images wk 2 Flashcards
What are angles of each of these?
lateral = 0
II = +60
aVF = +90
III = +120
aVL = -30
aVR = -150
What pathology is this? How can you tell?
SInus bradycardia
long space between QRS waves, but each waveform looks normal
indicates dysfunctional SA
What pathology is this?
First degree AV block
P-R interval should be 120-200 ms, these are 240 ms
means delayed but not blocked, all P waves still followed by QRS just takes longer
means you have delayed conduction through AV
What pathology is this?
second degree AV block
P waves not always followed by QRS
means some impulses fail to propagate to ventricles
What pathology is this?
Atrial fibrillation
P waves random and indistint
R-R intervals irregular
What pathology is this?
premature ventricular contractions [PVC]
normal QRS are very narrow
wide QRS are PVC = ventricles excite themselves
Two PVCs have different shapes = have multile ectopic foci
What pathology is this?
Monomorphic ventricular tachycardia [VT]
What is the pathology?
ventricular fibrillation
irregular, no identifiable pattern
asynchronous contractions, ineffective, can lead to death
What do each of these arrows point to on PV loop [x axis is LV volume, y axis is LV pressure]
left vertical arrow: end systolic volume [ESV]
right vertical arrow: end diastolic volume [EDV]
longer horizontal arrow: end diastolic volume [EDV]
shorter horizaontal arrow: stroke volume [SV]
What do these 3 arrows point to in PV loop?
top arrow: Pes = pressure at end systole [ESP]
middle arrow = EDP [end diastolic pressure]
bottom arrow = LAP [left atrial pressure]
What do these arrows point to in PV loop?
bottom arrow: DBP [diastolic blood pressure]
top arrow: SBP [systolic blood pressure]
What 2 things are constant in these circle, what is varied?
- contractility and afterload are constant
- preload is varied
What is varied here? What two things are constant?
TPR is varied
preload and contractility are constant
What is changing here? what is staying the same?
Contractility is changing [more contractility = bigger slope of ESPVR]
preload [EDP/EDV] and afterload [TPR] staying the same
What does this graph show [control on left]? What changed, what stayed the same?
- constriction of arterioles leading to: greater MAP, greater pressure drop across arterioles
same Pc
What is changing in this figure [control is left]?
- increased P in veins
- leading to increased Pc
What is the change happening here? What would this change due to starling curve?
changes in TPR
- tallest = increased TPR
- lowest = decreased TPR
taller PV = increased TPR/afterload and skinnier because decreased SV
starling: shifts to the right
What change does this new venous return curve represent? What change to steady state?
venoconstriction or decreased venous compliance
in steady state: increased CO, higher right atrial pressure
What changes do these 3 graphs represent?
[dotted line is the change]
far left: increased blood volume
middle: decreased TPR
right: venoconstriction
What change does this new starling curve represent? What pathology might cause this? What change in steady state?
Decreased contractility
in heart failure: due to damaged myocardium
steady state: decrease CO, increase venous pressure
What change causes these shifts? What pathology might cause this? What changes to steady state?
increased blood volume
due to retaining fluids to increase preload in heart failure
steady state: increased CO, increased venous pressure
What do the dotted and straight lines reflect in heart failure?
straight line = MI
dotted line = MI plus sympathetic stimulation
due to chronic sympathetic stimulation in heart failure
What do these 4 steps signify in heart failure
- healthy
- immediately after MI
- MI plus fluid retention
- MI plus fluid retention plus sympathetic stimulation
