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CardioPulmonary > Lecture 12: ECG Assessing Cardiac Function > Flashcards

Lecture 12: ECG Assessing Cardiac Function Flashcards

0
Q

What is the SA nodes rate in bpm?

A

60-80 bpm

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1
Q

What is the goal of the conducting system?

A

To coordinate pumping of the cardiac muscle

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2
Q

What is the AV nodes rate in bpm?

A

40 to 60bpm

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3
Q

What are the ventricular nodes rate in bpm?

A

20 to 40 bpm

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4
Q

What is an ectopic focus?

A

Any cardiac cell can depolarize on it’s own

Loner atrial cell

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5
Q

What is the normal time of the PR interval?

A

0.12 to 0.2 seconds

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6
Q

What is the PR interval?

A

The area between the p wave and the QRS complex

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7
Q

What does a longer PR interval indicate?

A

If the pr interval is longer than 0.2 seconds then there is a delay in conduction between the SA node and the ventricle (AVblock)

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8
Q

What is the normal time of the QRS complex?

A

0.04 to 0.12 seconds

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9
Q

What position should the ST segment be?

A

Isoelectric or at baseline

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10
Q

What is the beginning of the ST segment called?

A

The J point

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11
Q

When is the ST segment significant?

A

Depression more than 1mm and at least 0.08 seconds (2 small boxes)

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12
Q

What is a lead?

A

A combination of electrodes to give you a view of the heart (a combination of three electrodes)

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13
Q

What are the chest leads in a 12 lead EKG? What part of the heart do they look at?

A

V1, V2 right side of the heart
V3,V4 inter ventricular septum
V5, V6 left side of the heart

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14
Q

What should you start with when interpreting the ECG?

A

Determine the ventricular rate

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15
Q

How do you determine the ventricular rate?

A

Look from R wave to R wave

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16
Q

After looking at ventricular rate on an ECG, what is the next step in interpretation?

A

Look at the p wave. Is there a pave before each QRS?

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17
Q

A QRS complex should have a duration of…

A

Less than 0.12 seconds or 3 small boxes

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18
Q

What does ST segment elevation indicate?

A

Myocardial infarction

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19
Q

What does ST segment depression indicate?

A

(>2 mm) myocardial ischemia

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20
Q

What is a normal sinus rhythm?

A

Electrical conduction from the SA node through the normal conduction pathways
Sinus tachycardia is greater than 100
Sinus bradycardia is less than 60

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21
Q

What is a sinus arrhythmia? What are the two kinds?

A

Normal conduction but irregular rhythm. Respiratory and non respiratory arrhythmia

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22
Q

What are the characteristics of a sinus arrhythmia in order to be considered to be a respiratory sinus arrhythmia?

A

HR accelerates during inspiration and decelerates during expiration

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23
Q

What is an atrial premature depolarization/contraction?

A

An atrial premature beat caused by an ectopic focus

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24
Q

Will a PAC trigger the AV node?

A

Yes

25
Q

Does a PAC result in a normal CO?

A

Yes. It is considered a benign heart condition

26
Q

What is a saw tooth pattern?

A

An atrial flutter

27
Q

How many p waves per minute can occur in an atrial flutter?

A

250 - 300

28
Q

What are 2 possible causes of an atrial flutter?

A

(1) ischemic heart disease

(2) after surgery

29
Q

What feature on the ECG is missing when someone has atrial fibrillation?

A

P waves

30
Q

Will Afib disrupt cardiac output?

A

Yes

31
Q

What is the cause of Afib?

A

Multiple atrial cells depolarizing on their own

32
Q

What do the atria look like in an individual with Afib?

A

The atria quiver (looks like a bag of worms)

33
Q

What is a concern in someone with Afib?

A

Afib leads to blood stasis which may cause clot formation (which may lead to stroke)

34
Q

What are three clinical clues that someone may have AFib?

A

(1) irregular rhythm on palpation
(2) weak pulse
(3) clot risk increased

35
Q

What are junctional rhythms?

A

Tissue next to AV node (junctional tissue) taking over pacing and QRS depolarization

36
Q

Does the SA node fire in junctional rhythm?

A

No

37
Q

If the SA node doesn’t fire in junctional rhythm, what is the heart rate?

A

40 - 60 bpm

38
Q

Ventricular premature depolarization or contraction is caused by…

A

One ectopic focus in the ventricles before atrial depolarization

39
Q

What is the result of PVC on the ECG?

A

The QRS will become wide and larger in magnitude

40
Q

Are PVCs considered normal?

A

Yes, until there are more than 6 per minute

41
Q

What is a unifocal PVC?

A

A PVC with one ectopic focus (the PVCs look the same)

42
Q

What is a multifocal PVC?

A

A PVC with different ectopic foci (so the PVCs look different)

43
Q

What is bigeminy?

A

When every other beat is a PVC.

44
Q

What is trigeminy?

A

Every third beat is a PVC

45
Q

What is a couplet?

A

When there are 2 PVCs in a row.

46
Q

What is a triplet?

A

3 PVCs in a row

47
Q

Can PT be done if the patient has a couplet? Triplet?

A

Yes- couplet

No- triplet

48
Q

If there are 3 PVCs in a row it greater than 6 PVCs in one minute what is the patient at risk for?

A

Ventricular tachycardia

49
Q

What is ventricular tachycardia?

A

(Can be sustained or not sustained) I don’t know what it is

50
Q

V-Tach can become…

A

V Fib

51
Q

What is ventricular fibrillation?

A

When multiple ectopic foci are in the ventricle

No ventricular pumping

52
Q

What is a block?

A

I don’t understand

53
Q

Atrioventricular blocks or (AV blocks) have 3 different kinds…

A

First degree AV block
Second degree AV block
-Type I (Mobitz Type I, Wenckebach phenomenon)
-Type II (Mobitz Type II)
Third degree AV block (Complete AV block)

54
Q

What is a First degree AV block?

A

Conduction delay in AV node
PR interval > 0.20 sec (5 small boxes) and consistent
benign

55
Q

What’s a Second degree AV block, Type I (Mobitz Type I, Wenckebach phenomenon)?

A

PR intervals get progressively longer and longer until one P wave is not conducted through to ventricles (skipped QRS)
usually benign

56
Q

What’s a Second degree AV block, Type II (Mobitz Type II)?

A

Block in Bundle of His
PR intervals tend to be long but of consistent duration conduction often does not go through to ventricles;
may have P:QRS of 2:1, 3:1, 4:1, etc.
Ventricular rate tends to be irregular; pacemaker often required.
Pacemaker often required!

57
Q

What’s a Third degree AV block (Complete AV block)?

A

Atrial and ventricular depolarization are independent (completely dissociated).
P waves and QRS complexes are not coordinated, so PR intervals have no consistent duration.
QRS may be wider than normal.
Ventricular rate tends to be regular.
Needs a pacemaker!!!

58
Q

What’s a bundle branch block (BBB)?

A

Blockage between AV bundle (bundle of His) and Purkinje fibers leading throughout one ventricle.
QRS > 0.12 sec

59
Q

What’s a Right bundle branch block (RBBB)?

A

Left ventricle contracts first

Will be seen with leads V2 V3!

60
Q

What’s a Left bundle branch block (LBBB)?

A

Will be seen with leads V5 V6!

CardioPulmonary (13 decks)

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