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73 Cards in this Set
- Front
- Back
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What is recorded on an EKG?
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The wave of repolarization and depolarization.
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What does a long QT interval warn of?
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Patient if vulnerable to rapid ventricular rhythms
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What is the span on the EKG that represents ventricular contraction?
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QRS to the end of T.
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What is a normal time for the PR interval?
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< 0.2 secs
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< 0.8 secs is normal for what portion of the EKG?
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the ORS complex
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What is the time of a normal QT segment?
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< 0.4 seconds
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When is it normal for the line on the EKG to be isoelectric?
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-PR segment
-ST segment |
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What is a possible diagnosis for a PR interval > 0.2 seconds?
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First degree block, possibly from too much Digoxin
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How would a Bundle of HIs problem show up on the EKG?
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The QRS segment is > 0.8seconds
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What do the limb heads of the EKG do?
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They record activity in the coronal and frontal plane of the body
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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 |
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What direction does energy move in the electrodes? What does this mean?
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From negative to positive
-Will record as a positive inflection on the EKG |
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What the the chest leads record?
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Activity in the axial (horizontal plane of the body
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Where are chest leads V1 and V2 placed?
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4th Intercostal either side of the sternum
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V4-V5 chest leads are placed where on the chest
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Intercostal space, Mid-clavicular line
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Where do we put lead V3
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between V2 and V4
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State where V6 chest lead placed
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at the 5th intercostal MCL (mitral area)
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V5 lead is placed where on the chest?
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5th ICS between V4 and V6
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What will electrical activity moving towards the positive record as?
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Will be viewed as upright complexes on the monitor
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What does a downward deflection of the EKG indicate?
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That the electrical activity is moving from + to -
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What occurs when Lead II is used in particular?
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Both the flow of negative to positive impulses of the ECG machine and that of the heart are traveling in the same direction.
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What lines on the EKG grid is darker and Why?
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Every 5th to help you count
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What does each small box on the EKG grid represent?
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0.04 seconds in time
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The large block on the EKG grid corresponds to what time?
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0.2 seconds (5 small boxes)
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What is the regular heart rate for an adult?
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60-100 bpm
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What HR described bradycardia?
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< 60 bpm
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What is tachycardia?
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> 100 bpm
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What are the methods of rate calculation?
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-Count RR interval and large boxes
-Count RR interval and tic marks |
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What are the HRs when you are using the method of counting RR interval and large boxes?
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300, 150, 100, 75, 60, 50
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What does it mean to count RR interval and tic marks?
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3-second tic marks - count for 6 seconds and multiply by 10
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What is the rate that the EKG paper rolls out?
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25mm or 1inch/second
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What is Rhythm of HR?
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Is the quality of timing as one heart beat is compared to the next, regardless of rate
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How do you determine the heart rhythm?
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By comparing the length of several adjacent RR intervals
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How do you describe regular rhythm?
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All RR intervals of equal length
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What is regular irregular rhythm?
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RR intervalsof different lengths but overall pattern is present
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What is irregular irregular rhythm?
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No overall pattern
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What can cause a premature atrial beat?
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-adrenaline
-increased sympathetic stimulation -beta-1 receptor stimulants -caffeine -cocaine -amphetamines -excess digitalis (digoxin) -hyperthyroidism |
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Describe a premature atrial beat.
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The atrial foci become irritable due to many factors
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What are the signals on the EKG that would indicate a premature atrial beat?
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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
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Does a premature atrial beat indicate a problem with the SA node?
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No, it is working perfectly fine, but it irritable and triggers extra beats
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What is Sinus bradycardia?
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Normal sinus rhythm at a slower pace
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What is sinus tachycardia?
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Normal Sinus Rhythm at an accelerated rate
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What is sinus tachycardia?
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Normal Sinus Rhythm at an accelerated rate
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Describe Sinus Arrhythmia
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HR may be faster when inspiring. May be a normal finding
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Describe Sinus Arrhythmia
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HR may be faster when inspiring. May be a normal finding
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Describe Sinus Arrhythmia
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HR may be faster when inspiring. May be a normal finding
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What occurs in an atrial flutter? How would you describe the describe the EKG?
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Single, strong ECTOPIC focus in an atria start to beat fast 240-360 bpm.
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What type of rhythm is an atrial flutter?
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Regular Irregular
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What does the AV node do in Atrial Flutter?
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They act as the gatekeeper, blocking some of the impulses to the ventricle
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What occurs in atrial fibrillation?
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Many weak ectopic foci in the atria beat in an uncoordinated pattern, resulting in an uneven baseline of many tiny P waves.
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What type of rhythm is atrial fibrillation?
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Irregular Irregular
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How fast do the atria beat in atrial fibrillation?
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up to 300 bpm
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How fast is the HR in atrial fibrillation? Why?
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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 |
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What can occur due to atrial fibrillation? How is this counteracted?
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Clots can form
-Patients go on coumadin |
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Define Premature Ventricular Contractions
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VENTRICULAR FOCI made irritable by LOW CO2 and LOW K
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What pathologies cause premature ventricular contractions?
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-airway obstruction
-absence of air -low O2 -reduced cardiac output -poor or absent coronary blood supply -hypokalemia |
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What can Premature ventricular contractions trigger?
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V-Tach
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Describe the EKG of Premature Ventricular Contraction
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Premature beat that produces a giant ventricular complex on EKG
-QRS is WIDER! |
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Describe the EKG of Premature Ventricular Contraction
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Premature beat that produces a giant ventricular complex on EKG
-QRS is WIDER! |
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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 |
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What causes ventricular fibrillation?
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Beating of many weak ectopic foci in the ventricles, resulting in uncoordinated contractions
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What occurs in the body during V-fib?
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The blood cannot circulate to the brain or organs and cannot sustain life.
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What are the conduction abnormalities?
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-1st degree Atrioventricular Block
-2nd Degree Atrioventricular Block (Type I) -2nd Degree Atrioventricular Block (Type II) -Third Degree Ventricular Block |
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What does the EKG look like in a first degree AV block?
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PR interval >.20 and always constant
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What is a First Degree AV block?
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-Increased PR interval
-The impulse within the AV node is delayed making a longer than normal pause before ventricular contraction |
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How would you describe 2nd degree AV block type I?
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-Progressively longer PR duration until non-conducted PR
-Going, Going, GONE! |
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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 |
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Describe a Complete or 3rd degree block
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No relationship between the P waves and the QRS complex
-AV node is completely blocked -Not associated at all |
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What is the sympathetic response in the heart?
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NE binds on B1
-Increases SA node pacing -Increases force of myocardial contraction -Constricts arteries, increases BP |
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What is the parasympathetic response on the heart?
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-Ach activate cholinergic
-Decrease SA pacing -Decrease force of contraction -Dilates arteries - |
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Where does an MI occur in the heart?
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In the Coronary arteries
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When do coronary arteries fill?
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during Diastole
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What is bypass surgery?
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Take a vein from the leg and replace the blocked part of the artery.
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