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KIN 311 > Cardiovascular Assessment > Flashcards

Cardiovascular Assessment Flashcards

1
Q

ECG =

A
  • EKG

- electrocardiography

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2
Q

Electrocardiograph:

A

the machine (oscilloscope/chart recorder)

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3
Q

Electrocardiogram:

A

the tracing

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4
Q

ECG measures the _____ ____ of the heart along different _____.

A
  • electrical activity

- vectors

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5
Q

ECG is used to assess …

A

basic abnormalities in heart function

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6
Q

A 12-lead ECG requires ___ electrodes and provides ___ leads.

A
  • 10

- 12

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7
Q

A lead consists of ___ ____ that form an ____ to provide a different view or tracing of the heart’s ____ ____.

A
  • 2 terminals (eg. a pair of electrodes)
  • axis
  • electrical activity
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8
Q

A lead is _____ and aligned with a particular ____ from the _____ electrode towards the _____ electrode.

A
  • directional
  • vector
  • negative
  • positive
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9
Q

What produces the ECG waveform?

A

the orientation of the lead (vector) in relation to the electrical current of the heart

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10
Q

When the direction of current is towards the positive electrode (negative to positive), the resulting waveform is…

A

positive

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11
Q

When the direction of current is away from the positive electrode (positive to negative), the resulting waveform is…

A

negative

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12
Q

Why should we avoid musculature as much as possible when setting up a ECG?

A

neuromotor control/ movement = activity is picked up

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13
Q

Phrase to remember set up of ECG:

A
  • white on right

- smoke over fire (black over red)

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14
Q

12-lead ECG provides ____ information about the heart’s ____ ____ in 3 orthogonal planes:

A
  • spatial
  • electrical activity
  • right - left
  • superior - inferior
  • anterior - posterior
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15
Q

__ important vectors (leads) derived from the “limb” electrodes:

A
  • 6
  • RA to LA (lead I)
  • RA to LL (lead II)
  • LA to LL (lead III)
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16
Q

Describe lead I:

A
  • travels across the heart from right to left
  • positive depolarization
  • QRS complex
  • heart is on axis that is tilted from right to left = positive depolarization associated with the fact that activity is travelling in the same direction
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17
Q

Describe lead II:

A
  • positive QRS complex
  • positive depolarization T wave
  • along axis
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18
Q

Describe lead III:

A
  • across axis of heart

- positive and then negative component to QRS

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19
Q

Why not put leads on the legs?

A
  • practicality (can do it with just shirt off)

- tripping hazards

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20
Q

RA location:

A

upper right arm-chest region immediately below the midpoint of the clavicle

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21
Q

LA location:

A

upper left arm-chest region immediately below the midpoint of the clavicle

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22
Q

LL location:

A

lower left abdominal region, at the midclavicular line at the level of the last rib

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23
Q

V1 location:

A

on the right sternal border in the 4th intercostal space

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24
Q

How can we find the 4th intercostal space?

A
  • locate sternoclavicular joint
  • clavicle counts as rib 1
  • index finger in the space immediately below first rib is first intercostal space
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25
Know where ____, ____ and ____ is and fill in the rest.
- V1 - V2 - V4
26
V2 location:
on the left sternal border in the 4th intercostal space
27
V3 location:
at the midpoint on a straight line between V2 and V4
28
V4 location:
on the 5th intercostal space at the midclavicular line
29
V5 location:
on the anterior axillary line, horizontal to V4
30
V6 location:
on the midaxillary line, horizontal to both V4 and V5
31
Augmented (unipolar) limb | leads:
use two electrodes to create a “null point” which is compared to the 3rd electrode.
32
aVR uses which 2 electrodes to create a null point? What is the third electrode it is compared to?
- LA and LL | - RA
33
aVL uses which 2 electrodes to create a null point? What is the third electrode it is compared to?
- RA and LL | - LA
34
aVF uses which 2 electrodes to create a null point? What is the third electrode it is compared to?
- RA and LA | - LL
35
Precordial leads:
- V1 - V2 - V3 - V4 - V5 - V6
36
Limb leads:
- RA - LA - LL
37
Limb leads are ____, while precordial leads are _____.
- bipolar | - unipolar
38
Precordial leads are in close proximity to the _____, and measure ...
- heart | - the change in electrical potential along a vector from the heart towards the electrode
39
P wave:
atria depolarization
40
QRS complex:
ventricle depolarization
41
T wave:
ventricle repolarization
42
U wave:
repolarization of purkinje cells and/or papillary muscle of valves
43
R-R:
1 heart beat
44
J point:
transition point between QRS complex and the ST segment
45
Grid divided into _____ and ____ ____.
large and small squares
46
1 large square = ___ small squares.
5
47
Standard chart recorder speed:
25 mm/sec
48
One large square = _____ sec.
0.20
49
One small square = ___ sec.
0.04
50
Tachycardia:
rapid beating greater than 100 bpm at rest in an untrained adult
51
Bradycardia:
beating < 60 bpm at rest in an untrained adult (symptomatic < 50 bpm)
52
Arrhythmia:
abnormal rate, rhythm or conduction of electrical impulse in the heart
53
Cause of arrhythmias:
- multifaceted - several types - fever - dehydration - shock - hormonal imbalance - stress - various types of cardiac abnormalities - heart failure
54
Premature ventricular contraction is caused by:
- depolarization of ventricle before atria can contract | - absence of P wave before another QRS complex
55
Sinus pause:
- failure of S-A node firing - no P (atrial depolarization) - electrolyte abnormality - ventricle waits, if it doesn't get a signal, it depolarizes on it's own to make sure the heart keeps beating
56
Third degree heart block:
- nothing at SA node - ventricles start to beat on their own - P wave with no response
57
Fibrillation:
- uncoordinated atria or ventricle contractions caused by re-entry of electrical impulses and requires defibrillation - emergency
58
ECG is highly recommended in ____ ____ centres especially with....
- exercise testing | - untrained, older, diseased individuals
59
In exercise testing centres, you must...
- establish a resting ECG looking for abnormalities | - record a tracing every workload during exercise
60
It is difficult to obtain ____ ___ during high intensity exercise.
clear traces
61
_____ is qualified to conduct an ECG evaluation during exercise to identify (but not ____) irregularities. Stress testing must be done in the presence of a _____.
- CSEP - CEP - diagnose - physician
62
Elevated BP increases the _____ on the heart.
"afterload"
63
Afterload:
the pressure the heart needs to overcome to eject blood during systole
64
Stroke work =
sv*map
65
Cardiac work =
sw*hr
66
Auscultation method:
- BP | - listening to bodily sounds using a stethoscope
67
What are we listening to when taking blood pressure?
- laminar flow | - turbulence of blood underneath the cuff
68
Korotkoff sounds phases:
- phase I: clear tapping (systolic pressure) - phase II: softer tapping - phase III: clear tapping - phase IV: muffled tapping - phase V: tapping disappears (diastole)
69
BP is normally taken from the ____ ____. Why?
- brachial artery - it is close to the heart - easily accessible
70
When taking BP, individual should be ...... Why?
- seated - relaxed - legs not crossed - not talking - don't want muscular activity
71
Muscular activity during the measuring of BP can..
influence the ability to hear sounds and BP in general
72
When taking BP, the cuff should be at the level if the ____ (____ supported).
- heart | - arm
73
Appropriate size of cuff:
- length of bladder = 80% of arm circumference - width of bladder = 40% of arm circumference - size must apply enough pressure to stop blood flow
74
Cuff should be inflated to ____ mmHg above _____ pressure.
- ~30 | - systolic
75
Cuff should be deflated at rate of ___ mmHg/s.
2-3
76
Systolic pressure tends to be ______. Why?
- underestimated | - if you deflate too fast, you might miss the first sound
77
Diastolic pressure tends to be ______.
overestimated
78
When taking BP, repeated measures should be separated by ____ mins.
1+
79
Hydrostatic pressure is _____ mmHg for every cm.
~ +/- 0.8 mmHg
80
Pressure =
p*g*h
81
p =
Rho - density of liquid (blood)
82
g =
9.81 m/s^2 (gravity)
83
h =
height

KIN 311 (19 decks)

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