week 9 PT monitor tech Flashcards
Electrodes 2 jobs:
= stick & conduct (Electrodes sealed, skin prep_
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
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
Positive electrode makes wave:
Negative electrode makes wave:
= makes inverted wave “U”
= makes wave positive “/"
!!!Einthoven’s triangle: green electrode:
Blue electrode:
Red electrode:
= neutral/ground
= Negative
= Positive
!!!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)
!!!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
(Einthoven’s triangle) BiPolar Limb Leads:
= 2 electrodes, + & -, “+looks to -”,
Unipolar Limb Leads:
aVR:
aVL:
aVF:
= Augmented by the cardiac monitor
= Right Arm positive (inferior)
= Left Arm positive (lateral )
= Left Leg positive (inferior)
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
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
Horizontal Boxes: Each small box ?secs:
5 small boxes equal:
Each large box is ?secs:
= 0.04 sec
= 1 large box
= 0.20 sec
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
ECG Heart waves – P wave:
QRS complex:
T wave:
= Atrial depolarization
= Ventricular depolarization
= Repolarization of ventricles
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
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
