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12-lead > Chapter 8 > Flashcards

Chapter 8 Flashcards

1
Q

High lateral leads

A

I and aVL

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2
Q

Inferior leads

A

II III and aVF

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3
Q

Septal leads

A

V1 and V2

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4
Q

Anterior leads

A

V3 and V4

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5
Q

Low lateral

A

V5 and V6

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6
Q

Cheat rule for establishing rate

A

300 150 100 75 60 and 50

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7
Q

General major concepts for approaching arrythmias

A

Is the rhythm fast or slow
Is it regular or irregular
If irregular, regularly irregular or irregularly irregular

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8
Q

General concepts for approaching the p wave

A 
Upright
Uniform
Present
Does each QRS have a p wave
Is the PRI constant, or prolonged
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9
Q

General concepts for approaching the QRS complex

A

Narrow or wide
Grouped or not grouped
Any dropped beats

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10
Q

Sinus arrhythmia

A

A sinus rhythm with some variation in TP intervals due to normal variations caused by respiration. It occurs because inhalation increases venous return by lowering intrathoracic pressure.

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11
Q

Sinus pause or arrest

A

It is not a multiple of the normal P-P interval. It is a sinus rhythm with a pause with no sinus pacemaker working

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12
Q

Sinoatrial block

A

The block occurs in some multiple of the P-P interval. IT is a non conducted beat from the normal pacemaker. The rhythm returns to normal after

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13
Q

Premature atrial contraction

A

A pacemaker in the atria fires sooner than expected. P wave may be different than the rest

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14
Q

Ectopic atrial tachycardia

A

An alternate site fires earlier than expected creating a different p-wave and rapid heart rate. Usually not sustained for an extended period. May cause some ST and T-wave abnormalities

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15
Q

Wandering atrial pacemaker

A

Irregularly irregular. Three different p wave morphologies are present. Rate has to be less than 100. Each have their own PRI, they are longer when the origin site is further away

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16
Q

Multifocal atrial tachycardia

A

WAP with a rate of 100bpm or greater. May cause cardiac instability

17
Q

A flutter

A

Atrial rate of 250-350.
Ventricular rate of 125-175.
Rhythm is usually regular.
Presence of F waves (saw tooth appearance)
Normally a 2:1 P to qrs ratio
Possible to have a truly variable ventricular response

18
Q

A-fib

A

Ventricular rate is variable.
Irregularly irregular
Caused by numerous atrial pacer sites firing in a haphazard way

19
Q

Premature junctional contraction

A

Irregular
P waves (none, antegrade or retrograde)
It is a beat which arises prematurely in the AV node. Can occur in bi or trigeminy, or sporadically
P wave inverted in II III and aVF (inferior leads)
Retrograde p wave occurs after the QRS

20
Q

Junctional escape beat

A

Irregular
P waves - none, antegrade or retrograde
The distance of the junctional escape beat will be greater than the normal rhythm.
The difference between this and PVC is a PVC is from an early AV node depolarization, where this is from the SA node failing to depolarize

21
Q

Junctional rhythm

A

Rate is 40-60

Occurs when the SA fails to depolarize, or in AV dissociation or 3rd degree AV block

22
Q

Accelerate junctional rhythm

A

P waves may be absent retrograde or antegrade
Rate is 60-100 which is faster than expected for normal junctional pacemakers
If the rate is over 100 it is junctional tachycardia

23
Q

Compensatory pause

A

A pause where the premature contraction, added to the pause following it before the regular rhythm resumes, is equal to the regular rhythm

24
Q

Premature ventricular contraction

A

A ventricular pacer fires before the SA node, which causes the ventricles to be in a refractory state. The underlying rhythm is not interuppted, hence the compensatory pause

25
Q

Ventricular escape beat

A

The ventricles pick up the duty of depolarization because the SA node failed to fire. Followed by a non compensatory pause. PVC = early, ventricular escape beat = late

26
Q

Idioventricular rhythm

A

Wide QRS with a low rate (20-40). Could be by itself, or because of AV dissociation or 3rd degree block

27
Q

Accelerated idioventricular rhythm

A

Same same as idioventricular rhythm but 40-100

28
Q

V-tach capture and fusion beats

A

A fusion beat forms a morphology somewhere between the abnormal ventricular beat and the normal QRS complex. It happens when two pacer sites (SA node and ventricular pacer) fire simultaneously.
A capture beat is completely innervated by the sinus beat and is indistinguishable from the patient’s normal complex.
Also, irregularities in the QRS are caused by a regular underlying rhythm originating from the SA node

29
Q

Josephson’s sign

A

A small notching near the low point of the S wave.

30
Q

Torsade de pointes

A

Prolonged QT underlying. Rate is 200-250 bpm

31
Q

Ventricular flutter

A

When you can no longer tell if it is a QRS complex, a T wave, or an ST segment. Rate is 200-300BPM. Very fast V-tach.
Consider WPW with a 1:1 conduction of an atrial flutter

32
Q

V-fib

A

Shits fucked man

33
Q

First degree heart block

A

Prolonged PRI. Greater than .20 seconds
Caused by a prolonged physiologic block in the AV node, caused by medication, vagal stimulation, disease, and other things

34
Q

Mobitz 1 second degree heart block

A

Wenckebach.
Variable p wave to QRS ratios (2:1 3:2 4:3 etc)
Caused by a diseased AV node with a long refractory period.
Lengthening of the PRI until a beat is dropped

35
Q

Mobitz II second degree heart block

A

PRI is normal in conducted beats, until an extra P wave comes. Grouped beats with a dropped beat (just a p wave) shit is bad. Leads to complete heartblock.

36
Q

Third degree heart block

A

Rates are separate for ventricles and atrial firing site, but both regular. The escape beat may be junctional or ventricular, so the QRS morphology will vary

12-lead (9 decks)

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