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60 Cards in this Set
- Front
- Back
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CONTRACTILITY
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ABILITY TO SHORTEN THEN RETURN TO THEIR ORIGINAL LENGTH
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DEPOLARIZATION
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MOVEMENT OF IONS ACROSS THE MEMBRANE, ESPECIALY SODIUM
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PACEMAKER CELLS
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CERTAIN CELLS THAT POSSESS AUTOMATICITY
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THREE PRIMARY ELECTROLYTES
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Na+(SODIUM), Ca++(CALCIUM), K+(POTASSIUM)
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Na++
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PLAYS A MAJOR ROLE IN DEPOLARIZATION OF THE MYOCARDIUM
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Ca+
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PLAYS A MOJOR ROLE IN DEPOLARIZATION AND CONTRACTILITY, HYPERCALCEMIA=INCREASE CONTRACTILITY, HYPOCALCEMIA=DECREASED CONTRACTILITY&INCREASED ELECTRICAL IRRITABILITY
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K+
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PLAYS A MAJOR ROLE IN REPOLARIZATION, HYPERKALEMIA=DECREASED AUTOMATICITY AND CONDUCTION, HYPOKALEMIA=INCREASED IRRITABILITY
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THREE CARDIAC MUSCLES
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1.ATRIAL 2.VENTRICULAR 3.EXCITATORY&CONDUCTIVE FIBERS
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INTERCALATED DISCS
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CONNECT CARDIAC MUSCLE FIBERS AND CONDUCT ELECTRICAL IMPULSES 400 TIMES FASTER THAN THE STANDERD CELL MEMBRANE
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PHASE 0
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ACTION POTENTIAL, MYOCARDIAL CELL STIMULATED-MEMBRANE SUROUNDING CELL CHANGES-SODIUM RUSHES IN-NEGATIVE RESTING POTENTIAL DISAPEARS COMPLETELY
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PHASE1
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EARLY REPOLARIZATION BEGINS, SODIUM INFLUX STOPS-POTASIUM ESCAPES-INSIDE IS NEGATIVELY CHARGED AGAIN
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PHASE 2
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SLOW INFLUX OF CALCIUM THROUGH CALCIUM IONS-CALCIUM ACTIVATES MYOCARDIAL FIBER=CONTRACTIOM-THE ENTIRE MUSCLE MASS IS DEPOLARIZED(ALL OR NOTHING)
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PHASE 3
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RAPID REPOLARIZATION, K+ LEAVES INIDE-CELL IS MORE NEG.(Na INSIDE, K+ OUTSIDE)
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PHASE 4
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RESTING POTENTIAL, SODIUM PUMP MOVES Na+ OUT AND K+ OUT
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SA NODE
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PRIMARY PACEMAKER, 60-100 BPM
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AV NODE
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40-60 BPM
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PURKINJE FIBERS
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<40BPM
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SINUS PACED HEART (SA NODE)
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REPRESENTED BY PRESENCE OF "P WAVES", ALL NORMAL AND ALIKE IN MORPHOLOGY
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JUNCTIONAL PACED HEART (AV NODE)
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PRIMARY PACEMAKER IS AT AV JUNCTION, MAY SEE INERTED P AWAVES BEFORE OR AFTER QRS OR NOT AT ALL
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PURKINGE PACED HEART (IDIOVENTRICULAR)
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DRIVEN BY VENTRICLES, NO P WAVE, RATE WILL BE VINTRICULAR
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NORMAL SINUS RYTHEM
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SA NODE IS PACING THE HEART, P,QRS,T AT ALL SYNC
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THREE TYPES OF LEADS
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AUGUMENTED, PERICARDIAL, BIPOLAR
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BIPOLAR LEADS(123)
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1.L ARM-R ARM, 2.L LEG-R ARM, 3.L LEG-L ARM
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- IMPULSES
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RECORDED DOWN
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+ IMPULSES
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RECORDED UP
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INFO FROM A LEAD=
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HEART RATE, REGULARITY, TIME IT TAKES TO CONDUCT AN IMPULSE
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ARTIFACT
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DEFECTIONS FROM OUTSIDE ACTIVITY
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EACH BOX ACROSS=
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.04 SEC(SMALL), .20 SEC(LARGE), 1 SEC(5 LARGE)
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EACH BOX UP=
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2 LARGE BOXES= 1 MV
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P
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FIRST COMPONENT, POSITIVE ROUNDED WAVE BEFORE QRS COMPLEX, ATRIAL DEPOLARIZATION
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PR INTERVAL
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DISTANCE FROM BEGINING OF P WAVE TO BEGINING OF QRS COMPLEX
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PR SEGMENT
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DISTANCE FROM END OF P WAVE TO BEGINING OF QRS
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Q
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FIRST NEG. DEFLECTION AFTER P WAVE, NICROSIS, SIGNIFICANT IF 1MM WIDE OR ONE-THIRD QRS AMPLITUDE
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R
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FIRST POS. DEFLECTION AFTER P WAVE, IMPULSE TO BUNDLE BRANCHES
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S
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FIRST NEG. DEFLECTION AFTER R WAVE, IMPULSE TRAVELING THROUGHPURKINGE SYSTEM
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ABERRANT CONDUCTION
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SUPRAVENTRICULAR BEAT CONDUCTED THROUGH VENTRICALS THROUGH ADELAYED MANNER, QRS IS WIDER THAN .12 SEC.,
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NORMAL QRS SHOULD BE
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.04-.12 SEC., 1-3 BOXES
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ST SEGMENT
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DISTANCE FROM S WAVR TO BEGINING OF T WAVE, INITIAL PHASE OF VENTRICULAR DEPOLARIZATION
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ST DEPRESSION
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ISCHEMIA
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ST ELEVATION
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INJURY
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QT INTERVAL
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TOTAL DURATION OF VENTRICULAR DEPOLARIZATION, .33-.42 SEC., 8-11 BOXES
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P-WAVE?
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IS IT REG., IS THERE P FOR QRS, IS THERE QRS FOR P, IS P INFRONT OR BEHIND QRS, IS P NORMAL, DO THEY ALL LOOK ALIKE, ARE THEY ASSOCIATED WITH ECTOPIC BEATS
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RATE?
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what is exact rate, is atrial the same as ventricular rate, >100=TACHY, <60=BRADY
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RYTHM
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IS IT REG OR IRREG, IS THERE PATERN TO IRREG, ANY ECTOPIC BEETS(EARLY OR LATE?)
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PR INTERVAL
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ARE THEY ALL CONSTANT, WITH IN NORMAL RANGE, IF IT VARIES-IS THERE A PATERN
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5 STEPT TO RECOGNIZE RYTHM
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DETERMIN RATE, RYTHM, PRESENCE OF P WAVE, PR INTERVAL, QRS COMPLEX
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RATE DETIRMINATION
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6 SEC-COUNT R WAVES ON 6 SEC STRIP*10, TRIPLICAE-COUNT LARGE SQUARES BETWEEN 2 R'S~300, R-R-COUNT BIG SQUARE BETWEEN R-R~300
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DYSRHYTHMIA
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ANY DEVIATION FROM ANY NORMAL ELECTRICAL RHYTHM
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ARRHYTHMIA
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ABSENSE OF ELECTRICAL ACTIVITY
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DYSRHYTHMIAS ORIGINATING FROM SA NODE
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SINUS BRADY, SINUS TACH, SINUS DYSRHYTHMIA, SINUS ARREST
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SINUS BRADYCARDIA
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RATE <60, RHYTHM-REG., PACEMAKER-SA NODE, P-UP&NORMAL, P-R INTERVAL-.12-.20SEC.,QRS-.04-.12SEC.
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SINUS TACHYCARDIA
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RATE >100, RHYTHM-REG., PACEMAKER-SA NODE, P-UP&NORMAL, P-R INTERVAL-.12-.20SEC., QRS-.04-.12 SEC.
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SINUS DYSRHYTHMIA
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RATE 60-100(VARIES), RHYTHM-IRREGULAR, PACEMAKER-SA NODE, P-UP&NORMAL, P-RINTERVAL-.12-.20 SEC.,QRS-.04-.12 SEC.
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SINUS ARREST
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RATE NORMAL-SLOW, RHYTHM-IRREGULAR, P-UP&NORMAL, P-R INTERVAL-.12-.20 SEC., QRS- .04-.12 SEC.
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DYSRHYTHMIAS ORIGINATING IN ATRIA
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ATRIAL TAHCYCARDIA OR WANDERING PACEMAKER, MULTIFOCAL ATRIAL TACHYCARDIA, PREMATURE ATRIAL CONTRACTION, PSVT, ATRIAL FLUTTER, ATRIAL FIBRILLATION
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ATRIAL TACHYCARDIA OR WANDERING PACEMAKER
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RATE USUALY NORMAL, RHYTHN-SLIGHTLY IRREG., PACEMAKER-VARIES(SA, ATRIAL TISSUE, AV JUNCTION), P-ORGANIZED-DIFFERENT, P-R INTERVAL-VARIES, QRS-NORMAL OR +/-.12
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PREMATURE ATRIAL CONTRACTIONS
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RATE UNDERLYING RHYTHM, RHYTHM-USUALY REG. EXCEPT PAC, PACEMAKER-ECTOPIC FOCUS IN ATRIUM, P-R INTERVAL-USUALY NORMAL +/-.12, QRS-NORMAL OR WIDE
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PSVT
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RATE 150-250, RHYTHM-REG EXCEPT ONSET&TERMINATION, P-ATIRAL&SINUS DIFFER, P-R INTERVAL-USUALY NORMAL OR LESS, QRS-NORMAL .04-.12
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ATRIAL FLUTTER
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RATE 250-350, RHYTHM-ATRIAL REG/VENTRICAL-IRREG, PACEMAKER-IN ATRIA/OUTSIDE SA, P-SAW TOOTH, F-R INTERVAL-USUALY CONSTANT, QRS-NORMAL .04-.12
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ATRIAL FIBRILLATION
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RATE-350-750, RHYTHM-IRREG-IRREG, PACEMAKER-NUMEROUS FOCI IN ATRIA, P-NONE, P-R INTERVAL-NONE, QRS-NORMAL .04-.12
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