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PMP 201 Patient-Centred Learning > Cardiac Rhythms > Flashcards

Cardiac Rhythms Flashcards

1
Q

What effects cardiac output?

A
  • Pregnancy
  • Exercise
  • Respiration
  • Age
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2
Q

Right Coronary Arteries

A

Right coronary artery supply blood to right atrium, ventricle, SA node and AV node

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3
Q

Left circumflex artery

A
  • Supply oxygen rich blood to surfaces of left atrium and ventricles
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4
Q

Cardiac veins

A
  • Three major veins that empty into coronary sinus
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5
Q

Left anterior decending artery

A
  • Supply right ventricle and left ventricle
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6
Q

Left marginal artery

A
  • Supply of blood to the left ventricle
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7
Q

Right marginal artery

A
  • Supply blood to right ventricle and apex
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8
Q

Type 1 MI effects which area of heart

A
  • Athresclerosis in the anterior intraventricular branch of the coronary artery
  • 50% of MI occour there
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9
Q

Where do STEMI occour in the heart

A
  • Occour in the anterior intraventricular branch of left coronary artery
  • ST elevation above isoelectric point
  • Interval between depolarisation and repolarisation of ventricle
  • Larger infarction more damage and higher mortality rate
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10
Q

Cardiac pacemaker cells

A
  • Autorhymic pacemaker cells (1%) - unstable resting potential
  • Gap junction cause movemet along cardio myoctes propogation of action potential
  • Ion moves into cell becomes postive
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11
Q

Calcium channels

A
  • Ryanodine receptors and inositol triphosphate activated calium channels enable conduction of action potential and contraction of myocardium
  • L-type calcium channels important regualtion of vasular smooth muscle for cardiac rhythm
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12
Q

Depolarisation of pacemaker cells

A
  • Funny current enter the cell via receptor initiating autorhythmic aspects
  • Influx of calcium ions through the outside L type channels on the membrane
  • Cause depolarisation
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13
Q

Repolarisation pacemaker cell

A
  • L-Type calcium channels close
  • Potassium channel open and coming out of cell causing repolarisation
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14
Q

Depolarisation wave into cardio myocte Phase 0

A
  • Ion come in across gap junction as cardio myocytes recive action potential opening Na+ cause influx cause depolarisation
    • 70mV threshold
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15
Q

Depolarisation wave into cardio myocte Phase 1

A
  • Outflux of potassium causes decrease of levels in cell
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16
Q

Depolarisation wave into cardio myocte Phase 2

A
  • Plataeu formation due to influx of calcium countacting eflux of potassium
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17
Q

Depolarisation wave into cardio myocte Phase 3

A
  • Calcium channels close but potassium channels are still open leaving cell
  • Repolarisation of cardiac myoctes occour
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18
Q

Action potential comparision to ECG
Absolute refractory

A
  • Phase 1 two 2 represents QRS complex
19
Q

Action potential comparision to ECG
Effective refractory

A
  • Between 2 and 3 stimulus may cause cells to depolarise include qrs complex and a small part of T
20
Q

Action potential comparision to ECG
Relative refractory period

A
  • Greater than normal stimulus will depolarise the cell can cause action potential
  • Ectopic firing of pacemake cells additional in phase 3
21
Q

Sinus Node

A
  • Primary pacemaker fires approx 60-100 depolarisations a minute
22
Q

AV node

A
  • Base of right atrium and fires at rate of 40-60dmp
  • Allow ventricles to fill with blood
  • Smaller diameter greater resistance and slow opening calcium channels
23
Q

Ventricular bundle of His

A
  • Right and left right branches fire rate 20-40 dpm
24
Q

Ventricular purkinje fibres

A
  • Less than 40dpm
  • Normal sinus rhythm could have ectopic firing
25
Q

Ischemic heart disease

A
  • Ventricular fibrullation due to failure of heart muscles to contract
  • No Oxygen cause apoptosis of cardiac cells unable to contract in coodinated way
26
Q

P wave inn sinus rhythm

A
  • Depolarisation of atrium
  • Atrial systole 0.1s
27
Q

QRS wave in sinus rhythm

A
  • Depolarisation of ventricles
28
Q

T wave in sinus rhythm

A
  • Repolarisation of ventricles
29
Q

Interpret ECG

A
  • Speed is 25mm/s
  • Small box represent 0.04s and big box is 0.2ms
  • Shows in bradycardia or tachycardia
30
Q

Check regularity of ECG

A
  • Is R to R point evenly spaced out
  • In bradycardia or tachycardia
31
Q

Check P wave on ECG

A
  • Is there a P wave before the QRS complex
  • Is the PR interval long (>200ms) are they consistant
32
Q

Check QRS complex on ECG

A
  • Is QRS complex (<100ms) are they consistant looking the same following P wave
  • After ST return to isoelectric point
  • Aprox 2.5 little box
33
Q

T wave in ECG

A
  • Is the T wave after QRS complex and upwards not inverted or flattened
34
Q

PR segment

A
  • Pause between SA and AV
  • May become longer possible blockage
  • Sinus 3-5 boxes/0.12-0.2
35
Q

ST segment

A
  • Time between depolarisation of ventricle and repolerisation on isoeletric point
  • If elevated by more than 2 boxes could be ischemia or infarction
36
Q

QT interval with hypercalcemia

A
  • Short QT interval
  • Atrial eptopic firing
37
Q

Hypocalcemia

A
  • Long QT interval
  • Possible ventricular tachycardia lead to sudden cadiac death Torsedes DE pointes
38
Q

Caculations with ECG

A
  • Count boxes between R to R
  • Small box x 0.04 then 1/answer
  • Multiply answer by 60s
  • Alternative run 10 beats count no of R x 6
39
Q

General Big Box to Beats per min

A
  • 1 big box R-R is 300bpm
  • 2 big box apart 150bpm
  • 3 big box 100bpm
  • 4 big box 75bpm
  • 5 big box 60bpm
  • 6 big box 50bpm
40
Q

Dysrhythmia

A
  • Impuse formation altered conduction
41
Q

Abnormal ECG

A
  • Shape change in ECG conditions changes of cardiac rhythm
42
Q

Ishcemia

A
  • Acute imaprement of blood flow to the heart
  • Prior to evolving into acute MI
43
Q

Arrhythmia

A
  • Abnormal fast slow or irregular heart rhythms
  • Abnormal conduction of heart rhythms

PMP 201 Patient-Centred Learning (51 decks)

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