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56 Cards in this Set
- Front
- Back
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Define Electrocardiogram
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the tracing made by an electrocardiograph; also: the procedure for producing an electrocardiogram
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Define Contractility
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the capability or quality of shrinking or contracting; especially: the power of muscle fibers of shortening into a more compact form
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Define SA Node
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a small mass of tissue that is made up of Purkinje fibers, ganglion cells, and nerve fibers, that is embedded in the musculature of the right atrium of higher vertebrates, and that originates the impulses stimulating the heartbeat
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Define AV Node
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small mass of tissue situated in wall of R atrium adjacent to septum between atria. passes impulses received from SA node to ventricles via bundle of His, and in some pathological states replaces the SA node as pacemaker of heart
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Define Refractory period
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the brief period immediately following the response especially of a muscle or nerve before it recovers the capacity to make a second response
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Define Repolarization
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restoration of the difference in charge between the inside and outside of the plasma membrane of a muscle fiber or cell following depolarization
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Define Depolarization
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loss of polarization; especially : loss of the difference in charge between the inside and outside of the plasma membrane of a muscle or nerve cell due to a change in permeability and migration of sodium ions to the interior
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What does Lead I see?
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RA (-) to LA (+) (Right Left, or lateral)
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What does Lead II see?
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RA (-) to LF (+) (Superior Inferior)
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What does Lead III see?
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LA (-) to LF (+) (Superior Inferior)
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What does Lead aVR see?
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RA (+) to [LA & LF] (-) (Leftward)
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What does Lead aVF see?
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LF (+) to [RA & LA] (-) (Inferior)
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What does Lead aVL see?
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LA (+) to [RA & LF] (-) (Rightward)
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What do Leads V1, V2, V3 see?
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(Posterior Anterior)
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What do Leads V4, V5, V6 see?
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(Right Left, or lateral
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Define the part of the EKG tracing paper in terms of:
Voltage |
each small square running vertically represents 1 mm or 0.1 mV. The larger boxes are made up of five small squares and represent 5 mm or 0.5 mV
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Define the part of the EKG tracing paper in terms of: Time
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each small square running horizontally represents 0.04 seconds. Five of these small squares make up a larger box and represent 0.20 seconds. Five larger boxes = 1 second, 15 = 3 seconds
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Be able to identify: Isoelectric line
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a flat line indicating no electrical activity or activity too weak to be detected
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Be able to identify: P wave
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an upright, round waveform representing the initiation of the impulse in the SA node and its movement thru the atria (also conceptually represents contraction of the atria)
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Be able to identify: PR segment
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the isoelectric line following the P wave which represents the impulse traveling through the His-Purkinje system.
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Be able to identify: PR interval
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the distance from the beginning of the P wave to the beginning of the Q wave—represents depolarization of the heart from the SA node through the atria, AV node and His-Purkinje system. .12-.20 in duration.
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Be able to identify: QRS complex
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Consists of 3 parts: Q wave, R wave and S wave. Generally narrow & sharply pointed. Q wave is 1st downward deflection from baseline. R wave is 1st upward deflection after P wave; S wave is 1st negative deflection after R wave that extends below the baseline. Normally .06-.12 sec from beginning of Q to end of S or beginning of R. Represents movement of the electrical impulse thru ventricles and contraction
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Be able to identify: ST segment
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the pause following the QRS complex—ventricles are preparing to repolarize.
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Be able to identify: Junction or J point
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Where QRS meets ST is called the junction or J point.
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Be able to identify: The T wave
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follows the ST segment—represents ventricular Repolarization.
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Be able to identify: QT interval:
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The distance from the onset of QRS complex until end of T wave—represents ventricular depolarization & Repolarization. Varies according to age, sex & HR. Normally .36-.44 sec.
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Be able to identify: Artifact
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Markings on EKG that have no relationship to electrical activity of the heart; can be caused by pt movement, shivering, loose or improperly placed leads, worn out wires, malfunctioning machine or interference from improperly grounded equipment
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Compare and contrast limb lead and precordial lead locations and waveform patterns
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Limb leads (I, II, III, aVr, aVl and aVf) represent vertical cut thru middle of heart & view inferior, superior & lateral aspects of the heart. The precordial (chest) leads (V1, V2, V3, V4, V5, V6) represent horizontal plane/transverse cut thru middle of heart & provide anterior, lateral & posterior views
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Review and be able to utilize the Five-Step Process of EKG tracing analysis
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1. Determine the rate
2. Determine the regularity 3. Assess the P waves (uniform P wave preceding each QRS?) d4. Assess the QRS (do they appear normal?) 5. Assess the PR intervals ( are they identifiable? Within normal limits? Constant in duration?) |
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EKG I
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EKG I
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Determine regularity by using the R-R intervals and P-P intervals
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atrial regularity is determined by checking the distances between the upper or lower most points of the P waves to see if they are the same. Checking for differences between the R waves determines ventricular regularity
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When the nerve impulses are in a polarized state the heart is at a
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normal resting state
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When the nerve impulses are depolarizing, the heart is _______
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contracting
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What is a normal rate for the SA node
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60-100
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What is a normal rate for the AV node
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40-60
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What is a normal rate for the Purkinje fibers
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20-40
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What areas of the heart are refered to as the supraventricular areas
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SA, AV, Bundle of HIS
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What areas of the heart are refered to as the ventricular areas
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Bundle branches and purkinje fibers
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How are rhythms named
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named for the node generating the rhythm; sinus rhythm from SA node, A-fib from AV node, ventricular tachycardia from ventricles
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What does chronotropic refer to?
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affecting heart rate
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What does inotropic refer to?
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affecting contraction
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What does dromotropic refer to?
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affecting conduction
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What is a rapid influx of positively charged ions from outside to inside a cell called
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depolarization
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The impulse traveling thru the His_Purkinje system generates a _____ on the ECG
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flat line following the P wave
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The T wave represents?
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ventricular repolarization
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Cardiac output is equal to?
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stroke volume multiplied by the heart rate
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What is the reference point used to identify the changing electrical amplitude on the ECG called?
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isoelectric line
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Impulses that travel toward a positive electrode and away from a negative electrode are recorded as?
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upward, upright or positive defelction where impulses traveling toward a negative electrode and away from a positive electrode are recorded as downward deflections
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During the _______ initiation of the impulse in the SA node, its movement thru the atria and activation of the AV node occurs
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P wave
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The normal PR interval is how long in seconds
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0.12 to 0.20
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What lead is commonly used for continous ECG monitoring?
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Lead II
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What is the distance between 2 consecutive R waves called
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R-R interval
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The term used to describe sudden onset is
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paroxysmal
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Patterned irregularity is
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the irregularity repeating over and over in a cyclic fashion
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Which of the following produces a totally irregular rhythm? Paroxysmal atrial tachycardia, Wenckebach, A-fib, Atrial flutter with varying conduction ratio?
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A-fib
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When is a patterned irregular rhythm seen?
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premature complexes occur every other (second) complex, every 3rd complex or every 4th complex
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