Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

CardioPulmonaryPT > Essentials of CardioPulmonary PT Ch 9: ECG's > Flashcards

Essentials of CardioPulmonary PT Ch 9: ECG's Flashcards

1
Q

Four elements specifically assessed on a 12-lead ECG

A

1) Heart Rate
2) Heart Rhythm
3) Hypertrophy
4) Infarction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Assessment of Heart Rate (in BPM) via ECG: 3 methods

A

1) Six second tracing:
- —-The number of QRS complexes on the 6 second tracing is multiplied by 10.

2) R wave measurement:
- —-a) identify a specific R wave on heavy black line
- —-b) for each heavy black line that follows this R wave, count 300, 150, 100, 75, 60, 50. Where the next R wave falls on this counting is the HR

3) Counting (large) boxes:
- —-a) Count the number of large boxes (5mm or .20sec) between the first and next QRS complex
- —-b) # of large boxes is divided into 300 for HR
- Counting small boxes:
- —-a) count # of small boxes between QRS complexes and divide into 1500.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Wave of atrial depolarization is recorded as…

A

The P wave

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

The isoelectric line between the P wave and the QRS is…

A

the delay of the electrical impulse from the atria caused by the AV node

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Single lead monitoring is limited to…

A

detection of rate and rhythm disturbances; it cannot detect ischemia due to the inability to calibrate radiotelemetry

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Single lead monitoring may display artifacts caused by…

A

1) muscle tremors or movement
2) Loose electrodes
3) Sixty cycle electrical interference

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q
  • All P waves are upright, normal in appearance, and identical in configuration; a P wave exists before every QRS complex
  • The PR interval is between 0.12s and 0.20s
  • The QRS complexes are identical
  • The QRS duration is between 0.06s and 0.10s
  • The RR interval is regular (or, if irregular, the distance between the shortest and longest intervals is less than 0.12s)
  • The heart rate is between 60 to 100 BPM
A

Normal Sinus Rhythm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q
  • All P waves are upright, normal in appearance, and identical in configuration; a P wave exists before every QRS complex
  • The PR interval is between 0.12s and 0.20s
  • The QRS complexes are identical
  • The QRS duration is between 0.06s and 0.10s
  • The RR interval is regular throughout
  • The heart rate is less than 60 BPM
A

Sinus Bradycardia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q
  • All P waves are upright, normal in appearance, and identical in configuration; a P wave exists before every QRS complex
  • The PR interval is between 0.12s and 0.20s
  • The QRS complexes are identical
  • The QRS duration is between 0.06s and 0.10s
  • The RR interval is regular throughout
  • The heart rate is greater than 100 BPM
A

Sinus Tachycardia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q
  • All P waves are upright, normal in appearance, and identical in configuration; a P wave exists before every QRS complex
  • The PR interval is between 0.12s and 0.20s
  • The QRS complexes are identical
  • The QRS duration is between 0.06s and 0.10s
  • The RR interval varies throughout
  • The heart rate is between 40 to 100 BPM
A

Sinus Arrhythmia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Signs/symptoms:
_____ rate increases with inspiration, and decreasing with respiration (Respiratory type)
_____ rate not affected by respiratory cycle

A

Sinus Arrhythmia: Signs/symptoms/causes of:

  • Respiratory: found in young, or elderly at rest and disappears with activity
  • Non-respiratory arrhythmia may occur with:
  • –infection
  • –medication administration (toxicity associated with)
  • —-digoxin or morphine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Sinus Arrhythmia tx:

A
  • Respiratory type is benign; no tx

- Non-respiratory: Evaluate for and treat underlying cause

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

An irregularity in rhythm in which the impulse is initiated by the SA node but with a phasic quickening or slowing of impulse formation usually caused by an alternation in vagal stimulation.

A

Sinus Arrhythmia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q
  • All P waves are upright, normal in appearance, and identical in configuration; a P wave exists before every QRS complex
  • The PR interval is between 0.12s and 0.20s
  • The QRS complexes are identical
  • The QRS duration is between 0.06s and 0.10s
  • The RR interval is regular for the underlying rhythm, but occasional pauses are noted
  • The heart rate is usually between 40 to 100 BPM
A

Sinus Pause or Block

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

When the SA node fails to initiate an impulse, usually for only one cycle

A

Sinus Pause or Block

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Causes of Sinus Pause or Block :

A
  • Sudden increase in Parasympathetic activity
  • organic disease of the SA node (sick sinus)
  • an infection
  • rheumatic disease
  • severe infarction or ischemia to the SA node
  • Digoxin toxicity
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Sinus Pause or Block symptoms

A
  • If the pause or block is prolonged, or occurs frequently…
  • > cardiac output is compromised and patient may experience dizziness or syncope
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q
  • All P waves are present but vary in configuration; each P wave may look different
  • The PR interval is between 0.12s and 0.20s
  • The QRS complexes are identical
  • The QRS duration is between 0.06s and 0.10s
  • The RR intervals vary
  • The heart rate is usually less than 100 BPM
A

Wandering Atrial Pacemaker

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

The cause of “Wandering Atrial Pacemaker” is usually…

A

…an irritable focus.
…caused by ischemia or injury to the SA node
…congestive heart failure
…increase in vagal firing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

“Wandering Atrial Pacemaker” symptoms…

A

…usually this arrhythmia does not cause symptoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Types of Atrial arrhythmias

A
  • Premature atrial complexes
  • Atrial tachycardia
  • Paroxysmal atrial tachycardia
  • Atrial fibrillation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Types of Junctional Arrhythmias (3)

A
  • Premature Junctional or Nodal Complexes
  • Junctional or Nodal Rhythm
  • Nodal (Junctional) Tachycardia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Heart Blocks (types)

A

First Degree
Second degree AV block, Type 1
Second Degree AV Block, Type 2
Third Degree AV Block

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Ventricular Arrhythmias

A
  • Premature Ventricular Complexes
  • Ventricular Tachycardia
  • Ventricular Tachycardia: Torsade de Pointes
  • Ventricular Fibrillation
25
Q

Four cell types of the myocardium:

A

1) Working or Mechanical myocytes
- —-respond to electrical stimulation to contract and pump blood

2) nodal myocytes
- —- highest rhythymicity; slow impulse conduction

3) transitional myocytes
- —- transmit impulses twice as fast as as nodal cells

4) Purkinje cells
- —- low rate of rhythmicity, but high conductivity

26
Q

Depolarization of the myocardial cell membrane allows the influx of ________ and efflux of _________ ions.

A

sodium (known as fast channel) ; potassium (known as slow channel)

27
Q

_____ __________ __________ is present if the depth of the S wave in V1 plus the height of the R wave in V5 is greater than 35mm.

A

Left ventricular hypertrophy

28
Q

The cardiac muscle has (3) properties:

A

1) automaticity
- —- able to discharge electrical stimulus w/o stimulation from a nerve

2) rhythmicity
- —- the regularity with which pace-making activity occurs

3) conductivity
- —-ability to spread impulses to adjoining cells rapidly

29
Q

Inflammation of the pericardial sac

A

Acute Pericarditis

30
Q

The pain of acute pericarditis is usually aggravated by or relieved by…

A

…respiration and change of position.

31
Q

ECG findings in acute pericarditis include:

A
  • ST segment elevation
  • PR interval depression
  • late T-wave inversion
  • atrial arrhthmias
32
Q

Defined as an ectopic focus in either atria that initiates an impulse before the next impulse is initiated by the SA node:

A

Premature atrial complex

33
Q

Defined as: An erratic quivering of the ventricular muscle resulting in no cardiac output.

  • As in
A

Ventricular fibrillation

34
Q

Defined as: An erratic quivering of the ventricular muscle resulting in no cardiac output.

A

Ventricular fibrillation

35
Q

The sympathetic and parasympathetic systems discharge what neurotransmitters:

A

Sympathetic = NE

Parasympathetic = ACh

36
Q

Increased sympathetic activity:

A
  • increases HR
  • increases conduction velocity throughout the AV node
  • increases contractility of the heart muscle
  • increases irritability of the heart
  • Automaticity may also increase
37
Q

Parasympathetic activity:

  • Increased
  • Decreased
A

Increased:
- slows HR
slows conduction through AV node

Decreased:
- increases HR, conduction through the AV node, and irritability of the heart

38
Q

P wave:

A

atrial depolarization

39
Q

PR interval:

A

depolarization wave reaches AV node and slight pause occurs

40
Q

QRS complex:

A
  • Depolarization wave reaches Purkinje fibers

- ventricular depolarization

41
Q

Slight pause following QRS:

A
  • ST segment; initiation of ventricular depolarization
42
Q

T wave:

A
  • Ventricular depolarization complete
  • strictly an electrical event that records the return pf potassium inward and sodium outward; no contraction is occurring
43
Q

A single lead tracing (rhythm strip) records (3):

A
  • HR
  • Heart rhythm
  • presence of arrhythmias
44
Q

Where S wave ends and T wave begins:

A

…is the beginning of diastole (end of systole)

45
Q

Sinus bradycardia occurs in:

A
  • endurance trained athletes (normal)
  • individuals on beta blocker meds
  • when decrease in automaticity of SA node or increased vagal stimulation
  • —-such as suctioning or vomiting
  • TBI with ICP
  • brain tumors
  • Second or Third degree heart block
46
Q

Sinus tachycardia differs from NSR?

A
  • In rate only…it is greater than 100bpm
47
Q

The pace-making activity in this condition shifts from focus to focus, resulting in a rhythm that is very irregular and without a consistent pattern. Some impulses may arise from AV node:

A

Wandering atrial pacemaker

48
Q

Three or more premature atrial complexes in a row:

- HR is usually greater than 100bpm and may be 200bpm

A

Atrial tachycardia

49
Q

Sudden onset of atrial tachycardia or repetitive firing from an atrial focus. The underlying rhythm is usually NSR, followed by episodic burst of atrial tachycardia that eventually returns to NSR.

A

Paroxysmal Atrial Tachycardia

50
Q

Paroxysmal Atrial Tachycardia:

A

“All of a sudden my heart was racing away!”

—Initial tx are to try counghing or breath holding with Valsalva

51
Q

Rapid succession of atrial depolarization caused by an ectopic focus in the atria that depolarizes at a rate of 250 to 350 per minute.

A

Atrial flutter

52
Q

Erratic quivering of atrial muscle caused by multiple ectopic foci in the atria that emit electical impulses constantly.

None of these impulses actually depolarize the atria, so no true P waves.

A

Atrial fibrillation

53
Q

Occurs when AV node takes over as pacemaker of the heart:

A

Junctional or nodal rhythm

  • absence of P waves before QRS, but retrograde P wave may be identified
  • ventricular rate between 40-60bpm
54
Q

Accelerated rate of discharge when AV tissue is acting as pacemaker

A

Junctional (Nodal) tachycardia

  • absence of P waves , but retrograde P wave may be identified
  • Rate usually greater than 100bpm
55
Q

PVC’s occur…

A

…when an ectopic focus occurs from somewhere in one of the ventricles

56
Q

PVC’s appear on a ECG…

A

…as wide and bizarre looking QRS without a P wave followed by a compensatory pause.
—–this is because of the slow conduction of impulses by ventricular muscle itself

57
Q

A series of three or more PVC’s in a row defines:

A

Ventricular tachycardia

  • P waves absent
  • wide and bizarre QRS complexes
  • Ventricular rate between 100 and 250bpm
  • precursor to ventricular fibrillation
58
Q

Unique configuration of ventricular tachycardia associated with QT interval greater than .5 sec.

A

Ventricular Tachycardia: Torsade de Pointes

  • twisting around iso-electric line
  • characteristically occurs at a rapid rate and terminates spontaneously

CardioPulmonaryPT (2 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions