Ekg Final Exam 1: Ch. 1-8

Front 1

KNOW WHAT THE STRAIGHT LINE ON THE EKG IS CALLED

Back 1

ISOELECTRIC LINE (AKA: BASELINE)

Front 2

DEFINE UPRIGHT DEFLECTION

Back 2

IF THE ELECTRICITY FLOWS "TOWARD THE POSITIVE ELECTRODE", THE PATTERNS PRODUCED ON THE GRAPH PAPER WILL BE "UPRIGHT"

HENCE: UPRIGHT DEFLECTION

Front 3

DEFINE DOWNWARD DEFLECTION

Back 3

IF THE ELECTRICITY FLOWS "AWAY FROM THE POSITIVE ELECTRODE", THE PATTERNS PRODUCED WILL BE "DOWNWARD"

HENCE: DOWNWARD DEFLECTION

Front 4

KNOW WHAT THE HORIZONTAL LINES ON THE EKG MEASURE

Back 4

VOLTAGE

Front 5

KNOW WHAT THE VERTICAL LINES ON THE EKG MEASURE

Back 5

TIME

Front 6

KNOW THE NUMBER OF SECONDS BETWEEN THE "TIC" MARKS ON THE EKG PAPER

Back 6

3 SECONDS

Front 7

KNOW THE TIME BETWEEN THE HEAVY VERTICAL LINES AND THE TIME BETWEEN OF THE SMALL SQUARES ON THE EKG GRAPH PAPAER

Back 7

HEAVY VERTICAL LINES: 0.20 SECONDS

SMALL SQUARES: 0.04 SECONDS

Front 8

DEFINE SEGMENTS

Back 8

LINE BETWEEN 2 WAVE FORMS

Front 9

DEFINE INTERVALS

Back 9

BEGINNING OF A WAVE FORM AND THE SEGMENT COMBINED BEFORE THE NEXT WAVE FORM

* DISTANCE BETWEEN 2 POINTS ON AN EKG TRACING

Front 10

DEFINE WAVE FORMS

Back 10

UP OR DOWN MOVEMENT ON THE ISOELECTRIC LINE

Front 11

KNOW HOW TO IDENTIFY "P WAVES" AND WHAT THEY REPRESENT

Back 11

THE P WAVE INDICATES ATRIAL DEPOLARIZATION.

THE P WAVE STARTS WITH THE FIRST DEFLECTION FROM THE ISOELECTRIC LINE

Front 12

KNOW HOW TO IDENTIFY "QRS WAVES" AND WHAT THEY REPRESENT

Back 12

THE QRS WAVE INDICATES VENTRICULAR DEPOLARIZATION.

COLLECTIVELY KNOWN AS THE QRS COMPLEX.

THE Q WAVE IS FIRST, AND ITS THE FIRST NEGATIVE DEFLECTION FOLLOWING THE P WAVE.

THE R WAVE IS THE FIRST POSITIVE DEFLECTION AFTER THE P WAVE.

THE S WAVE IS THE 2ND NEGATIVE DEFLECTION FOLLOWING THE P WAVE.

Front 13

KNOW HOW TO IDENTIFY "T WAVES" AND WHAT THEY REPRESENT

Back 13

THE T WAVE INDICATES VENTRICULAR REPOLARIZATION

Front 14

KNOW WHAT CARDIAC ACTIVITY THE "PR INTERVAL" AND THE "QRS COMPLEX" REPRESENT

Back 14

PR INTERVAL BEGINS AT THE FIRST SIGN OF THE P WAVE AND ENDS AT THE FIRST DEFLECTION OF THE NEXT WAVE CALLED THE QRS COMPLEX.

THE PR INTERVAL INCLUDES ALL ATRIAL AND NODAL ACTIVITY BUT DOES NOT INCLUDE VENTRICULAR ACTIVITY

Front 15

KNOW THE ELEMENTS OF A SINGLE CARDIAC CYCLE

Back 15

THE INTERVAL FROM THE BEGINNING OF ONE HEARTBEAT TO THE BEGINNING OF THE NEXT ONE.

ON THE EKG IT ENCOMPASSES THE PQRST COMPLEX INCLUDING INTERVALS AND SEGMENTS

Front 16

KNOW THE INHERENT RATES

Back 16

INHERENT RATE OF SA NODE: 60-100 BPM

INHERENT RATE OF AV JUNCTION (AV NODE) : 40-60 BPM

INHERENT RATE OF VENTRICLE: 20-40 BPM

Front 17

DEFINE POLARIZATION

Back 17

WHEN CELLS ARE IN THEIR "RESTING STATE" BECAUSE ALL OF THE CHARGES ARE BALANCED AND THERE IS NO ELECTRICAL FLOW

Front 18

DEFINE DEPOLARIZATION

Back 18

REFERS TO THE PROCESS OF ELECTRICAL DISCHARGE AND FLOW OF ELECTRICAL ACTIVITY

Front 19

DEFINE REPOLARIZATION

Back 19

THE RETURN OF THE ELECTRICAL CHARGES TO THEIR ORIGINAL STATE

Front 20

KNOW THE CONDUCTIVE PATHWAY OF THE HEART

Back 20

THIS PATHWAY IS MADE UP OF 5 ELEMENTS

1. THE SA NODE (SINO ATRIAL NODE)
2. THE AV NODE (ATRIO VENTRICULAR NODE)
3. THE BUNDLE OF HIS
4. THE LEFT AND RIGHT BUNDLE BRANCHES
5. THE PURKINJE FIBERS

Front 21

KNOW HOW THE SYMPATHETIC AND PARASYMPATHETIC BRANCHES OF THE AUTONOMIC SYSTEM EFFECTS THE HEART

Back 21

SYMPATHETIC: FASTER

PARASYMPATHETIC: SLOWER
** WORKS WITH THE VAGEL /VAGUS NERVE

Front 22

KNOW HOW TO DETERMINE IF A HEART RATE IS REGULAR

Back 22

BY MEASURING THE R-R INTERVAL OR THE P-P INTERVAL.

HEART RATE IS DETERMINED BY PULSE: IF YOUR RESTING HEART RATE IS BETWEEN 60-100 BPM, YOUR HEART RATE IS CONSIDERED NORMAL/REGULAR.

Front 23

KNOW THE TERM SUPRAVENTRICULAR (SV)

Back 23

ORIGINATING ABOVE THE VENTRICLES

Front 24

KNOW HOW TO DETERMINE IF A P WAVE IS NORMAL AND ORGINATED IN THE SA NODE

Back 24

A NORMAL "SINUS" P WAVE IS ALWAYS "UPRIGHT"

IF THE P WAVE ORIGINATES IN THE SA NODE, IT WILL BE A SMOOTH, ROUNDED, UPRIGHT WAVE

Front 25

KNOW HOW TO DISTINGUISH BETWEEN SUPRA-VENTRICULAR AND VENTRICULAR RYTHMS

Back 25

SUPRA-VENTRICULAR RHYTHM: WHEN A RHYTHM ORIGINATES IN THE SA NODE; THE ATRIA; OR THE AV JUNCTION ITS CONSIDERED "SUPRA-VENTRICULAR" BECAUSE IT OCCURS ABOVE THE VENTRICLES

VENTRICULAR RHYTHM: ORIGINATES IN THE VENTRICLES

Front 26

KNOW THE TIME MEASUREMENTS FOR NORMAL PR INTERVALS AND QRS COMPLEX

Back 26

NORMAL PR INTERVALS (PRI) : 0.12-0.20 SECONDS

NORMAL QRS COMPLEX INTERVAL: LESS THAN 0.12 SECONDS

Front 27

KNOW WHAT REGULAR / IRREGULAR DESCRIBES

Back 27

IT MEANS THERE IS A PATTERN TO THE IRREGULARITY

Front 28

KNOW THE RATES FOR THE NORMAL SINUS RHYTHM (NSR); SINUS BRADYCARDIA; AND SINUS TACHYCARDIA

Back 28

NORMAL SINUS RHYTHM (NSR): 60-100 BPM

SINUS BRADYCARDIA: LESS THAN 60 BPM

SINUS TACHYCARDIA: MORE THAN 100 BPM
**USUALLY WILL NOT EXCEED 160 BPM

Front 29

KNOW WHAT CAUSES RATE CHANGES IN SINUS ARRHYTHEMIA

Back 29

THE RATE CHANGES WITH THE PATIENTS RESPIRATION.

PATIENT EXHALES: THE RATE SLOWS

PATIENT INHALES: THE RATE INCREASES

Front 30

KNOW THE FUNCTION OF THE CARDIOVASCULAR SYSTEM

Back 30

TO KEEP BLOOD CIRCULATING THROUGHT THE BODY; TO CARRY OXYGEN FROM THE LUNGS TO THE TISSUES; AND TAKING CARBON DIOXIDE FROM THE TISSUES TO THE LUNGS IN A CONTINUOUS GAS EXCHANGE

Front 31

KNOW THE TWO SYSTEMS OF THE HEART THAT KEEP THE BLOOD CIRUCLATING

Back 31

MECHANICAL SYSTEM: PUMPS THE BLOOD

ELECTRICAL SYSTEM: TELLS THE MECHANICAL SYSTEM HOW AND WHEN TO PUMP THE BLOOD

Front 32

KNOW THE LAYERS OF THE HEART MUSCLE

Back 32

1. ENDOCARDIUM: HOUSES ELECTRICAL SYSTEM

2. MYOCARDIUM: LAYERS OF CARDIAC MUSCLE TISSUE

3. EPICARDIUM: NERVES AND CORONARY VESSELS

Front 33

KNOW HOW THE HEART PUMPS BLOOD TO THE BODY

Back 33

1. THE SUPERIOR & INFERIOR VENA CAVA BRINGS DEOXYGENATED BLOOD FROM THE BODY INTO THE RIGHT ATRIUM

2. BLOOD PASSES THROUGH THE TRICUSPID VALVE INTO THE RIGHT VENTRICLE WHERE IT IS PUMPED TO THE PULMONARY ARTERY AND CARRIED TO THE LUNGS

3. OXYGENATED BLOOD IS CARRIED BACK TO THE HEART VIA THE PULMONARY VEINS INTO THE LEFT ATRIUM

4. IT IS THEN PUMPED THROUGH THE MITRAL VALVE INTO THE LEFT VENTRICLE, IT IS THEN PUMPED TO THE AORTA AND OUT OF THE HEART TO THE BODY

Front 34

KNOW WHAT KEEPS BLOOD FLOWING THROUGH THE HEART IN ONE DIRECTION

Back 34

HEART VALVES PREVENT THE BACKFLOW OF BLOOD

Front 35

KNOW WHAT CAUSES A HEART MURMUR

Back 35

DAMAGED / BROKEN VALVE

Front 36

KNOW WHAT CAUSES THE HEART SOUNDS HEARD WITH A STETHOSCOPE AS THE BLOOD FLOWS THROUGH THE HEART

Back 36

THE CLOSING OF HEART VALVES

Front 37

KNOW HOW THE HEART MUSCLE RECEIVES ITS BLOOD SUPPLY

Back 37

THE CORONARY ARTERIES

Front 38

DEFINE ESCAPE

Back 38

THE MECHANISM THAT ALLOWS A LOWER PACEMAKER SITE TO ASSUME PACEMAKER RESPONSIBILITIES WHEN A HIGHER SITE FAILS

Front 39

DEFINE IRRITABILITY

Back 39

OCCURS WHEN A SITE BELOW THE SA NODE SPEEDS UP AND TAKES OVER THE PACEMAKING ROLE

Front 40

KNOW WHAT HAPPENS IF AN ELECTRICAL IMPULSE DISCHARGES BEFORE THE VENTRICLES HAVE TIME TO FILL WITH BLOOD

Back 40

THIS MEANS THE VENTRICLES PUMP LESS BLOOD, OXYGEN, AND NUTRIENTS TO THE BODY WHEN THEY CONTRACT.

Front 41

KNOW WHAT HAPPENS IF THE VAGUS NERVE IS STIMULATED

Back 41

THE HEART RATE DECREASES / SLOWS DOWN

Front 42

KNOW THE TERM ECTOPIC BEAT AND WHAT IT REPRESENTS

Back 42

ECTOPIC: A SINGLE BEAT THAT ARISES FROM A FOCUS OUTSIDE OF THE SA NODE

WHEN ECTOPIC FOCUS STARTS AN IMPULSE AS AN "ESCAPE MECHANISM": THE BEAT WILL BE DELAYED

WHEN ECTOPIC FOCUS STARTS AN IMPULSE AS AN "IRRITABLE MECHANISM": IT OVER RIDES THE SA NODE & AND COMES EARLIER THAN EXPECTED

Front 43

DEFINE TACHYCARDIA AND BRADYCARDIA

Back 43

TACHYCARDIA: HEART RATE GREATER THAN 100 BPM

BRADYCARDIA: HEART RATE SLOWER THAN 60 BPM

Front 44

DEFINE UNIFOCAL AND MULTIFOCAL

Back 44

UNIFOCAL: REFERS TO ECTOPIC BEATS THAT ORIGINATE FROM A SINGLE IRRITABLE FOCUS; ALSO CALLED "UNIFORMED" ** CAN BE SEEN AS A RUN OF SEVERAL IDENTICAL PVC IN A ROW ON STRIP

MULTIFOCAL: TERM USED TO DESCRIBE ECTOPIC BEATS THAT ORIGINATE FROM MORE THAN ONE IRRITABLE FOCUS; ALSO CALLED "MULTIFORMED"

Front 45

KNOW THE DIFFERENCE BETWEEN MECHANICAL CELLS AND ELECTRICAL CELLS

Back 45

ELECTRICAL CELLS: ARE "CONDUCTIVE" CELLS WHICH INITIATE ELECTRICAL ACTIVITY AND CONDUCT IT THROUGH THE HEART

MECHANICAL CELLS: ARE "CONTRACTING" CELLS WHICH RESPOND TO THE ELECTRICAL STIMULUS AND CONTRACT TO PUMP BLOOD

Front 46

KNOW THE TERM CARDIAC OUTPUT AND WHAT IT MEANS

Back 46

CARDIAC OUTPUT: IS DEFINED AS THE TOTAL VOLUME OF BLOOD PUMPED BY THE HEART IN ONE MINUTE

Front 47

KNOW THE SYMPTOMS OF IMPAIRED CARDIAC OUTPUT

Back 47

ANXIETY; CHEST PAIN; SHORTNESS OF BREATH; DIAPHORESIS; HYPOTENSION; COOL CLAMMY SKIN; CYANOSIS; DECREASED CONSCIOUSNESS

THESE SYMPTOMS ARE INDICATIONS THAT CARDIAC OUTPUT IS INADEQUATE TO PERFUSE BODY TISSUE, ITS IMPAIRED & THE ARRHYTHMIA SHOULD BE TREATED

Front 48

KNOW WHAT A DEMAND PACEMAKER DOES

Back 48

PACEMAKER THAT SENSES PATIENTS INTRINSIC COMPLEXES AND FIRES ONLY WHEN NEEDED

Front 49

KNOW THE FEATURES OF ASYSTOLE

Back 49

IT IS A PERIOD OF ABSENT ELECTRICAL ACTIVITY, SEEN ON THE EKG AS A "STRAIGHT" LINE.

ASYSTOLE IS A LETHAL ARRHYTHMIA THAT IS VERY RESISTANT TO RESUSCITATION EFFORTS

Front 50

KNOW WHAT THE "R ON T" PHENOMENON MAY INDICATE

Back 50

WHEN AN EPTOPIC BEAT FALLS DURING THE "REFRACTORY PERIOD"

***DURING VENTRICULAR REPOLARIZATION ON THE
T WAVE

Front 51

KNOW THE VARIOUS PARTS OF A CARDIAC CYCLE AND HOW IT IS REPRESENTED ON THE EKG GRAPH

Back 51

1. P WAVE: ATRIAL DEPOLARIZATION

2. PR SEGMENT: DELAY IN TH AV NODE

3. PRI: INCLUDES THE P WAVE, PR SEGMENT, AND ALL ATRIAL & NODAL ACTIVITY

4. QRS COMPLEX: VENTRICULAR DEPOLARIZATION
Q WAVE: 1ST NEGATIVE DEFLECTION AFTER P WAVE
R WAVE: 1ST POSITIVE DEFLECTION AFTER P WAVE
S WAVE: 2ND NEGATIVE DEFLECTION AFTER P WAVE

5. ST SEGMENT: WHERE THE S WAVE STOPS & THE T WAVE BEGINS

6. T WAVE: VENTRICULAR REPOLARIZATION

Front 52

KNOW THE VARIOUS WAYS TO MEASURE HEART RATE

Back 52

1. COUNT THE # OF SMALL SQUARES BETWEEN 2 R WAVES AND DIVIDE IT INTO 1500

2. COUNT THE # OF LARGE SQUARES BETWEEN 2 R WAVES AND DIVIDE IT INTO 300

3. COUNT THE # OF r WAVES THAT OCCUR IN A 6 SECONDS AND MULTIPLY THAT NUMBER BY 10

Front 53

KNOW WHERE ATRIAL RHYTHMS ORIGINATE AND HOW TO IDENTIFY THE VARIOUS ATRIAL ARRTHYMIAS

Back 53

ATRIAL RHYTHMS ORIGINATE IN THE SA NODE
(SINUS ATRIAL NODE)

TYPES OF ATRIAL RHYTHMS:
1. WANDERING PACEMAKER
2. PREMATURE ATRIAL COMPLEX (PAC)
3. ATRIAL TACHYCARDIA
4. ATRIAL FLUTTER
5. ATRIAL FIBRILLATION

Front 54

RULES FOR IDENTIFYING "WANDERING PACEMAKER"

Back 54

REGULARITY: SLIGHTLY IRREGULAR

RATE: USUALLY NORMAL, 60-100 BPM

P WAVE: MORPHOLOGY CHANGES FROM ONE COMPLEX TO THE NEXT (EX. FLAT, NOTCHED...)

PRI: LESS THAN 0.20 SECOND; MAY VARY

QRS: LESS THAN 0.12

Front 55

RULES FOR IDENTIFYING " PREMATURE ATRIAL COMPLEX (PAC)"

Back 55

REGULARITY: DEPENDS ON THE UNDERLYING RHYTHM; CAN BE INTERRUPTED BY PAC

RATE: DEPENDS ON THE UNDERLYING RHYTHM

P WAVE: P WAVE OF EARLY BEAT DIFFERS FROM THE SINUS P WAVES; CAN BE FLAT, NOTCHED, OR LOST IN T WAVE

PRI: 0.12-0.20 SECOND; CAN EXCEED 0.20 SECOND

QRS: LESS THAN 0.12 SECOND

Front 56

RULES FOR IDENTIFYING "ATRIAL TACHYCARDIA"

Back 56

REGULARITY: REGULAR

RATE: 150-250 BPM

P WAVE: ATRIAL P WAVE; DIFFERS FROM SINUS P WAVE, CAN BE LOST IN T WAVE

PRI: 0.12-0.20 SECOND

QRS: LESS THAN 0.12 SECOND

Front 57

RULES FOR IDENTIFYING "ATRIAL FLUTTER"

Back 57

REGULARITY: ATRIAL RHYTHM IS REGULAR; VENTRICULAR RHYTHM IS USUALLY REGULAR BUT CAN BE IRREGULAR IF THERE IS A VARIABLE BLOCK

RATE: ATRIAL RATE 250-350 BPM; VENTRICULAR RATE VARIES

P WAVE: CHARACTERISTIC "SAWTOOTH" PATTERN

PRI: UNABLE TO DETERMINE

QRS: LESS THAN O.12 SECOND

Front 58

RULES FOR IDENTIFYING "ATRIAL FIBRILLATION"

Back 58

REGULARITY: GROSSLY IRREGULAR

RATE: ATRIAL RATE GREATER THAN 350 BPM; VENTRICULAR RATE VARIES GREATLY

P WAVE: NO DISCERNIBLE P WAVES; ATRIAL ACTIVITY IS REFERRED TO AS FIBRILLATORY WAVES (F WAVES)

PRI: UNABLE TO MEASURE

QRS: LESS THAN 0.12 SECOND

Front 59

KNOW THE CHARACTERISTICS OF "V-TACH" AND THEIR RULES

Back 59

REGULARITY: USUALLY REGUALR; CAN BE SLIGHTLY IRREGULAR

RATE: 150-250 BPM; CAN EXCEED 250 BPM IF THE RHYTHM PROGRESS TO VENTRICULAR FLUTTER; MAY OCCASIONALLY BE SLOWER THAN 150 BPM, IN WHICH CASE IT IS CALLED "SLOW VT"

P WAVE: WILL NOT BE PRECEDED BY P WAVES; DISSOCIATED P WAVES MAY BE SEEN

PRI: THERE WILL BE NO PRI SINCE THE FOCUS IS IN THE VENTRICLES

QRS: WIDE AND BIZZARE; 0.12 SECOND OR GREATER; T WAVE IS USUALLY IN OPPOSITE DIRECTION FROM R WAVE

Front 60

KNOW THE CHARACTERISTICS OF "V-FIB" AND THEIR RULES

Back 60

FOR ALL OF THE RULES: THIS WILL APPEAR CHAOTIC WITH NO DISCERNIBLE WAVES OR COMPLEXES

REGULARITY:
RATE:
P WAVE:
PRI:
QRS:

Front 61

KNOW WHAT CAUSES THE P WAVE IN JUNCTIONAL ARRTHYMIAS TO BE INVERTED

Back 61

IN JUNCTIONAL ARRHYTHMIAS THE ATRIA ARE DEPOLARIZED AT THE SAME TIME THE VENTRICLES ARE. THE "RETROGRADE DEPOLARIZATION" IN THE ATRIA & THE "NORMAL DEPOLARIZATION" IN THE VENTRICLES RESULT IN AN "INVERTED P WAVE" AND A "UPRIGHT QRS COMPLEX"

Front 62

KNOW THE RATES OF THE VARIOUS JUNCTIONAL RHYTHMS

Back 62

1. PREMATURE JUNCTIONAL COMPLEX: DEPENDS ON THE UNDERLYING RHYTHM

2. JUNCTIONAL ESCAPE RHYTHM: 40-60 BPM

3. ACCELERATED JUNCTIONAL RHYTHM: 60-100 BPM

4. JUNCTIONAL TACHYCARDIA: 100-180 BPM

Front 63

KNOW THE THREE PREMATURE CONTRACTIONS AND HOW TO IDENTIFY THEM

Back 63

1. PREMATURE ATRIAL COMPLEX (PAC):
THE P WAVE OF THE EARLY BEAT DIFFERS FROM THE SINUS P WAVES; CAN BE FLATTENED, NOTCHED; OR LOST IN T WAVE. PRI IS 0.12-0.20 SECS OR GREATER. QRS IS LESS THAN 0.12 SEC,

2. PREMATURE VENTRICULAR COMPLEX (PVC):
THE ECTOPIC IS NOT PRECEDED BY A P WAVE. YOU MAY SEE A COINCIDENTAL P WAVE, BUT ITS DISSOCIATED. QRS WILL BE WIDE AND BIZZARE AND MEASURING AT LEAST 0.12 SEC, THE T WAVE TENDS TO APPEAR IN THE OPPOSITE DIRECTION FROM THE QRS COMPLEX

3. PREMATURE JUNCTIONAL COMPLEX (PJC):
THE P WAVE WILL BE INVERTED & CAN FALL BEFORE, DURING, OR AFTER THE QRS COMPLEX. ALSO THE QRS COMPLEX WILL BE LESS THAN 0.12 SECOND

Front 64

KNOW THE TYPES OF HEART BLOCKS

Back 64

1. FIRST DEGREE HEART BLOCK

2. 2ND DEGREE HEART BLOCK TYPE 1 (WERNECKHE)

3. 2ND DEGREE HEART BLOCK TYPE 2

4. THIRD DEGREE HEART BLOCK
(CHB: COMPLETE HEART BLOCK)

Front 65

KNOW THE RULE FOR A FIRST DEGREE HEART BLOCK

( NOT A TRUE BLOCK, ACTUALLY A "DELAY" )

Back 65

ITS A DELAY IN THE AV NODE WHICH SLOWS DOWN CONDUCTION WHICH CHANGES THE PRI; PR SEGMENTS GETS LONGER BETWEEN COMPLEXES

REGULARITY: DEPENDS ON UNDERLYING RHYTHM

RATE: DEPENDS ON UNDERLYING RHYTHM

P WAVE: UPRIGHT, UNIFORM; EACH P WAVE WILL BE FOLLOWED BY A QRS COMPLEX

PRI: GREATER THAN 0.20 SECOND; CONSTANT ACROSS THE STRIP

QRS: LESS THAN 0.12 SECOND

Front 66

KNOW THE RULE FOR A SECOND DEGREE TYPE 1 HEART BLOCK (WERNECKHE)

(GOING, GOING, GONE.....)

Back 66

WERNECKE: GOING, GOING, GONE THIS CAUSES AN EVENTUAL P WAVE WITHOUT A QRS COMPLEX

REGULARITY: IRREGULAR IN A PATTERN OF GROUPED BEATING

RATE: USUALLY SLIGHTLY SLOWER THAN NORMAL

P WAVE: UPRIGHT AND UNIFORM; SOME P WAVES ARE NOT FOLLOWED BY QRS COMPLEXES

PRI: PROGRESSIVELY LENGTHENS UNTIL ONE P WAVE IS BLOCKED

QRS: LESS THAN 0.12 SECOND

Front 67

KNOW THE RULE FOR A SECOND DEGREE TYPE 2 HEART BLOCK

Back 67

HERE THE P WAVES AND QRS COMPLEXES REACT THE SAME AS IN 2ND DEGREE TYPE 1, MEANING YOU WILL EVENTUALLY SEE A P WAVE W/OUT A QRS. ALSO OCCURS WHEN ELECTRICITY STARTS IN THE SA NODE TO THE AV NODE, BUT ONLY SOME ELECTRICITY REACHES THE VENTRICLES

REGULARITY: R-R INTERVAL CAN BE REGULAR OR IRREGULAR; P-P INTERVAL IS REGUALR

RATE: USUALLY IN THE BRADYCARDIA RANGE ( > 60 BPM ); CAN BE 1/2 TO 1/3 THE NORMAL RATE

P WAVE: UPRIGHT AND UNIFORM, MORE THAN ON P WAVE FOR EVERY QRS COMPLEX

PRI: ALWAYS CONSTANT ACROSS THE STRIP; CAN BE GREATER THAN 0.20 SECOND

QRS: LESS THAN 0.12 SECOND

Front 68

KNOW THE RULE FOR A THIRD DEGREE HEART BLOCK, ALSO KNOWN AS A COMPLETE HEART BLOCK (CHB)

Back 68

COMPLETE HEART BLOCK; ELECTRICAL DISASSOCIATION BETWEEN THE ATRIA & VENTRICLES; ** NO STIMULUS FROM ATRIALS, SO VENTRICLES PACE THEMSELVES. THE RATE OF THE SA NODE WILL STILL BE NORMAL AS IT ORIGINATES AT THE TOP OF THE HEART.

REGULARITY: REGULAR

RATE: ATRIAL RATE: USUALLY NORMAL 60-100 BPM
VENTRICULAR RATE: 40-60 BPM IF JUNCTIONAL
VENTRICULAR RATE: 20-40 BPM IF VENTRICULAR

P WAVE: UPRIGHT AND UNIFORM; MORE P WAVES THAN QRS COMPLEXES

PRI: NO RELATIONSHIP BETWEEN P WAVES & QRS COMPLEXES; P WAVES ARE OCCASIONALLY FOUND IN/ON QRS COMPLEX

QRS: LESS THAN 0.12 SECOND IF FOCUS IS JUNCTIONAL; 0.12 SECOND OR GREATER IF FOCUS IS VENTRICULAR

Front 69

KNOW THE VARIOUS PATTERNS THAT A PVC CAN PRODUCE

(PVC: PREMATURE VENTRICULAR CONTRACTION)

Back 69

1. COUPLET 2. RUN 3. UNI & MULTI FOCAL
4. R ON T PHENOMENON 5. BIGEMINY
6. TRIGEMINY 7. QUADRIGEMINY

Front 70

KNOW THE BASIC RULE FOR QRS COMPLEX IN VENTRICULAR ARRHYTHMIAS

Back 70

ALL QRS COMPLEXES ORIGINATED IN THE VENTRICLES WILL BE 0.12 SECONDS OR GREATER

Front 71

KNOW WHICH ARRHYTHMIA INCREASE THE RISK OF PULMONARY AND CEREBRAL EMBOLI

Back 71

ATRIAL FIBRILLATION ( A-FIB )

Front 72

KNOW WHAT CAN BE DETERMINED WITH A 12-LEAD EKG

Back 72

CARDIAC RHYTHM, MYOCARDIAL DAMAGE (HEART ATTACK); CHAMBER ENLARGEMENT; HYPERTROPHY; MEAN QRS AXIS; BUNDLE BRANCH BLOCK; MISCELLANEOUS EFFECTS ( DRUGS, ELECTROLYTES, PERICARDITIS...)

Front 73

KNOW THE TERM ARTIFACT AND WHAT IT MIGHT LOOK LIKE ON AN EKG

Back 73

ARTIFACT: EXTERNAL FACTORS THAT CAN INTERFERE WITH THE EKG TRACING YOUR TRYING TO ANALYZE; EXAMPLES: MUSCLE TREMORS, SHIVERS, PATIENT MOVEMENT, LOOSE ELECTRODES, THE EFFECT OF OTHER ELECTRICAL EQUIPMENT IN THE ROOM-THIS IS CALLED 60 CYCLE INTERFERENCE

ON EKG MAY LOOK LIKE ELECTRICAL INTERFERENCE

Front 74

WHEN INTERPRETING A "WANDERING PACEMAKER"

Back 74

NOTICE THAT THE P WAVE MORPHOLOGY CHANGES FROM 1 COMPLEX TO THE NEXT

Front 75

WHEN INTERPRETING A "PAC"

(PREMATURE ATRIAL CONTRACTION / COMPLEX)

Back 75

THE P WAVES DIFFER FROM THE SINUS P WAVES AND CAN APPEAR FLATTENED, NOTCHED, OR LOST IN THE T WAVE

Front 76

WHEN INTERPRETING "ATRIAL TACHYCARDIA"

Back 76

THE RATE WILL FALL BETWEEN 150-250 BPM; AND THE P WAVE MAY LOOK FLATTENED, NOTCHED, OR LOST IN THE T WAVE

( IN A-TACH THE P WAVES MAY LOOK SIMILAR TO THOSE IN A PAC; BUT A-TACH HAS A HIGHER RATE)

Front 77

DURING "ESCAPE"

Back 77

VENTRICLES TAKE OVER FOR SA NODE

Front 78

REPOLARIZATION IS ALSO KNOWN AS

Back 78

"RECOVERY STATE"

Front 79

A SINGLE IRRITABLE BEAT THAT ORIGINATES IN THE VENTRICLES

Back 79

PVC: PREMATURE VENTRICULAR CONTRACTION

Front 80

ARE PVC's PRECEDED BY P WAVES

Back 80

NO BECAUSE PVC's ORIGINATE IN THE VENTRICLES

Front 81

PERJUNKIE FIBERS TRANSMIT ELECTRICAL FLOW TO

Back 81

THE MYOCARDIAL CELLS

Front 82

WHAT OCCURS WHEN ELECTRICAL FLOW STARTS IN THE SA NODE TO THE AV NODE AND ONLY SOME OF THE ELECTRICAL FLOW TRAVELS TO THE VENTRICLES

Back 82

IT INDICATES A SECOND DEGREE TYPE 2 HEART BLOCK

Front 83

PVC CAN BE LETHAL IF

Back 83

ITS ON A RUN, WHICH RESULTS IN V-TACH

Front 84

AN IRRITABLE FOCUS IN THE VENTRICLES TAKES OVER THE PACING OF THE HEART WITH A RATE OF 150-250 BPM

Back 84

THIS INDICATES V-TACH

Front 85

WHATS ANOTHER NAME FOR HIGH BLOOD PRESSURE

Back 85

HYPERTENSION

Front 86

IN JUNCTIONAL RHYTHMS P WAVES IF VISIBLE

Back 86

ARE ALWAYS GOING TO APPEAR INVERTED

Front 87

WHAT IS THE PACEMAKER OF THE HEART DURING ACCELERATED JUNCTIONAL RHYTHM

Back 87

THE AV NODE

Front 88

ECTOPIC BEATS CAUSE

Back 88

IRRITABILITY

Front 89

DURING "WANDERING PACEMAKER" WHY DOES THE P WAVE MORPHOLOGY CHANGE

Back 89

THE PACEMAKER HITS DIFFERENT PLACES IN THE ATRIA

Front 90

THERE ARE ONLY 4 WAVES WHERE YOU WILL HAVE MORE P WAVES THAN QRS COMPLEXES, THEY ARE

Back 90

1. ATRIAL FLUTTER (SAWTOOTH PATTERN)

2. 2ND DEGREE HEART BLOCK TYPE 1 (WERNECKE)

3. 2ND DEGREE HEART BLOCK TYPE 2

4. THIRD DEGREE HEART BLOCK (CHB)

Front 91

AN EXAMPLE OF BIGEMENY

Back 91

WHEN EVERY OTHER BEAT IS A PVC

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UNIFOCAL

Back 92

WHEN YOU HAVE PVC THAT LOOK IDENTICAL TO EACH OTHER, REGARDLESS OF HOW MANY THERE ARE

Front 93

WHAT DOES A PACER SPIKE LOOK LIKE

Back 93

A STRAIGHT LINE

Front 94

WHEN AN EKG TRACING APPEARS TO BE IN COMPLETE CHAOS, IT IS AN EXAMPLE OF WHAT

Back 94

V-FIB