EMT 230 Flashcards
Ethics Definition
The discipline relating to right and wrong. A standard for honorable behavior designed by a group with expected conformity
Automaticity
The ability of cardiac pacemaker cells to spontaneously generate their own electrical impulses without external (or nervous) stimulation
What angle is the head at when assessing for JVD?
45 degrees
What do the marginal arteries branch off of?
Left and Right Coronary Arteries
What is the treatment for an unresponsive, brady pt?
Pacing
What is the T wave?
Positive upward deflection of the T wave reflects repolarization of the ventricles
If pt is in condition PEA, do you pace?
No, treat as if asystole
Define Inotropy
Force of cardiac contractions
Sterling’s Law?
The more the heart is stretch the greater it contracts (to a certain point)
SA node intrinsic firing rate?
60-100
What does an EKG measure?
Rate, rhythm, electrical voltage but not how much Cardiac output there is
What is the P wave representing?
Atrial depolarization
What is the most likely cause of a 2nd degree type II heart block?
Septal MI
What are leads I, II, III known as?
Bipolar leads
Sinus tachycardia is most likely caused by?
Increased sympathetic stimulation
What does an ACE inhibitor do?
Prevents angiotensin I from becoming angiotensin II. Lowers BP
What does ST segment depression indicate?
Myocardial ischemia
As a medic, who do you have a legal responsibility to?
Patient, Employer, Medical director, and public
Where does the right atrium receive blood from?
Vena Cava and coronary veins
How do we treat AFib?
Calcium Channel blocker (verapamil, lidocaine, diltazem, cardizem, amio)
What kind of lung sounds are expected from a CHF patient?
Crackles, wheezing, rhonchi
Stroke Vol x Heart Rate = ?
Cardiac output
What is the most common cause of death for those experiencing a heart attack?
Lethal dysrhythmias
After the pacer pads are placed on the patient you should?
Select the rate
Maintenance infusion post ROSC for amiodarone?
1 mg/min for 6 hours. Then up to 0.5 mg/min for up to 18 hours.
Maintenance infusion post ROSC for lidocaine?
2-4mg/min
Venous return is important for stroke volume because?
It determines the preload
Atherosclerosis definition
Narrowing of medium and large lumen with fatty deposits
Other than oxygen what is one of the first things to give to a pt having a heart attack?
Aspirin
Why do we give Morphine to someone with a heart attack?
Allows for venous pooling, decreases the oxygen demand on the heart
Why do we give atropine fast?
Slow will cause rebound bradycardia
When semilunar valves close you hear?
S2
Cardiac plexus is?
Network of nerves that innervate near the aorta
Pericordial, Unipolar leads are?
V1-V6
Augmented, Unipolar leads are?
aVR, aVF, aVL
Common beta blockers end in?
olol
ACE Inhibitors?
Lisinopril, -pril
5 + 3 is?
Rate, rhythm, P wave, PR interval, QRS
ST elevation, ST Depression, q wave
Potassium Channel blocker
Amiodarone (300mg, 150mg)
Lidocaine (1-1.5mg/kg max 3mg)
Definitive diagnosis for cardiac events?
Lab values. Troponin values greater than 0.01
Spodick’s sign?
Pericarditis. Downsloping TP segment.
Layers of heart
Inside: Endocardium
Middle: Myocardium
Outside: Epicardium
Excitability
The ability of cardiac cells to respond to an electrical stimulus
Conductivity
The ability of cardiac cells to receive an electrical stimulus and to then transmit the stimulus to other cardiac cells
Contractility
The ability of cardiac cells to shorten and cause cardiac muscle contraction in response to electrical stimulus
What happens during depolarization?
Sodium rushes in, potassium rushes out
What happens during repolarization?
Potassium rushes in, sodium rushes out
RBBB Identification?
Waveforms look like M (look in septal leads)
LBBB Identification?
Waveforms look like W (look in septal leads)
Typically transient heart blocks?
1st degree. Fixed elongated PR, does not drop beats
2nd degree type I: Increasing PR, Drops QRS
Not transient heart blocks?
2nd degree type II: fixed PR, Drops QRS
3rd degree: regular but independent P waves and QRS complexes
Junctional Rhythms will have?
Inverted P waves or absent p waves
Junctional Rates
Junctional: 40-60
Accelerated Junctional: 60-100
Junctional tachycardia >100
Left Coronary artery branches
Left anterior descending artery, Marginal, Circumflex
Right coronary artery branches
Posterior descending, marginal
Parasympathetic Electrical impulse path
Brain Spinal Cord Preganglion Neuron Cholinergic fibers Acetylcholine Synapse Nicotinic Cholinergic Receptors Post ganglion neuron Cholinergic Fibers Acetylcholine Neuro effector junction Muscarinic Cholinergic Receptors Effector organ/muscle
Sympathetic Electrical Impulse path
Brain Spinal Cord Preganglion neuron Cholinergic Fibers Acetylcholine Synapse Nicotinic Cholinergic Receptors Post Ganglion Neuron Adrenergic Fibers Norepinephrine Neuro Effector Junction Adrenergic Receptors (alpha 1, beta 1, beta 2) Effector organ/muscle
Drop of Blood
Inferior/superior vena cava Right atrium Tricuspid Valve Right ventricle Pulmonary valve Pulmonary arteries Lungs Pulmonary Veins Left atrium Bicuspid/mitral valve left ventricle Aortic valve Aorta
Breath of Air
Nose Nasopharynx Oropharynx Epiglottis Laryngopharnx Vocal cords Larynx Trachea Primary Bronchi Secondary Bronchi Tertiary Bronchi Bronchioles Alveoli
Somatic Nerve Impulse
Brain Spinal Cord Neuron Cholinergic Fibers Acetylcholine Neuro-effector junction Nicotinic cholinergic receptors Effector organ/muscle
Heart Impulse Path
SA Node Intranodal and intra-artial pathways Atrio-ventricular node Bundle of His Right bundle branch and left bundle branche (left anterior and left posterior fascicle) Purkinje Fibers
Chronotropic
heart rate
Inotropic
Force of contraction
Dromotropic
Conduction speed
