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Basics and history Flashcards

(108 cards)

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1
Q

Who used two dissimilar metals to create an electrical charge? (Hint: frogs legs dancing)

A

Luigi Galvani (1790)

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2
Q

Who experimented on deceased individuals with electricity?

A

Charles Kite (1788)

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3
Q

Who advocated the use of zinc and silver as the most effective metals to carry an electric current? (Hint: developed the “voltaic pile” which was the precursor to a battery)

A

Alessandro Volta (1800)

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4
Q

Who used the electrical theories of Galvani in public spectacles?

A

Giovanni Aldini (1792)

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5
Q

Who proved the electrical currents of the heart by attaching leads to frog heart and amputated leg?

A

Koelliker & Mueller (1856)

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6
Q

Who developed the string galvanometer that was used for the tracings of an EKG from the leads?

A

Willem Einthoven (1901)

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7
Q

Clinical uses of an EKG (6)

A
  1. Detection of arrhythmias and heart abnormalities
  2. Indication of myocardial damage
  3. Detection of electrolyte disturbances
  4. Screening tool for diagnosis of ischemic disease
  5. Can indicate anatomic and physiologic state of the heart (i.e. hypertrophy, stenosis, etc. )
  6. Can diagnose some non-cardiac pathology
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8
Q

Is the systemic circulation a high pressure or low pressure circulation?

A

high pressure (~120/80 mmHg)

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9
Q

Is the systemic circulation a low resistance or high resistance circulation?

A

high resistance

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10
Q

Is the pulmonary circulation a high pressure or low pressure circulation?

A

low pressure (~25/10 mmHg)

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11
Q

Is the pulmonary circulation a low resistance or high resistance circulation?

A

low resistance

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12
Q

What is considered to be a normal blood pressure?

A

120/80 mmHg (Systolic/Diastolic)

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13
Q

What type of cardiac cells are considered to be the heart’s electrical power source of the heart?

A

Pacemaker cells

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14
Q

What type of cardiac cells are considered to be the hard wiring of the heart?

A

Electrical conducting cells

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15
Q

What is the role of myocardial cells?

A

Provides the contractile machinery of the heart

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16
Q

What is the normal conduction pathway of the heart?

A

SA node –> AV node –> Bundle of his –> Bundle branches –> Purkinjie Fibers

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17
Q

What is the inherent rate of the SA node?

A

60-100bpm

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18
Q

What is the predominant pacemaker of the heart?

A

SA node

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19
Q

Contraction of the heart is initiated by the influx of what ion?

A

Ca++

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20
Q

During repolarization, there is an efflux of what ion?

A

K+

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21
Q

During rapid depolarization, there is an influx of what ion?

A

Na+

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22
Q

Which wave on the EKG represents atrial depolarization?

A

P wave

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23
Q

What event is occurring during the PR interval?

A

Beginning of atrial depolarization to the beginning of ventricular depolarization

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24
Q

What event is occurring during the PR segment?

A

The end of atrial depolarization to the beginning of ventricular depolarization

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25
Which wave on the EKG represents ventricular depolarization?
QRS complex
26
What event is occurring during the QT interval?
Beginning of ventricular depolarization to the end of ventricular repolarization
27
What event is occurring during the ST segment?
The initial "plateau" phase of ventricular depolarization
28
Which wave on the EKG represents ventricular repolarization?
T wave
29
An action potential propagating toward a (+) lead produces a (-) or (+) signal?
(+)
30
A repolarization spreading toward a (+) lead produces a (-) or (+) signal?
(-)
31
Magnitude and polarity of the signal from an EKG depends on what two things?
1. What the heart is doing electrically- (depolarizing/repolarizing) 2. The position and orientation of the recording electrode
32
Who introduced the "augmented" (aV) leads?
Goldberger
33
What are the angles of the three standard limb leads (Leads I, II, III)?
I: 0 (R arm - and L arm +) II: 60 (R arm - and legs +) III: 120 (L arm - and legs +)
34
What are the angles of the three augmented leads (Leads aVL, aVF, and aVR)?
aVL: -30 (other limbs - L arm +) aVF: 90 (other limbs - legs +) aVR: -150 (other limbs - R arm +)
35
What are the inferior leads?
aVF, II and III
36
What are the left lateral leads?
I, aVL, V5 and V6
37
What is the right-ventricular leads?
aVR and V1
38
What are the anterior leads?
V2
39
One small square is equal to how many sec?
0.04sec
40
One large square is equal to how many sec and how many mV?
0.2 sec and 1/2mV
41
One small square is equal to how many mm?
1mm
42
What are the septal leads?
V3 and V4
43
List the rates (bpm) from one big square to the next.
``` 300, 150 100 75 60 50 30 Or...you can count the number of large squares and divide by 300 ```
44
What rate is considered a normal sinus rhythm?
60-100 bpm (3-5 large squares)
45
What rate is considered a sinus tachycardia?
>100 bpm (less than 3 large squares)
46
What are some of the causes of tachycardia? (10)
``` Pain Fear/anxiety Exercise Hyperthyroid Anemia Hypovolemia MH Pheochromocytoma Sepsis Drug abuse/caffeine ```
47
How would you treat tachycardia? (4)
Resolve underlying cause Vagal maneuvers (carotid massage, valsalva, gagging) AV blocking agents (adenosine, verapamil) Beta blockers
48
What rate is considered a sinus bradycardia?
40-59 bpm (more than 5 large squares)
49
What are some of the causes of bradycardia? (6)
``` Hypothyroid Vagal maneuvers Athleticism Sleep Severe HTN Beta blockers ```
50
How would you treat chronic bradycardia? (2)
pacemaker | thyroid therapy
51
How would you treat acute bradycardia? (3)
Cease stimulation Atropine Glycopyrrolate
52
What are the causes of a sinus arrhythmia? (2)
Spontaneous breathing | Heart disease
53
What is the intrinsic rate of the atrium?
60-80 bpm
54
What is the intrinsic rate of the AV junction?
40-60 bpm
55
What is the intrinsic rate of the ventricle?
20-40 bpm
56
The heart's "fail-safe" pacing mechanism, utilizing automaticity foci in the atria, the ventricles and the AV junction.
Overdrive suppression
57
When the SA node stops firing and you see a "dropped beat"
Sinus arrest.
58
If a sinus arrest occurs, and nothing happens, what can this lead to?
Asystole
59
Type of arrhythmia where there are aberrant or inverted P waves and the rates are regular
Junctional escape
60
Abnormal rhythms that arise from elsewhere other than the SA node and are essentially sustained escape beats.
Ectopic rhythms
61
Absolutely regular rhythm, rate 150-250 bpm and P waves buried in the QRS complex.
PSVT
62
Treaments for PSVT. (3)
Adenosine Esmolol Vagal maneuvers
63
Absolutely regular rhythm, rate 250-350 bpm, characteristic saw-tooth pattern.
Atrial flutter
64
What is the most common type of atrial flutter?
2:1
65
Can a carotid massage treat atrial flutter?
No, it can be used for diagnosis but doesn't treat it.
66
Chaotic atrial activity with undulating baseline with no true P waves, and an irregularly irregular AV conduction.
Atrial fibrillation
67
What are the symptoms of atrial fibrillation? (2)
syncope | low bp
68
What are the underlying pathology of atrial fibrillation?
``` mitral valve disease CAD hyperthyroidism PE pericarditis ```
69
How can you treat A-fib?
Cardioversion | anti-coagulants
70
Irregular rhythm occurring from random firing of various atrial foci with easily identifiable various P waves.
Multi-focal atrial tachycardia (MAT)
71
Warm up and cool down phases.
Paroxysmal Atrial tachycardia (PAT)
72
Any obstruction or delay of the normal pathways of electrical conduction in the heart.
Conduction blockade
73
What are the 3 types of conduction blockades?
Sinus node block AV node block Bundle branch block
74
Characterized by a prolonged delay in conduction at the AV node and results in long PR interval >0.2sec
First degree AV block
75
Type of block that is also known as the "Wenckebach block"
Second degree AV block (Mobitz type I)
76
Progressive lengthening of PR interval with each beat and then a "dropped beat"
Second degree AV, Type I
77
Conduction block in the bundle of his, where the conduction is all-or-none.
Second degree, Mobitz Type II
78
Dropped beat without PR interval lengthening.
Second degree, Type II
79
Also known as a "complete heart block" because the atria and ventricles are being driven by different pacemakers.
Third degree AV block
80
AV dissociation between P and QRS. | Regular P wave rate of 60-100bpm with ventricular escape rhythms of 30-45bpm
Third degree AV block
81
Conduction through the right bundle branch is blocked
RBBB
82
"Rabbit ears" in leads V1 and V2 with deep S waves in the other precordial leads
RBBB
83
Conduction through the left bundle branches are blocked.
LBBB
84
"Rabbit ears" in leads V5 and V6 with deep S waves in V1 and V2
LBBB
85
What is the most common type of bifasicular block?
RBBB with incomplete anterior LBBB
86
In which incomplete block do you see a left axis deviation?
Anterior LBBB
87
In which incomplete block do you see right axis deviation?
Posterior LBBB
88
Tall positive R waves in lateral leads (I, aVL, V5, V6) and deep S waves in inferior leads (II, III, aVF) and left axis deviation.
Anterior LBBB
89
Tall R waves inferiorly and deep S waves laterally with right axis deviation.
Posterior LBBB
90
Only one of the three fascicles is conduction.
Bifascicular blocks
91
What type of syndromes uses accessory pathways for the conduction of the heart?
Pre-excitation syndromes
92
Are pre-excitation syndromes more common in males or females?
males
93
Pre-excitation syndromes can be present in healthy or diseased hearts, but they are most commonly seen with what disorders? (3)
MVP Hypertrophic cardiomyopathy congenital disorders
94
What is the accessory pathway used in WPW?
The Bundle of Kent
95
Premature depolarization of the ventricles with the presence of delta waves.
WPW
96
When can WPW be harmful?
When it occurs with A-Fib due to inefficient CO
97
What is the accessory pathway used in LGL?
James fibers pathways
98
No part of the ventricles are depolarized independently with shortened PR intervals.
LGL
99
Global T wave peaking, PR interval prolongation and P wave disappearance, and QRS in sine wave formation
Hyperkalemia
100
Which electrolyte disturbance has presence of U wave?
Hypokalemia
101
Which electrolyte disturbance has QT prolongation?
Hypocalcemia
102
Which electrolyte disturbance has QT shortening?
Hypercalcemia
103
Sinus bradycardia, presence of J (osborn) waves and slow atrial fibrillation.
Hypothermia
104
What plant is the drug Digoxin synthesized from?
Black nightshade
105
What would you see if there were toxic levels of Digoxin? (3)
sinus exit block AV nodal blockade PAT
106
``` These pharmacological drugs can cause prolongation of which interval? Sotalol Quinidine Procainamide Disopryramide Amiodarone Tricyclic antidepressents Phenothiazines Erythromycins ```
QT prolongation
107
Beck's triad is seen in what condition?
pericarditis
108
What is Beck's triad?
Jugular vein distention muffled heart sounds hypotension

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