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73 Cards in this Set

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What is recorded on an EKG?
The wave of repolarization and depolarization.
What does a long QT interval warn of?
Patient if vulnerable to rapid ventricular rhythms
What is the span on the EKG that represents ventricular contraction?
QRS to the end of T.
What is a normal time for the PR interval?
< 0.2 secs
< 0.8 secs is normal for what portion of the EKG?
the ORS complex
What is the time of a normal QT segment?
< 0.4 seconds
When is it normal for the line on the EKG to be isoelectric?
-PR segment
-ST segment
What is a possible diagnosis for a PR interval > 0.2 seconds?
First degree block, possibly from too much Digoxin
How would a Bundle of HIs problem show up on the EKG?
The QRS segment is > 0.8seconds
What do the limb heads of the EKG do?
They record activity in the coronal and frontal plane of the body
What type of configuration do leads I, II and III have?
Describe this configuration.
Bipolar configuration
-THey have one positive pole electrode and one negative pole electrode
What direction does energy move in the electrodes? What does this mean?
From negative to positive
-Will record as a positive inflection on the EKG
What the the chest leads record?
Activity in the axial (horizontal plane of the body
Where are chest leads V1 and V2 placed?
4th Intercostal either side of the sternum
V4-V5 chest leads are placed where on the chest
Intercostal space, Mid-clavicular line
Where do we put lead V3
between V2 and V4
State where V6 chest lead placed
at the 5th intercostal MCL (mitral area)
V5 lead is placed where on the chest?
5th ICS between V4 and V6
What will electrical activity moving towards the positive record as?
Will be viewed as upright complexes on the monitor
What does a downward deflection of the EKG indicate?
That the electrical activity is moving from + to -
What occurs when Lead II is used in particular?
Both the flow of negative to positive impulses of the ECG machine and that of the heart are traveling in the same direction.
What lines on the EKG grid is darker and Why?
Every 5th to help you count
What does each small box on the EKG grid represent?
0.04 seconds in time
The large block on the EKG grid corresponds to what time?
0.2 seconds (5 small boxes)
What is the regular heart rate for an adult?
60-100 bpm
What HR described bradycardia?
< 60 bpm
What is tachycardia?
> 100 bpm
What are the methods of rate calculation?
-Count RR interval and large boxes
-Count RR interval and tic marks
What are the HRs when you are using the method of counting RR interval and large boxes?
300, 150, 100, 75, 60, 50
What does it mean to count RR interval and tic marks?
3-second tic marks - count for 6 seconds and multiply by 10
What is the rate that the EKG paper rolls out?
25mm or 1inch/second
What is Rhythm of HR?
Is the quality of timing as one heart beat is compared to the next, regardless of rate
How do you determine the heart rhythm?
By comparing the length of several adjacent RR intervals
How do you describe regular rhythm?
All RR intervals of equal length
What is regular irregular rhythm?
RR intervalsof different lengths but overall pattern is present
What is irregular irregular rhythm?
No overall pattern
What can cause a premature atrial beat?
-adrenaline
-increased sympathetic stimulation
-beta-1 receptor stimulants
-caffeine
-cocaine
-amphetamines
-excess digitalis (digoxin)
-hyperthyroidism
Describe a premature atrial beat.
The atrial foci become irritable due to many factors
What are the signals on the EKG that would indicate a premature atrial beat?
Pause following the premature atrial contraction (PAC) that is longer than the normal PP interval, but shorter than twice the normal PP interval and the different shape of the P wave
Does a premature atrial beat indicate a problem with the SA node?
No, it is working perfectly fine, but it irritable and triggers extra beats
What is Sinus bradycardia?
Normal sinus rhythm at a slower pace
What is sinus tachycardia?
Normal Sinus Rhythm at an accelerated rate
What is sinus tachycardia?
Normal Sinus Rhythm at an accelerated rate
Describe Sinus Arrhythmia
HR may be faster when inspiring. May be a normal finding
Describe Sinus Arrhythmia
HR may be faster when inspiring. May be a normal finding
Describe Sinus Arrhythmia
HR may be faster when inspiring. May be a normal finding
What occurs in an atrial flutter? How would you describe the describe the EKG?
Single, strong ECTOPIC focus in an atria start to beat fast 240-360 bpm.
What type of rhythm is an atrial flutter?
Regular Irregular
What does the AV node do in Atrial Flutter?
They act as the gatekeeper, blocking some of the impulses to the ventricle
What occurs in atrial fibrillation?
Many weak ectopic foci in the atria beat in an uncoordinated pattern, resulting in an uneven baseline of many tiny P waves.
What type of rhythm is atrial fibrillation?
Irregular Irregular
How fast do the atria beat in atrial fibrillation?
up to 300 bpm
How fast is the HR in atrial fibrillation? Why?
Can be 80 or up to 120, can have variable response from the ventricles
-Eventually the ventricles receive enough electrical stimulation to contract or they contract on their own
What can occur due to atrial fibrillation? How is this counteracted?
Clots can form
-Patients go on coumadin
Define Premature Ventricular Contractions
VENTRICULAR FOCI made irritable by LOW CO2 and LOW K
What pathologies cause premature ventricular contractions?
-airway obstruction
-absence of air
-low O2
-reduced cardiac output
-poor or absent coronary blood supply
-hypokalemia
What can Premature ventricular contractions trigger?
V-Tach
Describe the EKG of Premature Ventricular Contraction
Premature beat that produces a giant ventricular complex on EKG
-QRS is WIDER!
Describe the EKG of Premature Ventricular Contraction
Premature beat that produces a giant ventricular complex on EKG
-QRS is WIDER!
What is Ventricular Tachycardia?
Can it sustain life?
-Result of one strong Vent Ectopic Focus that hijacks the conduction system of the heart
-Cannot sustain life
What causes ventricular fibrillation?
Beating of many weak ectopic foci in the ventricles, resulting in uncoordinated contractions
What occurs in the body during V-fib?
The blood cannot circulate to the brain or organs and cannot sustain life.
What are the conduction abnormalities?
-1st degree Atrioventricular Block
-2nd Degree Atrioventricular Block (Type I)
-2nd Degree Atrioventricular Block (Type II)
-Third Degree Ventricular Block
What does the EKG look like in a first degree AV block?
PR interval >.20 and always constant
What is a First Degree AV block?
-Increased PR interval
-The impulse within the AV node is delayed making a longer than normal pause before ventricular contraction
How would you describe 2nd degree AV block type I?
-Progressively longer PR duration until non-conducted PR

-Going, Going, GONE!
Describe 2nd degree AV block Type II
What are the possible rhythm patterns?
Consistently normal PR interval but then a normal, punctual P wave with no QRS Complex
-Can be 2:1 or 3:1
Describe a Complete or 3rd degree block
No relationship between the P waves and the QRS complex
-AV node is completely blocked
-Not associated at all
What is the sympathetic response in the heart?
NE binds on B1
-Increases SA node pacing
-Increases force of myocardial contraction
-Constricts arteries, increases BP
What is the parasympathetic response on the heart?
-Ach activate cholinergic
-Decrease SA pacing
-Decrease force of contraction
-Dilates arteries
-
Where does an MI occur in the heart?
In the Coronary arteries
When do coronary arteries fill?
during Diastole
What is bypass surgery?
Take a vein from the leg and replace the blocked part of the artery.