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Patient Assessment > ECG > Flashcards

ECG Flashcards

1
Q

Automaticity

A

Ability of cells to generate an action potential without any external stimulation (nervous stimulation) Also known as autorhythmicity

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2
Q

Pacemaker Cells

A

Specialized cells that have a high degree of automaticity and provide the heart with electrical power

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3
Q

Locations of Pacemaker Cells

A

SA Nodes

AV Nodes

AV Junction Ventricles

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4
Q

Conducting Cells

A

Cells that conduct electrical impulses throughout the heart

Make up the conduction pathway

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5
Q

Myocardial Cells

A

Cells that will conduct an electrical impulse throughout the heart

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6
Q

Excitability

A

AKA irritability Ability of a cell to reach threshold potential The lower the stimulus needed to activate a cell the more excitable the cell (hypoxemia, schema, acidosis, and increased K)

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7
Q

Conductivity

A

Ability of cell to transmit electrical current

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8
Q

Contractility

A

Ability of muscles fibres to respond to electrical stimuli through shortening and contracting

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9
Q

Depolarization

A

Reversal of charges in the cell membrane The inside becomes more positive than the outside

Part of an action potential

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10
Q

Action Potential

A

A large depolarizing event that will cause a reversal of polarity in the cell

Will be transmitted along the membrane of muscles and nerve cells

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11
Q

Modified Cells

A

1% of the heart muscle cells are modified which means that they are auto rhythmic (pacemakers) and form conduction pathways (modified myofibers) with rapid transmission

When the signal reaches the “regular” cells of the heart then the muscles will contract

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12
Q

Modified Myocardium

A

Can spontaneously “fire” or generate an impulse (action potential) that will quickly travel along the conduction pathway (modified myofibers)

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13
Q

Electrical Activity

A

Electrical activity must preceded mechanical activity

There can be electrical activity without a mechanical response (contraction)

The electrical activity is what is recorded on an ECG

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14
Q

Purkinje Fibers

A

Subendocardial Branches

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15
Q

Sinoatrial (SA) Node

A

Main pacemaker 60-100 bpm

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16
Q

Atrioventricular (AV) Node

A

40-60 bpm

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17
Q

Bundle of His

A

AV Bundle

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18
Q

Left and Right Branches

A

Will go into the purkinje fibres in the ventricles with a rate of 20-40 bpm

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19
Q

Ectopic Beat

A

Electrical activation of the heat that originates outside of the SA node

Will be brought on due to an irritable spot that leads to an earlier depolarization

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20
Q

Ectopic Focus

A

Refers to the location that gives rise to an ectopic beat

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21
Q

Escape Beat

A

When the normal pacemaker (SA Node) fails or slows down and the next lower site will take over as pacemaker

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22
Q

Irritability

A

When a site speeds up and takes over as a pacemaker

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23
Q

Clinical ECG Interpretation

A

ECG should always be interpreted based on clinical presentation and history

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24
Q

What is an ECG

A

Also known as ECG or EKG

A graphic display on a modified volt meter of the heart’s electrical activity

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25
Q

Producing an ECG

A

Electrodes of an ECG are attached to the subject

Changes in voltages are recorded and represent changes in the heart’s electrical activity

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26
Q

Electrolytes

A

Cations (positive) or Anion (negative)

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27
Q

Main Intracellular Cation

A

Potassium (K)

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28
Q

Main Extracellular Cation

A

Sodium (Na)

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29
Q

Resting Membrane Potential

A

The inside of the cell is negative relative to the outside making it polarized

In the polarized cell the electrical change is balanced and ready to be discharged

There is no difference between electrodes meaning there will be a 0mv at baseline

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30
Q

Depolarization

A

Discharge of energy that accompanies the transfer of electrical charges (electrolytes) across the membrane Na inflow to help cell reach threshold to trigger an action potential

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31
Q

Repolarization

A

Return to the resting membrane potential

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32
Q

Lead II

A

The lead is created through the comparison of two leads For lead II the negative electrode is at the top right arm and the positive electrode is in the bottom left leg Will allow a partial view of the heart with a consistent reading If electricity flows towards the positive electrode it will result in an upright image on the ECG If electricity flows towards the negative electrode it will result in an inverted image on the ECG If the electrical impulse travels perpendicular there will be a straight line (isoelectric)

A type of cardiac monitor that is used to gain a basic view of the heart

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33
Q

Action Potential

A

Na rushed into the cell

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34
Q

ECG Recording Paper

A

All ECG recordings will use the same paper type and run at the same speed of 25 mm/sec x-axis=time y-axis = voltage

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35
Q

Large square on recording paper

A

5 mm2 5 mm= 0.20 sec

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36
Q

Small square on recording paper

A

1 mm2 1 mm= 0.04 sec 1500 little squares/min!

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37
Q

Steps in Intrepreting an ECG

A

1) Regularity 2) Rate 3) P Waves 4) PR Intreval 5) QRS Complex

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38
Q
A

Artifact Muscle Tremors

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39
Q
A

Artifact Loose Electrodes

40
Q

Steps in Interpretation

A

1) Regularity 2) Rate 3) P Waves 4) PR Interval 5) QRS

41
Q
A

Artifact 60 Cycle Interference

42
Q
A

Artifact Patient Movement

43
Q
A

Normal Sinus Rhythm

44
Q
A

Normal Sinus Rhythm

45
Q
A

Normal Sinus Rhythm

46
Q
A

Normal Sinus Rhythm

47
Q
A

3rd Degree Heart Block

48
Q
A

Unifocal PVCs

49
Q
A

Sinus Bradycardia

50
Q
A

Sinus Bradycardia

51
Q
A

Sinus Tachycardia

52
Q
A

Supraventricular Tachycardia

53
Q
A

Accelerated Junctional Rhythm

54
Q
A

Junctional Escape Rhythm

55
Q
A

Premature Junctional Contractions

56
Q
A

Sinus Brady with One PJC

57
Q
A

controlled a-fib

58
Q
A

Atrial Fibrillation

59
Q
A

Atrial Fibrillation

60
Q
A

Atrial Flutter

61
Q
A

Atrial Flutter

62
Q
A

Atrial Tachycardia

63
Q
A

wandering pacemaker

64
Q
A

Sinus rhythm with one PAC

65
Q
A

Regular Sinus Rhythm with a PAC

66
Q
A

Wandering Pacemaker

67
Q
A

Premature Atrial Contraction

68
Q
A

Atrial Tachycardia

69
Q
A

Sinus Arrhythmia

70
Q
A

Sinus Arrhythmia

71
Q
A

sinus rhythm with first degree heart block

72
Q
A

Sinus Tachycardia

73
Q
A

Sinus brady with first degree heart block

74
Q
A

Premature Ventricular Contractions

75
Q
A

Unifocal PVCs

76
Q
A

Third Degree Heart Block

77
Q

Pulseless Electrical Activity (PEA)

A

When there is a rhythm on the ECG but there is not a pulse. This will not include V fib, V tach, or asystole

Treatment will be based on the underlying cause

78
Q
A
79
Q

Inverted QRS Complex

A

This does not necessarily mean that there is a pathology as the direction that the EKG is is deflecting on the strip based on the electrical energy that is coming towards or away from the lead.

80
Q

Asystole

A

Flatline

81
Q

Idioventricular Rhythm

A

Rhythm: Regular

Rate: 20-40 bpm

P Waves: No P Wave

QRS: Greater than 0.12 and bizarre

82
Q
A

Supraventricular Tachycardia

83
Q
A

Junctional Escape Rhythm

84
Q
A

Ventricular Tachycardia

85
Q
A

Ventricular Tachycardia

86
Q
A

Ventricular Fibrillation

87
Q
A

Idioventricular Rhythm

88
Q
A

Idioventricular Rhythm

89
Q
A

Sinus rhythm with one PVC

90
Q
A

sinus tach with three unifocal PVCs

91
Q
A

First Degree Heart Block

92
Q
A

Idioventricular Rhythm

93
Q
A

PVCs Occurring as a Couplet (Pair)

94
Q
A

Idioventricular Rhythm

95
Q
A

PVCs Occurring in a Run

96
Q
A

Multifocal PVCs

97
Q
A

Idioventricular Rhythm

Patient Assessment (5 decks)

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