Brainscape's Knowledge GenomeTM

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


See full index

DPT 528 > Exam 1 > Flashcards

Exam 1 Flashcards

quiz 1 plus this

1
Q

87% of CVAs are due to _____

A

ischemia

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

t/f: a patient with a TIA are at increased risk for CVA within 90 days

A

true

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

t/f: TIA symptoms resolve within 24 hours

A

true

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

t/f: CVA deficits result after 24 hours

A

true

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

are patients with atherosclerosis at increased risk of coronary artery disease?

A

yes

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

is carotid stenosis more predictive of MI or stroke?

A

MI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what can carotid duplex ultrasonography identify?

A

plaque

stenosis

occlusions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

how is cerebrovascular disease diagnosed?

A

CTA (computed tomographic angiography)

MRA (magnetic resonance angiography)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

how is cerebrovascular disease medically managed?

A

decrease risk factors

decrease BP

pharmacological

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what are pharmacological ways to manage cerebrovascular disease?

A

aspirin

anti-coagulation

lipid-lowering

glycemic control

anti-hypertensives

stations

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

what is renal artery disease?

A

atherosclerosis of one or both renal arteries

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what is the gold standard for diagnosing renal artery disease?

A

renal angiography

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

what are the signs of renal artery disease?

A

HTN

decreased kidney function

edema of the legs, feet, or ankles

darkened skin

weight loss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what are the symptoms of renal artery disease?

A

increase/decrease in urination

drowsiness/tiredness

generalized itching or numbness

dry skin

headaches

loss of appetite

nausea and vomiting

sleep problems

trouble concentrating

muscle cramps

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

t/f: sign of renal artery disease are often absent until severe

A

true

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

what lab values determine kidney function in people at risk for developing or have known kidney disease?

A

creatinine and BUN (blood urea nitrogen)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what does creatinine levels show?

A

direct measurement of glomerular filtration rate and renal function

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

what does increased creatinine levels indicate?

A

decreased glomerular filtration rate which indicates renal insufficiency

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

if glomerular filtration rate decreases, creatinine will ______, indicating ______ ______

A

increase, renal insufficiency

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

what level of creatinine indicates serious impairment of renal function?

A

> 4.0 mg/dL

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

what are normal creatinine levels?

A

male: 0.6-1.2 mg/dL
female: 0.5-1.1 mg/dL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

what is creatinine?

A

a catabolic product creatine phosphokinase which is used in skeletal muscle contraction and is excreted entirely by the kidneys

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

what is BUN?

A

the nitrogen portion of urea that measures metabolic function of the liver and excretory function of urea

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

elevated BUN indicates _____ _____ and _____

A

renal failure, uremia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

what could cause decreased BUN?

A

starvation, dehydration, or organ dysfunction like liver disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

what is renal angiography?

A

x-ray that shows the blood vessels in the kidneys

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

why is renal angiography sometimes not the best option for a patient?

A

the contract used can increase creatinine levels in patients with kidney dysfunction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

how is renal artery disease medically managed?

A

pharmacological

BP control

risk factor modification

surgical management

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

what are common pharmacologic managements of renal artery disease?

A

angiotensin-converting enzyme (ACE) inhibitors

angiotensin receptor blockers (ARBs)

diuretics

calcium channel or beta blockers

cholesterol lowering meds

anti-coagulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

what are 2 common surgical treatments of renal artery disease?

A

angioplasty stenting and endarterectomy/bypass surgery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

what is angioplasty and stenting?

A

using a catheter to place a balloon and stent into an artery to flatten the plaque and keep the artery open

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

what is an endarterectomy or bypass surgery?

A

plaques cleaned out of the artery - endarterectomy

using a vein/synthetic tube b/w the kidney and aorta to bypass the occlusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

what can renal artery disease lead to?

A

increased BP

increased protein levels in urine

decreased kidney function

ankle and foot swelling

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

what can untreated prolonged renal artery disease lead to?

A

chronic kidney disease

kidney failure

pulmonary edema

stroke

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

what is the most common aneurysm?

A

brain aneurysm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

are aortic aneurysms more common in men or women?

A

men

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

history of smoking accounts for ___% of cases of aortic aneurysms

A

75%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

what are some causes of aneurysms?

A

atherosclerosis

PAD

cardiovascular disease

traumatic injuries to arterial wall

tobacco use

vasculitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

what is an aneurysm?

A

weakness in the arterial wall due to pressure that causes a bulge/ballooning of the wall

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

what are the changes in body structure and function in aneurysms?

A

damage to the arterial wall that causes permanent dilation

destruction of elastin in the artery so it can’t go back to normal and stays dilated

loss of smooth muscle cells due to formation of intraluminal thrombus

weakening of the tunica media layer

neutrophils, RBCs, and platelets attach to the thrombus along with fibrinogen and lipoprotein

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

what are the primary locations for aneurysms?

A

brain, aorta, abdomen, thorax, and extremities

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

aneurysms have a dilated arterial wall of more than ____ % normal diameter

A

50

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

aneurysms are described by their ____, ______, ______ _____, and ______

A

location, size, morphological appearance, origin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

when is an aneurysm at risk for rupture?

A

when it increases more than 5 cm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

if a cerebral aneurysm ruptures, what does it cause?

A

a hemorrhagic stroke

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

t/f: an aortic aneurysm can occur at any segment of the aorta coming off the heart

A

true

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

what aneurysm is life-threatening if it ruptures?

A

abdominal aneurysm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

is a thoracic aneurysm above or below the diaphragm?

A

above the diaphragm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

what is the most common peripheral aneurysm?

A

popliteal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

what are the common locations of peripheral aneurysms?

A

popliteal

femoral

illiac

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

t/f: peripheral aneurysms are very rare

A

true

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

what are pseudoaneurysms?

A

a breach in the arterial wall causes blood to leak and be contained by the adventitia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

what are the signs of an aneurysm?

A

bruit over the swollen area in the abdomen

pulsating tumor/mass in the abdominal area

pressure on surrounding parts such as low back

poor/absent distal pulses below the level of the aneurysm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

what are the symptoms of an aneurysm?

A

severe chest pain from back to front

LBP

leg pain/claudication

numbness in LEs

excessive fatigue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

what is the difference b/w a rupture and a dissection?

A

a rupture goes through all 3 layers of the aorta or cerebral artery

a dissection is a tear in the intima layer causing separation b/w the intima and media layer where blood flows into the separation

both life threatening

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

2/3 of people with an aortic dissection have ____

A

HTN

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

an aortic dissection most commonly involves what structures of the aorta?

A

ascending aorta

descending aorta

aortic arch

abdominal aorta

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

what are the s/s of an abdominal dissection?

A

sudden, severe sharp pain in the chest/upper back

SOB

faintness/dizziness

LBP

diastolic heart murmur, muffled heart sounds

rapid, weak pulse

heavy sweating

confusion

loss of vision

stroke symptoms/weakness/paralysis on one side of the body/trouble talking

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

what are ways to medically manage an aneurysm?

A

pharmacologics, monitoring, surgical repair

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

what drugs are used to manage aneurysms?

A

beta blockers

angiotensin 2 receptor blockers

statins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

if in the early stages, ____ will be used

A

monitoring

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

how is monitoring used in aneurysm management?

A

imaging done every 6 months following diagnosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

what imaging techniques are used to manage aneurysms?

A

echocardiogram

CT scan

MRA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

what are surgeries done to manage aneurysms?

A

repair of the aneurysm/dissection where it occurs

open heart surgery

abdominal aortic aneurysm repair

cerebral aneurysm clipping or endovascular coiling

peripheral vascular surgery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

what is open heart surgery?

A

aortic arch or root replacement or repair

thoracic aneurysm repair (open or TEVAR)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

is an AAA repair always open surgery?

A

no, it can be TEVAR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

what cause the structural changes in PAD?

A

degenerative conditions

infection

inflammation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

narrowing of the vascular lumen in PAD is affected by what 3 things?

A

atherosclerosis

thrombosis

inflammation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

symptoms appear in PAD when the athroma is so large it interferes with what?

A

blood flow to distal tissues

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

why does PAD cause pain with exercise?

A

bc the demand for blood flow to the skeletal muscles of the LE increases with exercise but the arteries can’t provide adequate supply due to stenosis and obstructions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

when do symptoms of PAD occur?

A

when the blood flow isn’t adequate to meet the demands of peripheral tissues

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

what are changes in body structure and function related to decreased blood flow to peripheral tissues?

A

denervation to muscle

loss of muscles fibers

limb ischemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

limb ischemia leads to increased risk for what?

A

limb loss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

what impairments can result from decreased blood flow to peripheral tissues?

A

decreased muscle strength w/atrophy

decreased sensation

decreased muscle and aerobic endurance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
75
Q

what is claudication?

A

muscle pain that develops as a result of ischemia in limbs from decreased blood flow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
76
Q

what percent of pts with PAD have clinically significant CAD?

A

40%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
77
Q

as PAD progresses, pts can develop…

A

pain at rest

skin changes

tissue necrosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
78
Q

what are the signs of PAD?

A

dry, shiny skin

hair loss

thick toenails

muscles atrophy

rubor on dependency

round wounds with regular borders

increased pallor in the foot with elevation

nectrotic tissue in toes and feet

decreased pulse below blockage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
79
Q

what are the symptoms of PAD?

A

intermittent claudication

impaired sensation

pain in lower leg w/activity or at rest

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
80
Q

how is PAD diagnosed?

A

using the ankle brachial index, pulse volume recordings, arterial duplex US, rubor on dependency, or exercise studies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
81
Q

what is the ankle brachial index?

A

non invasive means of quantifying degree of arterial insufficiency

requires a Doppler and BP cuff

divide the SBP of the ankle by SBP of brachial artery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
82
Q

in the ABI is the ankle or brachial pressure normally higher?

A

ankle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
83
Q

what is a normal ABI?

A

greater than 0.9

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
84
Q

what ABI score would be suggestive of severe occlusive disease?

A

less than 0.5

85
Q

what are pulse volume recordings?

A

measurement of volume changes along the segment using BP cuffs along the limb compressing the veins but not arteries

sensors in the cuffs detect arterial pulsation w/o venous interference

86
Q

what is arterial duplex US?

A

noninvasive way to visualize and assess the extent of stenosis and reduction of blood flow

can identify the width of a blood vessel and reveal arterial blockages

87
Q

what is the rubor on dependency test?

A

way to assess arterial circulation using skin over color changes and postural changes

88
Q

what is a positive rubor on dependency test?

A

the limbs turn dark red w/in 30 seconds from supine to dependent over the EOB and turn very white when elevated

89
Q

what is a normal response to the rubor on dependency test?

A

the feet turn a pink flush

90
Q

what are exercise studies?

A

used to elicit symptoms of claudication

measure ankle pressure b4 and after

91
Q

what is a positive result from an exercise study?

A

if the post exercise pressure DROPS, confirming arterial disease

92
Q

what are surgical intervention for PAD?

A

revascularization

angioplasty

arterial stent

93
Q

what is revascularization surgery?

A

LE arterial bypass surgery to restore blood flow to distal tissues through use of saphenous vein or prosthetic graft as bypass

94
Q

what is angioplasty surgery?

A

utilizing a catheter to balloon open the artery and push the plaque against the artery wall to increase lumen and restore blood flow

95
Q

what is arterial stent surgery?

A

utilizing a catheter to deploy a stent in artery to open the lumen and restore blood flow

96
Q

what are the venous diseases?

A

venous insufficiency

venous stasis ulcers

venous thromboembolism (VTE)

97
Q

what are the risk factors for venous insufficiency?

A

advanced age

genetics

obesity

prolonged standing

sedentary lifestyle

smoking

female hormones

98
Q

the venous system holds what percent of blood in the body?

A

65-70%

99
Q

what are spider veins?

A

dilated veins in dermal layer of skin

100
Q

what are varicose veins?

A

superficial subcutaneous veins appear knotted, swollen, twisted, and protrude more

101
Q

what are the changes in body structure and function in PVD?

A

damage to valves

obstruction to flow

failure of veins to pump

102
Q

what factors lead to PVD?

A

degeneration of valves

infection

inflammation

thrombosis (VTE)

103
Q

what are the signs of chronic venous insufficiency?

A

swelling

bulging of veins

wounds

dermatitis

hemosiderin staining in limb

104
Q

what are the symptoms in chronic venous insufficiency?

A

dull ache

limb heaviness

itching

tingling

cramping of extremity

105
Q

what is raynaud’s phenomenon?

A

vasospastic disease of digital arteries

extreme vasoconstriction response temporarily occluding vascular lumen

occurs in cold temps and stress

106
Q

what are the signs of raynaud’s?

A

initially finger and toes blanche white as blood flow is interrupted, followed by cyanosis as desaturated Hgb accumulates and then a ruddy color as blood flow returns

107
Q

what are the symptoms of raynaud’s

A

numbness, parasthesia, and pain in affected digits

108
Q

what is primary raynaud’s

A

primarily in fingers in women 20-40

only 40% in toes

109
Q

what is secondary raynaud’s

A

secondary to other health conditions

110
Q

how is raynaud’s diagnosed?

A

venous duplex US

venous filling time

Trendelenburg test

111
Q

what is venous duplex US?

A

uses high frequency sound waves (US) to capture images of internal views of veins that return blood to the heart

way to assess for varicose veins, valve dysfunction, and venous thrombosis

112
Q

what is venous filling time?

A

way to assess for arterial and venous blood flow

113
Q

what is the trendelenburg test?

A

a way to assess valvular competency of superficial and deep veins

114
Q

what happens during exercise in pts with PAD?

A

atherosclerosis prevents blood flow and O2 delivery to skeletal muscles

ischemia develops when blood supply cna’t meet demands

drop in pressure across area of stenosis/occlusion

impairment in endothelial function of the artery

production and accumulation of lactic acid

115
Q

what is intermittent claudication?

A

onset with particular amount of activity/exercise that is relieved with rest

116
Q

intermittent claudication symptoms in the calf reflect what?

A

femoral/popliteal artery disease

117
Q

intermittent claudication symptoms in the thigh/hip/buttocks reflect what?

A

aortoiliac arterial disease

118
Q

what works better to improve symptoms of PAD, supervised exercise or surgical intervention?

A

supervised exercise

119
Q

improvements in symptoms due to exercise are a result of what?

A

increased walking efficiency

increased peripheral blood flow through collateral circulation

reduced blood viscocity

regression of athrosclerosis

increased pain threshold

improved skeletal muscle metabolism

120
Q

why should PTs monitor SBP in pts with PAD?

A

bc pts with PAD have significant rise in BP w/exercise

121
Q

PTs should exercise to what grade ____ for optimal symptomatic benefit over time

A

3

122
Q

what is a non-invasive means of monitoring cardiac conduction

A

ECG

123
Q

when are 12 lead ECGs utilized?

A

primarily for medical diagnosis, formal stress testing, and formal exercise testing

124
Q

when are 5 lead ECGs utilized?

A

by PTs, telemetry units

125
Q

what does a 5 lead ECG tell us?

A

HR

rhythm

arryhthmias

126
Q

what does a 12 lead ECG tell us?

A

HR

rhythm

arrhythmias

hypertrophy

infarction

ischemia

127
Q

what are the 3 properties of cardiac muscles?

A

automaticity, rhythmaticity, conductivity

128
Q

what is automaticity?

A

the heart’s ability to continue to generate a signal without neuronal input

129
Q

what is rhythmaticity?

A

the heart’s ability to maintain regularity

130
Q

what is the order of signal flow through the heart?

A

SA–>AV–>Bundle of HIs–>l left and right bundle branch –> Purkinjie fibers

131
Q

what is the role of the SA node?

A

pacemaker of the heart that creates the impulse that paces the heart

132
Q

what is the intrinsic rate of the SA node?

A

60-100 bpm

133
Q

what is the role of AV node?

A

slows the impulse to allow ventricular filling

134
Q

what is the intrinsic rate of the AV node?

A

40-60 bpm

135
Q

which bundle branch is much thinner with fewer branches, the left or right?

A

right

136
Q

what happens when the Purkinjie fibers are stimulated?

A

ventricular contraction

137
Q

what nerve provides parasympathetic input to the heart?

A

vagus nerve

138
Q

what does the vagus nerve innervate?

A

the SA and AV nodes

139
Q

t/f: there is very little parasympathetic input to the ventricles

A

true

140
Q

vagus stimulation is _____ and leads to _____BP

A

inhibitory, decreased

141
Q

what is the sympathetic innervation of the heart?

A

cardiac nerves that influence the heart via E and NE

142
Q

sympathetic cardiac control is ____ and leads to ____HR, contractility, and BP

A

excitatory, increased

143
Q

does sympathetic, parasympathetic, or both reach the atria?

A

both

144
Q

does sympathetic, parasympathetic, or both reach the ventricles?

A

just sympathetic mostly

145
Q

what has more control on the heart, sympathetic or parasympathetic control?

A

sympathetic control

146
Q

what influences how the heart contracts?

A

electrolyte balance

147
Q

what electrolytes contribute to electrolyte balance in the cardiac system?

A

sodium, calcium, potassium, magnesium

148
Q

what does sodium do in the heart?

A

nerve and muscles function

keeps fluid in balance

149
Q

what does calcium do in the heart?

A

controls permeability of the cell membrane

drives myocardial contraction

150
Q

what does potassium do in the heart?

A

reactive in water and allows the heart to conduct electrical signals

151
Q

what does magnesium do in the heart?

A

regulates heart beat, normal nerve and muscle function, immune responses, and normal blood glucose

152
Q

where does the SA node go?

A

posterior wall of the right atria

153
Q

where does the AV node go?

A

b/w the atria and ventricles and the floor of the right atria

154
Q

what is the intrinsic rate of the bundle of His and Purkinjie fibers?

A

30-40 bpm

155
Q

what is the intrinsic rate of the bundle branches?

A

20-40 bpm

156
Q

what does the P wave represent?

A

atrial depolarization

157
Q

what does the PR interval represent?

A

the time from atrial depolarization to ventricular depolarization

158
Q

what does a prolonged PR interval show?

A

decreased HR

atrial fibrillation

159
Q

what does a shortened PR interval show?

A

junctional rhythm

160
Q

what does the QRS complex represent?

A

ventricular depolarization and contraction

161
Q

what does the ST segment represent?

A

the time b/w ventricular depolarization and repolarization

162
Q

what does the T wave represent?

A

ventricular repolarization

163
Q

what does the QT interval represent?

A

the entire ventricular activity (contraction through repolarization)

164
Q

what does a prolonged QT interval indicate?

A

electrolyte imbalance (Ca2+, K+) which puts you at risk for developing an arrythmia

165
Q

what portion of the ECG wave is important in MIs?

A

ST segment

166
Q

ECGs provide info on…

A

conduction disturbance

ventricular thickness

ischemia

effects of meds

electrical impulses

heart function

myocardium and cell function

167
Q

what does the horizontal axis on an ECG represent?

A

time

168
Q

what does the vertical axis on an ECG represent?

A

changes

169
Q

how long is a normal PR interval?

A

0.12-0.20 sec

170
Q

how long is a normal QRS complex?

A

0.06-0.10 sec

171
Q

how long is a normal QT interval?

A

0.32-0.40 sec

172
Q

what generates normal sinus rhythm?

A

the SA node

173
Q

when do we see sinus bradycardia?

A

when sleeping

in highly trained athletes

in pts on beta blockers

in pts with a pacemaker

in pts with sinus 6 syndrome

with parasympathetic activity

in pts with hypothyroidism

174
Q

when do we see sinus tachycardia?

A

with anxiety, stress, fear, caffeine, nicotine, fever, hypoxemia, hyperthyroidism, w/drawal from substances, severe dehydration/low blood volume

175
Q

what is a sinus pause/block?

A

rhythm generated by the SA node with a pause missing the QRS complex

176
Q

when does a sinus pause/block become pathologic?

A

when it becomes more frequent it can lead to decreased CO output leading to lightheadedness, dizziness, slow HR, and may need a pacemaker

177
Q

what is atrial rhythm?

A

heart rhythm generated by ectopic foci in the atria resulting is abnormal or absent p wave

178
Q

what are the 3 types of atrial rhythms?

A
  1. pre-mature atrial contractions (PACs)
  2. atrial tachycardia
  3. atrial fibrillation and flutter
179
Q

what is a pre-mature atrial contraction (PAC)?

A

indictive of heart disease and can lead to fibrillation/flutter

p wave directly after the t wave and a weak QRS complex

180
Q

when is atrial tachycardia seen?

A

in pts with COPD or following acute MI

181
Q

what is atrial tachycardia?

A

increased HR

abnormal p waves

atria contracting quickly

182
Q

what is atrial fibrillation?

A

generated by ectopic foci

absent p wave

no PR interval

normal QRS

irregular RR interval

varying HR

183
Q

t/f: a fib with a lower more controlled HR is not as severe

A

true

184
Q

what is paroxysmal a fib?

A

going in and out of a fib

185
Q

what is atrial flutter?

A

multiple p waves b4 QRS complex

variable HR

variable RR interval

atria depolarizing at a high rate

186
Q

what are junctional rhythms?

A

rhythms originating in the AV node

absent, hidden, or inverted p wave

normal QRS

HR: 40-60 bpm

short, absent, or retrograded PR interval

very pathologic

187
Q

what is junctional tachycardia?

A

increased HR

shortened RR interval

absent/buried p wave

decreased CO

188
Q

what causes heart blocks?

A

blocks to the AV node

189
Q

what is a 1st degree heart block?

A

can be caused by meds

start in SA node and is blocked to AV node

prolonged PR interval

stand alone p wave

normal/dropped QRS complex

varying HR

190
Q

what is a type 1 2nd degree heart block?

A

dropped QRS complex

varied RR interval

varied HR

stand alone p wave

can progress to 3rd degree

191
Q

what is a type 2 2nd degrees heart block?

A

no conduction to the ventricles

block below the bundle of His

normal/prolonged PR interval

wide QRS complex

associated with ischemia or acute MI

can quickly lead to 3rd degree

192
Q

what is a 3rd degree heart block?

A

life threatening

block at/below AV node

p wave has no relationship to QRS complex

atrai and ventricles fire at dif times

very wide QRS complex

varied PR interval

L coronary artery ischemia likely

requires pacemaker

decreased CO (pts may faint/fall)

193
Q

what is a bundle branch block?

A

wide QRS complex

knotched appearance

M feature on top

often seen after MI or with CAD

194
Q

what generates ventricular rhythms?

A

ectopic foci in the ventricles

195
Q

what are ventricular rhythms?

A

no p wave

bizzare, wide QRS complex

agonal: drops BP below 20 bpm, terminal, usually precedes asystole

196
Q

what are the 3 types of ventricular rhythms?

A
  1. pre-mature ventricular contractions
  2. ventricular tachycardia
  3. ventricular fibrillation
197
Q

what is a pre-mature ventricular contraction (PVC)?

A

normal rhythm very quickly followed by inverted ventricular contraction w/o repolarization

premature wide beat

missed beat

198
Q

when do PVCs become a concern?

A

when they become more frequent

199
Q

what is ventricular tachycardia?

A

3 PVCs in a row

electrolyte abnormalities

clinically significant arrhythmia

no p wave

bizzare, wide QRS

long QT interval

200
Q

what are the 3 types of ventricular tachycardia?

A
  1. supraventricular (SVT)
  2. sustained VT
  3. non sustained VT
201
Q

what is supraventricular tachycardia caused by?

A

anxiety or chest pain

202
Q

what is sustained VT?

A

> 30 sec of consecutive PVCs

203
Q

what is non-sustained VT?

A

3 beats in 30 sec

204
Q

when is ventricular tachycardia benign?

A

when the are <6 PVCs per minute

205
Q

what is ventricular fibrillation?

A

irratic quivering of ventricles

no CO

no ventricular depolarization/ repolarization

rapid intervention is necessary

shockable heart rhythm

206
Q

what method(s) can be used to determine HR of a regular rhythm?

A

counting large boxes or counting small boxes

207
Q

what method(s) can be used to determine HR of an irregular rhythm?

A

6 sec method

208
Q

what is the importance of ECGs?

A

know baseline, during activity, and post activity tolerance

discover real-time arrhythmias

know yellow and red flags and how to respond

recognize clinically significant rhythms

knowing when to cease therapy

DPT 528 (9 decks)

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