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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
Producing an ECG
Electrodes of an ECG are attached to the subject Changes in voltages are recorded and represent changes in the heart's electrical activity
26
Electrolytes
Cations (positive) or Anion (negative)
27
Main Intracellular Cation
Potassium (K)
28
Main Extracellular Cation
Sodium (Na)
29
Resting Membrane Potential
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
30
Depolarization
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
31
Repolarization
Return to the resting membrane potential
32
Lead II
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
33
Action Potential
Na rushed into the cell
34
ECG Recording Paper
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
35
Large square on recording paper
5 mm2 5 mm= 0.20 sec
36
Small square on recording paper
1 mm2 1 mm= 0.04 sec 1500 little squares/min!
37
Steps in Intrepreting an ECG
1) Regularity 2) Rate 3) P Waves 4) PR Intreval 5) QRS Complex
38
Artifact Muscle Tremors
39
Artifact Loose Electrodes
40
Steps in Interpretation
1) Regularity 2) Rate 3) P Waves 4) PR Interval 5) QRS
41
Artifact 60 Cycle Interference
42
Artifact Patient Movement
43
Normal Sinus Rhythm
44
Normal Sinus Rhythm
45
Normal Sinus Rhythm
46
Normal Sinus Rhythm
47
3rd Degree Heart Block
48
Unifocal PVCs
49
Sinus Bradycardia
50
Sinus Bradycardia
51
Sinus Tachycardia
52
Supraventricular Tachycardia
53
Accelerated Junctional Rhythm
54
Junctional Escape Rhythm
55
Premature Junctional Contractions
56
Sinus Brady with One PJC
57
controlled a-fib
58
Atrial Fibrillation
59
Atrial Fibrillation
60
Atrial Flutter
61
Atrial Flutter
62
Atrial Tachycardia
63
wandering pacemaker
64
Sinus rhythm with one PAC
65
Regular Sinus Rhythm with a PAC
66
Wandering Pacemaker
67
Premature Atrial Contraction
68
Atrial Tachycardia
69
Sinus Arrhythmia
70
Sinus Arrhythmia
71
sinus rhythm with first degree heart block
72
Sinus Tachycardia
73
Sinus brady with first degree heart block
74
Premature Ventricular Contractions
75
Unifocal PVCs
76
Third Degree Heart Block
77
Pulseless Electrical Activity (PEA)
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
79
Inverted QRS Complex
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
Asystole
Flatline
81
Idioventricular Rhythm
Rhythm: Regular Rate: **20-40 bpm** P Waves: **No P Wave** QRS**: Greater than 0.12 and bizarre**
82
Supraventricular Tachycardia
83
Junctional Escape Rhythm
84
Ventricular Tachycardia
85
Ventricular Tachycardia
86
Ventricular Fibrillation
87
Idioventricular Rhythm
88
Idioventricular Rhythm
89
Sinus rhythm with one PVC
90
sinus tach with three unifocal PVCs
91
First Degree Heart Block
92
Idioventricular Rhythm
93
PVCs Occurring as a Couplet (Pair)
94
Idioventricular Rhythm
95
PVCs Occurring in a Run
96
Multifocal PVCs
97
Idioventricular Rhythm

Patient Assessment (5 decks)

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