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Health Assessment (2) > Basic EKG > Flashcards

Basic EKG Flashcards

1
Q

The heart has the innate ability to generate its own spontaneous action potentials without any external stimuli, a phenomenon known as __________.

A

Automaticity

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2
Q

What are the two types of cells in the heart?

A

Pacemaker Cells (spontaneous action potentials)
Contractile Cells

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3
Q

When there is a stimulation above the threshold, __________ channels cause cell-to-cell conduction resulting in depolarization.

This will release ________ to interior myocytes and causes contraction.

_______ outflow causes repolarization.

A

Sodium Channels

Calcium

Potassium

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4
Q

Once the action potential is generated by the SA node, conduction will go to the right atrium via the __________ pathway.

Conduction will also travel from the right atrium to the left atrium via ____________.

A

Internodal Pathway

Bachman’s Bundle

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5
Q

The inherent pace of the SA node.

The inherent pace of AV node.

A

60-100 bpm

40-60 bpm

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6
Q

Atrial fibrillation will result in a _______% decrease in cardiac output.

A

20-25% decrease in CO

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7
Q

The bundle of His is located in the __________.
The bundle of His has pacemaker cells that can generate an action potential at _________ beats/minute.

A

interventricular septum

40 to 60 bpm

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8
Q

The bundle branch consists of pacemakers cells that can generate _________ bpm.

A

20 to 40 bpm

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9
Q

How many mV are the large boxes?
How many mV are the small boxes?

How many seconds are the small boxes?
How many seconds are the larges boxes?

A

0.5 mV
0.1 mV

0.04 seconds
0.20 seconds

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10
Q

What does the P-wave represent?

What is the normal duration of P-waves?

A

Atrial Depolarization

less than 0.12 seconds

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11
Q

What does the PR interval represent?

What is a normal PR interval?

What is a PR interval greater than 0.20 seconds called?

A

PR interval represents the time from the onset of atrial depolarization (contraction) to the onset of ventricular depolarization. The pause for the blood to go from the atria to the ventricles.

0.12 to 0.20 seconds

First-degree AV block

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12
Q

What does the QRS complex represent?

What is the duration of the QRS complex?

A

Ventricular depolarization

<0.12 seconds

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13
Q

What does the ST segment represent?

A

ST segment represents the interval between depolarization and repolarization of the ventricles.

Early stages of ventricular repolarization.

Elevation > 1mm is significant (injury/ischemia)

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14
Q

What does the T wave represent?

A

Repolarization of the ventricle

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15
Q

What leads will have positive P-waves?

A

I
II
aVF
V4-V6

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16
Q

What rhythms will have retrograde p-waves?

A

Junction rhythms

(Rhythm is coming from the AV node and back up to SA node)

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17
Q

Why is the later PR interval flat?

A

No contraction, so the blood can continue to flow down the ventricles.

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18
Q

What do we associate with a QRS complex wider than 0.12 seconds?

A

Bundle branch block

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19
Q

What causes elevated T-waves?

A

Hyperkalemia

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20
Q

What leads will have positive T-waves?

A

I
II
V3-V6

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21
Q

When is atrial repolarization?

A

During QRS complex

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22
Q

What is the rhythm?

A

Sinus Rhythm

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23
Q

What is the rhythm?

A

Sinus Bradycardia

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24
Q

What is the rhythm?

A

Sinus Tachycardia

(100-150 bpm)

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25
Q

What is the rhythm?

A

Junctional Rhythm
HR 40-60 bpm
Signal starts in AV node

(look for the inverted p-wave)

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26
Q

What is the rhythm?

A

Junctional tachycardia
HR >60 bpm
Signal starts in AV node

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27
Q

What is the rhythm?

A

Supraventricular tachycardia

(HR>150)

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28
Q

What does paroxysmal mean?

A

“comes and goes”

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29
Q

What is the rhythm?

A

Premature atrial contraction

(find the underlying rhythm and then figure out the accessory rhythm and look for compensatory pause)

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30
Q

What is the rhythm?

A

A-fib
(Think irregularly irregular)

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31
Q

What is the rhythm?

A

A-flutter

(Sawtooth pattern)

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32
Q

What is the rhythm?

A

Premature ventricular contraction

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33
Q

What is the rhythm?

A

1st-degree AV Block

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34
Q

What is the rhythm?

A

Bigeminy PVC

(PVC after every other normal beat)

35
Q

What is the rhythm?

A

Trigeminy PVC

(PCV on the 3rd beat)

36
Q

What is the rhythm?

A

2nd degree Type 1 AV Block or Wenckebach

37
Q

What is the rhythm?

A

2nd degree Type 2 AV Block

38
Q

What is the rhythm?

A

Complete heart block or 3rd degree AVB

39
Q

What is the rhythm?

A

Vtach

(150-180 bpm)

40
Q

What is the rhythm?

A

Vfib

41
Q

Polymorphic vtach is also known as _________-

A

Torsades de Pointes

42
Q

How do you treat V-fib?

A

Defibrillation (electricity)

43
Q

How do you treat polymorphic vtach?

A

Mag and Electricity

44
Q

What general anesthetics will cause sensitive myocardium?

A

Halothane and enflurane

45
Q

How does cocaine and ketamine cause tachycardia?

A

Norepinephrine reuptake inhibitors

46
Q

What causes bradycardia in infants?

A

Too much Sevoflurane

47
Q

What can cause prolonged QT during induction?

A

Desflurane

48
Q

Smashing the face mask will cause pressure to build up in the eye and will result in bradycardia due to what reflex?

A

Oculocardiac Reflex

49
Q

A local anesthetic will cause a _____________ block.

Which will result in ___________.

A

Sympathetic

Severe Bradycardia

50
Q

What happens if you inject local anesthetic into the blood vessel?

What is the treatment?

A

Patient will become asystolic (and so will you)

Treat with lipid rescue

51
Q

Endotracheal intubation can put pressure on the _________, resulting in bradycardia and other hemodynamic disturbances.

A

vagus nerve.

52
Q

There can be autonomic reflexes during a surgical case stimulation of the carotid baroreceptors can cause_________.

A

Bradycardia

Prevent this by asking the surgeon to put more local anesthetic around the area

53
Q

During a laparoscopic case, insufflation can cause ____________ due to _________________.

A

Bradycardia due to loss of venous return.

54
Q

Tugging the ___________ or _________ will cause bradycardia.

A

Peritoneum; Cervix

Hysterectomy

55
Q

What cannulation procedure can cause dysrhythmias?

A

Central lines

56
Q

What is the rhythm?

A

Sinus Rhythm with Trigeminy

57
Q

What is the rhythm?

A

PSVT

58
Q

What is going on here?

A

Ventricular Paced

59
Q

What is the rhythm?

A

2nd degree AV Block Type II

60
Q

What is the rhythm?

A

Artifact

61
Q

What is the rhythm?

A

PAC

62
Q

What is the rhythm?

A

A-fib

Rhythm is irregularly irregular

63
Q

What is the rhythm?

A

Atrial Paced

64
Q

What is the rhythm?

A

Atrial Flutter

65
Q

What is the rhythm?

A

A-fib

Rhythm is irregularly irregular

66
Q

What is the rhythm?

A

Sinus Brady

67
Q

What is the rhythm?

A

Sinus Rhythm with PJC

See the retrograde p-wave?

68
Q

What is the rhythm?

A

V-fib

69
Q

What is the rhythm?

A

A-fib

70
Q

What is the rhythm?

A

SVT

71
Q

What is the rhythm?

A

Junctional Tachy

Sometimes there might not be the classic retrograde p-wave

72
Q

What is the rhythm?

A

Idioventricular Rhythm or IVR

73
Q

What is the rhythm?

A

AV Sequential Pacer

74
Q

What is the rhythm?

A

Idioventricular Rhythm or IVR

75
Q

What is the rhythm?

A

Artifact

Look at both leads, they do not correlate.

76
Q

What is the rhythm?

A

A-fib with Bigeminy

77
Q

What is the rhythm?

A

Sinus with Junctional Escape

Look at the fourth beat, no p-wave

78
Q

What is the rhythm?

A

Torsades de Pointes

Treat with mag and electricity

79
Q

What is the rhythm?

A

Junctional Rhythm

80
Q

What is the rhythm?

A

Sinus Rhythm with Hyperkalemia

81
Q

What is the rhythm?

A

A-fib

82
Q

What is the rhythm?

A

2nd degree Type 2 AVB

83
Q

What is the rhythm?

A

NSR with PVC

84
Q

What is the rhythm?

A

Sinus Arrest

Can be caused by adenosine or the patient being hypoxic

Health Assessment (2) (22 decks)

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