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113 Sycope > Syncope > Flashcards

Syncope Flashcards

1
Q

What is syncope?

A

TLOC due to global cerebral hyopoperfusion.

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2
Q

What does the P wave represent?

A

Atrial depolarisation

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3
Q

What does the QRS complex represent?

A

Ventricular depolarisation

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4
Q

What does the T wave represent?

A

repolarisation of the myocardium of the ventricles.

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5
Q

Why is the T wave in the same direction as the QRS complex if one is repolarisation and one is depolarisation?

A

The depolarisation occurs from the inside to the outside of the ventricles - positive, travelling towards the lead. Repolarisation is negative, and travels away from the lead (net effect is the same).

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6
Q

What is the normal length of a PR interval?

A

120-200ms

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7
Q

What is Wolff-Parkinson-White syndrome?

A

propagation from atria to ventricles is not controlled through the AVN, instead, it passed through the muscle fibres.

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8
Q

Sinus rhythm, but the R wave has a delta wave at its base

A

Wolff-Parkinson-White syndrome.

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9
Q

What is the normal length of the QRS complex?

A

120ms - this is described as a narrow complex

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10
Q

If the QRS complex is wide, what might the pathology be?

A

Activity is starting in the ventricles, OR

Bundle of His is not working properly, causing the ventricles to depolarise at different times.

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11
Q

From where do sensory cardiac fibres arise (and therefore susceptible to referred pain)?

A

C8-T4.

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12
Q

Sinus rhythm, QRS complex follows every P wave, PR interval is greater than 220ms.

A

1s degree AV block.

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13
Q

Progressive PR interval prolongation until P wave fails to conduct.

A

2nd degree AV block - Mobitz 1

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14
Q

Regular P waves but QRS complexes within the P wave pattern are regularly dropped. A ratio of P:QRS can be determined.

A

2nd degree block - Mobitz 2

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15
Q

What is the cause of 2nd degree block Mobitz type 2?

A

His-purkinje conduction problem.

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16
Q

What is the cause of 2nd degree block Mobitz type 1?

A

AVN problem.

17
Q

What are the symptoms of Stoke-Adams?

A

Syncope,
often no warning,
slow/absent pulse,
After a few seconds, regains colour and consciousness.
May convulse if O2 level in brain drops too low.

18
Q

What is the pathology of vasovagal syncope?

A 
peripheral vasodilation,
venous bood pooling,
little/no return to heart,
responsive vigorous contraction,
starch receptors - 'too much stretch'
reduction in ventricular stretch (vigour) i.e. vasodilation,
reduction in BP
syncope.
19
Q

P waves, and QRS complexes, but no relationship between them.

A

Third degree/complete heart block - ventricular beats are escape beats - self generated.

20
Q

What is an escape beat?

A

a ‘self generated’ depolarisation of the ventricles after having not had an appropriate P wave stimulation.

21
Q

What is the sign for a RBBB?

A

Broad QRS
rsR wave
M in V1 and W in V6

22
Q

What is the sign of a LBBB?

A

Broad QRS

W in V1 and M in V6

23
Q

What is the sign of atrial flutter?

A

sawtooth waves

24
Q

What is the cause of atrial flutter?

A

Recurrent depolarisation around the fossa ovalis. They can stimulate the bundles of His with every depolarisation, or often in a 2:1 ratio (about 150 BMP).

25
Q

What does atrial fibrillation do to the heart?

A

AVN bombarded with multidirectional depolarisations, stimulating the bundle of His randomly.

26
Q

What is pulse pressure?

A

Difference between systolic and diastolic pressures.

27
Q

What is Darcy’s law of laminar flow?

A

Q = (P1 - P2) / R

Q - Flow
P - Pressure
R - Resistance.

28
Q

What is compliance (wrt vessels?)

A

The amount the tube can stretch.

Arteries are about 20x more compliant than veins.

29
Q

What is the Windkessel effect?

A

The elastic recoil properties of vessels enabling a more smooth change in BP throughout each cardiac stroke.

30
Q

What is mean arterial pressure?

A

NOT just the median of diastolic and systolic. The arteries spend about 2/3rds of their time closer to diastolic and 1/3 closer to systolic.

31
Q

What is the advantage of having some tissue perfused by parallel vascular circuits as opposed to series?

A

The tissue can regulate the amount of blood flow it receives by this method, rather then relying on the ‘standard’ output from the heart.

113 Sycope (1 decks)

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