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23 spring: med surg > Test 1: lecture 3 +4 ekg intro > Flashcards

Test 1: lecture 3 +4 ekg intro Flashcards

1
Q

change from — to — happens inside cell during action potential

A

negative to positive

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2
Q

— is the ability of certain cardiac cells to initiate an electrical signal

A

automaticity

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3
Q

why is HR controlled by SA node

A

automaticity of those cardiac cells produce a signal at a faster rate then any other cell types in the heart, blocks out other signals

if SA node disfunctional heart will beat according to AV node

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4
Q

— is the ability of cardiac cells to respond to an electrical signal

A

excitability

resting cell at -70
Na/K pump pushed 3 Na out and 2 K in. results in net negative

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5
Q

K will diffuse into or out of the cell

A

out of cell

will keep inside of cell negative

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6
Q

what happens during depolarization

A

rush of Na and Ca into a cell makes it positive inside

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7
Q

what happens during repolarization

A

cell returns to resting negative

potasium(K) diffuses out of cell

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8
Q

explain fast response action potential

A

cell negative at rest at -90 mV

stimulus causes rapid depolarization as Na floods into cell

Ca slowly comes into cell- 2 steady state-then stops

K leaks out of cell- causing repolarization

Na/K pump returns cell to normal resting

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9
Q

explain slow response AP

A

pacemaker cells
can cause impulse on its own
resting at -60mV
DOES NOT need outside actional potential

steady influx of Calcium causes AP

repolarization caused by K leaking back out

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10
Q

slow or fast response AP causes automaticity

A

slow

think SA or AV node

can trigger itself by slow influx of Ca into the cell

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11
Q

what part of the heart has a slow conduction velocity

A

SA and AV node

controlled by slow response AP- slow influx of Ca into the cell

allows for the atria to empty into the ventricles before the ventricles contract

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12
Q

what part of the heart has a fast conduction velocity

A

purkinje fibers
atrial muscle
ventricular muscle

controlled by fast response AP- rapid influx of Na into the cell

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13
Q

explain cardiac excitation-contraction coupling

A

when cardiac cell is depolarized (becomes more +)

calcium comes into cell, increased intracellular calicum leads to increased sarcomere activation= contraction of the muscle cell

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14
Q

fast EKG paper speed

A

50 mm/s
1 small square= 0.02 seconds

BIC: # R-R intervals x 20 for bpm
instantaneous: 3000/RR interval= bpm

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15
Q

slow EKG paper speed

A

25 mm/s
1 small square = 0.04 seconds

BIC: # R-R intervals x 10 for bpm
instantaneous: 1500/RR interval= bpm

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16
Q

a voltage change of 2 mV would be how many squares

A

20 mm (20 small squares)

20 squares tall

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17
Q

what color electrodes on what limb

A

black- left arm
red- left leg

white- right arm
green- right leg

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18
Q

lead 1 has + and - where

A

R arm negative
left arm positive

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19
Q

lead 2 has + and - where

A

positive left leg
negative right arm

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20
Q

lead 3 has + and - where

A

positive left leg
negative left arm

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21
Q

how to form augmented leads

A

aVR= will have positive on right arm and average negatives of L arm and L leg

aVR, aVL, aVF will look at heart from different prospectives on frontal plane (cranial to caudal and left to right)

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22
Q

where are the leads in a hexaxial mapping system

A
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23
Q
A
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24
Q

depolarizing current will cause an internal change from — to — and if moving toward the positive electrode will be seen at —

A

negative to positive

toward positive = positive deflection
away form electrode = negative deflection

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25
Q

repolarizing current will cause an internal change from — to — and if moving toward the positive electrode will be seen at —

A

positive to negative

toward positive= negative deflection
away from electrode = positive deflection

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26
Q

what happens in phase 3 of action potential

A

repolarization (loss of K)
cell changes from + to negative

the change moves toward the + electode= negative deflection

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27
Q

phase 2 of fast AP causes what to EKG

A

phase 2= slow increase in Ca = plateau

no change in EKG

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28
Q

A vector parallel to the lead will cause a — deflection

A

larger

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29
Q

A vector perpendicular to the lead will cause a — deflection

A

smaller or no deflection

30
Q
A
31
Q
A
32
Q

P wave represents

A

atrial depolarization

from SA to AV node (small positive bump)

33
Q

QRS represents

A

ventricular depolarization

Q= intraventricular septal depolarization= small negative

R= ventricular depolarization= big +

S= depolarization of base of ventricles = small positive

34
Q

PR interval/segment =

A

AV node holding signal
no change
flat line

35
Q

QT interval=

A

ventricular depolarization and repolarization

36
Q

— is between ventricular depolarization and repolarization

A

ST segment

37
Q

— is ventricular depolarization and repolarization

A

QT interval

38
Q

BIC pen on a 50 mm/sec paper is — long

A

150 mm= 150 small squares= 30 large squares = 3 seconds

count RR interval x 20 seconds= beats per minute

39
Q

what is HR

A

7 beats in 3 seconds

7x20=140 bpm

40
Q

paper speed 25 mm/sec
BIC pen =

A

150 mm= 150 small squares= 30 large squares= 6 seconds

RR interval x 10 = bpm

41
Q

on 50 mm/sec paper a BIC pen is equal to how many seconds

on 25mm/sec?

A

50 mm/sec: 3 seconds
x 20 for bpm

25 mm/sec: 6 seconds
x 10 for bpm

42
Q

vet use what paper speed for more spread out reading

A

50 mm/sec
faster

43
Q

with irregular HR, max and min HR is found by measuring the —

A

longest and shortest RR interval

44
Q

on 25 mm/sec paper how to calculate instantaneous HR

A

slow speed= 1 little square= 0.04 seconds
25 mm=1 sec
1500 mm=1 min

1500/RR interval= bpm (instant HR)

45
Q

how to calculate instant HR with fast paper

A

50 mm/sec
1 small square= 0.02 second
50 mm= 1 second
3000 mm=60seconds

3000/RR interval = bpm instant HR

46
Q

— ventricular enlargement leads to a MEA shift

A

right

left does NOT cause MEA shift

47
Q

what are some causes of axis shift of MEA

A

right ventricular enlargement
RBBB or left anterior fasicular block

48
Q

MEA for a dog points

A

40-100

49
Q

MEA for a cat points

A

0-160

50
Q

how to use isoelectric lead method

A

what lead is isoelectric?
lead 1
what lead is perpendicular to the iso lead?
aVF
Is the perpendicular + or negative?
positive

MEA= 90

51
Q

how to determine MEA using pizza

A

look at lead 1 and aVF

what is polarity of lead 1?
positive
what is polarity of lead aVF?
positive

what is the overlap?
0-90

52
Q

what is the MEA

A

pizza
lead 1= positive
lead aVF= negative
MEA =-90→0
left anterior axis shift

53
Q

what can ventricular enlargement cause on an EKG

A

Increased R wave amplitude (Left sided)
Increased S wave (Right sided)
Prolonged QRS (rare)

54
Q

what can atrial enlargement do to the EKG

A

P wave changes
Increased amplitude and/or increased duration

55
Q

P mitrale is another name for

A

increased P wave duration

can happen with atrial enlargement

56
Q

P pulmonale is another name for

A

increased amplitude of P wave

can be caused by atrial enlargement

57
Q

if large P waves what might be happening?

A

atrial enlargement secondary to valve disease (regurgitation)

58
Q

left ventricular enlargement will do what to EKG and MEA

A

increase R wave (gets taller/stronger)

rare prolonged QRS duration

NO change in MEA

59
Q

LV enlargement in a dog will be seen as
— in lead 1
— in lead 2
60 msecds wide (rare)

A

over 1.0
over 3.0

60
Q

LV enlargement in a cat will show as greater or equal to — in any lead

A

1 mV
greater then 60 msec wide (rare)

61
Q
A

large R wave= LV enlargement

can be from hypertrophic cardiomyopathy

will still have normal MEA

62
Q

right ventricular enlargement will cause — on the EKG

A

deep S wave
S>0.05 mV in lead 1
S> 0.35 mV in lead 2

right MEA shift
dog: MEA >103

63
Q

what is MEA
what is wrong

A

deep S wave= right ventricular enlargement=pulmonic valve stenosis

MEA= lead 1 negative, aVF negative = 180 to -90

64
Q

pulmonic stenosis will cause EKG —

A

right ventricular enlargement

leads to deep S in lead 1 and 2
right MEA shift

65
Q

RBBB will do what to EKG

A

QRS prolongation
dog > 0.08 seconds
cat > 0.06 seconds

right axis shift

deep S waves

66
Q
A

RBBB

long QRS
right axis shift
deep S waves (lead 1-3 and aVF)

67
Q
A

right ventricular enlargement

deep S wave
right MEA shift

68
Q
A

left ventricular enlargement

big R waves
NO change to MEA

69
Q

normal QRS interval in dog is

A

70 ms

RBBB causes >80ms

70
Q

normal QRS interval in cats

A

40 ms

RBBB causes >60ms

71
Q
A

LBBB

normal MEA
long QRS

72
Q

left or right BBB is always associated with underlying heart disease

A

LBBB

will cause QRS elongation
normal MEA

23 spring: med surg (60 decks)

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