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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
how does the sodium potassium pump pre-depolarize
it resumes the pre-depolarization electrolyte levels by exchanging 3 sodium ions for 2 potassium ions
26
requirements for sodium potassium atpase pump
active process requiring magnesium and energy (adenosine triphosephase ATP)
27
low magnesium or low ATP
resting membrane potential cannot be maintained, sodium remains in cell, cell swells and ruptures: manifested as PVC's
28
phase 4
resting membrane potential (-80--95) | maintains negativity via sodium potassium pump (NA out K in)
29
phase 4 on ECG
the isoelectric line (baseline) between the T wave and P wave on the ECG
30
Phase 0
rapid depolarization of the cell | sodium rushes into the cell making it less negative
31
phase 1
chloride ions enter the cell (making it a little more negative)
32
Phase 2
the plateau phase- slowing of re-polarization | calcium enters cell, leading to contraction of the muscle in a sustained slow manner
33
phase 2 purpose
This is where work occurs: the muscle contracts
34
Phase 3
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
requirements of phase 3
will require ATP and magnesium
36
pacemaker cell action potential (spontaneous action potential)
If funny channels- permeable to both K and Na
37
pacemaker cell action potential ion
calcium is the cause of depolarization in these cells
38
how it comes together SA node
SA node generates impulse; atrial excitation begins
39
how it comes together AV node
impulse delayed at AV node
40
how it all comes together; bundle branches
impulse passes to heart apex; ventricular excitation begins
41
how it all comes together; purkinje fibers
ventricular excitation complete
42
sympathetic innervation "the gas pedal"
increase in SA nodal chronotropy (rate), AV nodal dromotropy (speed of AV node conduction) and myocardial intropy (contractility)
43
parasympathetic innervation "the break pedal"
Decreased SA nodal chronotropy and decreased AV nodal dromotropy
44
positive chronotropic
increased heart rate
45
Relative refractory period
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
Reentry
normally impulse goes from AV to SA node but sometimes it turns around and goes backwards -reactivation of tissue by a returning impulse
47
accessory pathway
a form of reentry- a delayed or blocked impulse may travel through a different tract (no regulation)
48
reentry-orthodromic-antidromic
the impulse may travel down the normal pathway and then back up the accessory pathway (orthodromic) or vice versa (antidromic)
49
causes of reentry
myocardial ischemia certain medications hyperkalemia
50
horizontal plane values
measures time one small box-0.04 seconds one large box-0.20 seconds
51
p wave
atrial depolarization | electrical current generated by the SA node or atrial tissue
52
duration of p wave
less than 0.12 seconds
53
PR interval
impulse transmission time from SA node throughout the atria and to the AV node
54
PR duration
range 0.12 to .20 seconds 3-5 small boxes
55
QRS complex
depolarization of the ventricular myocardium
56
QRS duration
less than 0.12 seconds
57
Q wave
first downward deflection
58
pathological q wave
can tell if it is pathological if you can drop a little box into it
59
R wave
first positive upward deflection | more than one positive deflection noted as R'
60
S wave
first downward deflection after the R wave
61
QRS complex nomenclature
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
ST segment
excited state of the ventricular myocardium follows QRS ventricular contractility starts here
63
j point
landmark for MI to measure elevation or depression
64
t wave
electrical repolarization of the ventricular myocardium | following the QRS complex
65
QT interval
represents the return of stimulated ventricular myocardium to a resting state
66
normal QT
normal if QT interval is less than half distance of R-R interval
67
U wave
repolarization of the purkinje system
68
causes of prominent U wave
profound bradycardias hypokalemia hypothermia

Basic Electrocardiography (1 decks)

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