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CardioPulm > EKG stuff > Flashcards

EKG stuff Flashcards

1
Q

What is a holter monitor?

A

a portable EKG unit that CONTINUOUSLY records heart signal for about a day (25 hrs)
- pt presses button when theres symptoms or when theyre intentionally exercising

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2
Q

reasons to use a holter monitor

A
  • palpitations
  • SOP
  • syncope
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3
Q

BIG boxes on EKG time
little boxes on EKG time

A
  • .2 seconds = 5mm
  • .04 seconds = 1mm
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4
Q

What does the PR interval represent & why is it important

A

the PAUSE at the AV node

for refractory interval

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5
Q

What does the QT interval represent

A

the time it takes to depolarize and repolarize the VENTRICLES

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6
Q

Isoelectric Conditions (baseline) should occur what 3 times ?

A
  • after P wave
  • After QRS
  • After t wave
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7
Q

What does it mean if there is ST elevation? Depression?

A

Elevation: Myocardial infarction

Depression: Myocardial ischemia

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8
Q

What is the path and vector of depolarization in the heart

A
  • SA node
    ATRIA
  • AV node
    PAUSE
  • Bundle of His
  • Bundle branches
    APEX
  • Perkenjie fibres
    BASE

Vector must go down and to the L bc more muscle mass on left (towards L ventricle)

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9
Q

What can wandering baseline be due to?

A
  • loose wires
  • moving clothes
  • poor prep of electrode on skin
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10
Q

60 Cycle interference ???

A
  • produced by wall current
  • superimposed on tracing
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11
Q

Normal amplitude for P, QRS, and T wave

A

-P : upright and symmetrical

  • QRS : R is always first upward deflection
  • T : upright and symmetrical
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12
Q

Explain what each thing represents :

P wave
PR interval
QRS
ST Wave
T
QT Interval

A

P wave: produced by atrial depolarization

  • PR interval: pause in AV node; time between atrial depolarization and ventricular depolarization
  • QRS: ventricular systole/depolarization AND HIDDEN atrial repolarization
  • ST Wave: ventricular depolarization/diastole
  • T : ventricular repolarization
  • QT Interval: time for depolarization and repolarization to occur
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13
Q

What does inverted T wave represent?

A

Myocardial Ischemia

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14
Q

Pacemaker rates

A

SA node: 60-100 bpm
AV node: 40-60 bpm
Ventricular cells/Bundle of His: 40-60 bpm

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15
Q

Bradycardia vs tachycardia cause

A

Bradycardia < 60 ; caused by enhanced SV or BETA blockers, TBI

Tachycardia >100 ; normal w/ exertion

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16
Q

Ectopic Foci

A

an area in the heart that can generate a depolarization signal
- other than SA or AV

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17
Q

what part of the heart is the workhorse of the heart

A

bottom L Ventricle

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18
Q

what does a magnitude of > 1/3 QRS complex represent

A

an old MI

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19
Q

What is R’ (R prime?)

A
  • second upward deflection indicating abnormality when one ventricle depolarizes later than normal
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20
Q

what nerve slows HR below 100bpm?

A

vagus

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21
Q

How is HR increased?

A

by decreasing vagal and increasing sympathetic inputs

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22
Q

What is regular rhythm (time and boxes) ? whats the analogy that it looks like?

PR Interval
QRS Complex

A

PR interval: .1-.2 seconds OR 3-5 small boxes

QRS Complex: .01-.1 seconds 1.5-2.5 small boxes

LOOKS LIKE A PICKET FENCE

23
Q

Regularly Irregular

A

EKG not the same every time; there IS a PATTERN

24
Q

Irregularly Irregular
- what is it usually?

A

no consistent pattern; changes from one cardiac cycle to the next
- usually A Fib

25
Sinus Arrhythmia
Cause: increases w/ inspiration Tx: goes away w/ activity
26
Sinus Pause
damage to SA node Cause: infection, infarction, sick sinus syndrome, ischemia
27
Sinus pause vs Sinus arrest
Sinus pause : <2 sec Sinus arrest: >2 sec !STOP and REPORT!
28
Wandering atrial pacemaker
when there is more than one node initiating heart beat
29
PAC Premature atrial contraction
beats that occus earlier than normal and are generated by ectopic foci in the atria Cause: stress, nicotine, alcohol, caffine
30
Atrial Tachycardia
when theres 3+ PACs in a row w/ increased HR Cause: pH issues, hypoxia Tx: beta blockers, holding breath, valsalva maneuver
31
PAT - Paroxysmal Atrial Tachycardia
sudden increase in HR w/ normal looking complexes Cause: digital toxicity
32
Atrial Flutter
Multiple depolarization of atria caused by ectopic focus rate >250x/min Sawtooth pattern with F waves- no p waves
33
Atrial Fibrillation
no real pacemaker no p wave Tx: anticoagulant - warfarin
34
Artial Issues all have normal ____
QRST complexes
35
Significant Q represents
previous MI
36
Escape beat vs repeated beat
37
Junctional Tachycardia
no p before qrs - faster than 100
38
Premature Ventricle Contraction PVC
- wide unbalanced QRS - occurs when ectopic focus originates from an impulse in one of the ventricles - VERY SLOW conduction therefore giving large and weird
39
Psysiological consequences of a PVC (hint: SV AND BP
a weak contraction when BP drops increased preload and SV bc frank starling effect - pvc feels like pause followed by a stronger beat
40
What to do if you see V FIB
stop and call code stop and get defib
41
what to do if you see V Tach
stop pt and see if it resolve get help if it doesnt
42
Bigeminy PVC
when every other beat is a PVC
43
Trigeminy PVC
when every 3rd beat is PVC
44
Couplet
When 2 pvcs are paired together
45
Automaticity
altered pacemaker functionC
46
Conduction:
- blocks - abnormal propagation of AP
47
First Degree Block
pr interval longer than .2 sec - 5 little boxes or 1 big box depolarizes slowly
48
Second Degree Block: Mobitz type 1 (Wenckebach)
1. AV becomes more refractory w/ beats 2. PR interval lengthens 3. AV node fails DROPS QRS
49
Second Degree Block: Mobitz type 2
1. AV node slow to repolarize 2. blocks on next beat 3. AV node recovers 4. 2:1, 3:1 ratio of P:QRS REGULARLY DROPS QRS
50
Third Degree Block
no relationship between P and QRS - separate rates and rhythms for the atria (p waves) and ventricles (QRS)
51
Bundle Branch Block
one, both or part of one bundle branch conducts slowly - qrs wider than .12 (3 little boxes)
52
Wolff Parkinson White
- depolarization of atria and pause at AV node BUT theres an alternate pathway it takes without pause - causes delta shaped wave - can cause tachycardia
53
Atrial PAC nodial or av PJC Ventricle:
atrial: weird P wave ventricle:absent p after qrs or short pr interval junctional: p wave hidden, t missing
54

CardioPulm (17 decks)

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