lec 4

Question 1

SINUS RHYTHM means

Answer 1

rhythm is coming from the SA node→ heart rate is regular

Question 2

Arrhythmia

Answer 2

abnormal rhythm OR abnormal excitation.

Question 3

SINUS ARRHYTHMIA divide into four main categories

Answer 3

Sinus tachycardia
Sinus bradycardia
Respiratory arrhythmias
Sick sinus syndrome (SSS

Question 4

Sinus tachycardia

Answer 4

Physiological Responses increase in the heart rate

Question 5

Sinus bradycardia

Answer 5

Physiological Responses decrease in the heart rate

Question 6

لفهم

Answer 6

In all sinus arrhythmia, the AP will start normally in
the SA node, with normal ECG, but the rate of
excitation will be abnormal (increased or decreased or blocked)

Question 7

Respiratory arrhythmias

Answer 7

SINUS ARRHYTHMIA

Physiological Responses

Question 8

effect of Respiratory arrhythmias on heart rate

Answer 8

increase the heart rate

Question 9

Respiratory arrhythmias are manifested in

Answer 9

kids or newborn babies. (It is not that clear in the adults).

Question 10

respiratory arrhythmias occur

Answer 10

after taking a deep inspiration
increase in inspiration
a decrease in expiration

Question 11

Sick sinus syndrome (SSS)

Answer 11

1. problem in the SA node (in the excitation).
2. sss give high rate, slow rate or sinus block
3. the patient sometimes loses his conscious and falls down.

Question 12

we have to put an artificial pacemaker in

Answer 12

sinus block → Sick sinus syndrome (SSS)

Question 13

Atrial arrhythmia types

Answer 13

1. Atrial extra systole
2. Supraventricular Tachycardia/ atrial tachycardia
3. Atrial flutter
4. Atrial fibrillation

Question 14

what happen if extra excitation arrives at the heart

1. in the refractory period,
2. after the refractory period,

Answer 14

1. nothing will happen

2. it will re-stimulate the heart

Question 15

atrial extra systole.

Answer 15

one extra beat comes before the SA node normal beat, in any point in the atrium (except in the SA node)

Question 16

extra one beat is called

Answer 16

atrial ectopic / atrial extra systole

Question 17

patient feels his heart has stopped

Answer 17

atrial extra systole

Question 18

The patient will feel as if his heart has stopped, why

Answer 18

extra beat comes in the resting period after a
normal beat, the refractory period of the extra beat will cancel the next normal beat coming from the SA node
because a beat is missing and there will be a
pause).

Question 19

Atrial extra systole شو نوع ال

beat

Answer 19

premature beat \premature atria

Question 20

after the premature beat there is

Answer 20

pause

Question 21

Atrial extra systole is called

Answer 21

PAC: premature atrial contraction.

Question 22

Supraventricular Tachycardia/ atrial tachycardia شو وضع الECG

Answer 22

QRS is normal

Question 23

atrial tachycardia or SVT (supraventricular tachycardia) شو وضع ال Heart rate

Answer 23

is high, the rate will be 150 to 220 (beat/min).

Question 24

atrial tachycardia or SVT (supraventricular tachycardia).

Answer 24

T will come closer to the P

Question 25

T on P

Answer 25

atrial tachycardia or SVT (supraventricular tachycardia).

Question 26

the patient is watching TV at rest, he feels

tachycardia for few minutes then it’ll stop

Answer 26

atrial tachycardia or SVT (supraventricular tachycardia)

Question 27

SVT ECGs

Answer 27

Regular (R-R interval are the same, and the ratio between P, QRS and T is 1:1:1) {BUT the rate is high}.

Question 28

atrial tachycardia or SVT (supraventricular

tachycardia) كم beat / rate

Answer 28

150 to 220 (beat/min)

Question 29

Atrial flutter ECG

Answer 29

RR interval in between Three excitation in atrium (3 p) + one in ventricle (1 normal QRS)
 Repeated P wave in constant frequency (regular). (Here you
can notice 3 P then 1 QRS then 1 T repeatedly).
 ECG is abnormal.
 QRS is always normal.
 P waves more than QRS (and it is more than 220 P/minute).
 RR interval is regular.

Question 30

Atrial fibrillation The heart rate

Answer 30

more than 250 beat/min

Question 31

Atrial fibrillation ECG

Answer 31

three excitation (3 p) in atrium + one in ventricle 
(1 normal QRS); THEN five excitation (5p) in atrium + one in 
ventricle (1 normal QRS) {NOT REGULAR OR irregular}.

Question 32

Atrial fibrillation ECG

Answer 32

 P is repeated in different frequencies (irregular) {abnormal
ECG} in atrial fibrillation.
 QRS is always normal.
 In atrial fibrillation, the P wave will be very shallow and
sometime absent, you can see too many P waves, and R-R
interval is irregular. (Note that the R-R interval is regular
in atrial flutter).

Question 33

MOST common arrhythmia that develops in a normal hearT

Answer 33

Atrial fibrillation

Question 34

the only type of atrial arrhythmia with irregular R-R

interval is

Answer 34

the atrial fibrillation.

Question 35

Atrial fibrillation اكتر اشي خطر فيها

Answer 35

the blood in the atria will stay there because there is no time for pumping, leading to a clot.
And after atrial fibrillation is over, this clot will pass in the blood resulting in a cerebrovascular accident {CVA} (leading to paralysis).

Question 36

anticoagulant give to

Answer 36

atrial fibrillation patients

Question 37

N.B

Answer 37

الجدزل صفحة 8

Question 38

the different between atrial flutter and fibrillation

Answer 38

flutter the beats are more than 220 but going in
one pathway (starting and ending at the same point)
2.fibrillation there are so many points that generate
excitation at the same time so some of them cross to the AV
node while other can’t if the AV node is in refractory period