Test 4 - 10/25 Flashcards

1
Q

What is the tough outer layer of the pericardium?

A

Fibrous pericardium

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2
Q

What is immediately under the fibrous pericardium (attached)

A

Serous pericardium, parietal layer

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3
Q

Parietal pain is more ____ pain

A

tissue

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4
Q

Clear, stretchy, super thin layer that sits between the serous parietal layer and the actual heart tissue

A

Serous pericardium, visceral layer.

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5
Q

The serous pericardium visceral layer allows for the heart to ____

A

slide around easily within the pericardium

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6
Q

In the AP’s in the heart, where would we see lots of fast Na channels?

A
  1. ventricular muscle
  2. purkinje fibers
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7
Q

If something happens to the fast Na channels in our heart AP, what can happen?

A

it can turn out fast AP into slow AP and that can affect our HR and strength of contraction

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8
Q

Action potential propogation through two cells is only via

A

gap junctions

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9
Q

How are neurotransmitters used in the heart?

A

They aren’t, dumbass. its only gap junctions. this isn’t a neuron.

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10
Q

What fits through gap junctions?

A

Na fits best. Ca is big and clunky.

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11
Q

If we are relying on Ca to get us an AP what would we see?

A

It would still get us an AP but it is big and clunky and doesn’t move through the gap junctions very well

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12
Q

Since we are using gap junctions in the heart as a synapse it can be _____

A

a bidirectional synapse

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13
Q

Synaptic connections are ____

A

One way

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14
Q

Why can gap junctions being bidirectional be a negative thing?

A

If a part of the heart depolarizes spontaneously it can have retrograde movement and travel backward

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15
Q

What is protecting us from retrograde movement through the gap junctions

A

the absolute refractory period

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16
Q

What might happen if there is retrograde movement during the relative refractory period

A

might fire an odd AP. force generation wont look great.

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17
Q

What is the 3 lead EKG also called?

A

frontal or coronal plane

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18
Q

What are augmented leads?

A

3 extra leads if 3 isnt enough

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19
Q

What is the eyeball in terms of the EKG leads?

A

The positive lead, we can see if the AP is moving towards it (positive deflection) or away from it (negative deflection)

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20
Q

If there is current moving towards the eyeball that will show up as a ______ deflection

A

positive

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21
Q

For lead placement where will the negatives and positives always be?

A

L foot - 2 positives
R arm - 2 negatives
L arm - 1 positive and 1 negative

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22
Q

The equilateral triangle for the lead placements is called what?

A

Einthovens Triangle (Dutch..somewhere from europe)

23
Q

Need _____ to turn the EKG signals into something that the machine can process

A

amplifier.

24
Q

What is a left axis deviation

A

anything less than 59 degrees. If the depolarization is headed more superior towards the left arm.

Heart rotated left

25
Q

If the heart is turned towards the left that would give us a _____ deviation and it would be ______ degrees

A

left axis;
less than 59

26
Q

A bundle branch block might do what?

A

swing the electrical axis one way or another

27
Q

what can cause the heart to be pointed straight up and down instead of pointed towards the left foot?

A

Inflated lungs or COPD

28
Q

If we deflate the lungs the heart will be more oriented towards _____

A

L arm. kinda on its side

29
Q

If we take a really big deep breath that will turn the heart towards _____

A

the right

30
Q

anything greater than ____ degrees is considered a right axis deviation

A

59

31
Q

Anything less than _____ degrees is a left axis deviation

A

59

32
Q

The wall of the right ventricle is ______ compared to the left

A

thinner

33
Q

The main bundle branches are located in the _____

A

interventricular septum

34
Q

The atrial P wave is pointed towards _____

A

L foot.

35
Q

If we have repolarization for the atria it will be pointed towards _____ and will be a ______ deflection.

A

L foot.
negative

36
Q

Where do we see the atrial repolarization on the EKG?

A

We don’t, it is hidden by the QRS complex

37
Q

What do the wall size of the atria and the wall size of the ventricles have to do with the fact that we cant see the repolarization of the atria

A

The walls of the atria are super thin compared to the ventricles so its not powerful enough to obscure the QRS complex.

38
Q

Atrial depolarization and repolarization go in _______(same/opposite) direction

A

same

39
Q

If we had an atrial T wave it would be a _____ deflection

A

negative

40
Q

Which one is lead 1

A

green. 0 degrees

41
Q

which one is lead 2

A

pink. 60 degrees

42
Q

which one is lead 3. what is the axis for this lead

A

Blue. 120 degrees

43
Q

In a normal EKG if we are looking at the different readings for leads 1,2 and 3 what would we expect to see from lead 2.

A

the biggest magnitude of deflection.

44
Q

Why does lead 2 show the biggest magnitude of deflection?

A

Because everything is headed straight towards that lead (the eyeball)

45
Q

Why does lead one have a much smaller magnitude of deflection

A

Because lead one only picks up a portion of the current

46
Q

How would we figure out how much of a positive deflection we would see in lead 1?

A

Draw in the line L and the length of line A would be the positive deflection we would see in lead 1 vs lead 2.

it is much smaller.

47
Q

If the heart is positioned straight up and down and the mean electrical axis is now 90 degrees, what would we expect to see from lead 1? Why?

A

Should show zero because there is no left to right movement. The vector is perpendicular to lead 1.

48
Q

If the heart is pointed towards the right foot and this is our new mean electrical axis, what would we expect to see in lead 1

A

This should show a negative deflection

49
Q

What would this show in lead one?

A

Huge negative deflection

50
Q

What would this show in lead one?

A

Huge positive deflection

51
Q

What would we use 3 vs 6 leads for?

A

3: figure out what the problem is

6: figure out where the problem is

52
Q

What is Einthovens Law?

A

Lead 1 + Lead 3 = Lead 2

53
Q

How would we calculate einthovens law?

A

lead 1 + 3 = 2

Difference in peak positive deflection minus peak negative deflection

54
Q
A