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FF: cardio content > class 10: cardio examination > Flashcards

class 10: cardio examination Flashcards

1
Q

what is the flow of the conduction system of the heart

A

SA (pacemaker)

AV

bundle of his - bundle branches

purkinjie fibers

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2
Q

whta is the function of the AV node

A

pass depolarization to the ventricles

there is a brief delay to allow for ventricle filling

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3
Q

what is the function of the bundle fibers - where do they carry there depolrizatoin

A

To left and right ventricle

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4
Q

where do Purkinje fibers carry their depolarization

A

Throughout ventricles

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5
Q

what are the 4 parts of a ECG

A

P

QRS

T

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6
Q

what does the P wave represent

A

̶Atrial depolarization

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7
Q

what does the QRS complex represent

A

̶Ventricular depolarization and atrial repolarization

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8
Q

what does the T wave represent

A

̶Ventricular repolarization

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9
Q

what is the ST segment telling us

A

Ischemia or Infarction

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10
Q

how do we calcualte HR on a ECG

A

Six-second method

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11
Q

what is the Six-second method

A

Count off 30 large boxes = 6 seconds (remember 1 large box = 0.2
seconds, so 30 large boxes = 6 seconds).

Then, count the number of R waves in six seconds and multiply
by 10.

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12
Q

what are the Classification of AV Heart Blocks

A

1st degree heart block

2nd degree heart block

3rd degree heart block

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13
Q

what is 1st degree heart block

A

Delay in conduction

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14
Q

what is 2nd degree heart block

A

Partially blocked conduction

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15
Q

what is 3rd degree heart block

A

Fully blocked conduction

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16
Q

what is 1st degree heart block - 2/2

A

AV nodal disease

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17
Q

1st degree heart block - PR interval

A

> 0.2 seconds (1 large box)

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18
Q

1st degree heart block - P wave

A

Each P is followed by a QRS

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19
Q

1st degree heart block - population

A

Seen also in athletes with increased vagal tone (activity)

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20
Q

1st degree heart block - progress of this condition

A

Generally, won’t progress, benign condition

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21
Q

what is another name for 2nd degree block

A

Mobitz

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22
Q

what is the characteristics of 2nd degree block

A

Increasing PR interval before the QRS is
dropped, then the cycle is repeated.

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23
Q

what causes 2nd degree block

A

One or more – but not all – of the atrial impulses fail to conduct to the ventricles

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24
Q

what are the two kinds of 2nd degree block

A

Type I/Wenckebach

Type II

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25
Q

type 1 2nd degree block - also called

A

“Wenckebach” or “Mobitz type I”

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26
Q

type 1 2nd degree block - characteristics

A

PR interval gets progressively longer each beat until finally a QRS is “dropped”

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27
Q

type 1 2nd degree block - due to

A

Disease of the AV node

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28
Q

2nd degree block - Type 2: also called

A

“Mobitz type II”

29
Q

2nd degree block - Type 2: characteristics

A

PR intervals are constant and a QRS is “dropped” intermittently

  • No pattern can be discerned
30
Q

2nd degree block - Type 2: 2/2

A

Disease of the Bundles of His and Purkinje fibers

31
Q

3rd degree block - character

A

The atrial rate is independent of the ventricular rate

(P wave and QRS march out
separately)

No relationship at all, of the P-R intervals

QRS is usually wide and bizarre
because it is ventricular origin

32
Q

what does S-T Segment Depression on the Electrocardiogram indicate

A

Myocardial Ischemia

heart attack

33
Q

ECG of Myocardial Ischemia and what is it

A
  • Decreased blood supply
  • ST segment depression
  • T wave flattened or inverted
34
Q

ECG of Myocardial Infarction and what is it

A
  • Complete occlusion of blood
    supply and cell death
  • ST segment elevation
35
Q

Supraventricular Arrhythmias - 4 types

A
  • Premature Atrial Contractions
  • Atrial Tachycardia
  • Atrial Flutter
  • Atrial Fibrillation
36
Q

Atrial Tachycardia - rate

A

̶Atrial Rate: 100-250 bpm

37
Q

Atrial Flutter - rate

A

̶Atrial Rate: 250-350 bpm

38
Q

Atrial Fibrillation - rate

A

̶Atrial Rate: 400-600 bpm

39
Q

Premature Atrial Contractions - character

A

the contraction occurs before it should

the P wave bumps up with the T wave

no 911 - continue exercise

40
Q

Atrial Tachycardia - character

A

the atria (p wave) beat 2-3 time prior to the start of the QRS

no 911 - continue exercise

41
Q

Atrial Flutter - character

A

the atria (p wave) beat 5 times prior to the start of the QRS

sawtooth

no 911- sym stop exerise

42
Q

Atrial Fibrillation - character

A

the atrial is shivering - beating a lot before the QRS cannot count

no 911 - stop exercise

43
Q

Premature Ventricular Contraction (PVC) - character

A

Heartbeat initiated by the Purkinje fibers: skipped beat or palpitations

Ventricles contract before the atria: cannot be filled optimally

44
Q

Premature Ventricular Contraction (PVC) - strip character

A

̶No P, wide bizarre QRS

45
Q

what is ventricular tachycardia

A

̶PVCs that occur three (3) or more in a row

46
Q

PVC - Bigeminy

A

1 normal beat followed by 1 PVC

47
Q

PVC - Trigeminy

A

2 normal beats followed by 1 PVC

48
Q

PVC - Multifocal PVC

A

More than 1 PVC is present and 2 do not appear similar in configuration

49
Q

what do we do when we see a Multifocal PVC

A

STOP Exercise and immediately refer (call 911)

50
Q

PVC - Couplet

A

2 consecutive PVCs together with no normal beat between them

51
Q

if pt presents with Couplet what does we do

A

STOP Exercise

̶If 2 or more couplets, immediately refer (call 911)

52
Q

PVC - what is then name when there is 3 PVS in a row

A

V tach

53
Q

PVC - VTach what should we do

A

STOP and call 911

54
Q

S3 what condition

A

CHF

55
Q

what is another name for S3

A

ventricular gallop

56
Q

what is the S4 conditions

A

HTN

hypertrophy

57
Q

what is another name for S4 heart stops

A

artial gallop

58
Q

what part of the cardiac cycle does S1 and S2 heart sounds occur

A

systole

59
Q

what part of the cardiac cycle does S3 and S4 heart sounds occur

A

diastole

3 - early

4- late

60
Q

what does QT interval represent

A

the time it takes for the heart muscle to contract and relax

ventricles

61
Q

is 2nd degree heart block an emergency

A

type 1 - do not call 911

type 2 - stop exercise, no 911

62
Q

is 3rd degree heart block an emergency

A

yes - 911

63
Q

biventricular heart failure

A

a combination of left-sided and right-sided heart failure

64
Q

right sided heart failure

A

has peri edema

the purpose of the right side of the body is to collect blood form the body

SOB and cough

65
Q

left sided heart failure

A

no peri edema

the purpose of the left side of the heart is to send blood to the rest of the body

SOB and cough

66
Q

what is cor pulmonale

A

a condition that causes the right side of the heart to fail

Shortness of breath: Often the first symptom, especially during activity

Chest pain: Usually in the front of the ches
t
Swelling: In the feet, ankles, legs, or belly

67
Q

how much elevation and depression for ST wave changes

A

2 mm = depression

1 mm = elevation

68
Q

is 911 needed for any of the artial conditions

A

no because the the ventricle is still contracting at the proper rate

FF: cardio content (16 decks)

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