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Cardiology > Rule, Form, Def/s > Flashcards

Rule, Form, Def/s Flashcards

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1
Q

Systematic approach

A
  1. rate, 2. rhythm, 3. P waves, 4. PRI, 5. QRS
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2
Q

P wave:
Wandering atrial pacemaker:
Double hump morphology:
Sharp P morph/:

A

= Atrial depolarization
= dif/ pacemaker spots in atrium
= atrium ballooning or>1 firing
= pulmonale from R-atrium lungs

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3
Q

QRS complex:
T wave:
U wave:
QT segment:

A

= ventricular depolarization
= ventricular depolarization
= “late bloomer
= all ventricle’s action

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4
Q

RVR:
SVR:

A

= Rapid ventricular response
= Slow ventricular response

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5
Q

PRI:
ST segment:
P-T is:
RR:

A

= AV holding impulse for sync
= ventricular contraction
= 1 full cardiac cycle
= gives rate & rhythm

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6
Q

Rs 6sec strip method:
big box method:
Small box method:
Triplicate method:

A

= # of Rs x 10
= 1R to R BB#s then 300/BB#
= 1R-R SB#s then 1500/ SB#
= descend W/ SB 300, 150, 100, 75, 50, 43, 38

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7
Q

PAC:
PJC:
PVC:

A

= Premature Atrial Contraction
= Premature Junction Contraction (AV)
= Premature Ventricular Contraction

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8
Q

Re-entry loops

A

= stuck in nascar loop in a chambers pathway causing SVT / no P waves

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9
Q

Preexcitation Syndromes Arrhythmias Resulting from Most Common:

A

= Extra/s conduction pathways impulses used in assessory
= (WPW) bundle of Kent
= 2nd Lown-GanongLevine
= 3rd Mahaim Fiber

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10
Q

WPW definer:
Name of assessory pathway:

A

= has delta wave “wave leaning into R wave”
= Bundle of Kent

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11
Q

Lown-Ganong) definer:
Pathway name & path:

A

= has short PRI interval
= Bundle of James connects posterior internodal pathway to bundle of his

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12
Q

Paroxysmal Supraventricular Tachycardia (PSVT);

A

= SVT rules w/ stop or start; no P waves in SVT can be any rhythm before/after SVT

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13
Q

SA Pacemaker P wave shapes

A

Upright P waves & QRS WNL

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14
Q

Heart blocks are

A

blocks in AV node partial or complete
“Putting a rock or pebble on a cable”

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15
Q
  1. (Cardiac Pharmacology)
  2. NA Channel Blockers:
  3. Beta-Blockers:
  4. Potassium Channel Blockers:
  5. Calcium Channel Blockers:
  6. Miscellaneous:
A

1= (Vaugh-Will) Classes: 1]Na, 2]Beta, 3]K, 4]Ca, Misc] Adenosine
2= (Procainamide & Lidocaine) both Widened QRS & Prolongs QT
3= (Propranolol) Prolonged PRI & Bradycardias
4= (Amiodarone) Prolonged QT
5= (Diltiazem & Verapamil) Prolonged QT & Bradycardias
6= (Adenosine & Digoxin) Prolonged QT & Bradycardias

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16
Q

Propranolol, Labetalol, Metoprolol) class
Labetalol
Metoprolol

A

= class 2 Beta Blockers
= 2nd line med for SVT after Adenosine, A-fib/flutter w/RVR, Reduce myocardical ischemia in AMI PT’s w/elevated HR, Antihypertensive
= Hypertension, 2nd line med for A-Fib/A-Flutter w/ RVR, & SVT

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17
Q

(Procainamide & Lidocaine) class

A

= class 1A&B Na Channel Blockers
= Alterative to Amiodarone in cardiac arrest V-Fib/pVT, Stable monomorphic Ventricular TachyC w/ presserved LVF
= V-Tach with a pulse, pre-excitation rhythms (WPW) >50% QRS width

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18
Q

Amiodarone class & indication

A

Class 3 K channel blocker> VF/Pulseless VT unresponsive to shock, CPR & Epi, BradyCs to include AV blocks, Recurrent, hemodynamically unstable VT w/ pulse

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19
Q

Adenosine & Digoxin class & indication

A

class misc> Adenosine 1st line med for stable narrow complex SVT,
Regular & monomorphic wide-complex tachyC thought to be from a reentry SVT (SVT w/ BBB) Does not convert A-fib/flutter

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19
Q

Before shocking someone:
since unstable, contraindicated meds:
since unstable, Indicated meds:

A

= Sedate em! sedate to keep pain away
= Sodium Thiopental, Propofol (Diprivan), Diazepam (Valium), Midazolam (Versed)
= Etomidate (Amidate (0.2-0.4 mg/kg), Ketamine (Ketalar(1-2mg/kg)

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19
Q

(Diltiazem & Verapamil) class
Diltiazem
Verapamil

A

= class 4 Ca channel blocker
= 1st line med for A-Fib/Flutter w/ RVR >150 bpm, 2nd line med for SVT
refractory to adenosine
= 2nd line med for A-Fib/Flutter w/ RVR. May use as alterative after adenosine, narrow QRS complex tachycardia w/ preserved LV fn.

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20
Q

Cardiac Output:
Cardiac Output Formula:
Blood Pressure formula:

A

= amount of blood pumped by the heart in 1 min (70mL)
= SV x HR
= (SV x HR) x SVR

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21
Q

(Refractory periods) Absolute:
Relative:

A

= end of P to apex of T wave- cells absolute Beginning of repolarization
= “some really could happen” lot of cells repolar but not all so can throw out of rhythm Commodo cordis

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22
Q

When obtaining a 12 lead ECG, where do you place V2?
When obtaining a 12 lead ECG, where do you place V5?
When obtaining a 12 lead ECG, where do you place V6?
When obtaining a 12 lead ECG, where do you place V3?
When obtaining a 12 lead ECG, where do you place V1?
When obtaining a 12 lead ECG, where do you place V4?
When obtaining a 15 lead ECG, where do you place V4R?

A

= 4th ICS just left of Sternum
= Left 5th ICS anterior of auxiliary
= 5th ICS midaxillary
= ½ in between V2 & V4
= Right of Sternum 4th ICS
= 5th ICS left Midclavicular
= Right ICS midclavicular

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23
Natural pacemaker of the heart is: If SA Node failed to initiate a impulse, what is 1st back-up firing site? If both SA & AV fails what is last firing site:
= SA node = AV node = Purjunkie
24
Leads V3 & V4 view Leads V1 & V2 view Leads 2,3, & aVF view Leads 1, aVL, V5, V6 view
= Anterior = Septal = Inferior = Lateral
25
DIgoxin for
heart failure usually fools refractory Na K pumps
26
Leads V1 and V2 look at what part of the heart?
Septal (blockages from LAD commonly)
27
Leads 1, aVL, V5, V6 look at what part of heart:
L-Lateral (low view : views LCX & LAD)
28
Leads V3 and V4 look at what part of the heart?
L-Anteriorwall (LAD & LMCA blocks)
29
Leads II, III and aVF look at what part of the heart?
Inferior wall (most common blockacke(RCA)
30
Orthodromic Re-entry loop: Antidromic Re-entry loop
= Clockwise rentry conduction loop >narrow QRS = counterclockwise reentry conduction loop > wide QRS
31
Digoxin) Typically for: Dynamics works bc
= CHF = allows more Ca for better contraction = confuses K/Na pumps
32
w/ (PJC) Premature Junctional Contraction) 1Rules: 2CANNOT HAVE B/C: 3Compensatory pause 4Non-compensatory pause
1= rate by rhythm, usually slightly irregular, P waves are either inverted before, +after, or hidden w/in QRS 2=have upright P wave (up P= PAC) 3= keeps cadence 4= doesn't keep cadence
33
1. (Junctional rhythms) aka know by: 2. Definer:
1= junctional escape: “pick up workload b/c something failed” 2= AV P waves & AV node rate 40-60BPM, Regular rhythm
34
(Heart Blocks Raps) If the R is far from the P, then you have a: Longer, longer, longer, drop, then you have a: If some Ps don’t get through, then you have a: If Ps and Qs don’t agree, then you have a:
= FIRST DEGREE! = WENCKEBACH! = MOBITZ II! = THIRD DEGREE!
35
(Heart Blocks Raps) If the R is far from the P, then you have a:
FIRST DEGREE!
36
(Heart Blocks Raps) Longer, longer, longer, drop, then you have a
= WENCKEBACH!
37
(Heart Blocks Raps) If some Ps don’t get through, then you have a:
= MOBITZ II!
38
(Heart Blocks Raps) If Ps and Qs don’t agree, then you have a:
= THIRD DEGREE!
39
Re-entry loops
= stuck in nascar loop in a chambers pathway causing SVT / no P waves
40
WPW) Orthodromic loop; Antidromic loop: Treatmeats:
= Clockwise reentry w/ narrow complex = Counterclockwise reentry w/ wide QRS = procainamide 1a Na blocker, (if no procain) sedate & cardiovert) cardioversion
41
2nd-Degree Type I AV block) names
Mobitz 1 or Wenckebach
42
Wenckebach) Sir name
2nd-Degree Type I AV block
43
2nd-Degree Type 2 AV block) names:
Mobitz 2 or intranodal AKA "2:1 block” rhythm
44
Intranodal/Mobitz 2) Sir name
2nd-Degree Type 2 AV block
45
1. (1st Degree AV Block) know: 2. Definer:
1= “add to any rhythm” “gandolf slowly opening door(PRI)” 2= PRI: >than 0.20 seconds for every PRI & P-P cadence
46
1. (2nd Degree Type I) AKA & Know: 2. Definer:
1= “Morbitz 1”/“Wenckebach” rhythm & “AV turning off to fully down” 2= progressive longing PRI till drops beat then resets/starts over
47
1. (2nd Degree Type II) AKA & know: 2. Definer:
1= "Mobitz 2/Intranodal" & “random extra Ps” 2= some P's w/o QRS & same PRI/No longing before drop beat
48
1. (3rd Degree AV Block) AKA & know 2. Definer:
1= “Complete AV-Block/dissociation" (always TCPP on) "gandalf died" 2= No relations w/ Ps & QRSs & no same PRI (top & bottom dif)
49
only condition A-Fib has cadence:
Afib w/ 3rd degree In rhythm "Gandalf dead so Atriums & Ventricles doing own thing
50
!!Poiseuille's law: Example:
= vessel w/ relative radius of 1 would transport 1mL per min at BP difference of 100mmHg. Keep pressure constant = Less blood = vaso-press
51
Which coronary artery feeds the inferior wall of the heart?
Right Coronary Artery (RCA)
52
Which coronary artery feeds the left lateral wall of the heart?
Left Circumflex (LCX)
53
A blockage of which of the following would result in the entire left ventricle not receiving blood supply?
Left Main Coronary Artery (LMCA)
54
(T wave) Limb leads Amplitude: Precordial "chest" leads amplitude:
= <5mm in LL = <10mm in precordial
55
1Lateral Wall high view: 2Left Lateral low view: 3Inferior wall view: 4Septal wall view: 5L-Anterior view:
1= Lead I & aVL= LA 2= Lead 1, aVL, V5 & V6: views LCX & LAD 3= 2,3,aVF: LL most common block(RCA) Lots of blockages/infarcs 4= V1 & V2: Along sternal borders blockages from LAD commonly 5= V3 & V4: left anterior wall : LAD & LMCA blocks
56
Widowmaker :
clot in left coronary artery wiping out L side
57
The upward slurring of the isoelectric line after the P wave up into the QRS complex that is associated with Wolff Parkinson White Syndrome (WPW) is known as the: The accessory pathway associated with Wolff Parkinson White Syndrome (WPW) is known as the:
= Delta wave = Bundle of Kent
58
Typically, we don't attempt to control the rate of Atrial Fibrillation unless it is
above 150 per minute and the patient is presenting with signs and symptoms related to the rhythm.
59
Electrodes 2 jobs:
= stick & conduct (Electrodes sealed, skin prep_
60
Einthoven's triangle: green electrode: Blue electrode: Red electrode:
= neutral/ground = Negative = Positive
61
Einthoven's triangle: Lead 1 & view: Lead 2 & view: Lead 3 & view:
= negative RA → positive LA (Left lateral camera view) = negative RA→ positive LL (Inferior camera view) = negative LA→ positive LL (slight lateral Inferior camera view)
62
Einthoven's triangle) Negitive & Positive lead 1 sites: Negitive & Positive lead 2 sites: Negitive & Positive lead 3 sites:
=negative @ RA & positive @ LA = negative @ RA & positive @ LL = negative @ LA & positive @ LL
63
Unipolar Limb Leads: aVR: aVL: aVF:
= Augmented by the cardiac monitor = Right Arm positive (inferior) = Left Arm positive (lateral ) = Left Leg positive (inferior)
64
Horizontal Boxes: Each small box ?secs: 5 small boxes equal: Each large box is ?secs:
= 0.04 sec = 1 large box = 0.20 sec
65
Vertical Boxes Each small box is: Each small box also equals: 5 small boxes equal: Each large box is: 2 large boxes equal: 1 mV
= 0.1mV = 1 mm = 1 large box = 0.5 mV = 1 mV
66
ECG Heart waves – P wave: QRS complex: T wave:
= Atrial depolarization = Ventricular depolarization = Repolarization of ventricles
67
V1 V2 leads view:
Septum
68
V3 V4 leads look at
Left lateral wall
69
V5 V6 leads look at
Inferior
70
V1 & V2
71
V3 & V4
72
V5 & V6
73
SA node rate: AV node rate: Purjunkie rate:
=100-60BPM =60-40BPM =40-15BPM
74
Systematic approach
1. rate, 2. rhythm, 3. P waves, 4. PRI, 5. QRS
75
Heart blocks are
blocks in AV node partial or complete “Putting a rock or pebble on a cable”
76
Propranolol, Labetalol, Metoprolol) class Labetalol Metoprolol
= class 2 Beta Blockers = 2nd line med for SVT after Adenosine, A-fib/flutter w/RVR, Reduce myocardical ischemia in AMI PT's w/elevated HR, Antihypertensive = Hypertension, 2nd line med for A-Fib/A-Flutter w/ RVR, & SVT
77
(Procainamide & Lidocaine) class
= class 1A&B Na Channel Blockers = Alterative to Amiodarone in cardiac arrest V-Fib/pVT, Stable monomorphic Ventricular TachyC w/ presserved LVF = V-Tach with a pulse, pre-excitation rhythms (WPW) >50% QRS width
78
(Diltiazem & Verapamil) class Diltiazem Verapamil
= class 4 Ca channel blocker = 1st line med for A-Fib/Flutter w/ RVR >150 bpm, 2nd line med for SVT refractory to adenosine = 2nd line med for A-Fib/Flutter w/ RVR. May use as alterative after adenosine, narrow QRS complex tachycardia w/ preserved LV fn.
79
When obtaining a 12 lead ECG, where do you place V2? When obtaining a 12 lead ECG, where do you place V5? When obtaining a 12 lead ECG, where do you place V6? When obtaining a 12 lead ECG, where do you place V3? When obtaining a 12 lead ECG, where do you place V1? When obtaining a 12 lead ECG, where do you place V4? When obtaining a 15 lead ECG, where do you place V4R?
= 4th ICS just left of Sternum = Left 5th ICS anterior of auxiliary = 5th ICS midaxillary = ½ in between V2 & V4 = Right of Sternum 4th ICS = 5th ICS left Midclavicular = Right ICS midclavicular
80
Leads V3 & V4 view Leads V1 & V2 view Leads 2,3, & aVF view Leads 1, aVL, V5, V6 view
= Anterior = Septal = Inferior = Lateral
81
Leads V1 and V2 look at what part of the heart?
Septal (blockages from LAD commonly)
82
Leads 1, aVL, V5, V6 look at what part of heart:
L-Lateral (low view : views LCX & LAD)
83
Leads V3 and V4 look at what part of the heart?
L-Anteriorwall (LAD & LMCA blocks)
84
Leads II, III and aVF look at what part of the heart?
Inferior wall (most common blockacke(RCA)
85
(Heart Blocks Raps) If the R is far from the P, then you have a: Longer, longer, longer, drop, then you have a: If some Ps don’t get through, then you have a: If Ps and Qs don’t agree, then you have a:
= FIRST DEGREE! = WENCKEBACH! = MOBITZ II! = THIRD DEGREE!
86
(Heart Blocks Raps) If the R is far from the P, then you have a:
FIRST DEGREE!
87
(Heart Blocks Raps) Longer, longer, longer, drop, then you have a
= WENCKEBACH!
88
(Heart Blocks Raps) If some Ps don’t get through, then you have a:
= MOBITZ II!
89
(Heart Blocks Raps) If Ps and Qs don’t agree, then you have a:
= THIRD DEGREE!
90
2nd-Degree Type I AV block) names
Mobitz 1 or Wenckebach
91
Wenckebach) Sir name
2nd-Degree Type I AV block
92
2nd-Degree Type 2 AV block) names:
Mobitz 2 or intranodal AKA "2:1 block” rhythm
93
Intranodal/Mobitz 2) Sir name
2nd-Degree Type 2 AV block
94
1. (1st Degree AV Block) know: 2. Definer:
1= “add to any rhythm” “gandolf slowly opening door(PRI)” 2= PRI: >than 0.20 seconds for every PRI & P-P cadence
95
1. (2nd Degree Type I) AKA & Know: 2. Definer:
1= “Morbitz 1”/“Wenckebach” rhythm & “AV turning off to fully down” 2= progressive longing PRI till drops beat then resets/starts over
96
1. (2nd Degree Type II) AKA & know: 2. Definer:
1= "Mobitz 2/Intranodal" & “random extra Ps” 2= some P's w/o QRS & same PRI/No longing before drop beat
97
1. (3rd Degree AV Block) AKA & know 2. Definer:
1= “Complete AV-Block/dissociation" (always TCPP on) "gandalf died" 2= No relations w/ Ps & QRSs & no same PRI (top & bottom dif)
98
only condition A-Fib has cadence:
Afib w/ 3rd degree In rhythm "Gandalf dead so Atriums & Ventricles doing own thing
99
(T wave) Limb leads Amplitude: Precordial "chest" leads amplitude:
= <5mm in LL = <10mm in precordial
100
1Lateral Wall high view: 2Left Lateral low view: 3Inferior wall view: 4Septal wall view: 5L-Anterior view:
1= Lead I & aVL= LA 2= Lead 1, aVL, V5 & V6: views LCX & LAD 3= 2,3,aVF: LL most common block(RCA) Lots of blockages/infarcs 4= V1 & V2: Along sternal borders blockages from LAD commonly 5= V3 & V4: left anterior wall : LAD & LMCA blocks
101
Unipolar Limb Leads: aVR: aVL: aVF:
= Augmented by the cardiac monitor = Right Arm positive (inferior) = Left Arm positive (lateral ) = Left Leg positive (inferior)
102
V1 V2 leads view:
Septum
103
V3 V4 leads look at
Left lateral wall
104
V5 V6 leads look at
Inferior
105
V1 & V2
106
V3 & V4
107
V5 & V6
108
SA node rate: AV node rate: Purjunkie rate:
=100-60BPM =60-40BPM =40-15BPM
109
Respiration ratio=
1 sec inhalation 2 sec exhalation
110
Pulsus paradoxus
BP drop more than 10→ can indicate severe obstructive lung disease.
111
(60%) Fluid compartments % of water:
45% intracellular 15% extracellular (outside cell) Interstitial 10.5% Intravascular 4.5%
112
Cardiac Output: Cardiac Output Formula: Blood Pressure formula:
= amount of blood pumped by the heart in 1 min (70mL) = SV x HR = (SV x HR) x SVR
113
Pulse pressure: MAP: CPP Cerebral Perfusion:
= SBP-DBP = (PP/3) + DBP = (MAP-ICP) + 10
114
Celsius# to degrees Fahrenheit form Fahrenheit# to Celsius form
C# to F=(C# -32) / 1.8 F# to C= (1.8 x F) + 32
115
EMD
Electrical Mechanical disassociation (same as PEA)
116
Stable & symptomatic doesnt always mean
medicate; ex vagal is all that is needed

Cardiology (20 decks)

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