week 9 PT monitor tech Flashcards by Connor Hancock

Electrodes 2 jobs:

= stick & conduct (Electrodes sealed, skin prep_

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RA lead site
LA lead site
LL lead site
RL lead site
Distance needs to be=

= Right Arm (medial forearm)
= Left Arm (medial forearm)
= Left Leg (medial inside calf)
= Right Leg (medial inside calf)
= equal/same distance of other limb leads EX 6ft RA-LA same as LL-RL

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Positive electrode = what flex on ekg:& vice versa: LL & lead 2 +,
Positive charges look at what side of heart:

= + flex on ekg: LL & lead 2 positive
=+ charges look at inferior side of heart

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Positive electrode makes wave:
Negative electrode makes wave:

= makes inverted wave “U”
= makes wave positive “/"

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!!!Einthoven’s triangle: green electrode:
Blue electrode:
Red electrode:

= neutral/ground
= Negative
= Positive

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!!!Einthoven’s triangle: Lead 1 & view:
Lead 2 & view:
Lead 3 & view:

= negative RA → positive LA (Left lateral camera view)
= negative RA→ positive LL (Inferior camera view)
= negative LA→ positive LL (slight lateral Inferior camera view)

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!!!Einthoven’s triangle) Negitive & Positive lead 1 sites:
Negitive & Positive lead 2 sites:
Negitive & Positive lead 3 sites:

=negative @ RA & positive @ LA
= negative @ RA & positive @ LL
= negative @ LA & positive @ LL

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(Einthoven’s triangle) BiPolar Limb Leads:

= 2 electrodes, + & -, “+looks to -”,

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Unipolar Limb Leads:
aVR:
aVL:
aVF:

= Augmented by the cardiac monitor
= Right Arm positive (inferior)
= Left Arm positive (lateral )
= Left Leg positive (inferior)

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Unipolar Precordial Lead “12 leads”:> V1 site:
V2 site:
V4 site:
V3 site:
V5 site:
V6 site:
V4R site:
V5/V8 site:
V6/V9 site:

=(anterior) 4th ICS(between 4th&5th ~1inch R of sternum)
=(anterior) 4th ICS ~1inch L of the Sternum
=(anterior) 5th ICS Midclavicular (left breast)
=(anterior) ½ way in between V2&4
=(anterior) 5th ICS Anterior Axillary
=(anterior) 5th ICS Mid Axillary
=(anterior) 5th ICS Midclavicular
=(posterior) 5th ICS Mid-Scapular
=(posterior) ½ way in-between Scapula & Spine

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Vaughan-Williams Antiarrhythmic Classifications: Class, Medication, ECG Effects> NA Channel Blockers
Beta-Blockers:
Potassium Channel Blockers:
Calcium Channel Blockers:
Miscellaneous:

=class 1A&B, Procainamide & Lidocaine, Widen QRS & Prolongs QT
=class II, Propranolol, Prolonged PR & Bradycardias
= class III, Amiodarone, Prolonged QT
= class IV, Diltiazem & Verapamil, Prolonged QT & Bradycardias
=Miscellaneous, Adenosine & Digoxin, Prolonged QT & Bradycardia

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Horizontal Boxes: Each small box ?secs:
5 small boxes equal:
Each large box is ?secs:

= 0.04 sec
= 1 large box
= 0.20 sec

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Vertical Boxes Each small box is:
Each small box also equals:
5 small boxes equal:
Each large box is:
2 large boxes equal: 1 mV

= 0.1mV
= 1 mm
= 1 large box
= 0.5 mV
= 1 mV

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ECG Heart waves – P wave:
QRS complex:
T wave:

= Atrial depolarization
= Ventricular depolarization
= Repolarization of ventricles

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P Wave- Morphology:

Interval P Wave Duration:
PRI wave duration:
Amplitude in the limb leads:
Amplitude in the precordial leads:

= Smooth hump, Upright in limb lead:1-3, Biphasic(2 waved) in V1, should have same morphology (in same view)
= <0.12secs
= 0.12-0.20secs 3-5 small boxes >5 boxes (Atrium depolarizing)=
= < 2.5 mm in the limb leads
= < 1.5 mm in the precordial leads

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QRS Complex- Morphology- Q Wave is:
R Wave is:
S wave is:
Interval Duration:

= 1st negative deflection after the P wave
= 1st positive deflection after the P wave
= any negative deflection after the R wave
= 0.04 – 0.12 sec/ 1-3 small boxes

T Wave- Morphology:
Interval Duration:
Amplitude in limb leads:
Amplitude in precordial leads:

= Upright in all leads except aVR & V1, Normally downslope>upslope
= Variable (QT Calculation)
= < 5 mm/ 5 small boxes in the limb leads
= < 10 mm in the precordial leads

ECG – Systematic Approach– 1st: Rate
2nd: Rhythm:
3rd: P Waves:
4th: PR Interval:
5th: QRS Complex:

= What is the rate per minute?
= regular, regularly irregular or totally irregular?
= Present?, All look the same?, in front of every QRS complex?
= within normal limits?, Is it the same for every cardiac beat?
= Present?, All look same?, after every P wave?, within normal limits?

Pulse Ox measures:
Oxyhemoglobin is:
Carbaminohemoglobin:

= how much hemoglobin saturated w/ something %
= oxygen carrying Hemoglobin
= carbon dioxide on hemoglobin amino-acid

Carbonic Acid-Bicarbonate origin:
Lungs:

= CO2 + H2O<>H2CO3<>H + HCO3
= Lungs: H + HCO3<> H2CO3<>H2O + CO2

CO-Oximetry reads:

= PR & SPO2, Carboxyhemglobin(SpCO), Methemoglobin (SpMet), Hemoglobin (SpHb)

Carbon monoxide Poisoning Lvls- Mild:
Moderate:
Severe:
Fatal:

= 15-20% → N/V, dizziness, blurred vision, H/A
= 21-40% → confused, faint, dys/tachypnea&cardia, weak, chest pain
= 41-59% → Dysrhythmias, hypotension
= >60% → Death

Methemoglobin=
Methemoglobinemia=
treat w/:

= Hemoglobin not picking up ( w/ iron in ferric (Fe3+) vs oxy)
= changing color from lack of oxygenated hemoglobins
= Methylene Blue

MetHemoglobin Lvls- 1-3%:
3-15%:
15-20%:
25-50%:
50-70%:
>70%:

= Normal
= discoloration, grayish-blue
= Cyanotic, asymptomatic
= CNS H/A, N/V, Confusion, Chest pain
= AMS, delirium
= Fatal

(Capnography)- normal reading: Height: Length: Phase 1: Phase 2: Phase 3: Phase 4: Tachypnea leads to: bradypnea leads to: sharkfin waves mean: Curare cleft means:

= 35-45 = total CO2 = time/rate = baseline = respiratory upstroke = expiratory plateau = inspiratory downslope = alkalosis = acidosis = bronchoconstriction (asthma attack) = diaphragm waking up so→ sedate again

Endocrine A&P- Endocrine tissue of pancreas is called: Alpha Cells: Beta Cells: Type 1 vs Type 2 diabetic:

= Islets of Langerhans = Produce glucagon thus increases BGL "a upside down g" = Produce insulin thus decreases BGL = 1>insulin dependent 2>cell don't open for glucose when insulin bind

Insulin Acts as: Most well known as/for:

= a key to unlock door for glucose to enter the cell = facilitated diffusion

Glucagon “Gon Big” released by: Insulin released by:

= Alpha cells of pancreas when BGL drops & release rise BGL = Beta cells of pancreas when BGL rockets & release lower BGL

Type 1 AKA Insulin-Dependent Diabetes Mellitus (IDDM) or juvenileonset diabetes: Type 2 AKA Non- Insulin-Dependent Diabetes Mellitus (NIDDM):

= Usually by autoimmune disorder when immune system attacks beta cells & w/o insulin, glucose can't enter cell & cell can't make ATP (cant survive w/o external insulin = body resists insulin @ cellular Lvl & Highly associated w/ obesity (often on PO meds to treat: 1. Some up secretion of insulin, Some stim/ receptors on cell for insulin, Others down effects of glucagon & release of glucose stored in the liver)

Normal ECG Speed:

= 25mm/sec

Oxyhemoglobin is: Carbaminohemoglobin: Methemoglobin: Deoxyhemoglobin: Carboxyhemoglobin: Sulfhemoglobin: Glycated Hemoglobin (HbA1c):

= oxygen carrying Hemoglobin = carbon dioxide on hemoglobin amino-acid = Hemoglobin not picking up ( w/ iron in ferric (Fe3+) vs oxy) = Hemoglobin not bound to oxygen. = Hemoglobin bound to carbon monoxide (CO). = Hemoglobin irreversibly bound to sulfur. = Hemoglobin bound to glucose for measuring long-term BGL control