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CPR Midterm > Normal ECGs DSA > Flashcards

Normal ECGs DSA Flashcards

1
Q

What causes the heart to beat?

A

rhythmic discharge of electrical stimuli

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2
Q

What is an EKG?

A

records the electrical activity of the heart, provides a record of cardiac electrical activity, & info about heart function/structure

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3
Q

What does the EKG record?

A

electrical activity of contraction of heart muscle (myocardium)

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4
Q

How does the depolarization move throughout the heart?

A

cell to cell conduction of depolarization is carried by fast-moving Na+ ions

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5
Q

Where can you detect the heart’s electrical activity?

A

from the skin surface using electrodes

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6
Q

What does an upward wave indicate on an EKG?

A

depolarization wave moving toward positive electrode

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7
Q

What is the SA node?

A

in upper posterior wall of RA & is the heart’s dominant pacemaker

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8
Q

What is automaticity?

A

ability of SA node to generate pacemaking stimuli

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9
Q

What does the P wave represent?

A

contraction of BOTH atria

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10
Q

What happens to depolarization when it reaches the AV node?

A

depolarization slows down to allow time for blood in atria to enter the ventricles (b/c carried by slow moving Ca2+ ions)

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11
Q

What happens when depolarization reaches the ventricular conduction system?

A

depolarization rapidly shoots through the His bundle & the L/R bundles branches

(purkinje fibers)

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12
Q

What are Purkinje fibers?

A

rapidly conducting cells that use fast moving Na+ ions for conduction of depolarization to ventricular myocytes

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13
Q

What is the QRS complex on the EKG?

A

depolarization of the entire ventricular myocardium

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14
Q

How does ventricular depolarization spread?

A

from terminal filaments of Purkinje fibers beneath endocardium that proceeds outward to epicardium of ventricles

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15
Q

What does the ST segment represent?

A

ventricular repolarization

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16
Q

What does an abnormal ST segment indicate?

A

sign of serious pathology (if elevated or depressed beyond normal baseline level)

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17
Q

What is the T wave?

A

rapid phase of ventricular repolarization (K+ leaving the myocytes)

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18
Q

What does ventricular systole include?

A

begins w/ QRS & persists until end of T wave

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19
Q

What is a long QT interval syndrome?

A

pts vulnerable to dangerous rapid ventricular rhythms

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20
Q

What ions are used in cell to cell conduction in myocardium?

A

by Na+ ions

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21
Q

What ions are used in AV node conduction?

A

slow movement of Ca2+ ions

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22
Q

Where would you place electrodes?

A

on R & L arms, L leg

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23
Q

What are the lateral leads?

A

Leads I & AVL b/c each has a positive electrode positioned laterally on the L arm

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24
Q

What are the inferior leads?

A

leads II, III & AVF b/c each of these leads has a positive electrode positioned inferiorly on the L foot

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25
Q

What is at the center of leads V1 to V6?

A

AV node

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26
Q

What are leads V3 & V4 over?

A

oriented over the interventricular septum (V3 near RV & V4 near LV)

27
Q

What are bipolar limb leads?

A

pair of electrodes on each limb that has 1 positive & 1 negative

28
Q

What direction is lead I in?

A

horizontal (L arm is + & R arm is -)

29
Q

What is + & - in lead III?

A

L arm is negative & L leg is positivve

30
Q

What is the AVF lead?

A

uses L foot electrode as positive & both arm electrodes as negative

31
Q

What is the AVR lead?

A

R arm is positive & others are negative

32
Q

What is the AVL lead?

A

L arm is positive & others are negative

33
Q

How is the rate of an EKG read?

A

cycles per minute

34
Q

What is the most common cause of sinus tachycardia?

A

sympathetic stimulation of SA node via exercise

35
Q

automaticity of atria

A

60 to 80 beats per minute

36
Q

automaticity of AV junction

A

40 to 60 beats per minuate

37
Q

automaticity of venticles

A

20 to 40 beats per minute

38
Q

What happens if AV junction is blocked?

A

automaticity focus in Purkinje fibers of ventricles will act

39
Q

What is the importance of overdrive suppression?

A

provides emergency backup pacing @ 3 separate levels

40
Q

What should you first use to calculate the rate?

A

R wave

41
Q

What are the next 3 thick lines following R wave?

A

300, 150, 100

then 75, 60, 50

42
Q

How do you determine rate?

A

start with 1 R wave & where next R wave falls gives you the rate

43
Q

If rate is 60 beats per minute & due to rhythm from automaticity focus, which one is producing the rate?

A

pacemaker in the AV junction

would also not see any P waves on that ECG

44
Q

What is the proper term for slow heart rate?

A

bradycardia

45
Q

How does bradycardia show on an ECG?

A

few cycles per 6 second strip

(10 of 6 second strips gives 1 minute & #of cycles per min is rate…so cycles per 6 second strip is multiplied by 10)

46
Q

What does the vector on an EKG represent?

A

general direction of depolarization in the heart

47
Q

What is the mean QRS vector?

A

represents general direction of ventricular depolarization (tail is the AV node) & points more toward L

48
Q

What happen if heart is rotated toward R side?

A

mean QRS vector moves toward R

common in tall & slender pts

49
Q

What direction is heart rotated in obese people?

A

toward L side of pt

50
Q

What is a myocardial infarction?

A

when 1 branch of coronary arteries is occluded (that area of heart becomes electrically dead)

51
Q

What direction does mean QRS vector point in MI?

A

points away from infarction

52
Q

What is the normal mean QRS vector?

A

points down & to L side of pt (in 0-90 degree range)

53
Q

Describe normal position of mean QRS vector

A

points toward ventricular hypertrophy & away from MI

54
Q

What does lead I pass through?

A

AV node (R arm is - & left arm is +)

55
Q

What does a positive QRS complex in lead I indicate?

A

mean QRS vector is pointing to pt L half

56
Q

What does lead I detect?

A

right axis deviation

57
Q

What does a positive QRS complex in lead AVF indicate?

A

downward pointing mean QRS vector

58
Q

What does you want to see for lead I & lead AVF in normal pt?

A

lead I should point left & lead AVF should point down (in normal quadrant!)

indicates ventricular depolarization moving down & left

59
Q

What is left axis deviation?

A

lead I & lead AVF point upward & to left

60
Q

When do you see left axis deviation?

A

lead I QRS is positive & lead AVF QRS is negative

61
Q

What should lead V2 always be?

A

positive (just anterior to AV node)

62
Q

How does lead V2 split the body?

A

front half is positive & back half is negative (center of sphere is still the AV node)

63
Q

Why is QRS lead in V2 negative usually?

A

mean QRS vector should point backward b/c of general posterior position of thick L ventricle

CPR Midterm (20 decks)

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