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Basic Electrocardiography > Part 1 basics > Flashcards

Part 1 basics Flashcards

1
Q

SA node

A

primary pacemaker of the heart

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2
Q

SA node Location

A

located in the superior right atrium at the entrance of the superior vena cava

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3
Q

SA intrinsic rate

A

60-100 bpm (without other stimulation)

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4
Q

Intra-Atrial Tracts/Pathways

A

creates the preferred routes of propagation. conducts impulses through the atria from the SA to AV

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5
Q

Divisions of the intra-atrial tracts

A

anterior: extends to the left atrium called bachmans bundle
medial
posterior

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6
Q

AV node location

A

located in the triangle of Koch

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7
Q

AV node purpose

A

only normal conduction pathway to the ventricles

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8
Q

AV node rate

A

40-60 bpm is the secondary pacemaker

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9
Q

AV node Delay

A

allows for atrial contraction (increased preload due to frank-starling mechanism) protects ventricles from inappropriate high atrial rates

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10
Q

electrical conduction ion

A

calcium is the major ion responsible for action potential

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11
Q

refractory period

A

period of time between action potentials

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12
Q

relative refractory period

A

period of time where it takes a very strong impulse to stimulate

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13
Q

absolute refractory

A

a cell cannot be depolarized again, no matter how strong the impulse
correlates: phase 0 to mid phase 3
QRS to the peak of the T wave

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14
Q

Bundle of His

A

more proximal portion of the ventricle conduction system

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15
Q

Right bundle branch

A

contacts the ventricular myocardium at the base of the anterior papillary muscle

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16
Q

left bundle branch

A

thicker than the right bundle branch, perforates the IVS and divided into anterior & posterior fasicle

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17
Q

Purkinje fibers in conduction system

A

the terminal end of the entire conduction system

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18
Q

purkinje fiber rate

A

20-40 bpm last back up pacemaker of heart

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19
Q

cardiac automaticity

A

self excitation accomplished by the P cells

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20
Q

p cell location

A

cells located in SA node, atrial tissue, AV node and ventricular tissue

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21
Q

conduction velocity

A

varies through the conduction system

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22
Q

conduction velocity variation

A

necessary for synchronized myocardial contractions

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23
Q

action potential

A

influx or efflux of ions (NA, K and CA) changes the electrical state of the cell (positive intracellular)

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24
Q

what does the sodium potassium pump maintain

A

the sodium-potassium ATPas pump maintains the negative resting potential

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25
Q

how does the sodium potassium pump pre-depolarize

A

it resumes the pre-depolarization electrolyte levels by exchanging 3 sodium ions for 2 potassium ions

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26
Q

requirements for sodium potassium atpase pump

A

active process requiring magnesium and energy (adenosine triphosephase ATP)

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27
Q

low magnesium or low ATP

A

resting membrane potential cannot be maintained, sodium remains in cell, cell swells and ruptures: manifested as PVC’s

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28
Q

phase 4

A

resting membrane potential (-80–95)

maintains negativity via sodium potassium pump (NA out K in)

29
Q

phase 4 on ECG

A

the isoelectric line (baseline) between the T wave and P wave on the ECG

30
Q

Phase 0

A

rapid depolarization of the cell

sodium rushes into the cell making it less negative

31
Q

phase 1

A

chloride ions enter the cell (making it a little more negative)

32
Q

Phase 2

A

the plateau phase- slowing of re-polarization

calcium enters cell, leading to contraction of the muscle in a sustained slow manner

33
Q

phase 2 purpose

A

This is where work occurs: the muscle contracts

34
Q

Phase 3

A

Sudden acceleration in the rate of repolarization.
potassium movement into the cell causes this rapid return in intracellular negativity
sodium potassium pump operates at this phase

35
Q

requirements of phase 3

A

will require ATP and magnesium

36
Q

pacemaker cell action potential (spontaneous action potential)

A

If funny channels- permeable to both K and Na

37
Q

pacemaker cell action potential ion

A

calcium is the cause of depolarization in these cells

38
Q

how it comes together SA node

A

SA node generates impulse; atrial excitation begins

39
Q

how it comes together AV node

A

impulse delayed at AV node

40
Q

how it all comes together; bundle branches

A

impulse passes to heart apex; ventricular excitation begins

41
Q

how it all comes together; purkinje fibers

A

ventricular excitation complete

42
Q

sympathetic innervation “the gas pedal”

A

increase in SA nodal chronotropy (rate), AV nodal dromotropy (speed of AV node conduction) and myocardial intropy (contractility)

43
Q

parasympathetic innervation “the break pedal”

A

Decreased SA nodal chronotropy and decreased AV nodal dromotropy

44
Q

positive chronotropic

A

increased heart rate

45
Q

Relative refractory period

A

if an impulse is strong enough, it may stimulate a depolarization (even though the cell is not completely re polarized)
Late phase 3
descending limb of T wave on ECG

46
Q

Reentry

A

normally impulse goes from AV to SA node but sometimes it turns around and goes backwards -reactivation of tissue by a returning impulse

47
Q

accessory pathway

A

a form of reentry- a delayed or blocked impulse may travel through a different tract (no regulation)

48
Q

reentry-orthodromic-antidromic

A

the impulse may travel down the normal pathway and then back up the accessory pathway (orthodromic) or vice versa (antidromic)

49
Q

causes of reentry

A

myocardial ischemia
certain medications
hyperkalemia

50
Q

horizontal plane values

A

measures time
one small box-0.04 seconds
one large box-0.20 seconds

51
Q

p wave

A

atrial depolarization

electrical current generated by the SA node or atrial tissue

52
Q

duration of p wave

A

less than 0.12 seconds

53
Q

PR interval

A

impulse transmission time from SA node throughout the atria and to the AV node

54
Q

PR duration

A

range 0.12 to .20 seconds 3-5 small boxes

55
Q

QRS complex

A

depolarization of the ventricular myocardium

56
Q

QRS duration

A

less than 0.12 seconds

57
Q

Q wave

A

first downward deflection

58
Q

pathological q wave

A

can tell if it is pathological if you can drop a little box into it

59
Q

R wave

A

first positive upward deflection

more than one positive deflection noted as R’

60
Q

S wave

A

first downward deflection after the R wave

61
Q

QRS complex nomenclature

A

if a deflection is greater an 3 mm in amplitude than use a capital QRS of less than 3 mm then use lower case qrs

62
Q

ST segment

A

excited state of the ventricular myocardium
follows QRS
ventricular contractility starts here

63
Q

j point

A

landmark for MI to measure elevation or depression

64
Q

t wave

A

electrical repolarization of the ventricular myocardium

following the QRS complex

65
Q

QT interval

A

represents the return of stimulated ventricular myocardium to a resting state

66
Q

normal QT

A

normal if QT interval is less than half distance of R-R interval

67
Q

U wave

A

repolarization of the purkinje system

68
Q

causes of prominent U wave

A

profound bradycardias
hypokalemia
hypothermia

Basic Electrocardiography (1 decks)

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