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SF3 > Arrhythmias and Blocks > Flashcards

Arrhythmias and Blocks Flashcards

1
Q

Where do impulses originate?

A

The SA node

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2
Q

How do you measure heart rate?

A

divide 300 by the number of blocks inbetween peaks

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3
Q

When you have a change in frequency (HR) what changes?

A

Diastolic time (T-P segment) not the systolic time.

This affects stroke volume

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4
Q

Sinus Bradyardia

A

HR below 60 bpm

T-P segment long

Automacity is lower

Conduction unchanged

All other things on EKG are normal

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5
Q

Sinus Tachycardia

A

Above 100 bpm

T-P segment is short

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6
Q

Sinus bradycardia and Sinus tachycardia are examples of what?

A

Supraventricular Normotopic Rhythms

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7
Q

What is Ectopic Arrhythmias?

A

Excitation starts at an abnormal location

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8
Q

What are the two type of Ectopic Arrythmias discussed in class?

A

Passive Rhythm or Escape

Active Rhythm or Ectopic Tachycardia

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9
Q

Passive Rhythm or Escape

A

Norma Rhythm does not reach a area in the heart so it begins to create its own excitation at a lower rate than the SA node

  • Latent pacemakers fires (escape)
  • Long pause precedes the escape rhythm (straight line seen on EKG)
  • Site of Origin limited to latent pacemakers
    • Atrial
    • AV junctional
    • Ventricular
  • SA node must be silenced first which creates a pause in your heart
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10
Q

Ative Rhythm or Ectopic Tachycardia

A

Occurs regardless of SA node

  • Active rhythms superimpose on the normal sinus rhythm
  • Interval is shorter than normal and higher rate of firing than SA node
  • Site of origin:
    • Atrial
    • AV junctional
    • Ventricular
  • Abnormal Automaticity of latent pacemaker
  • Abnormal conduction: reentry circus
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11
Q

What is the effect of ischemia on conduction?

A

Ischemia causes depolarization

This causes conduction to decreases and Na+ System becomes inactive

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12
Q

Partial One Way block

A

This allows for a reentry loop to be created.

Electricity circles back to orifinal area of conductance.

The loop is able to form because the initial cells that were fired recover quickly so they are able to to fire again where as the area that is blocked is not able to fire. Electricity is going to go to area of availability.

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13
Q

When you have a junctional escape beat what is seen on the the EKG?

A

You no longer have a P wave (atrial depolarization)

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14
Q

Retrograde grade conduction causes what on the EKG?

A

zig zag line

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15
Q

What occurs when you have a ventricular escape beat?

A

Ventricles take over

Inverted T wave

QRS is wider

No synchronism

Myogenic Conduction

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16
Q

What are the three type of Ectopic Supraventricular Tachycardias?

A

Atrial Flutter

Atrial fibrillation

Junctional Rhythm

17
Q

Atrial Flutter

A

Impulses travel in circular course in atria, setting up regular rapid flutter (F) waves without and isolectric baseline

  • Ectopic site beating at a higher rate
  • Asynchronous conduction of AV node to ventricle
  • Ventricular contracton not steady
18
Q

Atrial Fibrilation

A

Impulses take chaotic random pathways in atria

  • Multiple Ectopic Sites creates electricity that bump into each other
  • You wont see any significant atrial excitation
  • Unsteady Ventricular Contraction
19
Q

Junctional Rhytm

A

Impulses originare in AV node with Retrograde and anterograde transmission

  • Sometime you may see a inverted T wave but not always
  • SA node is still beating sometimes but when Ectopic AV node is diseased = spacing ventricles => retrograde and silencing of the SA node
20
Q

Ectopic Ventricular Tachycardias

A
  • Ventricular Tachycardia (more than 120 bpm)
    • infarct present
    • Slowed conduction in margin of ischemic area permits ciruclar course of impulse and reentry with rapid repetive depolarization
    • Loop created
    • Myogenic contraction
    • No P wave or Twave, Wide QRS
  • Ventricular Fibrilation
    • Chaotic ventricular depolarization
    • Multiple ectopic sites in ventricle
21
Q

First Degree AV Block

A

Fixed but prolonged PR interval

(more than 260 msec)

less severe

diastolic and systolic are the same

Excitation resides in AV node

(AV node conduction velocity is slower)

22
Q

Second Degree Block

A

SERIOUS “ NO PREDICTION/NO WARNING”

  • Mobitz I (Wenchebach)
    • Progressice lengthning of PR interval with intermittent dropped beats
    • PR interval is normal in the first beat and after the drop
    • 4:1 less severe than 2: 1
    • L type Ca+ channels are affected (can be stimulated but take a long time to recover from inactivation) -> AP Phase 0 decreases over time
    • Occurs at the proximal end of AV node
  • Mobitz II (Non- Wenchebach)
    • sudden dropped QRS without prior PR lengthning
    • Occurs at distal end of AV node toward septum
23
Q

Third Degree Block

A

MOST SEVERE

No relationship between P waves and QRS complexes

QRS rate slower than P rate

  1. impulses can originate at both SA node (P wave) and below site of block in AV node (junctional rhythm) conducting to ventricles
    * damage proximal to AV node so AV node takes over and has its independent wave
  2. Impulsed can originate at SA node (P wave) and also below sithe of block in ventricles (Idioventricular rhythm)
  • abdnormal cardiomyocytes takes over
  • Myogenic conduction = Wide QRS, inverted T wave (independent of P wave)
24
Q

Differentiate Arrythmias from Blocks

A

Arrythmias are related to pacemake activity so it is all about automaticity

Blocks is about conduction

25
Q

What are the most vunerable areas for Arrythmias and Blocks?

A

AV node

Bundle of His

26
Q

Look at powerpont for bundle branch block

A

SF3 (15 decks)

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