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Cardiopulmonary > ECG > Flashcards

ECG Flashcards

1
Q

Types of cardiac cells

A

1) myocardial = working cells(contraction)
2) pacemaker cells = specialized for electrical conduction system
- spontaneously generate and conduct impulses

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2
Q

phases of cardiac action potential

A

Phase 0 = Na+ rushing into cell(depolarization)
- responsible for QRS complex
Phase 1 = K rushing out of cell(brief early repolarization)
Phase 2 = Ca moving into cell(plateau phase)
- ST segment
Phase 3 = repolarization(Na-K pump)(Final rapid repolarization)
- T wave
Phase 4 = returns to polarization(resting)

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3
Q

Hypercalemia

A

too much K+

- bradycardia

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4
Q

hypocalemia

A

low K+

  • dysrythmia, changes in ST(depression)
  • from diuretic medication
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5
Q

absolute refractory period

A

cells cannot be stimulated to conduct an electrical impulse

- period from onset of QRS complex to peak of T wave

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6
Q

relative refractory period

A

cardiac cells can be stimulated if stimulus is strong enough

- downslope of T wave

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7
Q

supernormal period

A

weaker than normal stimulus can cause cardiac cells to depolarize
- end of T wave

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8
Q

Pacemaker sites

A

SA node = 60-100 bpm(normal sinus rhythm)
AV(junctional ectopic focus = 40-60 bpm
Ventricular ectopic focus = 20-40 bpm(purkinje fibers and bundle branch)

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9
Q

P wave

A

atrial depolarization

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10
Q

QRS complex

A

ventricle depolarization and atrial repolarization

- less than 0.1 seconds

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11
Q

ST segment and T wave

A

repolarization

  • ST elevation = MI or injury
  • ST depression = ischemia
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12
Q

PR interval

A

less than 0.2 seconds

  • time for impulse from SA node through AV node
  • atrial and atrioventricular node depolarization
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13
Q

QT interval

A

systolic phase of heart

- electrical systole

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14
Q

7 steps for basic EKG interpretation

A

1) general rhythm = regular or irregular
2) rate = both general and specific
3) P wave = present or absent(are they identical)
4) Interval = PR interval(.12-.2 secs), QRS interval(.06-.1 secs), QT interval(<.4 secs)
5) origin = supraventricular(SA&AV nodes) or ventricular
6) rhythm interpretation = name of the rhythm and location of any abnormalities
7) hemodynamic compromising?

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15
Q

Sinus Tachycardia

A

rate >100bpm

- caused by anxiety, thyroid toxicosis, fever

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16
Q

sinus bradycardia

A

rate < 60 bpm

- athletes, B-blockers, vomiting, valsalva stimulation, hypotension

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17
Q

sinus arrhythmia

A

irregular rhythm with impulses originating in the SA node(supraventricular)

18
Q

premature atrial contraction

A

PAC

  • regular with premature beats(premature P waves)
  • peaked P waves
19
Q

paroxysmal atrial tachycardia

A

sudden onset tachycardia(150-250 bpm)

20
Q

Wandering atrial pacemaker

A

“wandering atrial pacemaker”

  • P wave changes in size, shape, and direction from beat to beat(at least three different P wave configurations)
  • rhythm is irregular
21
Q

atrial flutter

A

250-350 bpm(atrial rate)

  • multiple activations of P wave, but does not cause QRS
  • AV node prevents ventricle from contracting and reducing output
22
Q

Atrial fibrillation

A

350-450 bpm(atrial rate)

  • atrium quivers and doesn’t contract fully so all blood does not go into ventricle = decreased Q
  • tend to develop clots so pt’s on blood thinner
23
Q

Paroxysmal junctional tachycardia

A
  • sudden onset tachycardia(150-250 bpm)
  • P wave absent or inverted
  • from emotional stress, hypoxia
24
Q

premature ventricular contraction

A

PVC = originates suddenly in an ectopic focus in a ventricle producing a giant ventricle complex

  • bigeminy = PVC every 2 beats
  • trigeminy = PVC every 3 beats
  • quadrigeminy = PVC every 4 beats
  • couplet = 2 PVC’s in a row
  • triplet = 3 PVC’s in a row
25
Q

Ventricular tachycardia

A

greater than 40 bpm

  • all signals from the ventricle
  • no P wave, origin from ventricle
  • emergency situation
26
Q

ventricular flutter

A

250-350 bpm

  • no effective cardiac output
  • no relaxation stage
27
Q

ventricular fibrillation

A

greater than 350 bpm

28
Q

1st degree AV block

A

PR interval > 0.2 sec and constant

  • generally benign
  • one P wave per QRS
29
Q

2nd degree AV block

A

Mobitz 1 or Wenckebach(type 1)

- PR interval progressively lengthens until missing QRS

30
Q

2nd degree AV block(type 2)

A

Mobitz 2

  • PR interval are constant and within normal limits for those conducted beats
  • some P waves are not followed by QRS complex
  • need pacemaker to correct otherwise will progress to 3rd degree
31
Q

3rd degree AV block

A

AV dissociation, complete heart block

- atrial rate and ventricular rate are regular but not matched(independently)

32
Q

Bundle branch block

A

one ventricle depolarizes slightly later than the other, causing two joined QRS’s(one for right ventricle and one for left ventricle)

33
Q

ischemia

A

T wave inversion

34
Q

Injury(acute)

A

ST segment elevation

  • returns to baseline with time
  • ST elevation associated with Q waves indicates an acute infarct
35
Q

infarction

A

significant Q wave

- 1mm wide or 1/3 amplitude of QRS

36
Q

sinus rhythm with ST segment depression

A

depression > 2mm boxes

37
Q

Torsades de pointes

A

complexes gradually increase then gradually decrease causing a classical spindle shaped progression of waves

38
Q

Rhythm

A

1) regular
2) regular but interrupted by premature beats
3) regular but interrupted by pauses
4) irregular
5) regularly irregular

39
Q

Rate

A

1) regular = one HR
2) irregular = range from slowest to fastest, plus mean rate
3) regular but interrupted by premature beats = one HR(ignore premature rates)
4) regular by interrupted by pauses = range from slowest to fastest, plus mean rate
5) if it has two origins, calculate the rate from each origin separately

40
Q

P wave

A

1) present
2) absent
3) shape
4) relationship with QRS complexes
5) is each followed by a QRS
6) do all P waves look the same

41
Q

Intervals

A

1) PR < .2 sec
2) QRS < .1 sec and same shape
3) QT < .4 sec

42
Q

origin

A

1) supraventricular = SA node, atrium, junction

2) ventricular

Cardiopulmonary (6 decks)

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