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The Cardiovascular System > Arrhythmias > Flashcards

Arrhythmias Flashcards

1
Q

What is the role of the SA node

A

Generates a normal heart rhythm.

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2
Q

How does the SA node fire

A

Spontaneous

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3
Q

What is the ocation of the SA node

A

The interface between the superior vena cava and the right atrium

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4
Q

What is the nature of the cells in the SA node

A

Specialised conducting tissue.

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5
Q

What is the AV node

A

The electrical connection between the atria and the ventricles.

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6
Q

What is represented by the QRS complex

A

Depolarisation and contraction of the ventricles.

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7
Q

what are the indications of the size of the QRS complex

A

Length of time taken for the ventricles to contract.

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8
Q

what are the indications of a long QRS complex

A

An enlarged heart.

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9
Q

What is represented by the gap between the P wave and the QRS complex

A

Time delay introduced by the AV node activation.

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10
Q

What is represented by the T wave

A

Ventricular diastole - where the ventricles are relaxing/repolarising after one cardiac cycle.

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11
Q

What is represented by the PR interval

A

The start of atrial activation to the start of ventricular activation

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12
Q

What is the indication of a long PR interval

A

An issue with the AV node

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13
Q

What is the indication of a short PR interval

A

An accessory pathway is active which conducts faster than the AV node

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14
Q

What is represented by the QT interval

A

The start of ventricular activation to the start of repolarisation.

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15
Q

What is long QT syndrome

A

A problem with ventricular repolarisation (diastole).

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16
Q

What is the impact of long QT syndrome

A

Lethal rhythms.

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17
Q

What are the names of the four heart valves

A

Tricuspid, mitral, pulmonary and aortic.

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18
Q

What is the role of the fibrous rings surrounding the valves

A

Electrical insulation.

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19
Q

What is the role of the AV node

A

To slowly conduct the impulse from the atria to the ventricles to introduce a time delay so the ventricles contract after the atria.

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20
Q

what is the role of the perkinje fibres

A

To spread the impulse quickly through both ventricles.

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21
Q

What are the branches of the bundle of his

A

Right bundle branch and left bundle branch.

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22
Q

What is one second represented by on an ECG graph

A

5 large squares (25mm)

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23
Q

How do you work out heart rate from an ECG trace

A

Count the number of large squares between successive heart beats and divide 300 by this number.

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24
Q

What is a normal PR interval

A

3 to 5 small squares

25
Q

What is the impact of breathing on heart rate.

A

When you breath in you draw blood from your vena cavae into the heart and increase pressure in the chest to reduce heart rate.

26
Q

What modulates the heart rate

A

The parasympathetic nervous system through vagus nerve activation.

27
Q

What is a sinus arrhythmia

A

The sinus node fires at a variable rate. It speeds up during inspiration and slows down during expiration.

28
Q

What is tachycardia

A

Heart rate of 100bpm or more,

29
Q

What is bradycardia

A

Heart rate of 60bpm or less.

30
Q

What is sinus tachycardia

A

Tachycardia coming from the SA node.

31
Q

What ate the normal causes of sinus tachycardia

A

Exercise or stress

32
Q

What are the pathological causes of sinus tachycardia

A

Fever, anaemia, hyperthyroidism, heart failure and others.

33
Q

What is atrial fibrillation

A

Loss of co-ordination of contraction.

34
Q

What is the main cause of atrial fibrillation

A

Age

35
Q

What are the complications of atrial fibrillation

A

Increased risk of clotting and subsequently stroke.

36
Q

What drugs are used in atrial fibrillation to decrease the risk of stroke

A

Anticoagulants

37
Q

What is sino-atrial disease

A

Mixture of sinus-tachycardia, bradycardia and atrial “ectopic” beats (atrial fibrillation)

38
Q

What is the treatment for sino-atrial disease

A

A permanent pacemaker to prevent slow rhythms or antiarrhythmic drugs to prevent rapid rhythms.

39
Q

What are two examples of anti-arrhythmic drugs

A

Digoxin, amiodarone.

40
Q

what are the normal causes of sinus bradycardia

A

Sleep, athletic training.

41
Q

What are the pathological causes of sinus bradycardia

A

Hypothyroidism, hypothermia, sinus node disease, raised inter-cranial pressure.

42
Q

what is a possible cause of a blackout

A

Rhythm problems - the SA node may stop firing for a short time.

43
Q

What is type 1 AV block

A

A problem with the AV node causing a long delay (long PR interval) however, the signal still reaches the ventricles.

44
Q

What is second degree AV block

A

The AV node becomes more fatigued with every heart beat and the signal does not reach the ventricles every time.

45
Q

What is complete AV block

A

There are no P waves conducting to the ventricles.

46
Q

What is the back-up mechanism for complete AV block

A

The ventricles can conduct themselves. It is abnormal activation but enough to allow blood to be distributed around the body for a short while.

47
Q

What is the treatment for complete AV block

A

Permanent pacemaker.

48
Q

What are some possible causes of damage to the AV node

A

Disease of the aortic valve which is close by, coronary heart disease, damage during heart surgery, sino-atrial disease, drugs (beta-blockers, digoxin, calcium channel blockers).

49
Q

What us used for the treatment of AV nodal block

A

Removal of any triggers such as drugs, fitting of a permanent pacemaker, atropine or isoprenaline.

50
Q

What is the action of atropine in the treatment of AV nodal block

A

Blocks the inhibition which vagus nerves give the heart rhythm (through the parasympathetic nervous system)

51
Q

What is the action of isoprenaline in the treatment of AV nodal block

A

Stimulates the sympathetic nervous system.

52
Q

What is the indication of a saw tooth wave which shows a flutter

A

A short circuit in the right atrium - atrial fibrillation.

53
Q

What are the causes of atrial fibrillation

A

Sino-atrial disease, coronary heart disease, valve disease (especially mitral valve), hypertension, cardiomyopathy, hyperthyroidism, pneumonia.

54
Q

What is used in the treatment of atrial fibrillation

A

A drug to block the AV node and limit heart rate (such as digoxin or a beta-blocker), electrical cardioversion.

55
Q

what are the indications of a fast rhythm with no clear P wave

A

Ventricular tachycardia

56
Q

what are the indications of a fast rhythm with a clear P wave

A

Sinus tachycardia

57
Q

What is the impact of ventricular tachycardia

A

Life threatening - not compatible with consciousness.

58
Q

What is the emergency treatment for ventricular tachycardia

A

Immediate defibrillation.

The Cardiovascular System (15 decks)

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