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Cardiopulm > ECG > Flashcards

ECG Flashcards

1
Q

Myocytes have 3 properties

A

automaticity
rhythmicity
conductivity

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2
Q

Automaticity

A

-able to discharge/depolarize w/o stimulation from a nerve
automatically discharge

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3
Q

Rhythmicity

A

-depolarization occurs at regular intervals
-cardiac muscle cells can depolarize at regular intervals

SA node- rhythmicity creates sinus rhythm (60-100)

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4
Q

AV
His-purkinje fibers

A

AV: 40-60 times per min

His: 30-40 times per min

faster/higher discharge rate predominates
autonomic influence >SA>AV>Purk

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5
Q

conductivity

A

-ability to spread impulses quickly w/o nerve involvement

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6
Q

ECG tracings are…

A

superficial recordings of electrical events/ ionic events occuring within the myocytes

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7
Q

P wave

A

atrial depolarization is depicted on ECG as p wave.
impulse spread to L atrium via bachmann bundle

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8
Q

PR interval

A

when spread of depolarization reaches AV node, slight delay occurs
reads as PR interval

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9
Q

Purkinjes/ bundle branches

A

-L and R division, L has an A and P division
ventricular depolarization occurs when impulse reaches PFs, carries signal to myocytes .

QRS complex reflects this
greater amp bc of greater muscle mass

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10
Q

T wave

A

-represents repolarization of ventricles
interval from beginning of QRS complex to apex of t wave = absolute refractory period

most leads- T wave is positive (upward deflection) and reflects repolarization of myocytes

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11
Q

Limb leads

A

I,II,III (standard limb leads)
aVR,aVL,aVF (augmented)

each leads records from different angle, providing a diff view of same cardiac activity

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12
Q

Chest leads

A

6, show gradual changes
record in horizontal plane

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13
Q

Single lead assessment
look for:

A

-heart rhythm or rate
-normal waveforms
-abnormal wavefroms

use lead II!!!

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14
Q

ECG recording

A

vertical deflections: voltage
horizontal axis- time
1 large square=0.20sec, 5=1 sec
30=6secs
horizontal distance becomes a stopwatch!

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15
Q

determine HR from ECG

A

count large boxes between two R waves
300/count
lower number R waves= higher BPM and vise versa
can only do this with normal

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16
Q

Assessing cardiac cycle

A
  1. eval P wave
  2. eval PR interval (norm is 0.12-0.20 or 3-5 small boxes)
  3. eval QRS (look alike?)
  4. Eval QRS interval (0.06-0.10 or 1.5-2.5 small boxes)
  5. eval t wave
  6. eval RR wave interval
  7. eval HR (6 sec strip, norm 60-100)
  8. observe pt and eval sxs
17
Q

First degree AV block

A

-occurs when impulse initiated in SA node but is delayed on way to AV node
-AV conduction time is prolonged

if R is far from P, you have first degree

18
Q

2nd degree, Wenckeback

A

-progressive lengthening of PR interval

longer longer longer drop, that MF in Wenckeback!!

19
Q

2nd degree AV block Mobitz II

A

-intermittent non-conducted p waves W/O progressive prolongation of PR interval
P waves constant
RR is exact multiple of preceding RR interval

If some p’s don’t get thru you have Mobitz II!

20
Q

3rd degree AV block

A

–NO impulses initiated above the ventricles are conducted to the ventricle
atria fire at own rate
ventricles fire at own rate

If p’s and q’s dont agree, then you have 3rd degree

21
Q

Tx 1st degree

A

benign and not treated

22
Q

2nd degree tx

A

depends on type
no tx necessary or pacemaker
result of an MI

23
Q

3rd degree tx

A

LIFE threatening
MI, degen of conducting system
permanent pacemaker
medical emergency

24
Q

PAT/PSVT

A

a sudden recurrence of atrial tachycardia

p waves present but may be merged with t wave
PR less than 0.20
QRS identical but between 0.06-0.10
RR regular and may show start/stop of PAT

25
Q

PAT/PSVT arryhtmia

A

-emotional, overexertion, caffeine, nicotine, aspirin, RHD, mitral valve dysfunc, PE

dizziness, weakness, SOB

determine cause and treat accordlingly

26
Q

atrial flutter

A

P waves are sawtooth pattern (uniform due to only one ectopic focus)
rapid succession of atrial depolarization, rate of 250-350

27
Q

A fib

A

-quiver/twitch of atrial muscle

p waves absent
RR is irregular
QRS between 0.06-0.10

old age, CHF, drugs, stress/pain, RHD, renal failure
not threatening unless HR elevated at rest
lose atrial kick
potential to develop mural thrombi

28
Q

WPW syndrome

A

-common
-HB abnorm fast
-preexcitation syndrome

sxs: pounding HB, chest pain, difficult breathing, fainting, SOB, anxiety

cause: congential, or heart defects
tx: cardioversion, propranolol (b blocker)

29
Q

PVCs

A

-ectopic focus originates an impulse from somewhere in the ventricles
QRS wide and bizzaew without P wave followed by compensatory pause
heart skips beat

tx depends on cause, frequency, severity, sxs

serious when: paired together, mutlifocal, >6 per min, land on t wave, triplets or more

30
Q

Vtach

A

3+ PVCs in a row
twisting of points’
bc rapid firing by a single ventricular focus with increased automaticity
P waves absent
prolonged QT interval

QRS wide and bizzare
100-250
ventricular tachy can be precursor to vent fibrillation

31
Q

Vtach causes and tx

A

causes: ischemia, acute infarc, CAD, hypertensive HD, med reaction

tx: cardioversion, defib, meds

MED emergency- mostly unconscious

32
Q

Vfib

A

quivering of ventricular muscle = no CO
creates asynchrony
ECG shows irregular up/down in zigzag
MED emergency
causes same as vtach
tx: defib followed by resuscitation, O2, and meds

33
Q

Hypertrophy

A

longer QRS

34
Q

Ischemia

A

inverted T wave
ST seg depression

35
Q

ST deg depression at rest in presence of chest pain

A

-subendocardial infarc
may indicate a pending transmural infarc

36
Q

ST seg depression in absence of ischemia or angina

A

may be due to digitalis toxicity

37
Q

ST seg elevation/depression is diagnostic for

A

-acute infarc
-also presence of sig Q wave

38
Q

Leads that demonstrate presence of t wave inversion, ST seg changes, or Q waves identify…

A

location of ischemia, injury or infarc

Cardiopulm (6 decks)

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