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Cardiopulmonary PT > Electrocardiography basics > Flashcards

Electrocardiography basics Flashcards

1
Q

Purpose of ECG training

A
  • recognize benign vs life threatening situations
  • be able to make clinical decisions based on HR/rhythm as seen on a rhythm strip
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2
Q

what does the hearts ability to pump depend on

A
  1. automaticity:
  2. rhythmicity:
  3. excitability:
  4. conductivity
  5. contractility
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3
Q
  1. automaticity:
A

the ability to initiate it’s own electrical impulse

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4
Q
  1. rhythmicity:
A

the ability to repeat the cycle with regularity

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5
Q
  1. excitability:
A

the ability to respond to an electrical impulse

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6
Q
  1. conductivity
A

the ability to transmit electrical impulses from cell to cell within the heart (coordinates)

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7
Q
  1. contractility
A

the ability to stretch as a single unity and then passively recoil while actively contracting

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8
Q

Depolarization vs repolarization

A
  • depolarization: depolarization is when the membrane potential becomes less negative (more positive)
  • repolarization returns it to its resting negative state (more negative)
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9
Q

Sympathetic NS with the heart

A
  • equated with acceleration
  • branches of the sympathetic trunk
  • discharges norepineprhrine resulting in increase velocity and force of contraciton
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10
Q

parasympathetic NS with the heart

A
  • equated with deceleration or braking
  • discharges acetycholine
  • vagus nerve is main component and acts primarily on SA node as an inhibitor rate and velocity of impulse
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11
Q

Nodal myocytes

A
  • within the SA/AV node
  • susceptible to change and depolarization
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12
Q

transitional myocytes

A
  • along the internodal pathways/bundle branches/purkinjie cells
  • regular working myocytes
  • myocytes have ability to fire automatically due to automaticity
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13
Q

SA node firing rate

A
  • 60-100
  • drives HR
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14
Q

AV node firing rate

A
  • 40-60 and will take over if SA node is not firing properly
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15
Q

Myocytes firing rate

A
  • <40
  • can throw off rate
  • etopci folki cells especially
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16
Q

ECGs - how many leads
1. diagnositc
2. bedside monitoring
3. holter monitoring
4. New technology

A
  1. diagnostic: 10-12 lead system
  2. bedside monitoring: 3-5 leads/rhythm strip
  3. holter monitoring: establish baseline/monitor change
  4. New technology: establish baseline/monitor change
17
Q

what does a 12 lead ECG mean

A
  • really only 10 leads
  • 12 views of the heart that can tell where the irregularity is coming from
  • diagnositic
18
Q

bed side monitoring

A
  • 3-5 leads
  • used to monitor rate and rhythm
  • may reflect issues that then require diagnostic EKG
  • looks at ventricle
19
Q

Holter monitor

A
  • 24-48 hour EKG
  • analyzed afterward
  • electrodes attached at doctors
  • wires attach to a small device
  • record activities
20
Q

New technology

A
  • kardio mobile app
  • zio mobile monitor system
  • smart watch
  • pick up the most common problems
21
Q

ECG paper

A
  • displays the time on horizontal axis
  • runs at 25mm/sec
  • at this speed each small box is 0.04 seconds
  • each large box = 0.2 seconds
  • 5 boxes = 1 sec
  • 15 boxes = 3 seconds
  • 30 boxes = 6 seconds
22
Q

What do each part of the ECG mean

A
  • P-wave: atrial depolarization n
  • QRS: ventricular depolarization and contraction
  • ST segment: beginning of ventricular repolarization to prepare for next beat
  • T-wave: ventricular repolarization
23
Q

Can QRS vary explain?

A
  • yes
  • can be different from individual to individual and from different views
24
Q

5 rules when determining heart rhythm/dysrhythmias

A
  1. is the rhythm regular or irregular
  2. determine HR
  3. What atrial activity is evident
  4. what ventricular activity is present
  5. is there a relationship between Atrial and ventricular activity (p-wave with QRS complex)
25
Q
  1. is the rhythm regular or irregular
    (5 rules)
A
  • are there pauses
  • early beats
  • are R-R intervals equal
    CANNOT COUNT HR IF IT IS NOT EQUAL
26
Q
  1. determine HR - what about HR?
A
  • is it regular or irregular
  • fast or slow
27
Q
  1. What atrial activity is evident
A
  • are P waves present, are they alike in appearance
  • are there more Pwaves than QRS?
28
Q
  1. what ventricular activity is present
A
  • are QRS of normal duration (<.12seconds)
  • are they uniform across the tracing
29
Q
  1. is there a relationship between Atrial and ventricular activity
A
  • is each P wave producing a QRS
  • are there P waves without QRS
  • is there QRS without a P wave
30
Q

Calculating Heart rhythm (sinus rhythm)- what to use

A
  • inspection
  • calipers: see if they are the same distance
  • marking paper to measure distance as well
31
Q

Calculating HR

A
  • IF rhythm is regular
  • heart ruler
  • # in 6 second intervals x 10
32
Q
A

Cardiopulmonary PT (25 decks)

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