Exam 2 Flashcards by Megan Kelly

What is the first thing estimated when plotting a treadmill or bike submax test?

Estimated max workload

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What are the assumptions that allow us to predict VO2max?

Max HR can be predicted accurately
A linear relationship exists between HR, workload, and VO2max.
VO2max is the same at any given workload.

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What is occurring at the P wave?

Atrial contraction

SA node begins electrical impulse, which spreads in wave motion, stimulating atria and sets heart rate

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What is the PR segment?

Flat line between P wave and Q wave
When the impulse reaches the AV node but there is a 1/10 second pause before impulse stimulates AV node so blood can enter ventricles

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What is the QRS complex?

Made up of R, S and sometimes Q wave
Ventricular contraction
Impulse travels from the AV node down the AV bundle, to left and right bundle branches.

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Left ventricle sends blood to the

Body

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Right ventricle sends blood to the

Lungs

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ST segment

Flat line between QRS complex and T wave

Pause before ventricles repolarize so they can contract again

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T wave

Ventricle repolarization

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What are the 6 limb leads?

I, II, III, aVR, aVL, and aVF

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What view do the limb leads provide?

Frontal

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What are the 6 chest leads?

V1, V2, V3, V4, V5, V6

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What view do the chest leads provide?

Horizontal

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What are the normal EKG responses to exercise?

P-wave had increased magnitudes among inferior leads
PR segment shortens and slopes downward among inferior leads
QRS duration decreases
J point depresses below isometric line with upsloping DT segments
T wave decreases in amplitude in early exercise and returns to preexercise intensities
QT interval decreases

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What are the 6 steps if interpreting EKG data?

Heart rate
Rhythm 
Calculating intervals
Axis 
ST segment and abnormal waves
Hypertrophy

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What are the two ways to interpret heart rate?

On a machine

With a ruler

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What is tachycardia?

Fast HR

Greater than 100 bpm

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What is bradycardia?

Slowed heart rate

Less than 60 bpm

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What are the ways to determine regular rhythm?

Single P wage for every QRS
p upright in I, II, V3 and V6, biphasic in V1
Normal regular rhythm has equal distance apart and similar waves

What are the overall types of rhythm problems an individual can have?

Varying rhythm
Extra beats and skips
Rapid rhythm
Heart blocks

What are two types of varying rhythm?

Sinus arrhythmia

Atrial fibrillation

What is sinus arrhythmia?

Unequal distances between Ps

Problem in the atrium

What is atrial fibrillation?

No real P waves
Continuous contraction of atrium
Never fully fills or contracts

What is a premature beat?

Wide QRS followed by a pause
Ventricles fire too soon
Stands out
Only a problem if there are multiple

What are multifocal PVCs?

Multiple PVCs

What does PVC stand for?

Premature ventricular contraction

What is V tach?

Not having any regular filling or emptying Looks like a lot of PVCs Person can be conscious Absolute reason to terminate

What is V FIB?

Totally irregular appearance, no effective pumping of ventricles No blood movement Needs AED Absolute reason to terminate

What are the three types of heart blocks?

SA block AV block Left or right bundle branch block

What is the normal range for a PR interval?

.12-.20 seconds

What is the PR interval representing?

The time it takes for blood to go from the SA node to ventricles Start of P wave to start of QRS complex

What is the normal range for the QRS complex?

What is being measured in the QRS complex?

Start of Q or R wave to end of S or R | The initial deviation from the baseline

What is being measured at the QT interval?

Start of QRS to the end of the T wave | Depolarization and repolarization of ventricles, interval times are dependent on rate

What does axis refer to?

The direction of depolarization which spreads throughout the heart to stimulate the muscle fibers to contract

What is the direction of electrical activity called?

Vector

What must occur for a personal to have a normal axis?

Lead I should have a positive QRS vector | aVF should have mainly positive QRS

What occurs when an individual has left axis deviation (LAD)?

QRS is negative in aVF but positive in lead I

What occurs when a person has right axis deviation?

They have positive QRS in aVF and negative QRS in lead I

What occurs when a person has extreme right axis deviation?

QRS is negative in both

What does it mean when there is a depression in the the ST segment?

Positive for ischemia | Relative reason for termination when dips below 1 mm

What happens when there is an elevation in the ST segment?

Heart attack | Absolute reason to terminate

Describe hypertrophy

Can be detected on an EKG but not an exercise testing issue Walls on the ventricles are too thick Doesn't have full contraction and doesn't have as much or enough room/space

What are absolute reasons to terminate an exercise test?

``` Sustained V-Tach with 3 or more PVCs in a row ST elevation (>1mm) ```

What are relative reasons to terminate?

ST depression greater than 2mm or a marked axis shift Multifocal PVCs PVC triplets Supraventricular tachycardia (sinus arrhythmia, a fib, atrial flutter Heart block Bradyarrythmias (slow and irregular$ LBBB/RBBB