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EKG > Lectures for exam 1 > Flashcards

Lectures for exam 1 Flashcards

1
Q

Define Automaticity

A

Poduce impulse without stimulation

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2
Q

Which cells exhibit Automaticity?

A

Pacemaker cells in SA node

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3
Q

Define Excitability

A

Ability to respond to an electrical stimulus

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4
Q

Which cells exhibit Excitability?

A

Electrical conduction cells (myocardial cells)

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5
Q

Define Conductivity

A

Ability to transmit electrical signal from cell to cell

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6
Q

Which cells exhibit Conductivity?

A

Electrical conducting cells (myocardial cells)

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7
Q

3 cells of the heart?

A
  1. Electrical conducting cells
  2. Myocardial cells
  3. Pacemaker cells
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8
Q

Which cells are the hard wiring of the heart?

A

Electrical conducting cells

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9
Q

Which cells are the contractile machinery of the heart?

A

Myocardial cells

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10
Q

Which cells are the muscle cells of the atria and ventricles?

A

Myocardial cells

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11
Q

Which cells are able to depolarize spontaneously and are the normal electrical power source?

A

Pacemaker cells

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12
Q

What determines the rate of the pacemaker cells? (2 things)

A
  1. Innate electrical characteristics of cells

2. External neurochemical input

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13
Q

Examples of electrical conducting cells?

A

AV Node, His bubdle, LBB, RBB, Ant and Post Fascicles, Purkinge fibers

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14
Q

Pathway of electricity in the heart to myocardial cells?

A

Pacemaker->Contracting pathway->myocardial cells

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15
Q

What is the Cardiomyocyte Action Potential responsible for initiating?

A

Initiating each cardiac contraction

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16
Q

What initiates cardiac contraction?

A

Cardiomyocyte Action Potential

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17
Q

What are the 2 types of Cardiomyocyte Action Potential?

A

Spontaneous and Non-spontaneous

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18
Q

Are pacemaker cells in the SA node spontaneous or non-spontaneous Cardiomyocyte Action Potential?

A

Spontaneous

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19
Q

Are cardiac muscle cells spontaneous or non-spontaneous Cardiomyocyte Action Potential?

A

Non-spontaneous

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20
Q

What chemicals increases rate of pacemaker cell discharge causing increased heart rate?

A

Catecholamines (Epi and Norepi)

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21
Q

What chemical causes the decrease of pacemaker cell discharge thus slowing the heart rate?

A

Acetylcholine

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22
Q

What releases Acetylcholine?

A

Released during vagal stimulation

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23
Q

What causes myocardial cells to contract?

A

Depolarization which releases calcium from sacroplasmic reticulum

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24
Q

What type of coupling do myocardial cells exhibit?

A

Excitation-contraction coupling

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26
Q

What muscle components do myocardial cells contain?

A

Actin and myosin

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27
Q

What does the EKG waveform primarily reflect?

A

Electrical activity of myocardial cells

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28
Q

What are the 3 main characteristics of the EKG waveform?

A
  1. Duration in ms
  2. Amplitude in mV
  3. Configuration
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29
Q

When does ventricular excitation begin?

A

Begins at atrial relaxation

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30
Q

Time duration of small square on EKG paper?

A

0.04sec

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31
Q

Time duration of large square on EKG paper?

A

0.20 sec

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32
Q

How many small squares make up a large square on EKG paper?

A

5 small squares long and high

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33
Q

How many precordial leads are there?

A

Six

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34
Q

Precordial leads aka?

A

Chest leads or V leads

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35
Q

Which are the six precordial leads?

A

V1-V6

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36
Q

How many Limb Leads are there?

A

Three

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37
Q

What are the three Limb Leads called?

A

Lead 1
Lead 2
Lead 3

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38
Q

Lead 1 degree? Which arm positive and negative?

A

0º. Left arm positive, right arm negative.

39
Q

Lead 2 degree? What is positive and which arm negative?

A

60º. Leg positive, right arm negative.

40
Q

Lead 3 degree? What is positive and which arm negative?

A

120º. Leg positive, left arm negative

41
Q

What are the 3 augmented limb leads?

A

aVL
aVR
aVF

42
Q

aVL degree? Positive and negative?

A

-30º. Left arm positive, other limbs negative.

43
Q

aVR degree? Positive and negative?

A

-150º. Right arm positive, other limbs negative.

44
Q

aVF degree? Positive and negative?

A

+90º. Leg positive, other limbs negative.

45
Q

Which are the 3 anterior leads?

A

V2
V3
V4

46
Q

Which are the 3 inferior leads?

A

II, III, aVF

47
Q

Which are the 2 Right Ventricular leads?

A

aVR, V1

48
Q

Which are the 4 Left Lateral leads?

A

I, aVL, V5, V6

49
Q

Where does Atrial Excitation begin and complete?

A

Begin=SA node

Complete=AC node

50
Q

What depolarized in the P-Wave?

A

Both atria. RA then LA.

51
Q

Normal P-wave amplitude?

A

0.5-2.5mm

52
Q

Normal P-wave duration?

A

0.06-0.10sec

53
Q

Which lead does P-wave have negative deflection

A

aVR

54
Q

Where does P-wave have biphasic deflection? (hint: 2)

A

III, V1

55
Q

P-Wave deflection variable/unpredictable in which 3?

A

V2, V3, V4

56
Q

P-wave amplitude in Right Atrial Enlargement?

A

> 2.5mm. Normal duration.

57
Q

What will V1 show in Right Atrial Enlargement?

A

Taller initial component in biphasic P-wave

58
Q

Amplitude of P-wave in Left Atrial Enlargement?

A

Normal or increased

59
Q

P-wave in Left Atrial Enlargement?

A

Wide, often notched

60
Q

V1 P-wave in Left Atrial Enlargement?

A

Wide biphasic wave

61
Q

PR interval is from start of what in atria to start of what in ventricles?

A

Time from start of atrial depolarization to start of ventricular depolarization

62
Q

Normal time of PR Interval?

A

0.12 to 0.2 seconds (up to one big box)

63
Q

What can it means if PR Inteval is more than one big box?

A

Heart block

64
Q

PR Segment is from end of what in atria to beginning of what in ventricles?

A

Time from end of atrial depolarization to beginning of ventricular depolarization

65
Q

What does the Q-wave reflect?

A

Left to right septal depolarization

66
Q

What is a pathological Q Wave due to?

A

Irreversible myocardial damage.

67
Q

When does a pathological Q Wave occur?

A

Hours to days after an MI

68
Q

Duration of pathological Q Wave?

A

≥0.04sec

69
Q

Depth of pathological Q Wave?

A

≥1/3 height of R wave

70
Q

Which lead’s negative deflected QRS complex is not a pathological Q Wave?

A

aVR

71
Q

What depolarizes in QRS-complex?

A

Remainder of ventricles depolarize (started with PR Segment)

72
Q

Average vctor of QRS-complex correct flow?

A

0º to 90º

73
Q

Which 2 leads have deep negatively deflected S-waves?

A

V1 and V2

74
Q

What is R-Wave Progression?

A

Pattern of progressively increasing R-wave amplitude from right to left in V1-V6

75
Q

Which lead do the R-Wave Progression occur in?

A

V1-V6

76
Q

What is a normal QRS-interval (duration)?

A

Narrow is normal! 0.06-0.1sec

77
Q

QRS-interval not more than how many small boxes?

A

3

78
Q

Duration of a wide QRS-interval?

A

> 0.1 sec

79
Q

2 causes a wide QRS-interval?

A
  1. Impulse generated in ventricle

2. Abberant pathway through ventricle

80
Q

ST-segment time from end of what to start of what?

A

Time from end of ventricular depolarization to start of ventricular repolarization

81
Q

What can you tell from ST-segment?

A

Active cardiac ischemia or infarction (STEMI)

82
Q

STEMI height in limb leads (I, II, III)?

A

≥1mm

83
Q

STEMI height in precordial leads (V1-V6)?

A

≥2mm

84
Q

Tombstone or frowning face appearance?

A

STEMI in precordial leads (V1-V6)

85
Q

ST depression is a sign of what?

A

Cardiac ischemia

86
Q

T-waves represent what?

A

Repolarization

87
Q

QT-interval is beginning of what to end of what?

A

Beginning of ventricular depolarization to end of ventricular repolarization

88
Q

QT-interval is inversely proportial to what?

A

Heart rate

89
Q

What is a normal precent of the QT-interval?

A

40%

90
Q

Normal QT-interval is where between two QRS complexes?

A

<1/2 way

91
Q

What will a fast heart rate do to the length of the QT-interval?

A

Shorten it

EKG (7 decks)

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