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Complex Exam One > Week One > Flashcards

Week One Flashcards

1
Q

automaticity

A

electrical signals generated by pacemaker cells
pacemaker cells can generate stimulus without outside stimulation

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2
Q

Cardiac Cycle

A

Electrical (caused by automaticity)
mechanical (muscular) (contraction)

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3
Q

Electrical Activity

A

depolarization
repolarization

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4
Q

mechanical responses

A

systole
diastole

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5
Q

depolarization = ______ = contraction

A

systole

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6
Q

repolarization= ______ = resting or filing phase

A

diastole

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7
Q

Depolarization begins with?

A

SA node firing
atrial contraction and atrial kick

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8
Q

SA node beats?

A

60-100 bpm

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9
Q

AV node beats

A

40-60 bpm

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10
Q

Ventricles (purkinje fibers) beats?

A

15-40 bpm

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11
Q

What can the ECG tell us?

A

orientation of the heart in the chest
conduction disturbances
electrical effects of medication and electrolytes
mass of cardiac muscles
presence of ischemic damage
ELECTRICAL (not mechanical -contraction)

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12
Q

lead 1

A

records flow from right to left arm

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13
Q

lead 2

A

Records flow from right arm to left leg

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14
Q

lead 3

A

records flow from left arm to left leg

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15
Q

augmented limb leads

A

unipolar center of heart to lead

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16
Q

aVR

A

from heart to right arm

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17
Q

aVL

A

heart to left arm

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18
Q

aVF

A

heart to left foot

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19
Q

lead 2,3, aVF see what part of the heart?

A

inferior heart

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20
Q

V1 and V2 see?

A

septal (mid heart)

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21
Q

V3 and V4 see?

A

anterior heart

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22
Q

1, aVL, V5 and V6 see?

A

lateral heart

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23
Q

one small ecg square is how many seconds?

A

0.04 s

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24
Q

how many small squares make up a large square?

A

5

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25
Q

how many seconds is a large square?

A

0.20 s

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26
Q

P wave

A

atrial depolarization (SA node is firing)

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27
Q

normal P wave

A

round, upright, before every QRS complex, all look the same

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28
Q

QRS complex

A

ventricular depolarization

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29
Q

Q wave

A

less than 0.04 s
less than 1/3 the height of the R wave

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30
Q

PR interval

A

beginning of P wave to beginning of QRS complex
0.12- 0.20 sec (3-5 small blocks)

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31
Q

longer PRI

A

first degree AV block

32
Q

shorter PRI

A

impulse from AV junction

33
Q

QRS interval

A

0.06-0.12 s

34
Q

wide QRS interval means

A

slowed conduction

35
Q

ST segment

A

end of QRS to beginning of T wave
is it elevated or depressed
should be at baseline

36
Q

T wave

A

ventricular repolarization
follows QRS complex
bigger than T wave
upright, round, smooth

37
Q

when is the most vulnerable period of the ECG?

A

the peak of the T wave

38
Q

QT interval

A

beginning of QRS to end of T wave
0.39-0.43s

39
Q

atrial rate

A

peak of P to peak of the next P wave

40
Q

ventricular rate

A

R-R wave

41
Q

Normal Sinus Rhythm

A

regular
6-100 bpm
normal P wave in lead 2
P wave before QRS complex
normal PRI, QRS, and QT intervals

42
Q

Sinus Tachy

A

rate: 101- 150 bpm

43
Q

causes of tachy?

A

stimulants, exercise, fever, and alteration in fluid status

44
Q

Symptoms of low CO

A

change LOC
chest pain
HoTN
SOB (RR distress)
dizziness, syncope
fatigue
restless

45
Q

Management of STach

A

find and treat the cause
(pain give pain meds, fever give anti-pyretic)

46
Q

Sinus Bradycardia

A

<60 bpm
regular
normal PRI and QRS

47
Q

Management of SBrady

A

atropine
pacemaker

48
Q

Sinus Arrhythmia

A

irregular RR
rate: 60-100
no real treatment (can live with them)

49
Q

atrial dysrhythmias

A

increased automaticity in the atrium (SA node firing)
generally see changes in P wave
PRI normal
QRS normal

50
Q

Causes of Atrial Dysrhythmias

A

stress
electrolyte imbalances
hypoxia
atrial injury
digitalis toxicity
hypothermia
hyperthyroidism
alcohol
pericarditis
caffeine

51
Q

Premature Atrial Contractions

A

early beats initiated by atrium (SA node firing too early)
P waves and PR interval may vary
P wave may be found on T wave

52
Q

Atrial Flutter

A

sawtooth (leads 2, 3, aVF)
RATE: 250-350 bpm
seeing many p waves before QRS (2:1, 4:1, etc)
no true p wave
QRS normal

53
Q

Management of A Flutter

A

anticoagulant (blood is just laying in the body so blood thinners are 1st thing to do)
rate control with meds
elective cardio-version
interventional radiology - ablation of irritable site

54
Q

Atrial Fibrillation

A

erratic impulse formation in atria
no PRI
P waves do not look the same
irregular ventricular rate

55
Q

Causes of AFIb

A

heart disease
ischemia
mitral or tricuspid valve disease
CHF (overstretched chambers)

56
Q

management of AFib

A

anticoagulation 4-6 weeks before cardioversion (so clots do not go everywhere in the body after being shocked)
ventricular rate control
emergent synchronized cardioversion if instability and not responsive to meds
CCB, Beta-blockers, digoxin, amiodarone
MAZE procedure

57
Q

Ventricular Dysrhythmias

A

in the lower portion of the heart
depolarization occurs (wide QRS complex >0.12s)
the polarity of T wave
no p waves

58
Q

Causes of Ventricular Dysrhythmias

A

myocardial ischemia, injury, and infarction
low K+ or Mag
hypoxia
acid-base imbalance (pH is acidic)

59
Q

Premature Ventricular Contractions (PVCs)

A

no p wave
compensatory pause
early beat that interrupts the underlying rhythm
QRS > 0.12s
irregular
no PRI

60
Q

When are PVCs dangerous?

A

frequently happen
multifocal - look different
two in row
three of more in row
R on T

61
Q

R on T PVCs can cause what

A

VTach or VFIb

62
Q

management of PVCs

A

find the cause and treat it
anti-dysrhythmic meds

63
Q

causes of PVCs

A

drug induces (caffeine, alc, cocaine, sympathomimetic drugs)
hypoxia
cardiac disease, ACS, cardiomyopathy, vent aneurysm
hypokalemia
irritation of ventricle

64
Q

Supra ventricular Tachycardia (SVT)

A

above the ventricle
abrupt onset and termination
RATE: 150-250 bpm
regular

note Stachy rate was 101-150, this rate is above 150

normally not tolerated well

65
Q

ventricular tachycardia

A

rapid, life-threatening dysrhythmia
three of more PVCs in a row
fast RATE >100 bpm

THERE IS NO CO

wide QRS (>0.12 s)
regular
may or may not have a pulse
HoTN

66
Q

management of V Tach

A

pulseless
- defibrillate
-CPR
- epinephrine

pulse
- amiodarone
- sotalol
- lidocaine
- cardioversion

67
Q

Torsade de Pointes

A

type of Vtach
smaller to larger looking

68
Q

Ventricular Fibrillation

A

chaotic
no P Q, R S, or T waves
no CO
emergent defibrillation
always assess pt for pulse and consciousness

69
Q

management of VFib

A

check for pulse
no pulse = shock and CPR for 5 cycles (2 min)
check for pulse again
med: epinephrine

70
Q

Idioventricular Rhythm (Ventricular Escape Rhythm)

A

Purkinje Fibers has an escape
RATE: 15-40 bpm
regular
wide QRS (> 0.12s)
no p waves
DO NOT GIVE LIDOCAINE

71
Q

Asystole

A

a line
no nothing
no cardiac activity
first check leads
if forreal start CPR
epinephrine every 3-5 min

72
Q

Pulseless Electrical Activity (PEA)

A

electrical system of heart works but the muscles do not contract
management: CPR, epine, must treat cause
this is a late sign

73
Q

First Degree Block

A

delayed conduction from SA node to AV node
prolonged PRI (>0.20s)
same PRI for each beat
assess cause and treat it

74
Q

Second Degree Block: Mobitz Type I Wenckebach

A

progressive lengthening PRI
some P waves without QRS
PP interval regular
RR interval regular
QRS normal
irregular rhythm

75
Q

Second Degree Type II

A

more severe block
PR interval is fixed
PP interval is regular
P waves not followed by QRS
Management: transcutaneous (skin) or transvenous (vein) pacing

76
Q

Third Degree

A

Complete
atria and ventricles beat independently
P’s not related to QRS
P wave not associated with QRS complex
PP interval regular
RR interval regular
BP is extremely low

77
Q

Artifact

A

loose electrodes
broken ECG cables or broken wires
muscle tremor
patient movement
external chest compressions
60 cycle interference

Complex Exam One (3 decks)

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