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CV II Exam 1 > Rapid EKG IV > Flashcards

Rapid EKG IV Flashcards

1
Q

runs of VT

A 
coronary insufficiency (ischemia)
-irritable ventricular foci

**junctional or atrial SVT can mimic VT with wide QRS

also BBB with SVT can widen QRS to give same impression

NEVER give meds for SVT to a patient with VT

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2
Q

VT vs. wide QRS SVT

A

coronary artery disease - VT
QRS .14 - VT
captures or fusions - VT
RAD - VT

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3
Q

torsades de pointes

A

twisted ribbon

  • rapid ventricular rhythm
  • low K, long QT syndrome
  • rapid rate 250-350
  • brief self-terminating bursts

-gradual changes in amplitude

theory - two competitive irritable foci

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4
Q

atrial flutter

A

rapid rate 250-350

  • sawtooth pattern
  • atrial auto foci

AV node in refractory - so only one in series of flutter conducts to ventricles

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5
Q

vagal maneuver

A

will reveal atrial flutter

-slow AV conduction - cause fewer flutter waves to be conducted to ventricles

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6
Q

maze surgery

A

cut atria into maze of channels for conduction

-eliminates possibility of reentry

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7
Q

ventricular flutter

A

rapid rate 250-350

  • ventricular auto foci
  • smooth sine waves of similar amplitude

**will likely deteriorate to V-fib

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8
Q

fibrillation

A

multi foci firing rapidly

  • rate 350-450
  • foci either atrial or ventricles
  • parasystolic - entrance block
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9
Q

atrial fibrillation

A

erratic rhythm

  • rate 350-450
  • wavy baseline with no P waves
  • irregular QRS complexes

**determine rate - QRS per 6 second strip x 10

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10
Q

ventricular fibrillation

A

irritable parasystolic ventricualr foci

  • rapid rate 350-450
  • twitching of ventricle
  • non-discernible QRS complexes
  • bag of worms

-amplitude decreases as heart dies

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11
Q

cardiac arrest

A

no pumping of heart

-V-fib - requires CPR and defib

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12
Q

cardiac standstill

A

asystole

-no cardiac activity on EKG

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13
Q

pulseless electrical activity

A

weak electrical signals - but heart can’t respond

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14
Q

wolf-parkinson-white syndrome

A

alternate AV pathway- bundle of kent

  • rapidly through AV node - no delay
  • premature depolarization of ventricles
  • delta wave forms
  • shortened PR interval and lengthened QRS
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15
Q

bundle of kent

A

in WPW syndrome

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16
Q

delta wave

A

forms in WPW syndrome

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17
Q

patients with WPW

A

can have paroxysmal tachycardia by three mechanisms

  • rapid conduction
  • kent bundle auto foci
  • re-entry
18
Q

lown-ganong levine syndrome

A

AV node bypassed by extension of anterior internodal tract

  • james bundle
  • skips delay at AV node
  • directly to His bundle
  • serious problem - rapid atrial arrhythmia like atrial flutter
19
Q

james bundle

A

extension of anterior internodal tract

  • skips AV node
  • in LGL syndrome
20
Q

sinus block

A

SA node fails to pace for at least 1 cycle
-skip P wave

  • before and after - identical P waves
  • may get escape beat from auto foci
21
Q

sick sinus syndrome

A

SA node dysfunction
-unresponsive supraventricular auto foci

  • elderly with heart disease
  • sinus bradycardia
22
Q

excessive PS activity

A

depresses SA, atrial, and junctional foci

-seen in athletes - pseudo SSS

23
Q

bradycardia-tachycardia

A

patients with SSS

-intermittent SVT (or A-flutter, A-fib)

24
Q

first degree AV block

A

lengthened PR interval

  • longer than 0.2s***
  • consistent lengthened interval
25
Q

AV blocks

A

delayed conduction from atrial to ventricles

26
Q

PR interval > 0.2s

A

AV block

27
Q

segment

A

portion of baseline

28
Q

interval

A

contains at least one wave

29
Q

PR interval

A

beginning P wave to beginning of QRS complex

30
Q

second degree AV block

A

some depolarizations blocked at AV node

-two types - wenckebach and mobitz

31
Q

type I second degree AV block

A

wenckebach

  • progressively longer PR intervals
  • with dropped QRS complex
  • consistent P:QRS ration
  • narrow QRS
32
Q

wenckebach

A

type I second degree AV block

-progressively longer PR intervals with dropped QRS complex

33
Q

type II second degree AV block

A

mobitz

  • single P-QRS-T followed by series of P waves that fail to conduct
  • consistent P:QRS ratio
  • widened QRS
34
Q

progressively longer P intervals with eventual dropped QRS

A

wenckeback

-second degree AV block type I

35
Q

normal P waves that fail to conduct QRS

A

consistent ratio

-mobitz block

36
Q

wenckebach origin

A

AV node

37
Q

mobitz origin

A

below AV node

  • His bundle or bundle branches
  • widened QRS
38
Q

vagal maneuver and mobitz vs. wenckebach

A

2: 1 AV block??
- vagal maneuver - increasead PS will inhibit AV node
- cause wencekebach to increase cycles to 3:2 or 4:3
- causes mobitz to become 1:1
- wenckebach

39
Q

third degree AV block

A

complete block
-conduction atria to ventricles totally blocked

atria and ventricular paced independently
-ventricles at junctional or ventricualr foci

40
Q

third degree block with junctional foci

A

ventricular rate 40-60

-narrows QRS

41
Q

third degree block with ventricular foci

A

ventricular rate 20-40

-PVC like QRS

42
Q

forms of complete third degree block

A
  • upper AV node block - junctional foci can escape
  • complete AV node block
  • ventricular foci only
  • below His bundle - ventricular foci onyl

CV II Exam 1 (10 decks)

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