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PEDS 103 > Pathophysiology > Flashcards

Pathophysiology Flashcards

1
Q

What are auto-rhythmic cells?

A

Generate action potentials spontaneously
1% of myocardial cells
Do not contribute to contractile force
ANS innervates the heart

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2
Q

What is the conducting pathway of the Heart?

A

1) SA node (pacemaker)
2) AV node
3) AV bundle ( bundle of HIS
4) Right and left bundle branches
5) Purkinje fibers

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3
Q

Electrical Pathway of the SA node

A

1) SA depolarizes
2) Moves rapidly to the AV node via inter nodal pathway
3) Depolarization spreads more slowly across atria (so atria can finish filling) Conduction is slow though AV node

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4
Q

Electrical Events of the Cardiac Cycle

P wave

A

P wave: Atrial depolarization

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5
Q

PR segments

A

time between end of atrial depolarization and onset of ventricular depolarization
Conducting through the AV nose and continuing atrial contraction

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6
Q

Q wave
R wave
S wave

A

Down the apex
Up from the apex
Up the ventricle

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7
Q

ST segment

A

time between end of ventricular depolarization and onset of ventricular repolarizaton
Continuing ventricular contraction

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8
Q

PR Interval (combination of waves and segments)

A

time between onset of atrial depolarization and ventricular depolarization
AV blocks

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9
Q

QT interval

A

Time between onset of ventricular depolarization and end of repolarization
long QT syndrome (abnormality of ion channel on the cardiac cells)

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10
Q

What is a normal HR

A

60-100 bpm

average 70 bpm

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11
Q

What is tachycardia?

A

fast resting heart rate

greater than 100 bpm

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12
Q

What is bradycardia?

A

Slow resting heart rate
less than 60 bpm
Some endurance athletes have bradycardia but is a physiological advantage

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13
Q

What is Primary AV Block?

A

increase duration of PR interval

increase delay between contraction

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14
Q

What is secondary AV block?

A

Slowed conduction through AV node
lose 1 to 1 P wave and QRS complex
lose 1 to 1 atrial to ventricular contraction

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15
Q

What is tertiary AV block?

A

loss of conduction through AV node
P wave is independent of QRS
Atrial and ventricular and contractions are independent

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16
Q

ECG interpretations

A 
Shape, timing, duration of wave segments
These may indicate changes in
- conduction velocity
- enlargement of heart
- tissue damage
17
Q

Arrhythmia (abnormal heart rhythm)

A 
electrical problems in the generation or conductance of action potentials
Seen as :
-missed or extra beats
- atrial fibrillation
-premature ventricular contraction
18
Q

What is atrial fibrillation?

A

SA node is not acting as pacemaker
Absence of P wave and irregular rate
May be no symptoms

19
Q

What is premature ventricular contractions (PVC)

A

Extra beats under the influence of auto-rhythmic cells other than SA node
QRS and T waves look abnormal
Felt like a skipped heart beat, strong beat or suction
Cause chest pain, fainting, fatigue or hyperventilation
Several in a row becomes ventricular tachycardia
Need to be treated if greater than 6bpm

20
Q

What is ventricular fibrillation?

A

Uncoordinated contraction

Cause of cardiac arrest

21
Q

ST Elevation

A

Indicate myocardial infraction

22
Q

ST depression

A

indicate myocardial ischemia

23
Q

What are some treatments of conduction abnormalities?B

Bradycardia

A

Pacemaker- put in where contraction starts and the AV node because that is the only pathway

24
Q

Conduction Abnormality Treatments

Tachycardia

A

medication (calcium blockers)
Cadrioversion (overriding the heart)
- Electrical shock (sets heart to regular ryhthm
- Emergency cardioversion = defibrilation

25
Q

Conduction Abnormality Treatments

Ablation Therapy

A

Destroy cardiac tissue = electrical block along pathway to prevent arrhythmia

26
Q

Other Treatments for Arrhythmia

A

Surgery
-Bypass for CAD (plaque build up)
-Maze procedure to correct electrical pathway
-Implantable cardioverter-defibrillator (ICD)
(monitors heart rhythm, sends out electrical shock to set heart back to normal)

27
Q

What do ECG represent?

A

The summed electrical activity of all cells recorded from the surface of the body

PEDS 103 (8 decks)

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