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Paramedic > Cardiology > Flashcards

Cardiology Flashcards

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1
Q

BPM for the atrial cells

A

55-60 bpm

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2
Q

BPM for the AV node

A

45-50 bpm

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3
Q

BPM for bundle of his

A

40-45 bpm

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4
Q

BPM bundle branch

A

40-45 bpm

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5
Q

BPM for purkinjie cells

A

35-40 bpm

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6
Q

BPM for myocardial cells

A

30-35 bpm

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7
Q

Main function of the SA node aka the pacemaker

A

The pacemaker dictates the rate at which the heart will cycle through its pumping action to circulate blood. The pacemaker creates an organized beating of all cardiac cells in a specialized sequence to produce effective pumping action

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8
Q

Where is the SA node located and where does it receive its blood supply?

A

Its located in the wall of the right atrium and mainly comes from the RCA. In 38% of cases it can come from the LCA and in less cases can come from both arteries.

P.11 arrhythmia recognition

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9
Q

Where are the internodal pathways located and what are its function?

A

They are located in the walls of the right atrium and inter-atrial septum. Their main purposes is to conduct the impulses from the SA node to the AV node.

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10
Q

Where is the AV node located and what is its main purpose?

A

The AV node is located in the wall of the right atrium next to the opening of the coronary sinus. It slows down the signal from the SA node long enough for the atria to overfill and contract.

Note: The AV node is always supplied by the RCA.

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11
Q

Where is the bundle of his located and how does it function?

A

It starts after the AV node and travels the walls of the right atrium and inter ventricular septum. It allows for the singalong from the AV node travel down the heart.

NOTE: The bundle of his is the only route of communication between the atria and the ventricles.

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12
Q

Where is the LBB located and how does it function?

A

It begins at the end of the His bundle and travels through the inter-ventricular septum. The LBB sparks the fibers that will set off the left ventricle and left face of the left ventricular septum. It ends at the beginning of the left anterior fascicles.

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13
Q

Where is the RBB located and how does it work?

A

The RBB starts after the Bundle of His and sparks the right ventricle and right face of the inter-ventricular septum. It terminates in the purkinjie fibers associated with it.

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14
Q

Explain the Left and Right Fascicles

A

Both fascicles travel to the left ventricle. The left supplies the anterior part of the heart while the right supplies the posterior.

The LAF Innervates the anterior and superior aspects of the left ventricle. It is a single stranded in comparison to the right which branches off into smaller pathways

The RPF innervates the posterior and inferior side of the left ventricle. It is harder to block this fascicles as it is so widely distributed rather than being one main strand like the LAF.

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15
Q

Explain the Purkinje system

A

They are made up of individual cells just beneath the endocardium. They are cells that directly innervate the myocardial cells and initiate ventricular depolarization cycle.

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16
Q

List the four arrthymogenic zones

A

Sinus
Atria
Nodal / Bundle
Ventricles

17
Q

List the sinus arrhythmias

A 
Sinus Bradycardia
NSR
Sinus Tachycardia
SA block
SA pause/arrest
Sinus arrhythmia/PAC
18
Q

List Atria arrhythmias

A 
Ectopic atrial
Atrial Flutter
Atrial Tachycardia
A-fib
WAP - wandering atrial packe maker
Multifocal atrial Tachycardia 
Variable atrial flutter
19
Q

List Nodal arrhythmias

A 
Junctional
Junctional Escape
1st Degree Block
Accelerated Junctional 
Junctional Tachycardia
AV nodal re-entry
PJC
2nd Degree block
3rd Degree Block
20
Q

List Ventricular arrhythmias

A 
Ventricular Escape 
Idoventricular
Accelerated idioventricular
PVC
Asystole
Ventricular Tachycardia
Torsades de Pointers
Polymorphic V-tach
V-fib
21
Q

List each phases of depolarization and repolarization

A

Cells are naturally negatively charged. Eventually the cell becomes so positive that a new set of channels opens. The point at which the channels open is called the threshold potential and the channels are fast sodium channels. This process is the balance of the Sodium Potassium pump that allows the heart to contract.

Phase 0 - A influx of sodium makes the cell become positively charged. This creates a spike in the cell and allows for the cell next to it to do the same

Phase 1 - When the cell is at its peak positive charge some negative ions of chloride enter the cell to slow down the sodium. This allows for two more channels to open. One for the slow sodium and one for calcium

Phase 2 - The cells begins to plateau. These two cells combined allow for the cell to maintain a steady positive/depolarized state. Calcium is a double positive ion.

Phase 3 - Some potassium channels open and allow it to go into the cell to re polarize. The positive cells now leave the cell.

22
Q

Chronotropic

A

Speeds up rate

23
Q

Inotropic

A

Increases contractility

24
Q

Dromotropic

A

Speeds up conduction through the AV node

25
Q

Main chemical messenger for the Parasympathetic System

A

Acetylcholine

26
Q

Main chemical messenger for the sympathetic system

A

Epinephrine

27
Q

What is the main pathway from the Central Nervous System to the heart?

A

Vagus Nerve (10th cranial nerve)

28
Q

How does epinephrine work on the sympathetic nervous system?

A

It shortens the phase 4 of the action potential essentially speeding up the pacemaker action of the SA node and all the other pace makers as well

29
Q

How does acetylcholine affect the parasympathetic nervous system?

A

It slows the rate of depolarization essentially making the cells less excitable.

30
Q

BPM for the SA node

A

60-100 bpm

31
Q

P wave represents…

A

Atrial depolarization

32
Q

Duration of P wave

A

.08 - .11

33
Q

TP Wave represents….

A

Represents the repolarization of the atria
Normal Duration: usually not seen
Wave Orientation: Opposite to the P wave

Paramedic (24 decks)

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