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EKG Interpretation > Dubin Chapter 1-3 > Flashcards

Dubin Chapter 1-3 Flashcards

1
Q

The initial phase of ventricular repolarization is represented by…

A

ST Segment

pg 26

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2
Q

What occurs in the myocytes when K+ leaves the cells?

A

Repolarization

pg 27

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3
Q

How long does ventricular systole persist? (waves)

A

Beginning of QRS to end of T wave

pg 27

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4
Q

QT interval represents…

A

Ventricular systole

pg 28

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5
Q
  1. Normal QT interval is measured as…

2. Long QT intervals could lead to…

A
  1. < 1/2 of RR interval
  2. Dangerous rapid ventricular rhythms
    pg 28
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6
Q

The cardiac cycle lasts from…

A

P wave to P wave

pg 29

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7
Q

Myocardial contraction is produced by _______ released into the myocytes.

A

Free Ca++

pg 29

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8
Q

Repolarization is due to the outflow of _____ from the myocytes

A

K+

pg 29

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9
Q

Cell to cell conduction of depolarization (action potential) through the myocardium is carried by ______

A

Na+

pg 29

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10
Q

AV node conduction is due to slow moving ______

A

Ca++

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11
Q

Vertical amplitude on an EKG is a measure of _____

A

amplitude or voltage regardless of upward or downward defection
pg 32

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12
Q

Upward deflections are ________ and downward deflections are __________.

A

positive, negative

pg 33

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13
Q

As a positive depolarization wave advances through the myocardium and toward a positive electrode what type of deflection is seen on the EKG?

A

Upward

pg 33

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14
Q

5 small squares =

A

.20s

pg 35

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15
Q

A different pair (bipolar) of electrodes is used to record_____ ______.

A

each lead

pg 37

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16
Q

How many limb leads are there?

A

6
I, II, III, AVR, AVL, AVF
pg 36

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17
Q

Lead I is horizontal, left arm is ______ and right arm is _________.

A

positive, negative

pg 38

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18
Q

Lead III, left arm is _________ and left leg is ______

A

negative , positive

pg 38

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19
Q

Lead II, right arm is _______ and left leg _______

A

negative, positive

pg 38

20
Q

AVF is an augmented lead and uses the left foot as ________ and both arms as _______.

A

positive, negative (avF) foot = positive

pg 40

21
Q

AVR is an augmented lead where the right arm is ________ and the left foot and arm are______

A

positive, negative

pg 41

22
Q

AVL is an augmented lead where the left arm is ________ and the left foot and right arm are______

A

positive, negative (avL) left arm = positive

pg 41

23
Q

What are the lateral leads?

A

I, AVL because each is positive on L arm

pg 47

24
Q

What are the inferior leads?

A

II, III, AVF because each is positive on L foot

pg 47

25
Q

A depolarization wave moving toward any chest electrode produces what type of deflection?

A

Upward

pg 48

26
Q

Limb leads analyze the _________ plane and chest leads analyze the _________ plane.

A

frontal, horizontal

pg 49

27
Q

Each chest leads is oriented through the _______ and projects to the ______ ______.

A

AV node, patients back (chest is positive, back is negative)

pg 49

28
Q

The right chest leads are…

A

V1 and V2

pg 53

29
Q

The left chest leads are …

A

V5 and V6

pg 53

30
Q

Leads located over the interventricular septum are …

A

V3 and V4

pg 53

31
Q

Sympathetic nerves secrete a neurotransmitter called ________. It activates _________ receptors.

A

Nor-epinephrine, adrenergic

pg 56

32
Q

Parasympathetic nerves secrete a neurotransmitter called _________. It activates _______ receptors in the ________ to produce an inhibitory effect.

A

Acetylcholine (ACh), cardiac cholinergic, atria

pg 56

33
Q

Adrenergic receptors a.k.a… ________

A

Beta 1

pg 57

34
Q

What kind of response does norepinephrine have when it activates the Beta 1 (adrenergic) receptors?

A

Stimulates the SA node to beat faster
Improves AV node conduction
Increases force of myocardial contraction
Increases irritability of atrial and junctional automaticity foci and minimally affects ventricular foci
pg 57

35
Q

T or F

Epinephrine is a more potent stimulator of the hearts Beta 1 (adrenergic) receptors?

A

True

pg 57

36
Q

What kind of response does ACh have when it activates the cholinergic receptors?

A

Inhibits the SA node and decreases HR
Slows myocardial conduction and depresses the AV node
Decreases the force of myocardial contraction
Depresses irritability of automaticity foci, mainly in the atria and AV junction
pg 58

37
Q

What nerve is stimulated by the parasympathetic response?

A

Vagus nerve

pg 58

38
Q

What effect does over stimulation of the parasympathetic system have on the Gi tract?

A

Stimulates the GI Tract and may lead to vomiting and diarrhea
pg 58

39
Q

What effect does sympathetic stimulation have on arterial A1 (adrenergic) receptors?

A

Constricts arteries
Increases BP and flow
pg 59

40
Q

Are arterial A1 receptors more or less responsive to epinephrine or norepinephrine?

A

> N-epi, < Epi

pg 59

41
Q

What effect does parasympathetic stimulation have on arterial A1 (cholinergic) receptors?

A

Dilates arteries
Reduces BP and flow
pg 59

42
Q

An induced parasympathetic response, such as a vagal maneuver or carotid sinus massage may slow _____ ______ conduction, or make it more refractory to to depolarization

A

AV Node

pg 61

43
Q

Standing produces a compensatory ___________ response that ___________ peripheral arteries to prevent blood pooling and stimulate sinus pacing.

A

sympathetic, constricts

pg 62

44
Q

What are baroreceptors?

A

pressure sensors that detect low BP and initiate the sympathetic response.
pg 62

45
Q

Explain neuro-cardiogenic syncope

A

Partially filled ventricles contract rigorously, stimulating the parasympathetic “mechanoreceptors” in the LV and initiates a parasympathetic reflex that slows SA Node pacing and low BP results
pg 63

46
Q

5 requirements of proper EKG interpretation are…

A

Rate, Rhythm, Axis, Hypertrophy, Infarction

pg 64

EKG Interpretation (6 decks)

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