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Patho 1 > Dysrhythmias > Flashcards

Dysrhythmias Flashcards

1
Q

Automaticity function

A

ability to generate electric impulses

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2
Q

Excitability fxn

A

can respond to outside impulses like chem, mech, elec

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3
Q

Conductivity fxn

A

receive electrical impulses and conduct it

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4
Q

Contractility fxn

A

myocardial cells shorten in response to impulse (pump)

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5
Q

How does cardiac conduction occur?

A

with action potentials!!

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6
Q

atrial depol

A
  • contraction of atrium
  • p wave
  • atrial systole
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7
Q

ventricular depol

A
  • ctx of vent
  • QRS complex
  • vent systole
  • bundle of HIS and Purkinjean fibers tell them to get their squeeze on
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8
Q

cardiac repolarization

A

refilling the heart

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9
Q

ventricular repol

A
  • t wave
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10
Q

SA node

A

in atria
- stimulates the P wave

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11
Q

AV node

A
  • listens to SA
  • gatekeeper
  • tells vents to squeeze
  • stimulates the QRS wave
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12
Q

Sinus rhythm

A
  • normal conduction of the heart
  • rate 60-100
  • reg rhythm
  • P wave upright and round, one before each QRS
  • PR interval 0.12-0.2 seconds
  • QRS under 0.12 seconds
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13
Q

Sinus arrhythmia

A
  • another normal rhythm
  • variability in HR
  • no chx to CO
  • HR 60-100
  • PR 0.12-0.2
  • narrow QRS
  • common in younger ppl, assoc with respiratory or ANS fluctuations
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14
Q

Dysrythmias

A

any prob with impulse generation or conduction–abnormality of HR or CO, filling time

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15
Q

Causes of dysrhythmia

A
  • inappropriate automaticity - cell initiates AP inappropriately in atrium
  • triggered activity - extra impulse generated during or just after repol
  • re-entry - cardiac cell or impulse in one part of the heart continues to depol after main impulse is done
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16
Q

What does “sinus” indicate

A

SA node prob

17
Q

Sinus brady

A
  • rate under 60 bpm
  • normal rhythm
  • normal PR int and QRS
  • caused by hyperK, vagal response, digoxin tox, late hypoxia, olol, Ca block, amio, MI
  • CM: dec CO, lightheaded, dizzy esp wit exert, syncope, chest pain, dyspnea, conduction, easy fatigue
  • tx is atropine or pacemaker
18
Q

What should you do before acting with sinus brady?

A

ASSESS FOR SX

19
Q

Sinus tachy

A
  • HR 100-150
  • reg rhythm
  • P waves similar (may be partial hidden)
  • normal PR and QRS
  • caused by catecholamines, fever, FVD (tachy is first), meds (beta, albuterol), coffee, nic, cocaine, EARLY hypoxia
  • tx based on cause (fluids, antipyretics, analgesics, beta block if needed)
20
Q

Paroxysmal supraventricular tachy (PSVT)

A
  • occasional and fast
  • above the ventricles
  • 150-200 bpm
  • usually no “p” wave or abnormal if present
  • normal QRS
  • usually r/t reentry of the AV node
  • start, stop quick
  • “heart racing”
  • causes: overexert, stress, stims, dig tox, rheumatic CHD, CAD, WPW sx, R side HF
  • s/s: palpits, chest pain, fatigue, dyspnea, lightheaded, dizzy
21
Q

Premature atrial ctx (PACs)

A
  • early p waves that look a little diff (morph chx)
  • normal PR and QRS that follow P wave
  • if freq–pt high risk for other dysrhythmia (usual afib)
  • tx: check electros, may need O2 (hypoxia)
22
Q

Atrial flutter

A
  • originates in AV node and overrides SA node
  • reentry impulse that is cyclic and repetitive
  • atrial contraction at reg rhythm but quick rate >250
  • vent rate slower (QRS) and narrow
  • P wave classic sawtooth look
  • 2:1, 3:1, 4:1
  • caused by CHF, cardiomyo, valve disease, heart inflam, HTN, lung disease, electro, overactive thyroid, heart surg
23
Q

A-fib

A
  • irregular irregularity from lack of comm btwn atria and vent
  • HR 100-175 or lower
  • no identifiable P wave or even T
  • fibrillation waves
  • CM - racing, fatigue, dizzy, papits, dicomfort in chest, SOB, asymp
  • caused by electro, hypoxia, CVD
24
Q

What do you need to know about a-fib?

A

IF THE RATE IS CONTROLLED

25
Q

a-FIB complications

A

HF, dec CO, embolus
- STROKE bc blood not pumped like it is meant to

26
Q

a-fib tx

A

CONTROL RATE
- olol, CCB, digitalis
- prevent stroke - anticoag/plt
- ablation and cardioversion

27
Q

Premature ventricular contractions (PVCs)

A
  • ctx from ectopic focus in the vents
  • early QRS, no p waves or normal rhythm, or negative QRS
  • wide and distorted shape - QRS
  • cause - electro, hypoxia, stims, fever, exercise, stress, CVD
  • tx the cause
28
Q

V tachy

A
  • 3+ PVCs together
  • ectopic focus in vents takes control and fires repeated - no atrial ctx occurs
  • V dec CO
  • assoc with MI, CAD, insignificant electro abnorm, HF, drug tox
  • DEADLY RHYTHM
  • 150-200 bpm, usual regularity
  • no p-wave
  • PR immeasurable
29
Q

V tachy tx

A
  • treat ACLS - depend on if palpable pulse
  • pt v symptomatic unless converts back to other rhythm
  • may need anti-dysrhythmic med like olol or CCB or electro replace
  • if sustained v-tach, check pulse, CPR
30
Q

First question to ask about V-tachy?

A

Pulse or pulse less?

31
Q

V-fib

A

irregular waveform of varied shape and size
- vents quivering
- no effective ctx and NO CO
- CPR may be needed

Patho 1 (37 decks)

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