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95 Cards in this Set
- Front
- Back
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NAME THE TWO TYPES OF CARDIAC CELLS AND TELL WHAT TYPE OF ACTIVITY EACH IS RESPONSIBLE FOR.
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ELECTRICAL: CONDUCTION; MECHANICAL; CONTRACTION.
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hOW DO THESE TWO TYPES OF CELLS WORK TOGETHER TO PRODUCE CARDIAC ACTIVITY
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ELECTRICAL CELLS STIMULATE MUSCLE CELLS TO CONTRACT
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WHAT PHYSICAL SIGNS ARE USED TO REFLECT THE MECHANICAL FUNCTION OF THE HEART
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PULSES; BLOOD PRESSURE, OTHER PERFUSION PARAMETERS
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HOW DO YOU ASSESS ELECTRICAL ACTIVITY IN THE HEART
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ANALYZE THE EKG
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ARRHYTHMIAS ARE MANIFESTATIONS OF WHICH TYPE OF CARDIAC ACTIVITY
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ELECTRICAL
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WHAT HAPPENS WHEN THE POSITIVE AND NEGATIVE ELECTRICAL CHARGES EXCHANGE PLACES ACROSS THE CELL MEMBRANE OF A CARDIAC CELL
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IT INITIATES THE FLOW OF ELECTRICAL CURRENT
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EXPLAIN THE POLARIZED STATE
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WHEN ELECTRICAL CHARGES ARE BALANCED AND IN A STATE OF READINESS FOR DISCHARGE
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EXPLAIN DEPOLARIZATION
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THE DISCHARGE OF ELECTRICAL ENERGY THAT ACCOMPANIES THE TRANSFER OF ELECTRICAL CHARGES ACROSS HE CELL MEMBRANE
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IS DEPOLARIZATION THE SAME AS CONTRACTION
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NO, DEPOLARIZATION IS AN ELECTRICAL PHENOMENON; CONTRACTION IS MECHANICAL AND IS EXPECTED TO FOLLOW DEPOLARIZATION
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WHAT IS REPOLARIZATION
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THE RETURN OF THE ELECTRICAL CHARGES TO THEIR ORIGINAL STATE OF READINESS
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LIST THE AREAS OF THE CONDUCTION SYSTEM IN THE ORDER IN WHICH THE IMPULSES TRAVEL THROUGH THE HEART
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SA NODE; INTRAATRIAL AND INTERNODAL PATHWAYS; AV NODE; BUNDLE OF HIS; BUNDLE OF BRANCHES;PURKINJE FIBERS
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WHICH SITE IS NORMALLY THE PACEMAKER OF THE HEART AND WHY
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THE SA NODE; IT HAS THE FASTEST INHERENT RATE
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GIVE THE INHERENT RATES FOR EACH OF THE FOLLOWING SITES; SINUS NODE, AV JUNCTION, VENTRICLES
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60-100 TIMES PER MINUTE; 40-60 TIMES PER MINUTE; 20-40 TIMES PER MINUTE
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WHAT PROCESS IS RESPONSIBLE FOR A SITE SPEEDING UP AND OVERRIDING A HIGHER SITE, THUS TAKING OVER AS A PACEMAKER
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IRRITABILITY
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WHAT MECHANISM IS IN PLAY IF A LOWER SITE TAKES OVER RESPONSIBILITY FOR THE PACE MAKING FUNCTION FOLLOWING FAILURE OF A HIGHER SITE
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ESCAPE
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WHICH NERVOUS SYSTEM HAS TWO BRANCHES THAT CONTROL THE ACTIVITIES OF THE HEART
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AUTONOMIC
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NAME THE TWO BRANCHES OF THE NERVOUS SYSTEM IDENTIFIED IN THE PRECEDING QUESTION
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SYMPATHETIC, PARASYMPATHETIC
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LIST THREE THINGS THAT WILL HAPPEN TO THE HEART IF THE SYMPATHETIC BRANCH IS STIMULATED
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INCREASED RATE, INCREASED AV CONDUCTION, INCREASED IRRITABILITY
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WHAT PAR OF THE HEART DOES THE SYMPATHETIC BRANCH INNERVATE
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THE ATRIA AND VENTRICLES
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WHAT PART OF THE HEART DOES THE PARASYMPATHETIC BRANCH INNERVATE
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ONLY THE ATRIA
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WHAT HAPPENS IF ONE BRANCH IS BLOCKED
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THE INFLUENCE OF THE OPPOSING BRANCH WILL CONTROL THE HEART
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WHAT IS AN ELECTRODE USED FOR
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TO PICK UP ELECTRICAL ACTIVITY FROM THE SKIN SURFACE
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LIST THREE WAYS TO IMPROVE CONTACT BETWEEN THE ELECTRODE AND THE SKIN
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ABRADE SKIN; CLEAN SKIN; USE CONTACT MEDIUM
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IF THE ELECTRICAL CURRENT FLOWS TOWARD THE POSITIVE ELECTRODE, WILL THE DEFLECTION ON THE GRAPH PAPER BE UPRIGHT OR DOWNWARD
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UPRIGHT
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WHY IS IT IMPORTANT TO STANDARDIZE ELECTRODE PLACEMENT
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TO AVOID CONFUSION WHEN INTERPRETING EKG PATTERNS
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WHAT IS A LEAD, AND HOW DOES IT DIFFER FROM AN ELECTRODE
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A LEAD IS A SINGLE VIEW OF THE HEART, OFTEN PRODUCED BY A COMBINATION OF INFORMATION FROM SEVERAL ELECTRODES
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HOW MANY LEADS DO YOU NEED TO KNOW TO INTERPRET ARRHYTHMAIS
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ONE; ONLY A MONITORING LEAD
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WHICH LEAD WILL BE DISCUSSED THROUGHOUT THIS BOOK
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LEAD II
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WHAT ARE THE ELECTRODE POSITIONS FOR THE LEAD IDENTIFIED IN THE PRECEDING QUESTION
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NEGATIVE ELECTRODE BELOW RIGHT CLAVICLE; POSITIVE ELECTRODE AT THE APEX; GROUND ELECTRODE BELOW THE RIGHT NIPPLE
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WHAT FEATURES ARE IMPORTANT FOR A GOOD MONITORING LEAD
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CLEAR VISUALIZATION OF THE BASIC WAVES
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IN LEAD II, WILL THE PRIMARY DEFLECTIONS BE UPRIGHT OR DOWNWARD ON THE EKG
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UPRIGHT, BECAUSE THE CURRENT IS FLOWING TOWARD THE POSITIVE ELECTRODE
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WHY IS IT IMPORTANT TO USE STANDARDIZED EKG GRAPH PAPER
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STANDARDIZED MARKINGS ENABLE YOU TO MEASURE THE EKG AND COMPARE IT TO NORMAL
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WHAT IS AN ISOELECTRIC LINE
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THE STRAIGHT LINE ON THE EKG MADE WHEN NO ELECTRICAL CURRENT IS FLOWING
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WHAT DO THE VERTICAL LINES ON THE GRAPH PAPER TELL YOU
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TIME
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WHAT DO THE HORIZONTAL LINES ON THE GRAPH PAPER TELL YOU
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VOLTAGE
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HOW MUCH TIME IS INVOLVED BETWEEN TWO HEAVY LINES ON THE GRAPH PAPER
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.20 SECONDS
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HOW MUCH TIME IS INVOLVED IN ONE SMALL SQUARE ON THE GRAPH PAPER
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.04 SECONDS
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WHICH CHAMBERS CONTRACT FIRST IN A SINGLE CARDIAC CYCLE
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THE ATRIA
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WHAT MUST OCCUR IN ORDER FOR THE HEART TO CONTRACT
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THE MUSCLE CELLS MUST RECEIVE AN ELECTRICAL STIMULUS
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WHAT CARDIAC ACTIVITY IS INCLUDED IN A SINGLE CARDIAC CYCLE ON THE EKG
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EVERYTHING FROM DEPOLARIZATION OF THE ATRIA UP TO AND INCLUDING REPOLARIZATION OF THE VENTRICLES
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HOW MANY HEART BEATS WOULD YOU EXPECT A SINGLE CARDIAC CYCLE TO PRODUCE
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ONE
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WHAT ARE THE FIVE WAVES FOUND IN A SINGLE CARDIAC CYCLE ON THE EKG
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P,Q,R,S, AND T
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DIFFERENTIATE BETWEEN WAVES, SEGMENTS, AND INTERVALS
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WAVES ARE DEFLECTIONS, SEGMENTS ARE STRAIGHT LINES, AND INTERVALS INCLUDE BOTH WAVES AND SEGMENTS
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WHAT DOES THE P WAVE REPRESENT, AND HOW IS IT FOUND ON THE EKG
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ATRIAL DEPOLARIZATION; IT IS MEASURED FROM THE FIRST DEFLECTION ON THE CARDIAC CYCLE UNTIL THE DEFLECTION RETURNS TO THE ISOELECTRIC LINE
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WHAT DOES THE PR SEGMENT REPRESENT
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DELAY IN THE AV NODE
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WHAT IS THE PR INTERVAL,HOW IS IT MEASURED, AND WHAT IS ITS NORMAL DURATION
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THE PRI INCLUDES THE P WAVE AND THE PR SEGMENT; IT IS MEASURED FROM THE BEGINNING OF THE P WAVE TO THE VERY BEGINNING OF THE QRS COMPLEX; IS IS NORMALLY .12-.20 SECONDS
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WHAT DOES THE QRS REPRESENT, HOW IS IT MEASURED, AND WHAT IS ITS NORMAL DURATION
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VENTRICULAR DEPOLARIZATION; MEASURE FROM THE BEGINNING OF THE Q WAVE TO THE END OF THE S WAVE; NORMALLY LESS THAN .12 SECONDS
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WHAT DOES THE T WAVE REPRESENT
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VENTRICULAR DREPOLARIZATION
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LIST FOUR EXTERNAL FACTORS CAPABLE OF PRODUCING ARTIFACT ON THE EKG TRACING
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MUSCLE TREMORS,, SHIVERING; PATIENT MOVEMENT, LOOSE ELECTRODES; 60 CYCLE ELECTRICAL CURRENT
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WHAT IS MEANT BY ELECTRICAL REFRACTORINESS
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THE CELLS ARE NOT YET REPOLARIZED AND THUS CANNOT ACCEPT AND RESPOND TO ANOTHER STIMULUS
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DIFFERENTIATE BETWEEN ABSOLUTE REFRACTORY PERIOD AND REALTIVE REFRACTORY PERIOD
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ABSOLUTE REFRACTORY PERIOD MEANS THAT THE HEART CANNOT ACCEPT ANY STIMULUS AT ALL; RELATIVE REFRACTORY PERIOD MEANS THAT SOME OF THE CELLS ARE CAPABLE OF RESPONDING TO A STRONG STIMULUS
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WHAT IS SO IMPORTANT ABOUT THE RELATIVE REFRACTORY PERIOD
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IF AN IMPULSE HITS ON THE RELATIVE REFRACTORY PERIOD, THE HEART CAN BE DISCHARGED IN AN ABNORMAL WAY
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WHAT PART OF THE EKG COMPLEX SIGNIFIES THE RELATIVE REFRACTORY PERIOD
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THE DOWNSLOPE OF THE T WAVE
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WHAT IS A CARDIAC CYCLE ON THE EKG
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THE ELECTRICAL IMPULSES ASSOCIATED WITH A SINGLE HEART BEAT; THE P,Q,R,S AND T WAVES
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WHAT IS THE NAME OF THE NORMAL CARDIAC RHYTHM ASSOCIATED WITH A HEALTHY HEART
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NORMAL SINUS RHYTHM
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WHY IS IT NECESSARY TO HAVE AN ORGANIZED FORMAT FOR APPROACHING ARRHYTHMIA INTERPRETATION
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THERE ARE SO MANY POSSIBLE CONFIGURATIONS OF EKGS THAT YOU WOULD NEVER BE ABLE TO MEMORIZE ALL OF THEM. YOU MUST BE ABLE TO SYSTEMATICALLY GATHER ALL OF THE AVAILABLE INFORMATION AND THEN COMPARE IT TO THE RULES FOR THE RHYTHMS. WITHOUT A ROUTINE FOR MAT YOU COULD OVERLOOK IMPORTANT CLUES
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WHY DO YOU HAVE TO MEMORIZE THE RULES FOR EACH OF THE ARRHYTHMIAS
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SO THAT YOU CAN COMPARE THEM TO THE FINDINGS ON AN EKG STRIP, AND THUS DETERMINE THE IDENTITY OF THE ARRHYTHMIA
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WHAT ARE THE FIVE PARTS OF THE ANALYSIS FORMAT THAT YOU LEARNED IN THIS CHAPTER
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REGULARITY(RHYTHM) RATE, P WAVE, PR INTERVAL, QRS COMPELX
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HOW CAN YOU TELL WHETHER OR NOT AN ARRHYTHMIA IS REGULAR
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MEASURE THE R-R INTERVAL OR THE P-P INTERVAL
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WHAT DOES THE PHRASE "REGULARLY IRREGULAR" MEAN
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THERE IS A PATTERN TO THE IRREGULARITY
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WHAT DOES THE PHRASE 'BASICALLY REGULAR' MEAN
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THE UNDERLYING RHYTHM IS REGULAR BUT IT IS INTERRUPTED BY ECTOPICS
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WHAT DOES IT MEAN WHEN YOU CALL AN ARRHYTHMIA "TOTALLY IRREGULAR"
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THERE IS NO PATTERN TO THE IRREGULARITY
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IF YOU WANTED TO CALCULATE ACCURATELY THE RATE OF A REGULAR RHYTHM, YOU COULD COUNT THE NUMBER OF SMALL SQUARES BETWEEN TWO R WAVES AND DIVIDE IT INTO WHAT NUMBER
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1500
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IF YOU COUNTED THE NUMBER OF LARGE SQUARES BETWEEN TWO R WAVES, WHAT NUMBER WOULD YOU DIVIDE THAT TOTAL INTO TO DETERMINE THE HEART RATE
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300
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WHEN AN ARRHYTHMIA IS IRREGULAR, YOU SHOULD DETERMINE THE HEART RATE BY COUNTING THE NUMBER OF R WAVES IN 8 SEC AND MULTIPLYING THAT TOTAL BY WHAT NUMBER
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10
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WHAT IS THE FIRST WAVE YOU SHOULD TRY TO LOCATE AND MAP OUT WHEN ANALYZING A RHYTHM STRIP
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THE P WAVE
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WHAT DOES A NORMAL SINUS P WAE LOOK LIKE
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IT HAS A SMOOTH ROUNDED SHAPE; IT IS UPRIGHT AND UNIFORM
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WHERE CAN OU NORMALLY FIND THE P WAVE
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IT IS USUALLY LOCATED IMMEDIATELY IN FRONT OF THE QRS COMPLEX
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ARE P-P INTERVALS USUALLY REGULAR OR IRREGULAR
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THEY ARE USUALLY VERY REGULAR
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WHAT IS MEANT WHEN A P WAVE IS SAID TO BE "LOST" IN THE T WAVE
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IT MEANS THAT THE P WAVE OCCURRED ON OR NEAR THE T WAVE AND IS THUS OBSCURED BEYOND CLEAR IDENTIFICATION
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IN YOUR ANALYSIS OF A RHYTHM STRIP WHAT WAVES SHOULD OU LOOK FOR AFTER YOU HAVE LOCATED THE P WAVES
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THE QRS AND THE T WAVES
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WHY IS IT IMPORTANT FOR YOU TO KNOW ALL THESE WAVES AND MEASUREMENTS
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BECAUSE THEY REFLECT CARDIAC ACTIVITY
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WHAT IS A SUPRAVENTRICULAR ARRHYTHMIA
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AN ARRHYTHMIA THAT ORIGINATES ABOVE THE VENTRICLES
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IF A QRS COMPLEX MEASURES LESS THAN .12 SECONDS, WHERE CAN YOU ASSUME THAT IT ORIGINATED
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FROM A SUPRAVENTRICULAR FOCUS
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IF A QRS COMPLEX MEASURES .12 SECONDS OR GREATER IT COULD POSSIBLY BE A SUPRAVENTRICULAR RHYTHM WITH A VENTRICULAR CONDUCTION DISTURBANCE. WHAT IS THE OTHER POSSIBLE EXPLANATION FOR A WIDE QRS COMPLEX
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A RHYTHM THAT ORIGINATES IN THE VENTRICLES WILL HAVE A QRS MEASUREMENT OF .12 SECONDS OR MORE
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WHY DO SINUS RHYTHMS HAVE UPRIGHT P WAVES
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BECAUSE AN IMPULSE THAT ORIGINATES IN THE SIMUS NODE WILL TRAVEL DOWNWARD THROUGH THE ATRIA TO THE VENTRICLES IN LEAD II THE PSITIVE ELECTRODE IS PLACED BELOW THE APEX THUS THE MAJOR ELECTRICAL FLOW IS TOWARD THE POSITIVE ELECTRODE IN LEAD II
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IN A NORMAL SINUS RHYTHM , WAHT WILL THE RATE RANGE BE
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60-100 BEATS PER MINUTE
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WHAT IS THE DEFINED PRI FOR AN NSR
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.12-.20 SECONDS AND CONSTAT
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IS NSR DEFINED AS BEING REGULAR OR IRREGULAR
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REGULAR
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WHAT SHOULD THE QRS MEASUREMENT BE IN ORDER TO BE CALLED A NORMAL SINUS RHYTHM
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LESS THAN .12 SECONDS
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WHAT WOULD YOU CALL A RHTHM THAT ORIGINATED IN THE SINUS NODE AND FITS ALL THE RULES FOR NSR EXCEPT THAT THE QRS WAS TOO WIDE
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SINUS RHYTHM WITH A WIDE QRS
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WHAT WILL THE P WAVE BE LIKE FOR SINUS BRADYCARDIA
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NORMAL AND UPRIGHT ONE P WAVE IN FRONT OF EVERY QRS COMPLEX
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IN SINUS BRADYCARDIA, WHAT IS THE RATE RANGE
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LESS THAN 60 BEATS PER MIN
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IS SINUS BRADYCARDIA REGULAR OR IRRERGULAR
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REGULAR
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WHAT WILL THE PRI MEASUREMENT BE IN A SINUS BRADYCARDIA
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.12-.20 SECONDS AND CONSTANT
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WHAT IS THE NORMAL QRS MEASUREMENT IN A SINUS BRADYCARDIA
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LESS THAN .12 SECONDS
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HOW DOES SINUS BRADYCARDIA DIFFER FROM NORMAL SINUS RHYTHM
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THE RATE IN SINUS BRADYCARDIA IS SLOWER THEN NSR
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IS SINUS TACHYCARDIA REGULAR OR IRREGULAR
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REGULAR
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WHAT IS THE RATE RANGE FOR SINUS TACHYCARDIA
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GRATER THAN 100 BEATS PER MINUTE USUALLY DOES NOT EXCEED 160 BEATS PER MIN
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WHAT IS THE PRI FOR SINUS TACHYCARDIA
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.12-.20 SECONDS AND CONSTANT
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WHAT IS THE NORMAL QRS MEASUREMENT FOR SINUS TACHYCARDIA
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LESS THAN .12 SECONDS
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WHAT DO THE P WAVES LOOK LIKE IN SINUS TACHYCARDIA
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NORMAL AND UPRIGHT ON P WAVE IN FRONT OF EVERY QRS COMPLEX
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HOW DOES SINUS TACHYCARDIA DIFFER FROM NSR
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THE RATE IN SINUS TACHYCARDIA IS FASTER THAN NSR
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DESCRIBE THE RHYTHM )REGULARITY) OF SINUS ARRHYTHMIA
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IT IS IRREGULAR; THE RATE INCREASES WITH EACH RESPIRATORY INSPIRATION AND DECREASES WITH EACH EXPIRATION
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WHAT IS THE RATE RANGE FOR SINUS ARRHYTHMIA
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USUALLY 60-100 BEATS PER MINUTE
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