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anatomy and physiology > test 3 clinical heart > Flashcards

test 3 clinical heart Flashcards

1
Q

in ventricular rhythms

A

QRS complex will be ugly and P wave will likely be hidden or missing, atrial contraction often not present

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2
Q

premature ventricular complex is similar to ____- because

A

PAC and PJC because its an early/premature beat

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3
Q

what is a premature ventricular complex

A

an early beat when the signal comes from a cell in the ventricle

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4
Q

premature ventricular complexes are usually

A

very common, but not too dangerous unless they happen many times each minute

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5
Q

premature ventricular complexes are often felt by

A

felt by the person in palpitations

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6
Q

PVCs are much more common than

A

PACS or PJCs

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7
Q

PVC

A

premature ventricular complex

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8
Q

PVCs often come in

A

waves and patterns

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9
Q

what patterns can PVCs come in

A
  • Bigeminy
  • Trigeminy
  • Quadrigeminy
  • Idioventricular Rhythm
  • Accelerated Idioventricular Rhythm
  • Ventricular Tachycardia
  • Ventricular Flutter
  • Ventricular Fibrillation
  • Asystole
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10
Q

Bigeminy

A

PVC happens every other beat

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11
Q

Trigeminy

A

PVC or irregular contraction happens every third beat

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12
Q

Quadrigeminy

A

irregular contraction every fourth beat

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13
Q

generally which PVCs come in waves

A

bigeminies, trigeminies, quadrigeminies come in waves then the heart returns to normal rhythm

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14
Q

idioventricular rhythym

A

an escape rhythm where electricity is generated by ventricular cells

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15
Q

idioventricular rhythm is very

A

very slow, below 40 bpm

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16
Q

all contractions in idioventricular rhythms are

A

wide N ugly

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17
Q

accelerated idioventricular rhythm

A

QRS complex are still wide and ugly, but the rate is between 40 bpm and 100 bpm

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18
Q

ventricular Tachycardia (V-tach)

A

like accelerated junctional rhythm but over 100 bpm

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19
Q

ventricular flutter

A

like atrial flutter, very rapid ventricular contractions

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20
Q

ventricular flutter often

A

descends into ventricular fibrillation

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21
Q

ventricular fibrillation (v-Fib)

A

like atrial fibrillation, but with more amplitude

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22
Q

ventricular fibrillations usually only

A

lasts a few seconds before falling to a flatline

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23
Q

it V-fib there is an absence of

A

of normal QRS complexes

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24
Q

Asystole

A

no electrical output and the patient is clinically dead

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25
Q

common rhythms

A

sinus
atrial
junctional
ventricular

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26
Q

the sinoatrial node is supposed to be the ______

A

pacemaker of the heart

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27
Q

when the sa node is the pacemaker of the heart

A

it is in sinus rhythm

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28
Q

normal sinus rhythm

A

all things normal, heart rate 60-100, rhythm is regular

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29
Q

sinus bradycardia

A

all things normal. heart rate is under 60 rhythm is regular

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30
Q

sinus tachycardia

A

all things normal, heart rate is is above 100, rhythm regular

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31
Q

how can you check bradycardia

A

more than 5 big boxes between each contraction, less than 60 bpm

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32
Q

how can you check tachycardia

A

less than 3 big boxes between each contraction, rate over 100

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33
Q

sinus arrythmia

A

all things normal w/ IRREGULAR CONTRACTIONS

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34
Q

sinus arrest

A

SA node and rest of heart does not contract for a span of time

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35
Q

how are sinus arrests reported

A

w/ a duration, such as sinus arrest, 3.5 sec delay

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36
Q

w/ each passing second of sinus arrest

A

blood pressure rapidly drops

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37
Q

when the SA node fails to be the pacemaker, then

A

other cardiomyocytes can take over

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38
Q

when other cardiomyocytes take over when the SA node fails to be the pacemaker (not just for one beat)

A

said t be an escape rhythm

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39
Q

the cells that release the new signal in an escape rhythm

A

ectopic pacemakers

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40
Q

escape rhythms occur in a variety of

A

shapes and sizes

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41
Q

when rogue atrial cells take over as the pacemaker for just one beat

A

premature atrial complex

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42
Q

how to distinguish a premature atrial complex

A

there will be one early beat w/ a modified P wave that is NOT inverted

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43
Q

wandering atrial pacemaker

A

escape rhythym where SA node fails to generate signal, so diff parts of atria create a signal to compensate

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44
Q

WAP

A

wandering atrial pacemaker

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45
Q

WAP is defined by

A

3 unique types of P waves across a strip

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46
Q

multifocal tachycardia

A

WAP (3 or more P wave morphologies) with heart rate over 100

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47
Q

where is multifocal tachycardia common

A

typically only seen in elderly patients with COPD

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48
Q

atrial flutter

A

atria rapidly contract, but QRS complexes happen normally

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49
Q

atrial fibrillation

A

similar to atrial flutter, but atria just quiver instead of rapidly contracting

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50
Q

both A-fib and A-flutter

A

happen unknowingly

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51
Q

what often happens in atrial flutter

A

electricity in atria forms a loop n causes continuous contraction. rhythm is thrombogenic but not life threatening if ventricles still readily contract

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52
Q

A-Fib and A-Flutter generally

A

affect elderly people and come and go in waves

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53
Q

primary symptoms A-Fib/ A-Flutter

A

shortness of breath when lying down

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54
Q

Atrial rhythms

A 
premature atrial complex 
wandering atrial pacemaker
multifocal tachycardia
atrial flutter
atrial fibrillation
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55
Q

sinus rhythms

A 
normal sinus rhythm 
sinus bradycardia 
sinus tachycardia
sinus arrhythmia 
sinus arrest
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56
Q

when the AV node takes over as the pacemaker

A

junctional rhythm

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57
Q

PJC

A

premature junctional complex

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58
Q

what happens in PJC

A

AV node releases one signal quickly above another contraction

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59
Q

how to distinguish PJC

A

inverted p wave and early beat

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60
Q

all junctional rhythms have

A

inverted p wave

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61
Q

junctional escape beat

A

like PJC, one beat that is not premature, later than usual inverted p wave,

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62
Q

junctional escape rhythm

A

pacemaker long term, not just one beat and inverted p wave , below 60 bpm

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63
Q

accelerated junctional rhythm

A

like junctional escape rhythm, but from 60-100 bpm, still inverted p wave

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64
Q

atrial cells usually only create a signal

A

40-60 times per minute

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65
Q

junctional tachycardia

A

liek other junctional rhythms, but from 100-180 bpm, still inverted p wave

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66
Q

supraventricular tachycardia

A

when ur in tachycardia w/ a buried p wave

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67
Q

in supraventricular tachycardia

A

p wave is buried, you know signal is above ventricles but not from where

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68
Q

BP

A

blood pressure

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69
Q

blood pressure

A

the pressure blood exerts on walls of blood vessels

70
Q

where is blood pressure normally measured

A

brachial artery in arm

71
Q

blood pressure changes a lot depending on whether

A

the heart has just eaten or not

72
Q

blood pressure is measured in what 2 numbers

A

systolic blood pressure, diastolic blood pressure

73
Q

systolic blood pressure

A

the pressure at the peak of ventricular contraction

74
Q

list junctional rhythyms

A 
premature junctional complex 
junctional escape beat
junctional escape rhythm
accelerated junctional rhythm
junctional tachycardia
75
Q

diastolic blood pressure

A

the pressure when ventricles are relaxed

76
Q

blood pressure are measured in

A

mmHg

77
Q

what are blood pressures listed as

A

systolic/diastolic

78
Q

normal blood pressure

A

around 120/80

79
Q

what do u use to take blood pressure

A

a sphygmomanometer

80
Q

how do u use a sphygmomanometer

A
  • inflate slightly above expected range (140-160 mmHg)
  • hold stethoscope or feel for pulse
  • slowly deflate until a pulse is sensed
  • continue deflating until a pulse is no longer sensed
81
Q

systolic BP

A

number at which pulse is sensed

82
Q

diastolic BP

A

the number at which pulse disapears

83
Q

if blood pressure is too high

A

cuff totally blocks blood flow

84
Q

just right blood pressure

A

cuff blocks blod flow unless heart has just pumped

85
Q

too low blood pressure

A

cuff does not block blood flow

86
Q

blood pressure should ideally fall where in adults

A

between 110-140/70-80

87
Q

hypotension

A

a person with a resting systolic BP under 100

88
Q

hypertension

A

a person with a resting systolic BP over 130

89
Q

BP relies on what factors

A
  • how big is the container (affects vasodilation/vasoconstriction)
  • how much much stuff is in the container (how much water in blood)
  • how fast/hard stuff is being pumped (cardiac output)
90
Q

bigger the container

A

the lower the blood pressure

91
Q

cardiac output is

A

heart rate times stoke volume

92
Q

cardiac output formula

A

CO= HR x SV

93
Q

one blood pressure reading is not

A

not enough to make a diagnosis of hypertension or hypotension

94
Q

orthostatic hypotension

A

when you stand suddenly. blood falls to lower portion of the body and decreases flow to head. quickly vessels contract, increase BP, returning blood flow to body

95
Q

another word for orthostatic hypotension

A

head rush

96
Q

long term hypertension

A

especially dangerous, linked to CAD, CHF and other arterial diseases

97
Q

CAD

A

coronary artery disease

98
Q

CHF

A

congestive heart failure

99
Q

hypertension makes the heart

A

work unnecessarily hard and puts extra strain on artery walls

100
Q

with hypertension over time

A

the heart swells to large sizes and artery walls lose their elasticity

101
Q

generally the ______ have a major role in regulating

A

kidneys, blood pressure

102
Q

when BP is low, what does the kidneys do

A

release renin

103
Q

what does renin do

A

initiates a cascade releasing angiotensin II

104
Q

angiotensin II functions

A
  • directly causing vasoconstriction (BP up)

- stimulates release of hormone aldosterone

105
Q

aldosterone

A

causes kidneys to leave more sodium, causing water to enter blood through osmosis (BP ^)

106
Q

what is also involved in BP regulations

A

temperature, sympathetic nervous system

107
Q

how does temperature affect BP

A

the higher the temp the higher the BP

108
Q

how does sympathetic nervous system affect BP

A

epinephrine release increases BP

109
Q

final step in renin cascade

A

ACE turns inactive angiotensin I to active angiotensin II

110
Q

ACE

A

angiotensin converting enzyme

111
Q

popular way to treat hypertension

A

ACE inhibitors

112
Q

normally the heart beats how much

A

60-100 times per min

113
Q

skeletal muscle must be

A

stimulated by a nerve to contract

114
Q

cardiac muscle can

A

generate its own signal to contract

115
Q

any one cell along the electrical wiring of the cardiac muscle

A

can fire and send its signal to the rest of the heart

116
Q

different parts of the heart contract on

A

own different intervals

117
Q

arterial tissue contracts

A

50-60 times a minute

118
Q

ventricular tissue will contract

A

20-40 times a minute

119
Q

how are lub/dub contractions coordinated

A

the heart has a built in conduction system to pass signals

120
Q

the conduction pathway is a series of

A

nerve-like, muscle like fibers called cardiomyocytes

121
Q

what do cardiomyocytes do

A

carry the signal to make cardiac muscle contract

122
Q

the signal to make cardiac muscle contract is normally generated by what

A

sinoatrial node (SA node)

123
Q

where is SA node located

A

right atrium

124
Q

how does the signal to make cardiac muscle contract travel from the SA node to Av node

A

runs across left and right atria, making them contract, captured by the AV node

125
Q

AV node

A

atrioventricular node

126
Q

how long are signals held in the AV node

A

.12 seconds

127
Q

what happens after signal is held by Av node

A

passes through the Bundle of His

128
Q

how does a signal travel through bundle of His

A

breaks into 2 bundle branches, which travel to apex of heart then run back up the outer walls

129
Q

why 2 bundle branches

A

one for each ventricle

130
Q

what do the bundle branches break into

A

small strands called purkinje fibers

131
Q

what do purkinje fibers do

A

tell nearby heart muscle to contract

132
Q

electrical pathway

A

SA node» AV node» Bundle of His» Bundle Branches» Purkinje Fibers

133
Q

kno which part of pathway is lub and dub

A

ask at review

134
Q

generally, cardiomyocytes have a ____ charge compared to enviroment

A

negative

135
Q

how do cardiomyocytes transmit signals

A

by briefly changing charge fro negative to positive charge (DEPOLARIZATION0

136
Q

can depolarization be measured

A

YES

137
Q

EKG can also be called

A

electrocardiography or ECG

138
Q

EKGs do what

A

detect and record depolarization of cardiac cells under the skin

139
Q

in an EKG usually

A

10 electrodes placed around torso for different looks and summed into 1 signal

140
Q

many leads on EKG lead to

A

many outputs

141
Q

3.5 parts of an EKG

A

P wave, QRS complex, T wave, U wave

142
Q

P wave

A

shows depolarization of atrial cells

143
Q

QRS complex

A

shows depolarization of ventricular cells

144
Q

T wave

A

shows repolarization of ventricular cells

145
Q

U wave

A

unsure, probs repolarization of other cells in the heart , often absent

146
Q

why is there a delay between the P wave and the QRS complex

A

there is a delay when the signal sits on the AV node

147
Q

the SA is supplied w/ nerves by

A

sympathetic and parasympathetic nervous syetms

148
Q

what does sympathetic nervous system affect SA node

A

influence how quick it can generate a signal

149
Q

how does parasympathetic nervous system affect SA node

A

influence how slow it generates a signal

150
Q

5 components of rhythm analysis

A 
regulrity
Rate
P wave morphology 
PR interval 
QRS interval
151
Q

regularity

A

should be even, fluctuation of 1.5 boxes or .3 sec is abnormal

152
Q

Rate

A

how much heart beats in a minute

153
Q

to calculate regular rate

A

1500 rule

154
Q

1500 rule

A

1500/ # of small boxes

155
Q

irregular rate

A

how many contractions in 6 second strip and mult by 10

156
Q

what is a p wave morphology

A

the shape

157
Q

usual p wave is usually

A

short, round, compact, no more than .1 sec

158
Q

usual size of P wave

A

.5-2.5 small squares

159
Q

changes to p wave

A

burial, inversion, notched, biphasic, flutter, after QRS, multiple

160
Q

inversion p waves

A

P wave is upside down

161
Q

notched p waves

A

p wave has multiple peaks

162
Q

biphasic p waves

A

up and down or down and up

163
Q

flutter waves

A

p waves happen very quickly

164
Q

after QRS

A

P waves happen after QRS complex

165
Q

multiple

A

many types of p waves present

166
Q

PR interval

A

amount of time from beginning of p wave and beginning of QRS

167
Q

PR interval should be

A

between .12 to .20 sec (3-5 small boxes )

168
Q

measure PR interval

A

for every contraction on a strip

169
Q

QRS duration

A

length of QRS complex

170
Q

QRS should be between

A

.06 and .10 sec

anatomy and physiology (25 decks)

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