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Physiology I Block 3 > Cardio 7.13 > Flashcards

Cardio 7.13 Flashcards

1
Q

second degree heart block

A

P wave is not always followed by QRS

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2
Q

describe mobitz type I

A

a second degree heart block

PR interval gets progressively longer and then QRS will drop

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3
Q

describe motbitz type II

A

randomly dropped QRS

PR interval the same and then random drop of QRS

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4
Q

mobitz type II thought to reflect damage to

A

specialized conduction system

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5
Q

which is worse mobitz type I or II

A

II

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6
Q

what happens to AP with hyperkalemia

A

it shortens - it promotes potassium conductance so increased potassium current

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7
Q

what happens to rate of rise with yperkalemia

A

slowed - this is the sodium current

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8
Q

what happens to AP with hyperkalemia

A

shortens AP duration

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9
Q

as you depol cell you switch from what for sodium channels

A

to inactivated state

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10
Q

how do you get from inactivated state to closed state

A

negative resting membrane potential again

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11
Q

QRS you don’t want bigger than

A

2 little boxes (80)

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12
Q

peaked t wave

A

cells really sensitive to high potassium (hyperkalemia) so they repol fast and you get peak t wave (pg 205)

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13
Q

causes of conduction block

A

closure of gap junctions

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14
Q

what could cause closure of gap junctions

A

ischemia
low pHi
high Cai

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15
Q

what happens to pH during ischemia

A

low

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16
Q

why is pH low in ischemia

A

CO2 increases

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17
Q

what happens to calcium in ischemia

A

increases - can close gap junctions

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18
Q

lidocaine does what

A

blocks sodium channels

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19
Q

cocaine does what

A

blocks sodium channels

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20
Q

sodium channel blockers used to block pain and also as

A

antiarthmia

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21
Q

sodium current (INa) produces upstroke of

A

everything but SA and AV, so atrial ventricular, Hi-spurkinje myocytes

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22
Q

inhibition of Ica by medications

A

decreases upstroke of AV and SA nodes, would think it would also decrease AP duration

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23
Q

Ica produces

A

upstroke of SA and AV nodal cells

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24
Q

Ach blocks

A

calcium current

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25
Ach affects
conduction velocity through AV nodes and contractability of atria
26
what is most common caues of tachycardia
re-entry
27
how can you get unidirectional conduction
dead cells that can't fire AP - you end up with one cell trying to activate a bunch and i isn't ble to do that (pg 210)
28
what is reentry
AP is re-entering in spacial area (like dog chasing its tail)
29
when wave fronts come through ventricles what normall yhappens
collide come togther, activate, and extinguish (but in re-entry it doesn't extinguish)
30
re-entry in AV node would cause
ventricles to fire at fast rate
31
micro-rentry you would see in
ventricular fibrulation
32
two broad types of reentry and reentrant arrhytmias
anatomical & functional (spiral waves)
33
what do you need for re-entry to proceed
excitable gap
34
put a premature beat in and what happens
anatomical reentry (ppt 210) there is video
35
look at anatomical reentry
pg 215
36
describe reentrant ventricular tachycardia
very fast HR lower CO QRS wider than normal and no distinguishable P or T waves pg 216
37
if there is bypass track what syndrome can develop
wolff-parkinson white syndrome
38
what is bypass track
band of muscle tat connects atria directly to ventricle
39
describe wolff parkinson white syndrome
fast AP conduction via accessory pathway (bypass track_ - short PR interval. pre-excitation with delta waves
40
What does WPW stand for
wolff-parkinson-white syndrome
41
what is delta wave
ramp like start to R wave, no Q wave
42
Look at WPW
pg 217
43
pt with WPW pre-disposed to what
pre-disposed to re-entrant ventricular tachycardia
44
what does AVRT stand for
atrioventricular reentrant ventricular tachycardia
45
how might you treat WPW
can identify the bypass track and put catheter and apply frequency nd destroy the accessory pathway can also reduce calcium current, so it slows AV node, so can give pt calcium channel blockers
46
adenosine is
fast channel calcium blocker
47
atrial flutter characterized by
"saw-tooth"atrial activity
48
atrial flutter describe
crazy re-entry through the atria every time it fires - goingso fast it's not contributing to ventricle filling
49
how to identify atrial flutter
the saw tooth pattern of p waves
50
atrial flutter can degrade into
atrial fibrulation
51
Ventricular fibrillation can be caused easily by
even small hit to tet | or electrecutted
52
VF stands for
ventricular fibrillation
53
SCA stands for
sudden cardiac arrest
54
who is at risk for SCA
pts with coronary artery disease pts with heart failure pts with inherited channelopathies causing ventricular arrhythmia
55
most widespread sustained arthymia
atrial fibrillation
56
AF stands for
atrial fibrillation
57
describe AF
no visible P waves | ventricular firing often fast and irregular
58
look at AF
pg 225
59
what is missing in ECG in AF
p wave
60
why isn't there P wave in AF
P wave is b/c of normal coordinated propegation of AP through atria - so you might get little squiggle but no discernible p wave.
61
how do you treat arrhythmia
Electrical Cardioversion Antiarrhythmic Drugs Catheter Ablation Implanted Rhythm Devices
62
defibrilation
- put electrodes on chest (v fib)
63
cardioversion
apply shock and convert to normal sinus
64
ccardioversion vs. defibrillation
cardioversion apply shock during QRS

Physiology I Block 3 (14 decks)

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