow
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When is there no movement electrical movement in a cardiac cell?
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When each of the positive charges on the outside of the cell is balanced by a negative charge on the inside of the cell
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Polarizing is considered the _______ state
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ready
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depolarization is considered the ________ state
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discharge
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Repolarization is considered the ________ state
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recovery
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polarization, depolirzation, and repolarization are happening to single cells within the heart, that cause what type of movement and result?
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wave like movement, resulting in the entire heart responding electrically to the same activity.
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The electrical cells in the heart are all arranged in a systme of pathways called the.........
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conduction system
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Where does the electrical pulse originate?
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In the SA node
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After the electrical pulse leave the SA node where is it headed?
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To the ventricles
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In a normal heart, where does the first impulse start?
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SA node
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The impulse travels through the atria form the SA node by way of the what?
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intratrial pathways and to the AV node by means of the internodal pathways
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After the Impulse is started in the SA nodes and travel to the Intratrial and Internodal pathways, where do they go next?
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AV node
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The AV node is unique in what way?
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It has conductive tissue, but it does not have any pacemaker cells like other areas of the conduction system
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The pacemake cells are located at what junction?
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AV Junction
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AV node is used when talking about what?
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conduction
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AV junction is used when talking about what?
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formation of impulses
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What term should be used when talking about pacemaker capabilities?
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AV Junction
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What term should be used when talking about conduction?
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AV Node
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After leaving the area of the AV node, the impulses go through the ........
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bundle of his
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The pulses have to go through the bundle of his to reach what?
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The right and left bundle branches
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Where are the right and left bundle branches located?
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Within the right and left ventricles
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What is the name of the fibers at the end of the bundle branches that distribute the electrical impulses to the muscle cells to stimulate contraction?
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Purkinje fibers
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Each of the three major areas of the conduction system has it's own built in rate, what is this called?
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The Inherent rate
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An inherent rate means simply that......
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each site has a rate range at which it usually produces impulses
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A site can exceed or fall below what? What does this mean?
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Its inherent rate, indicating that these rates are not concrete rules.
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The sites will produce impulses at a _____ within their own _________ rate ranges
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rates, Inherent
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SA Node Inherent rate
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60-100 beats per minute
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AV Junction Inherent rate
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40-60 beats per minute
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Ventricle Inherent rate
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20-beats per minute
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The inherent rate will give you a clue what _________ ________ stimulated the rhythm
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electrical impulses
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If the inherent rate is 40-60 beats per minute, the impulse probably came from the?
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AV Junction
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The Inherent rates are often helpful clues to be used in interpreting________, but can be ____________ unless they are understood to be mere guidelines and not concrete __________
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Arrhythmias, misleading, rules
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The _______ inherent rate will become the pacemaker of the heart
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fastest
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Which rate is the fastest inherent rate, and is considered the natural pacemaker?
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SA node
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The normal EKG is ______ in orgin
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sinus
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Why is the SA node the pacemaker of the heart?
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Because it has the highest Inherent rate of 60 - 100
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If a site begins to discharge impulses at a faster rate than its inherent rate, this is called?
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Irritability
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When will a site overide the SA Node at take over as the pacemaker?
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When it has become irritable and starts to fire faster than it's inherent rate
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When a site becomes irritable, this is a ________ occurrence
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undesirable
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If the SA node slows down for any reason and drops below its inherent rate, what will happen?
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The site with the next highest inherent rate will usually take over the pacemaking role.
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If the SA node fails and the AV node which has the next highest inherent rate takes over as the pacemaker, this is called _________, and is what type of feature
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escape mechanism, safety
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Would you expect an irritable rhythm to be faster or slower than an escape rhythm?
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faster
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The inherent rate of different areas of the conduction system refers to the rate at which that site ________
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intiates pulses
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What is the inherent rate of the ventriular conductive tissue?
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20-40 beats per minutes
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The purkije fibers have an inherent beat of what?
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less than 15 beats per minute
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Because the inherent rate at each site cannot be relied upon as firm rules, they should be viewed only as what?
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guidelines
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If the AV junction or the ventricle became irritable, either could become the pacemaker if it were able to accelerate until it
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became faster than the SA node
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In addition to the inherent rates, the heart can be influenced by what?
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The autonomic nervous system
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The autonomic nervous system has how many branches, and what are they called
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Two, the sympathetic branch and the parasympathetic branch
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What is affected when the sympathetic branch of the autonomic nervous sytem influence the heart?
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It affects the Atrial (the SA node, The intratrial and internodal pathways, and the AV junction) and the ventricles
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If the sympathetic branch is stimulated it will cause both the atria and ventricles to respond it what way?
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Increased rate
Increased conduction through the AV node Increased irritability |
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If the parasympathetic branch interferes with the heart, what part is affected
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Only the ATRIA; it has little or no effect on the ventricles
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While stimulation of the parasympathetic branch causes the atria to
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slow down as well as decrease irritablility, and it also slow conduction through the AV node
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The vagus nerve is in what part of the autonomic nervous system?
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The para sympathetic branch
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If the vagus nerve is stimulated what happens?
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It decreases heart rate
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If both the sympathetic and the parasympathetic branches are balanced, how would the heart rate respond
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It would beat at a normal rate.
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What would you get if you blocked the normal influence of the vagus nerve?
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You would get a response similiar to stimulation of the sympathetic branch: heart rate would increase as well as irritability and AV conduction
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If a patient had a heart rate that was too slow, you might try to speed it up by giving a drug that would either stimulate the _________ or block the ____________ branch
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sympathetic branch, parasympathetic branch
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What will happen if one of the branches of the autonomic nervous system is blocked?
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The heart will respond to the influence of the opposing branch.
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What would happen to the heart rate if the parasympathetic branch were blocked
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The heart rate would increase
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The vagus nerve is part of the_______ branch of the autonomic nervous system. Therefore, stimulation of the vagus nerve would cause the heart rate to ______, and blocking of the vagus nerve would cause the heart rate to _______
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parasympathetic, decrease, Increase
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In order to discuss the heart contracting and producing a pulse, we must connect the electrical activity with _______ activity
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mechanical
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What would cause the mechanical response, and muscle from contracting?
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Chemical Imbalance, or damage.
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Although you can still get a reading of the EKG, if the mechanical response is damaged, what sign or symptom would present itself?
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You would get no palpable pulse or blood pressure.
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The electrical response can be erratic and cause the......
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Ventricle to contract, before the atrium, or too many electrical pulses that the heart can't respond effectively to any of them. Sometime the electrical impulse will discharge before the ventricles have time to fill with blood, thereby causing the ventricles to contract and eject insufficient blood for an adequate pulse. These are called arrhythmia
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If both the sympathetic and the parasympathetic branches are balanced, how would the heart rate respond
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It would beat at a normal rate.
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What would you get if you blocked the normal influence of the vagus nerve?
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You would get a response similiar to stimulation of the sympathetic branch: heart rate would increase as well as irritability and AV conduction
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If a patient had a heart rate that was too slow, you might try to speed it up by giving a drug that would either stimulate the _________ or block the ____________ branch
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sympathetic branch, parasympathetic branch
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What will happen if one of the branches of the autonomic nervous system is blocked?
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The heart will respond to the influence of the opposing branch.
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What would happen to the heart rate if the parasympathetic branch were blocked
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The heart rate would increase
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The vagus nerve is part of the_______ branch of the autonomic nervous system. Therefore, stimulation of the vagus nerve would cause the heart rate to ______, and blocking of the vagus nerve would cause the heart rate to _______
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parasympathetic, decrease, Increase
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In order to discuss the heart contracting and producing a pulse, we must connect the electrical activity with _______ activity
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mechanical
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What would cause the mechanical response, and muscle from contracting?
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Chemical Imbalance, or damage.
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Although you can still get a reading of the EKG, if the mechanical response is damaged, what sign or symptom would present itself?
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You would get no palpable pulse or blood pressure.
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The electrical response can be erratic and cause the......
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Ventricle to contract, before the atrium, or too many electrical pulses that the heart can't respond effectively to any of them. Sometime the electrical impulse will discharge before the ventricles have time to fill with blood, thereby causing the ventricles to contract and eject insufficient blood for an adequate pulse. These are called arrhythmia
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