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DPT830 (Exam 2) > EKG #2 > Flashcards

EKG #2 Flashcards

1
Q

The P Wave is associated with the activation of what area of the heart?

A

Activation of the Atria

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2
Q

The QRS Complex is associated with the activation of what area of the heart?

A

Activation of the Ventricles?

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3
Q

The T Wave is associated with the activation of what wave of the heart beat?

A

The Recovery Wave

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4
Q

How much time is equivalent to one square on an ECG readout?

A

1 square = 0.04 sec (40 m/s)

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5
Q

What is a normal HR for an ECG analysis?

A

60-100 bpm.

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6
Q

What is a normal PR Interval for an ECG analysis?

A

0.12 - 0.20 sec (about small 3 boxes)

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7
Q

What is a normal QRS Interval for an ECG analysis?

A

< 0.12 sec

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8
Q

How do you calculate rate on an ECG?

A

Count the number of large boxes between consecutive R waves and divide 300 by this number.

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9
Q

The SA Node has 3 levels of backup. What are they?

A

Atrial Foci, Junctional Foci, Ventricular Foci

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10
Q

What is Atrial Foci’s inherent rate?

A

60-80 per min

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11
Q

What is Junctional Foci’s inherent rate?

A

40-60 per min

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12
Q

What is Ventricular Foci’s inherent rate?

A

20-40 per min

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13
Q

What are Ectopic Beats?

A

Small changes in an otherwise normal heartbeat. [extra or skipped beat(s)]

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14
Q

What are some potential causes of ectopic beats?

A

Caffeine, Alcohol, Medications/Drugs, Hypokalemia, Ischemia, Infarction, Cardiomyopathy & Increase in Catecholamines (e.g. Epinephrine).

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15
Q

What are 6 causes of Irregular Rhythms (Arrhythmias)

A

Premature beats, Atrial flutter, Atrial fibrillation, Other Atrial Tachycardias, Bradycardias, Ventricular Tachycardias.

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16
Q

PAC’s, PSVT, A-Flutter, A-Fib are examples of what kind of Arrhythmias?

A

Supraventricular Arrhythmias

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17
Q

When does Premature Atrial Contraction (PAC) occur?

A

When a focus in the atrium (not the SA node), generates an action potential (AP) before the next scheduled SA node action potential.

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18
Q

What are the 4 main characteristics of PAC’s?

A

Premature, Ectopic, Narrow Complex’s, Compensatory Pause.

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19
Q

What is Paroxysmal Supraventricular Tachycardias (PSVT)?

A

Sudden run of >3 premature beats (both sustained for up to hours or longer + brief & non-sustained: 3 beats up to 30 sec)

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20
Q

What are some characteristics of Atrial Flutter’s?

A

Atrial rate is constant, Ventricular rate depends on AV junction, Variable Rhythm (regular or irregular), and No Observable P Waves.

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21
Q

What are 6 cases where an A-Flutter can be observed?

A

Acute M.I., Hypertensive Heart Disease, Valvular Heart Disease, Post Cardiac Surgery, Lung Disease, Pulmonary Emboli

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22
Q

What are some medications used for treatment of A-Flutter?

A

Digitalis, B-Blockers, Ca2+ Channel Blockers, Quinidine or Procainamide

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23
Q

In Atrial Fibrillations Atrial Rates are _____ and Ventricular Rates are ______ ?

A

Atrial: Chaotic | Ventricular: Irregular

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24
Q

How would you describe the Rhythm of Atrial Fibrillation?

A

Irregular, with no specific pattern. No stable relationship between fibrillary atrial waves and the QRS complex’s.

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25
Q

How would you describe the P waves of Atrial Fibrillation?

A

No identifiable P waves, only fibrillary (f) waves, irregular movements of baseline.

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26
Q

Is the PR Interval measurable in Atrial Fibrillation?

A

Not measurable.

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27
Q

What triggers an Atrial Fibrillation?

A

Rapid electrical activity starting in the pulmonary vein and spreading to the atrium.

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28
Q

Can Atrial Fibrillations occur suddenly or chronically?

A

Paroxysmal (both)

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29
Q

Who are Atrial Fibrillations most common in?

A

Person’s with organic heart disease.

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30
Q

What are some consequences of Atrial Fibrillation?

A

Decreased Q, Congestive Heart Failure, Hypotension, Myocardial Ischemia, Atrial Thrombi & Embolism.

31
Q

What does the treatment of Atrial Fibrillations entail?

A

Digitalis, B-Blockers, Ca++ Channel Blockers, Electrical Cardioversion, RF Ablation Therapy

32
Q

What is AV (Atrio-Ventricular) heart block?

A

Conduction disturbances, impaired transmission from atria to ventricles. (AV node dysfunction)

33
Q

What is the primary measure of AV Heart Blocks?

A

PR Interval

34
Q

What are the most common causes of AV Heart Blocks?

A

Most often caused by aging, swelling, or scarring of the heart.

35
Q

How many types of AV Heart Block are there?

A

1st Degree, 2nd Degree (Type 1 & Type 2), and 3rd Degree

36
Q

How would you describe 1st Degree AV Heart Block?

A

Mildest, more of a delay & not a block. Impulses moving through the AV node too slowly.

37
Q

What is the PR Interval of 1st Degree AV Heart Block?

A

> 0.20 sec

38
Q

What are some causes of 1st Degree AV Heart Block?

A

Medication-Induced, Myocardial Infarction, and Hyperkalemia.

39
Q

How would you characterize 2nd Degree Heart Block Mobitz Type I?

A

Progressive lengthening of PR interval w/non-conducted P wave. (usually only 2-3 P waves occur before a QRS is dropped)

40
Q

What are some causes of 2nd Degree Heart Block Type 1?

A

Medication-Induced, Ischemic Heart Disease, Acute Inferior Wall Infarction, and Enhanced Vagal tone (Athletes)

41
Q

How would you describe the Rhythm of 2nd Degree Heart Block Type 2?

A

Irregular with “grouped” beats.

42
Q

How would you describe the Rate of 2nd Degree Heart Block Type 2?

A

Atrial: Constant between 60-100 bpm. Ventricular: Varies due to non-conducted P wave.

43
Q

How would you describe the P wave & PR Interval of 2nd Degree Heart Block Type 2?

A

P Wave: sudden appearance of a non-conducted P wave

PR Interval: NO progressive lengthening.

44
Q

What is 2nd Degree Heart Block Type 2 a general sign of & what is the treatment?

A

General sign of severe conduction system disease (AV node & below)

Treatment: Pacemaker

45
Q

How would you describe 3rd Degree Heart Block?

A

PR Interval is irregular & not related to the flow of electrical stimuli.

46
Q

What are some causes of 3rd Degree Heart Block?

A

Most common is Coronary Ischemia.

Acute MI, Inferior wall MI, Congenital, Lyme Disease.

47
Q

How is the pacemaker rhythm recognized?

A

Easily recognized through pacemaker spikes (vertical signals that represent the electrical activity of the pacemaker)

48
Q

What is the most common ventricular Arrhythmias?

A

Premature Ventricular Contractions (PVCs)

49
Q

What causes Premature Ventricular Contractions?

A

Either:

Ventricular focus that generates AP’s at an accelerated rate.

(or)

Problem in the heart’s electrical conduction system.

50
Q

How do Premature Ventricular Contractions occur?

A

Randomly or may alternate with normal beats in a regular pattern.

51
Q

How do Premature Ventricular Contractions interact with age?

A

Occur more frequently

Common with any type of Heart Disease

PVC’s will increase with underlying heart disease.

52
Q

What are some EKG rhythm properties associated with PVC’s?

A

P Wave: not conducted
PR Interval: not measurable
QRS Complex: > 0.12 secs with abnormal form
Rhythm: irregular
Rate: variable

53
Q

A Unifocal PVC is what shape?

A

Identical

54
Q

A Bigeminy PVC is what shape?

A

Every Other

55
Q

A Couplet PVC is what shape?

A

Paired

56
Q

A Triplet PVC is what shape?

A

Non-Sustained VTach

57
Q

A Multifocal PVC is what shape?

A

More than one shape

58
Q

Treatment is required of PVCs if?

A

Is associated with an acute MI

Occur as couplets, bigeminy, trigeminy, or multifocal

Is frequent (>6/min)

59
Q

What is Ventricular Tachycardia (V-Tach)?

A

Fast heart rhythm that originates in one of the ventricles.

60
Q

A Ventricular Tachycardia has a run of ___ QRX complex’s?

A

> 3 (single, non-sustained, or sustained for > 30 sec)

61
Q

What are some EKG rhythm properties associated with V-TACH?

A

Rate: Ventricular rate is 150-200 bpm
Rhythm: Regular or Slightly Irregular
P Wave: Usually not distinguishable
PR Interval: Not Measurable
QRX Complex: Wide & Bizarre (>0.12 secs)

62
Q

What is a Ventricular Fibrillation (V-Fib)?

A

Uncoordinated contraction of the ventricles resulting in a “quivering” rather than a normal contraction.

63
Q

What are some EKG rhythm properties?

A

P Wave: Not Identifiable
PR Interval: Not Measurable
QRS Complex: Not Identifiable
Rhythm: Chaotic, not identifiable
Rate: cannot be determined

64
Q

In V-TACH & V-FIB, if the ventricles are not contracting properly, what is the outcome?

A

Decrease in cardiac output.

65
Q

V-TACH may lead to what?

A

V-FIB, Asystole, and Sudden Death

66
Q

How is V-FIB identified?

A

Most commonly identified as arrhythmia in cardiac arrest patients.

67
Q

In F-FIB, if there is no intervention what will happen?

A

Quickly degenerate to asystole.

68
Q

What are Bundle Branch Blocks?

A

Delays in electrical signal conduction to the R & L ventricular tissue

69
Q

How do you determine the presence of BBB?

A

Primarily examine QRS waves

70
Q

How is a R Bundle Branch Block typically spotted? (characteristics)

A

“Bunny Rabbit Ears”

71
Q

How is a L Bundle Branch Block typically identified?

A

Produced an R, R’ in the left chest leads V5/V6 with accompanying broad R-wave and deep S and inverted T-Wave.

72
Q

What are some clinical causes of RBBB’s?

A

Right-Sided heart disease

Myocardial Infarction

73
Q

What are some clinical causes of LBBB’s?

A

One indicator of heart disease
Long-Standing HTN with LVH
Valvular Lesions
Cardiomyopathy

DPT830 (Exam 2) (8 decks)

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