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airways part 2 RTH 121 > Heart, leads, sinus rhythm > Flashcards

Heart, leads, sinus rhythm Flashcards

1
Q

initiate and conduct impulse. the hearts wiring is called?

A

electrical cells

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2
Q

contract in response to electrical stimulation; pumping action is called?

A

mechanical cells

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3
Q

if the heart is in a resting or polarized (poolarized) state how would the cardiac cell look?

A

positive (+) on the outside

negative (-) on the inside

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4
Q

if a cardiac cell is depolarized how would the cell look?

A

negative (-) on the outside
positive (+) on the inside
we see this first as a P-wave on ECG monitor

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5
Q

how would the cardiac cell look in the recovery state called repolarization?

A

positive on the outside

negative on the inside

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6
Q

what is the dominant controller or pacemaker of conduction system?

A

SA node

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7
Q

the SA node pumps a normal range of ______ bpm?

A

60-100

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8
Q

the AV node pumps at _____ bpm?

A

40-60

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9
Q

the ventricle (purkinje fibers) pumps at _____bpm?

A

20-40

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10
Q

when the upper pacemaker fails the next in line will step in is known as the______?

A

escape mechanism

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11
Q

clump of heart cells become irritable and take over the SA node is called?

A

irritability mechanism

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12
Q

the heart is influenced by autonomic nervous system called _____ and ______?

A

sympathetic and parasympathetic

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13
Q

increased irritability, increased rate, increased force of contraction is what autonomic system?

A

sympathetic

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14
Q

decreased irritability, decreased HR, decreased force of contraction is what autonomic system?

A

parasympathetic

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15
Q

______ stimulation of the heart must occur before mechanical contraction, but electrical activity can occur without _______ contraction?

A

electrical

mechanical

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16
Q

how do we asses mechanical activity?

A

pulse, BP, cardiac output

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17
Q

how do we asses electrical activity?

A

electrocardiogram (ECG) monitor

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18
Q

electrical activity travel form the base to the _____ in a natural direction called a vector, which would start in the atria and move to the ________?

A

apex

ventricle

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19
Q

The “Key” electrode is the positive, negative, or ground lead?

A

positive electrode

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20
Q

if the current is heading toward the positive electrode this will produce a ____ deflection on the oscilloscope ?

A

upward (+)

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21
Q

if the current is heading away from positive electrode this will produce a _____ deflection on the oscilloscope?

A

downward (-)

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22
Q

why do we not use only one pattern of leads?

A

different arrangements give different view of the heart

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23
Q

right arm (-) left arm (+) what limb lead?

A

lead 1

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24
Q

right arm (-) left leg (+) what limb lead?

A

lead 2

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25
Q

left arm (-) left leg (+) what limb lead?

A

lead 3

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26
Q

hint right arm is always (-) left leg always (+) that leaves left arm with a (-) and a (+) !!!

A

do the motions and talk it out !!!

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27
Q

what lead is the vector? most common monitoring lead or viewpoint

A

lead 2

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28
Q

you put all the lead together this makes a _______ triangle?

A

Einthoven

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29
Q

_____ leads are created by making a single limb positive and all other limbs negative (6 limb leads total)

A

augmented leads

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30
Q

offer vertical and horizontal views of the heart (12 limb leads) is known as?

A

precordial leads

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31
Q

what limb leads can tell if myocardial infarction and where MI is located?

A

precordial leads

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32
Q

true or false? pregeled electrodes can use both contact gel and KY

A

false only contact gel

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33
Q

friction of electrode wires with sheets and bedrails, loose connections, muscle movement can cause what?

A

artifacts

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34
Q

lead colors green is ___
white is ____
black is _____

A

ground
negative
positive (more test come up positive!!!)

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35
Q

what is the paper speed in a ECG recorder?

A

25mm/sec

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36
Q

Millivolt (Mv) is on the __ axis?

A

y-axis (vertical)

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37
Q

time is on the ___ axis?

A

x-axis ( horizontal)

38
Q

tic marks are made on the ECG paper every ___ seconds?

A

3

39
Q

on the y-axis 1 MV = ___ large boxes or 10mm ___ small boxes?

A

2 large boxes or

10 small boxes

40
Q

on the x-axis (time) how many large boxes = 1 second?

A

5 large boxes = 1 sec

41
Q

30 large boxes would = how many seconds?

A

6 seconds

42
Q

if we want to find out the _____ count the R-R in 6 seconds X 10

A

heart rate

43
Q

1 small box = ___ mm

A

1 mm

44
Q

1 small box = ___ seconds

A

0.04 sec

45
Q

one large box = __ mm

A

5 mm

46
Q

one large box = __ seconds

A

0.20 sec

47
Q

what wave represents the depolarization of the right and left atria

A

P- wave

48
Q

the P-wave is ___ to ___ mm in amplitude?

A

0.5 to 2.5 mm

49
Q

the P-wave should be no more than ____ seconds in duration?

A

0.11 seconds

50
Q

the area from the end of the P wave to the beginning of the QRS complex is known as the what?

A

PR segment

51
Q

remember PR “segments” isoelectric or a

A

flat line

52
Q

___ segment represents a delay in conduction through the AV junction spread through the bundle of his and purkinjie fibers before contraction?

A

P-segment

53
Q

The P-wave added to the PR segment is called the ______?

A

PR interval

54
Q

begins with the onset of the P wave and ends with the onset of the QRS complex?

A

PR interval

55
Q

The PR interval measures ___ to ___ seconds?

A

0.12 to 0.20 seconds

56
Q

a long PR interval > 0.20 seconds indicates delay to long through AV junction. < 0.12 seconds indicate impulse originates at the ___ junction?

A

AV junction

57
Q

The QRS complex represents ______ depolarization ?

A

ventricular

58
Q

Q wave is the first (-) deflection and represents depolarization of the ________ septum?

A

interventricular

59
Q

The R and S wave represents depolarization of the right and left ______?

A

ventricles

60
Q

what is the normal duration of the QRS complex?

A

0.06 to 0.10 seconds for simplicity anything < 0.12 is normal

61
Q

A QRS > 0.12 is a partial or incomplete bundle branch ______?

A

block

62
Q

ventricular repolarization after the QRS happens in the isoelectric or flat portion of the ____ segment ?

A

ST segment

63
Q

ventricular repolarization after the S wave and before the T wave is known as the _____ segment?

A

ST segment

64
Q

an ST segment depression is suggestive of myocardial ______?

A

ischemia

65
Q

a more than 1 to 2 mm elevation in ST segment is suggestive of an acute myocardial _______?

A

infarction

66
Q

ventricular repolarization is represented by the ___ wave?

A

T wave

67
Q

the absolute refractory period is present during the _____ of the T wave?

A

beginning ( you want you absolute vodka first)

68
Q

At the peak of the T wave the _____ refractory period has begun?

A

relative ( have the vodka first cause your relatives are peaking you nerves )

69
Q

the normal T wave is not higher than __ mm in amplitude ?

A

5mm

70
Q

an inverted T wave my represent myocardial ____?

A

ischemia

71
Q

a peak in the T wave are commonly seen in patients with _______?

A

hyperkalemia

72
Q 
rate- 60-100 bpm
rhythm- P-P and R-R regular
P wave- positive (up right) 
PR interval - 0.12 to 0.20 seconds 
QRS < 0.10 seconds
this is known as what kind of rhythm?
A

sinus rhythm

73
Q

SA node fires at slower rate than normal is known as what rhythm?

A

sinus bradycardia

74
Q

rate- < 0.10 seconds
ST segment- depression
this is known as what kind of rhythm?

A

sinus bradycardia

75
Q

the normal heartbeat is the result of an electrical impulse that starts in the SA node is known as what kind of rhythm?

A

sinus rhythm

76
Q

this rhythm occurs during sleep, in well conditioned athletes?

A

sinus bradycardia

77
Q

If the SA node fires faster than normal what sinus rhythm is this?

A

sinus tachycardia

78
Q 
rate-101-180 bpm 
rhythm- P-P and R-R regular
P wave- positive (upright) 
PR interval - 0.12 to 0.20 seconds
QRS-
A

sinus tachycardia

79
Q

A very fast rate may be hard to tell difference between P wave and T wave?

A

sinus tachycardia

80
Q

the SA node fires irregularly is know as what sinus rhythm?

A

sinus arrhythmia

81
Q

associated with the phases of respiration and changes in intrathoracic pressure is known as ?

A

respiratory sinus arrhythmia

82
Q

what sinus arrhythmia is not related to the respiratory cycle?

A

non respiratory sinus arrhythmia

83
Q 
rate- 60-100 bpm may be slower or faster
rhythm- irregular phasic with respiration.  heart rate increase with inspiration (R-R shorten) heart rate decreases with expiration ( R-R lengthen) 
P wave- positive (upright)
PR interval- 0.12 to 0.20 seconds
QRS-
A

sinus arrhythmia

84
Q

how do we treat sinus bradycardia?

A
  • oxygen
  • Iv
  • atropine
85
Q

what medications cause sinus bradycardia?

A
  • calcium blockers - amiodarone
  • digitalis -sotalol
  • beta blockers
86
Q

what medications cause sinus tachycardia?

A
  • epinephrine
  • atropine
  • dopamine
  • dobutamine
87
Q
  • vagal stimulation
  • hypothermia
  • increased ICP
  • post heart transplant
  • hypothyroidism
  • OSA
A

causes of sinus bradycardia

88
Q

treatment for sinus tachycardia?

A
  • fluid replacement
  • pain relief
  • removal of offending medications
  • reducing fever or anxiety
89
Q
  • exercise -dehydration
  • fever -pulmonary emboli
  • pain -caffeine
  • fear/anxiety -nicotine
  • infection -cocaine
  • shock
A

causes of sinus tachycardia

90
Q

what causes sinus arrhythmia In respiratory?

A

phases of respiration and changes in intrathoracic pressure commonly seen in children and adults < 30 years

91
Q

what causes non- respiratory sinus arrhythmia?

A
  • seen in older individuals with heart disease
  • common after MI
  • Increased ICP
  • medications- digitalis
    - morphine
92
Q

what treatment would we use for sinus arrhythmia?

A

doesn’t require treatment unless slow rate causes hemodynamic compromise; in that case treat with IV atropine

airways part 2 RTH 121 (3 decks)

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