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Apex > 6 Rhythms > Flashcards

6 Rhythms Flashcards

1
Q

Anterior, middle, and posterior intermodal tracts

A

Bachman, wenkebach, and thorel

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2
Q

Slow, intermediate, and fast conductions in cardiac pathway

A

SA+AV (slow), myocardial muscle (intermediate), HIS/BB/purkinje (fast)

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3
Q

Conduction velocity is a func of: 3

A

RMP, AP amplitude, rate of change in potential in phase 0

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4
Q

Accessory pathway connection: James fiber, atrio hisian fiber

A

Atria to AV, atria to his

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5
Q

Accessory pathway connection: Kent’s bundle, mahaim bundle

A

Atrium to ventricle, AV node to ventricle

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6
Q

Ventricle: phase 0-4 with electrical event

A

0-depolarization, 1-initial repol, 2-plateau/ST, 3-final repol, 4-resting

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7
Q

Ventricle: ion movement phase 0-4

A

0-Na in, 1- cl in and K out, 2- ca in k out, 3- k out, 4- na out

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8
Q

Event that leads to: pr depression, ST elev

A

Pericarditis. High k or endocarditis

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9
Q

Q wave abn that may make you think MI: 3

A

Amp grater than 1/3 of R wave, lasts > 0.04 sec, Depth >1 mm

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10
Q

T wave pts opposite direction of QRS if what: 2

A

Myo ischemia or BBB

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11
Q

T wave may be peaked with: 3

A

Myo ischemia, high K, IC bleed

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12
Q

U wave >1.5 mm when what

A

Low K

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13
Q

K too high can lead to what changes 7 (early to late)

A

Narrow/peaked T, short QT, wide QRS, low p amplitude, wide PR, nodal block, fusion of QRS-T—> VF/asystole

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14
Q

Low K leads to: 4

A

U wave, ST dep, flat T, long QT interval

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15
Q

High hi or low ca affects ekg

A

Hi- short QT, low- long QT

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16
Q

How hi or low mg affects ekg

A

Only if very hi —> heart block/arrest. Only if very low —> long QT

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17
Q

Vector of depolarization in heart

A

Base to apex and endo to epicardium

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18
Q

Vector of repolarization

A

Apex to base and epi to endocardium

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19
Q

Lateral leads and coronary artery

A

I, avl, V5-6. Circumflex

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20
Q

Inferior leads and artery

A

II, III, avf, RCA

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21
Q

Septal leads and artery

A

V1-2, LAD

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22
Q

Anterior leads and artery

A

V3-4, LAD

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23
Q

Right axis deviation

A

Leads reaching towards each other (I down Avf up)

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24
Q

Left axis deviation

A

Leads leaving each other (I up avf down)

25
Extreme right axis deviation
I and avf point down
26
Normal I and avf axis
Both point up
27
Normal axis between __ and __. L axis dev more neg than __, R axis dev more pos than
-30 to 90. -30, 90.
28
Causes of r axis dev: 5
COPD, acute bronchospasm, cor pulmonale, pulm htn, PE
29
Causes of L axis deviation: 6
Chronic htn, L BBB, AS, AI, mitral regurg
30
Sinus arrythmia
Inhalation —> dec intra p —> inc venous ret —> inc hr. Exhale —> inc intra p —> dec venous return —> dec hr
31
Brugada syndrome
Na ion channelopathy. Can cause sudden nocturnal death d/t v tach or fib
32
Second degree type I block
Wenkebach, longer longer drop. In AV node
33
Second degree type 2 block
Some ps dont conduct to ventricle. His or bundle branches
34
Third degree HB
AV dissociation. In av node rate 45-55, below av node 30-40.
35
IA, IB, IC where they work/how
A- dep phase 0, prolong phase 3. B- weak dep phase 0, shortens phase 3. C- strong 0 dep, little phase 3 fx
36
Where class II blockers work
Slows phase 4 depol in SA node
37
Where phase III blockers work
K channels, prolongs phase 3 repol, inc QT, inc refractory period
38
How phase IV blockers work
Dec velocity through AV node
39
When adenosine works and doesnt work
Works in SVT or WPW w narrow QRS. Doesn’t work in a fib, a flutter, or v tach.
40
How wpw works
No delay between atria and ventricle impulse, shorter refractory period
41
Orthodromic anvrt: incidence, pathway
More common, a—>av—>ventricle—>accessory path—>atrium
42
Orthodromic anvrt: QRS, tx
Narrow. Inc av node refractory period: vagal, amio, adenosine, bb, verapamil, cardiovert
43
Antidromic anvrt: incidence, pathway
Less common. Atrium, accessory, ventricle, av node, atrium
44
Antidromic anvrt: QRS morphology, tx
Wide. His purkinje bypassed. Block conduc pathway: procainamide, amio, cardiovert. DONT give agents that inc the refractory period of av node
45
Drugs to avoid in antidromic anvrt: 5
Adenosine, dig, ccb, bb, lidocaine
46
DOC in afib w wpw. Consid in radiofreq ablation
Procainamide. Monitor esophageal temp
47
Drugs that prolong QTc
Methadone, droperidol, haldol, zofran, halogenated IAs, amio, quinidine
48
Syndromes that prolong qtc, misc causes of inc qtc 3.
Romano ward and Timothy syndromes. HOCM, SAH, bradycardia
49
Pacers: positions 1, 2, 3, 4, 5
Chamber paced, chamber sensed, response, programmability, pacer can program multiple sites
50
how cautery affects pacer: which mode causes more Emi
Coag more than cutting
51
Conditions that make myo more resistant to repolarization
Low/hi k, low co2 (k into cell), low temp, mi, fibrosis around leads, antiarrythmic meds
52
Pacer/icd: ___ contraindicated but __ not
MRI. Lithotripsy
53
Reflex that mediates sinus arrythmia
Bainbridge
54
Glucagon initial dose and drip rate for bradycardia
50-70 mcg/kg q5 min then 2-10 mg/hr
55
Bipolar lead that is always positive, one that is always negative
I/right arm always negative, II left leg always positive
56
Part of ekg that is absolute vs relative refractory period
Absolute= first 1/3 t. Relative= last 2/3.
57
Causes of first degree hb 5
Aging, posterior wall mi, pns stim, amio, dig
58
Best lead to visualize the p wave
Lead II
59
Adenosine is best tx for
SVT

Apex (21 decks)

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