Test 2 Flashcards
V1-V6
precordial leads
ammonia sulfur dioxide chlorine nitrogen dioxide ozone phosgene
irritant gases
pulmonary fibrosis diseases of the spine and chest wall diseases of the neuromuscular system
restrictive lung diseases
decreased exercise tolerance
decreased oxygen consumption
loss of muscle strength
sedentary
abnormal HR response
chronic renal failure and exercise
Give radioactive agent at peak of stress test then while patient is at rest 4 hours later if cold spot is still present after 4 hours of rest the tissue is dead and blood flow did not return after stress
Radionuclide perfusion testing with SPECT
normal QRS characteristics
.07-.11 sec in width should not be smaller than 6 mm in leads I, II and III should not be taller than 25-30 mm in precordial leads
posterior curvature of spine
kyphosis
normal p wave
no wider than .11 sec under 3 mm positive and rounded
refers to the direction of depolarization or vector of the QRS complex
axis
placed in the 4th left intercostal space at the sternal border
V2
Unipolar leads all other leads are averaged together to make a reference
augmented voltage leads
ABI, Ultrasound, exercise studies
Vascular diagnostic testing
normal creatine
<1.5 mg/dL
types of emphysema
centriacinar panacinar
V1-V6
precordial leads
objectives of stres test: quantitatively and accurately assess;
chronotropic capacity and HR recovery
aerobic capacity
myocardial aerobic capacity;
RPP exertional symptoms
changes in electrical function
Used gamma rays to detect myocardial blood flow 3d 360 rotating camera `
SPECT Single photon emission computed tomography
normal PR interval
.12-.2 sec ( no longer than 1 large box)
funnel chest
pectus excavatum
Left atrial enlargemennt
a broad (sometimes m shaped) p wave in Lead II or/and a diphasic p wave (sine wave) in V1
sequel to V tach life threatening emergency situation
v fib
fasting serum glucose normal
70-100 100-125 prediabetes >126 diabetes
holter monitor, 12 lead EKG, exercise EKG
HR rhythm abnormalities
A chronic lung disease of unknown cause chronic slow progressive dyspnea chronic inflammation and fibrosis 50% of pts live 5 more yrs after dx
idiopathic pulmonary fibrosis
significant improvement on health in people with obesity
5-10% weight loss
normal p wave
no wider than .11 sec under 3 mm positive and rounded
progressive prolongation of PR interval culminating in a non conductive p wave generally asymptomatic causes: right CAD or infarct, digoxin toxicity, and excessive beta blocker
Second degree type 1
represents repolarization of the ventricles should have the same polarity as the QRS complex very fickle and not as reliable as ST depression or elevation in diagnosis of ishemia
T wave
Lead 1
left arm + right arm -
m shaped r and r prime see in V1 and V2
Right BBB
normal Q wave
present only in leads I aVL V5 and V6 less than .04 sec not deeper than 1/3 of QRS
begins at the end of the p wave and ends with the onset of the QRS complex should be isoelectric and flat can be elevated with atrial infarct or pericarditis
PR segment
II, III, aVF
inferior left ventricle
right atrium
left atrium
regular HR >100 p waves that do not originate from the sinus node but from another site in the atria same causes as PAC but also includes pulmonary HTN, altered pH and COPD
Atrial tachycardia
Lead III
left leg + left arm -
what do you count when calculating HR in 6 sec period
cycles not r waves
V4, V5, V6
anterolateral LV
diet, fluid balance, BP management, reduce symptoms of uremia
goals with chronic renal failure
represents depolarization of the atrial myocardium
p wave
normal Q wave
present only in leads I aVL V5 and V6 less than .04 sec not deeper than 1/3 of QRS
refers to the direction of depolarization or vector of the QRS complex
axis
<5 Mets or considerable below anticipated peak: increase gradually (2-3 min stages)
assess functional status
Promote client confidence and reassurance normal activities can be undertaken safely
Low level exercise testing
represents atrial depolarization plus the normal delay at the AV node
PR interval
special considerations
PAD or DM: know precautions
adjust by 1 met increments
minimum frequency of training; 3 nonconsecutive days/wk education
Normal BUN
8-18 mg/dL
Lead II
left leg + right arm -
bradycardia
>60
optimize medical management end point may be a MET level= work or ADL
therapeutic (with or w/o meds)
ectopiic focus in either atria initiates and impulse before the next impulse initiated by the SA node
when frequency increased, atrial tachy or a-fib may result
compensitory pause
premature atrial contraction
emphysema chronic bronchitis asthma CF
COPD
rate of each line to calculate HR
300 150 100 75 60 50
Lead II
left leg + right arm -
represents repolarization of the ventricles should have the same polarity as the QRS complex very fickle and not as reliable as ST depression or elevation in diagnosis of ishemia
T wave
rate is 30-45 QRS complexes are wide no p wave
idioventricular rhythm
dyspnea (on exertion) fatiigue chronic cough wheezing and/or rhonchi expectoration of mucus
COPD physical symptoms
contraction of bronchial smooth muscle denuded cilia increased secrrethins swelling of mucosa
Chronic bronchitis
the acute form of inflammatory polyneuritis of unknown cause effects peripheral nerves ascending paralysis (1-3 wks, recovery 2-4 wks)
Guillan barre
T1-T11
intercostals
V2, V3, V4
anterior and apical LV
left axis deviation
more - than 30
V1, V2
right ventricle, RA, LA and ateroseptal LV
T8-T12
abdominals
represents the time when ventricular cells are in the plateau phase starts at the j point should be isoelectric
ST segment
lobar bronchi segmental bronchi subsegmental bronchi
chronic bronchitis
place in the midaxillary line at the same horizontal plane as V4
V6
The heart rate varies due to reflex changes in vagal tone during the different stages of the respiratory cycle
sinus arrythmia
tacycardia
>100
affects airspaces distal to the respiratory bronchile lower loves most affects generally in alpha-1 antitrypsin deficiency
panlobular
specific organ dysfunction, cough, dyspnea, and generalized weakness, fatigue, weight loss, malaise, and fever
sarcoidosis
a very stretched out unit inceased risk of blow out and increase in pressure cough can cause a blow out
bollous
Cuases: ischemia, acute infarct, hypertensive heart disease, reaction to meds (digoxin) Q and blood pressure greatly diminished symptoms are light-headedness and syncope, weak thready pulse, disorientation
V tach
tacycardia
>100
respiratorly brochioles alveolar ducts alveolar sacs
emphysema
chronic productive cough (generally clear mucus unless infection overweight blue is color to lips and nailbeds peripheral edema in LE d.t Right side heart failure rhonchi and wheezes expiratory phase increased
chronic bronchitis
pathologic conditions of the respiratory tract that result directly form the inhalation of gas or particulate matter in the air
environmental lung diseases
Chest x ray, MUGA, echo
Ventricular size and EF
normal in athletes beta blockers, decreased function of SA node generally asymptomatic unless pathologic may c/o dizziness syncope, angina
sinus bradycardia
associations with increased frequency of PVCs
filling time of ventricles is decreased
decreased pre load
decrease SV
Decreased Q (dizziness, SOB)
patient activity can be compromised
exercise should be monitored if pt having isolated or couplet PVCs should be considered serious and can be life threatening Can lead to v-tach
Placed in the 4th R intercostal space at the sternal border
V1
a negative wave preceding the R wave not all lead record represents septal deviation pathologic indicated MI
Q wave
a negative wave preceding the R wave not all lead record represents septal deviation pathologic indicated MI
Q wave
C5-C6
Scalenes
chronic autoimmune neuromuscular disease varying degrees of weakness of the skeletal muscles of the body weakness increases during levels of activity and improves with rest
myasthenia gravis
contraction of bronchial smooth muscle denuded cilia increased secrrethins swelling of mucosa
Chronic bronchitis
Bipolar leads
Limb leads
MI, CVA, Heart failure fluid overload increases pressure
end stage renal disease
