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Part 2 Exam > ECG > Flashcards

ECG Flashcards

1
Q

SA node

A

primary pacemaker of the heart

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2
Q

SA node location

A

located in the superior right atrium at the entrance of the superior vena cava

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3
Q

SA node intrinsic rate

A

60 to 100 bpm

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4
Q

Intra-Atrial Tracts/Pathway

A

creates preferred routes of propagation

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5
Q

Bachman’s Bundle

A

anterior tract divided and extends to the LA

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6
Q

AV node

A
  • only normal conduction pathway to the ventricles
  • secondary pacemaker if SA nodal rate suppressed
  • calcium is the major ion responsible for the action potential
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7
Q

Triangle of Koch

A

located in the floor of the right atrium superior to the septal leaflet of the tricuspid valve

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8
Q

Purposes of delay at AV node

A
  • allows for atrial contraction

- protects the ventricles from inappropriate high atrial rates

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9
Q

Bundle of His

A

most proximal portion of the ventricular conduction system

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10
Q

Purkinje Fibers

A

terminal end of entire conduction system

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11
Q

AV node intrinsic rate

A

40 to 60 bpm

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12
Q

Purkinje Fibers intrinsic rate

A

20 to 40 bpm

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13
Q

Action Potential (contractile tissue)

A
  • the sodium-potassium ATPase pump maintains the negative resting potential
  • resume the pre-depolarization electrolyte levels by exchanging 3 sodium ions out for 2 potassium ions into the cell
  • active process requiring magnesium and energy (ATP)
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14
Q

Phase 0

A
  • rapid depolarization of the cell

- Na+ rushes into cell, making it “less negative”

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15
Q

Phase 2

A
  • “plateau” phase
  • slowing of depolarization
  • calcium enters cell, leading to contraction of the muscle is sustained, slower manner
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16
Q

Phase 3

A
  • sudden acceleration in the rate of depolarization
  • potassium movement into cell causes this rapid return in intracellular negativity
  • Sodium-potassium pump operates at this phase
  • required ATP and magnesium
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17
Q

Pacemaker Cell Action Potential

A

Funny channels

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18
Q

Orthodromic

A

traveling in the normal direction and then back up the accessary pathway

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19
Q

Antidromic

A

traveling in opposite direction to the normal pathway

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20
Q

PR interval

A

impulse transmission from SA node throughout the atria and to the AV node

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21
Q

PR interval normal range

A

0.12 to 0.20 seconds

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22
Q

QRS complex

A

depolarization of the ventricular myocardium

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23
Q

QRS duration

A

less than 0.12 seconds

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24
Q

Rate ruler

A

easiest with least amount of math involved

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25
Q

Six-second strip method

A
  • count the number or QRS complexes in six seconds

- multiple by 10

26
Q

Large Box Method

A
  • find a QRS on a thicker line of the ECG graph paper

- count how many large grid boxes to the next QRS

27
Q

Large Box Method rate

A

300, 150, 100, 75, 60, 50, 43, 37

28
Q

Normal heart rate

A

60 to 100 bpm

29
Q

Bradycardia

A

less than 60

30
Q

Tachycardia

A

greater than 100

31
Q

QRS Complex width

A

normal is 0.08 to 0.12 seconds

32
Q

Lead I

A

records voltage difference from the right arm to the left arm

33
Q

Lead II

A

records voltage difference from right arm to left leg

34
Q

Lead III

A

records voltage difference from the left arm to the left leg

35
Q

Right leg lead

A

ground lead

36
Q

V1

A

4th intercostal space right sternal border

37
Q

V2

A

4th intercostal space left sternal border

38
Q

V3

A

midline between V2 and V4

39
Q

V4

A

5th intercostal space midclavicular line

40
Q

V5

A

5th intercostal space anterior axillary line

41
Q

V6

A

5th intercostal space mid-axillary line

42
Q

Limb Lead Reversal

A
  • P wave in lead II inverted
  • there is “global negativity” in lead I
  • QRS is upright in aVR
  • Dextrocardia
43
Q

Precordial Lead Problems

A
  • incorrect identification of angle of Louis (2nd ICS)
  • placing electrode on top of breast tissue vice under (on chest wall)
  • interchanging two leads
44
Q

Misplaced Precordial Leads

A
  • unusual chest wall configuration

- inappropriate “landmarks”

45
Q

V1 and V2

A

septal area

46
Q

V3 and V4

A

anterior (apical) area

47
Q

Lead I, aVL, V5, V6

A

lateral area

48
Q

Lead II, III, and aVF

A

inferior area

49
Q

Normal axis

A

Lead I is positive

Lead aVF is positive

50
Q

Left Axis Deviation

A 
I = positive
aVF = negative
51
Q

Right Axis Deviation

A 
I = negative 
aVF= positive
52
Q

Indeterminate Axis

A 
I = negative
aVF = negative
53
Q

Arrhythmia

A

1) a disturbance in or loss of regular rhythm. (2) especially, any variation from the normal rhythm of the heartbeat, it may be an abnormality of either the rate, regularity, or site of impulse origin or the sequence of activation. The term encompasses abnormal regular and irregular rhythms as well as loss of rhythm.

54
Q

Automaticity

A

(1) the state or quality of being automatic. (2) the capacity of a cell to initiate an impulse, such as depolarization, without an external stimulus.

55
Q

Bradycardia

A

slowness of the heartbeat, as evidenced by slowing of the pulse rate to less than 60 beats per minute.

56
Q

Chronotropy

A

referring to the time or rate, as the rate of contraction of the heart. Something that causes positive chronotropy will result in an increase in heart rate (e.g., epinephrine, atropine), while a negative chronotrope causes a decrease in heart rate (e.g. beta-blockers, calcium channel blockers).

57
Q

Depolarization

A

1) the process or act of neutralizing polarity. (2) in electrophysiology, the reversal of the resting potential in excitable cell membranes when stimulated, i.e., the tendency of the cell membrane potential to become positive with respect to the potential outside the cell.

58
Q

Dromotropy

A

referring to the conductivity of a nerve fiber, such as the rate of depolarization, thus affecting the speed at which impulse transmission flow. Positive dromotropy refers to a state in which impulse transmission is made faster (e.g., epinephrine, atropine), whereas a negative dromotrope causes a reduction in the velocity of such transmission (e.g., digitalis, adenosine).

59
Q

Inotropy

A

referring to the force or energy of muscular contraction. Something causing positive inotropy will result in an increase in the contractile force (e.g., dopamine, dobutamine), while a negative inotrope leads to a reduced or weaker degree of contractility (e.g., beta-blockers, calcium channel blockers).

60
Q

Reentry

A

reexcitation of a region of cardiac tissue by a single impulse, continuing for one or more cycles and sometimes resulting in ectopic beats or tachyarrhythmias. It can exist over either an anatomical or a functional area of slowed impulse conduction and requires also refractoriness of tissue to stimulation and an area of unidirectional block to conduction.

Part 2 Exam (7 decks)

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