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31 Cards in this Set
- Front
- Back
- 3rd side (hint)
Limb leads are
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Bipolar leads
Consist of two electrodes, one negative and one positive. |
27.42
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Einthoven triangle
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The triangle form by the three limb leads around the heart. I accross, II to the right side, III to the left side. RA all -, LA and -, and LL all . The leads go fro negative to positive with I from Rt the Lt. II from RA to LL. III from LA to LL.
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27.43
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1mm box is equal to ___ seconds. One large/5 1mm boxes is equal to ____ seconds.
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0.04
0.20 |
27.43
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P wave is formed...
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As the impulse is gnerated by the SA node in the right atrium and spreads over the atria, causing depolarization.
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27.43
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P wave usually last
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0.6 to 0.11 seconds.
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27.44
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A p wave but no QRS signifies a...
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block is present somewhere in the AV junction or below and is preventing conduction from the atria to the ventricles.
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27.44
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PRI
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From the beginning of the p to thed strart of the QRS complex. Includes atrial depolarization and the conduction through the AV junction. The delay is nomal from 0.12 to 0.20 seconds as the impulse is held at the AV node.
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27.44
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QRS
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Represents depoloarization of the ventricles simultaneously. Measure from the beginning of the Q to the end of the S wave, normally less than 0.12 seconds.
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27.44
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R-prime wave
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Second upward deflection (right after the usual R wave), which is never normal and indicates trouble in the conduction systme of the ventricles.
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27.44
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When are Q waves abnormal or pathologic?
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If they are one small squrare wide or deeper than one thrid the total height/amplitude of the QRS complex (in lead II). May indicate an AMI.
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27.44
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J point
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The point in the ECG wher the QRS ends and the ST segment begins. Represents the end of depolarization and the beginning of repolarization. Should be at the isometric line.
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27.44
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ST segment
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Line between the QRS and beginning of the T wave, normally at the isometric line.
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27.44
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T wave
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Represents ventricle repolarization.
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27.44
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A tall shaped peak T wave represents what?
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hyperkalemia (high potassium)
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27.44
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Q-T interval
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Ventricle depolarization and repolarization which includes all of the QRS to the end of the T wave. Normally last 0.36 to 0.44 seconds.
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27.45
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What does an extended Q-T indicate?
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That the heart is experiencing an exteded refractory period, making the ventricle more vulnerable to arrhythmias.
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27.45
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What is the acceptable variance for a rhythm to still be consider regular?
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0.12 second or three small boxes.
If there is a gap of 0.12 second or more than it is considered irregular. |
27.45
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Serious causes of bradycardia:
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hypothermia, SA node disease, AMI, which may stimulate vagal tone; ICP, beta blockers, calcium channel blockers, morphine, quinidine, or digitalis.
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27.48
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Common cause of sinus arrhythmia?
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Repiratroy cycle causing the HR to accelerate during inspiration and to slow with expiration. Increased filling pressure of the heart during inspiration stimulate the Bainbride reflex, which increases the HR and is partially responsible for repiratory sinus arrhythmia.
Normal finding in children and young adults. Tends to diminish with age. |
27.48-49
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A pause without a P QRS or T wave is considered...
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a sinus arrest.
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27.49
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Sinus sick syndrome
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A variety of rhythms that involve a poorly functioning SA node and is common in elderly patients. These include sinus bradycardia, sinus arrest, SA block, and extreme bradycardia or tachycardia. May cause decrease cardiac output causing symptoms or remaining asymptomatic.
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27.49
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A WAP over 100 bpm is
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Multifocal Atrial Tachycardia
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27.51
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List rhythms of the SA node with rate if applicable
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NSR 60 to 100 bpm
Sinus Bradycardia < 60 bpm Sinus Tachycardia > 100 bpm Sinus Arrhythmia Sinus Arrest |
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List rhythms of the atria with rate if applicable
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WAP
Multicfocal Atrial Tachycardia >100 bpm PAC SVT >150 bpm (150 to 180 bpm) A-Fib A-Flutter |
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List rhythms of the AV node/junction with rate if applicable
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Juctional (Escape)
Accelerated Junctional Junctional Tachycardia PJC |
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List the rhythms of the ventricles
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Idioventricular rhythms 20 to 40 bpm
Accelerated Idioventricular Rhythm 40 to 100 bpm V-Tach >100 bpm PVC V-Fib (Fast) Asystole 0 bpm :D ;) |
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Agonal rhythm
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Asystole which is occastionally interrupted by small sinusoidal complexes or wide rhythms.
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Notes on WPW
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Wolff-Parkinson-White syndrome
An accessory pathway between the atria and the ventricles called the bundle of Kent. This causes the conduction to bypass AV node and begin ventricular depolarization early. This results in a delta wave or the rapid up slope to the R wave immediately after the end of the p wave. Pts with WPW are highly susceptible to SVTs. |
27.61
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Notes on Osborne or J wave
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Often cause by hopothermia and presents as a P wave immediately at the end of the QRS complex. Consider to be an indication of hypothermia not a definitive diagnosis. Looks different from ST elevation in that it comes down towards the isometric wave and actally makes a wave not just elevation.
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27.61
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Electrolytes imbalances presentations on an EKG
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The two most common are hyper or hypokalemia (potassium).
Hyperkalemia often presents as very tall T waves which may be as tall or taller than the QRS complex. Hypokalcemia presents as a flat or absent T wave along with the development of a U wave. Often mistaken for another P wave. |
27.61-62
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Hyper vs hypocalcemia abnormalites on the EKG
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Not likely to be noticed on the EKG especially prehospital.
Hyper has a shorten Q-T interval while hypo has a slightly lengthen Q-T wave. |
27.62
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