4. & 5. Rhythm

Question 1

describe sinus rhythm

Answer 1

• 60-100 bpm
• regular rhythm

Question 2

describe sinus arrhythmia

Answer 2

• rate between 60-100 bpm
• inspiration: slightly increases HR
• expiration: slightly decreases HR

Question 3

Irregular Rhythms

what are the 3 irregularly irregular rhythms?

Answer 3

• WAP
• MAT
• a fib

Question 4

Irregular Rhythms

describe WAP

Answer 4

1. p’ waves
2. rate less than 100 bpm
3. irregularly irregular

Question 5

Irregular Rhythms

describe MAT

Answer 5

1. irregularly irregular
2. rate > 100bpm
3. p’ waves

Question 6

Irregular Rhythms

describe a fib

Answer 6

1. irregularly irregular
2. no real p waves
3. normal QRS

Question 7

Escape Arrhythmias

differentiate escape beat vs rhythm

Answer 7

• beat: 1 1 1 PAUSE 2 1 1 1
• rhythm: 1 1 1 PAUSE 2 2 2 2

Question 8

Escape Arrhythmias

when does:
1. atrial escape rhythm
2. junctional escape rhythm
3. ventricular escape rhythm
occur

Answer 8

1. atrial: SA node fails and an atrial foci takes over
2. junctional: when SA node and atrial foci fail, AV junction takes over
3. ventricular: SA node, atrial foci, and AV junction fail

Question 9

Escape Arrhythmias

EKG findings of atrial escape rhythm

Answer 9

1. p’ wave
2. rate 60-80bpm
3. p’ wave continues in all beats after pause

Question 10

Escape Arrhythmias

EKG findings junctional escape rhythm

Answer 10

1. 40-60bpm
2. normal QRS
3. absent, inverted, or hidden p waves

Question 11

Escape Arrhythmias

EKG findings for ventricular escape rhythm

Answer 11

1. 20-40 bpm
2. absent p waves
3. wide QRS complex

Question 12

Escape Arrhythmias

describe atrial escape beat

Answer 12

p’ wave followed by normal QRS complex & return to initial p waves

Question 13

Escape Arrhythmias

describe junctional escape beat

Answer 13

retrograde, absent, or hidden p wave w/ normal QRS

Question 14

Escape Arrhythmias

describe ventricular escape beats

Answer 14

absent p waves + wide QRS complex

Question 15

Premature Beats

what can cause atrial or junctional premature beats

Answer 15

1. adrenaline
2. increased sympathetic stimulation
3. stims
4. drug toxicity
5. hyperthyroidism

Question 16

Premature Beats

EKG findings of PAB

Answer 16

1. p’ wave
2. early cardiac depolarization
3. compensatory pause to maintain NSR

Question 17

Premature Beats

what is PAB w/ AVC

Answer 17

p’ wave w/ wide QRS

don’t worry about this

Question 19

Premature Beats

describe bigeminy/trigeminy

Answer 19

when premature beats are coupled (1 reg beat + irregular or 2 reg beats + irregular)

Question 20

Premature Beats

EKG findings of premature junctional beats

Answer 20

1. norm QRS
2. inverted, hidden, or absent p wave
3. early beat

Question 21

Premature Beats

EKG findings of PVC

Answer 21

1. QRS wide
2. QRS tall
3. absent p wave
4. early beat

Question 22

v tach vs sustained v tach

Answer 22

1. 3+ PVCs
2. 30+ s of v tach

Question 23

Tachy-Arrhythmias

what is a paroxysmal tachycardia?

Answer 23

sudden rapid pacing, 150-250 bpm

Question 24

Tachy-Arrhythmias

describe SVT on EKG

Answer 24

• 150 + bpm
• cannot differentiate p or t waves

Question 25

# Tachy-Arrhythmias EKG findings of paroxysmal ventricular tachycardia

Answer 25

1. series of PVCs 2. 150-250 bpm 3. wide/tall QRS

Question 26

# Tachy-Arrhythmias describe torsades de pointes

Answer 26

* rapid ventricular rhythm * rate: 250-350 * "ribbon" shape

Question 27

# Tachy-Arrhythmias describe a flutter

Answer 27

* "saw tooth" pattern

Question 28

# Tachy-Arrhythmias describe v flutter

Answer 28

* 250-350 bpm * nnnnnnnn (waves all approx same size) * taller waves than v fib

Question 29

# Tachy-Arrhythmias describe v fib

Answer 29

EKG looks like child's drawing all over the place

Question 30

# Tachy-Arrhythmias which accessory bundle exists with wolff-parkinson-white syndrome?

Answer 30

bundle of kent

Question 31

# Tachy-Arrhythmias hallmarks of WPW

Answer 31

1. short PR 2. slurred R wave (delta) 3. wide QRS

Question 32

# Tachy-Arrhythmias which accessory bundle exists with lown-ganong-levine syndrome?

Answer 32

james bundle (AV bypassed)

Question 33

# Tachy-Arrhythmias EKG findings

Answer 33

* no PR interval * normal size QRS

Question 34

# AV Blocks describe First Degree AV Block

Answer 34

* slowed conduction through AV node

Question 35

# AV Blocks EKG findings of 1st Degree AV

Answer 35

* long PR interval * fixed, continuous

Question 36

# AV Blocks EKG findings of type 1 2nd degree AV block

Answer 36

* regularly irregular * progressively longer PR intervals until QRS is dropped

Question 37

# AV Blocks EKG findings Type II 2nd Degree AV block

Answer 37

* QRS drop * fixed width PR interval (can be long or normal)

Question 38

# AV Blocks EKG findings of 3rd Degree AV block

Answer 38

* regular rate of p waves * regular rate of QRS complex * they occur separate from each other

Question 39

# BBBs describe RBBB

Answer 39

* "rabbit ears" * best seen in V1/V2 * LV depolarizes before RV

Question 40

# BBBs describe LBBB

Answer 40

* "leprochaun hat" * RV depolarizes before LV * best seen in V5/V6