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Cardio Management > EKG > Flashcards

EKG Flashcards

1
Q

What occurs in phase 0 of cardiac action potential?

A

phase 0 = depolarization

  • Na+ channels open and there is a rapid influx of Na+
  • Na+ channels are rapid opening and rapid closing
  • resting membrane potential is -90mV
  • Ca2+ channels are also opened, but slower at opening and closing than Na+
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2
Q

What is the cardiac cell muscle permeable to during rest?

A

K+ ions only

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3
Q

What occurs in phase 1 of cardiac action potential

A

phase 1 = repolarization begins

  • some K+ channels remain open while others are closed resulting in outflow of K+
  • Ca2+ channels still open
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4
Q

Why does cardiac m have a prolonged AP in comparison to skeletal m?

A

Ca2+ channels open slower and have an extended opening

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5
Q

What occurs in phase 2 of cardiac action potential?

A

phase 2 = plateau

  • outward flow of K+ is balanced by inward flow of CA2+
  • delayed resting membrane potential
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6
Q

What occurs in phase 3 of cardiac action potential?

A

phase 3 = completion of repolarization

  • closure of Ca2+ channels accompanied by opening of additional K+ channels, causing rapid outflow of K+
  • negative resting membrane potential is restored
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7
Q

What occurs in phase 4 of cardiac action potential?

A

phase 4 = resting phase

- Na+ and Ca2+ are actively pumped out of the cell and K+ is pumped into the cell

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8
Q

Why is intrinsic atrial rhythm more rapid than intrinsic ventricular rhythm?

A

the refractory period of atrial cells is significantly shorter than that of the ventricular cells

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9
Q

What are the standard limb leads?

A

I = diff btwn L arm and R arm
II = diff btwn L leg and R arm
III = diff brown L leg and L arm
- bipolar leads

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10
Q

What are the augmented limb leads?

A

aVR, aVL, and aVF

- unipolar leads

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11
Q

Where are the precordial leads?

A 
V1 = 2nd ICS, to R of sternum
V2 = 2nd ICS, to L of sternum
V3 = midway between V2 and V4
V4 = 5th ICS, L midclavicular line
V5 = 5th ICS, L anterior axillary line
V6 = 5th ICS, L mid axillary line
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12
Q

What are the “big box” intervals for HR?

A

300, 150, 100, 75, 60, 50, 42

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13
Q

What is the conduction of normal nerve impulse?

A

SA node –> AV node –> Bundle of his –> BB –> Purkinje –> depolarization of myocardial cells

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14
Q

What is a normal PR interval and QRS?

A

PR

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15
Q

Arrhythmia related to discharge from atrial foci; characterized by waves of different shapes

A

Wandering pacemaker

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16
Q

Arrythmia with no clear p wave, quivering baseline; occasional impulse gets through to stimulated ventricles; determine rate with 3 second marks

A

Atrial fibrilation

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17
Q

originates in ventricular ectopic foci; giant ventricular complex after the pause; 20-40 bpm

A

ventricular escape

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18
Q

What are the HRs for paroxysmal tachy, flutter, and fibrillation?

A 
Paroxysmal = 150-250
flutter = 250--350
fibrillation = 350-450
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19
Q

What does paroxysmal tachy look like for atrial? jxn’l? ventricular?

A 
Atrial = P waves look different
jxn'l = inverted or no p-wave
ventricular = rapid PVC's
20
Q

What does flutter look like for atrial? ventricular?

A 
atrial = saw-tooth appearance
ventricular = smooth wave appearance
21
Q

What does fibrillation look like for atrial? ventricular?

A 
atrial = no p waves, irregular baseline, QRS irregular
ventricular = "bag of worms", no repetition is recognizable
22
Q

What’s 1* AV block criteria?

A

PR interval > 5 boxes (.2s)

23
Q

What’s 2* AV block, Mobitz 1, criteria?

A

PR interval becomes gradually longer cycle to cycle

24
Q

What’s 2* AV block, mobitz 2, criteria?

A

QRS dropped without lengthening PR interval

25
Q

What’s 3* AV block criteria?

A

No associated P wave and QRS complex; going to their own beat

26
Q

What are the criteria for axis?

A 
Normal: I = +, aVF = +
LAD: I = +, aVF = -
RAD: I = -, aVF = +
Extreme RAD: I = -, aVF = -
- impulse goes toward hypertrophy and away from infarct
27
Q

What are the criteria for atrial hypertrophy?

A

Diphasic p wave
initial portion larger = RAH
terminal portion larger = LAH

28
Q

What symptoms would you see with hypertrophy upon examination?

A

increased PMI and BP

29
Q

What are the criteria for ventricular hypertrophy

A 
RVH = S persists in V5 and V6
LVH = S1 + R5 > 35mm
30
Q

What are the criteria for ischemia?

A
  • Jpoint > 1mm below baseline

- inverted T wave

31
Q

What are the criteria for injury?

A
  • ST elevated > 4mm

- big tombstones = acute infarction

32
Q

What are the criteria for infarct?

A

significant Q waves
- width > 1mm
- amplitude ⅓ of QRS
(not significant in aVR and V1

33
Q

What chest leads indicate anterior infarct?

A

V1-V4

34
Q

What chest leads indicate lateral infarct?

A

I, aVL

35
Q

What chest leads indicate inferior infarct?

A

II, III, aVF

36
Q

Symptoms of bradycardia?

A
  • sx of hemodynamic compromise
    1. hypotension
    2. dizziness
    3. lightheadedness
    4. syncope
37
Q

symptoms of SVT?

A

Pts perceive a racing heart; also have sx of hemodynamic compromise

  1. dizziness
  2. lightheadedness
  3. syncope
38
Q

What is afib often associated with clinically?

A

embolic cardiac events

39
Q

symtoms of V-tach?

A
  • pt may be asymptomatic if it is a brief run

- if sustained, pt may be asymptomatic, symptomatic, or unconscious and pulseless

40
Q

symptoms of V-fib?

A

immediate loss of consciousness and loss of circulation

41
Q

what conditions refer the myocardium vulnerable to v fib?

A
  1. v-tach
  2. myocardial ischemia or infarction
  3. dilation of the heart
  4. hyperkalemia
  5. electric shock
42
Q

Posterior infarction: larg R with ST depression in V1 and V2; what artery is compromised?

A

R coronary artery

43
Q

Lateral infarction: Qs in lateral leads I and aVL; what artery is compromised?

A

Lateral circumflex coronary artery

44
Q

Inferior infarction: Q’s in inferior leads II, III, and aVF; what artery is compromised?

A

R or L coronary artery

45
Q

Anterior infarction Q’s in V1-V4; what artery is compromised?

A

anterior descending coronary artery

Cardio Management (5 decks)

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