16048036
Description
Flashcards by Carly Pruemer, updated more than 1 year ago
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Created by Carly Pruemer
over 5 years ago
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| Question | Answer |
| AVR lead should always be positive or negative | negative |
| What is the hearts dominate pacemaker? | SA Node |
| Automaticity is? | Ability to generate pacemaking stimuli |
| Name the internodal tracks and where are they located | Anterior internodal Middle internodal Posterior internodal Located: right atrium |
| What is the conduction tract to the LA called? | Bachmann Bundle |
| The atrial conduction system is composed of what tracks? | Internodal tracks: SA to AV node Bachmann bundle: SA and depolarizes LA |
| What cation slows the AV node Depolarization | Calcium (this insures proper filling time for isometric volume contraction) Frank stalling effect |
| Where does the ventricular conduction originate? | Bundle of HIS |
| After activation of the bundle of HIS what is the depolarization sequence? | - It immediately bifurcates in the interventircular septum into the RBB and LBB - The left bundle produces fine terminal filaments - Right bundle does not - terminal filaments purkinje fibers deplo the ventricular myocytes= ventricle contraction |
| For a right BBB what side is depolarized first? Left or right | Left |
| For a left BBB what side is depolarized first? Left or right | Right |
| SA node pacemaker rate | 60-100 bpm |
| atrial cell pacemaker rate | 55-60 |
| AV node pacemaker rate | 40-50 |
| HIS bundle pacemaker rate | 45-60 |
| Bundle Branches pacemaker rate | 40-45 |
| Purkinje fiber pacemaker rate | 35-40 |
| Ventricular cell pacemaker rate | 30-35 |
| P wave is | atrial depolarization and contraction |
| PR interval is | time between atrial contraction and ventricular contraction |
| QRS complex is | ventricular depolarization and contraction |
| T- wave is | Ventricular repolarization |
| QT interval | Duration of ventricular systole/contraction (less than 1/2 R to R ratio) |
| EKG paper- one small box is..? | 0.04 seconds 0.1 mV |
| EKG paper- 5 small boxes (one large square).? | 0.2 seconds 0.5 mV |
| EKG paper- 5 large boxes | 1 sec |
| Chest leads | I II III AVR AVL AVF |
| Limb Leads | V1 V2 V3 V4 V5 V6 |
| Bipoar limb leads | I II III |
| unipolar limb leads | AVF AVR AVL |
| AVF | augmented/amplified, voltage, left foot left foot + Combination of leads II and III |
| AVR | right arm electrode positve |
| AVL | left arm electrode positve |
| lateral leads | I AVL |
| Inferior leads | II III AVF |
| Chest leads are all positive or negative | positive oriented through AV node and projects through the patients back |
| EKG Interpretation: | quality rate rhythm axis hypertrophy infarction |
| Automaticity Foci (eptopic foci) | focal areas of automaticity of the heart pacemakers (atria 60-80, ventricle 40-60, AV junction 20-40) |
| Rhythm | Regularity P before QRS QRS after each P PR interval (AV Block) QRS interal (BBB_ |
| Normal PR Interval | 0.12-0.20 seconds |
| Normal QRS | 0.004-0.12 |
| Bundle Branch Blocks | Wide QRS (3 sm squares or 0.12 sec) Wide QRS in other leads you look for block |
| Right Bundle branch | R and R' in V1/V2 |
| Left bundle branch block | R and R' in V5/V6 |
| Causes of axis deviation | Change in position of the heart obesity hypertrophy MI BBB |
| Normal axis | Positive electrodes in I and AVF |
| Right axis deviation | Lead I = neg AVF= postive |
| left axis deviation | lead one= positive AVF= neg |
| Extreme right axis deviation | lead I- neg AVF- neg |
| atrial hypertrophy | p-wave |
| right ventricular hypertrophy | R wave |
| left ventricular hypertrophy | S-wave depth V1 R wave height V5 (exaggerated) |
| right atrial hypertrophy | large diphasic p-wave V1 with initial tall component |
| Left atrial hypertrophy | large diphasic with wide terminal component in V1 (MVS and HTN) |
| Right ventricular hypertrophy | R-wave get progressively smaller V1-V6 |
| Left Ventricular hypertrophy | Exaggerated amplitude of QRS in V1-V6 Large R V5 Inverted T wave V5-V6 mmS V1 + mmR in V5= >35mm LVH |
| Coronary blood flow | Right and left coronary artery Left: left anterior descending (anterior) Circumflex (lateral) Right: SA node, AV node, Bundle of HIS (Posterior portion of heart) |
| Types of infarction | Ischemia- CP Injury- Decreased flow Necrosis- perm injury |
| Ischemia | Decreased blood supply Angina Transient inverted T-waves |
| Injury | Acute infarct ST elevation- > 1mm Earliest EKG sign of MI |
| prinzmental angina | transient ST elevation at rest in absence of an infartion |
| Persistent ST depression can represent.. | Compromised coronary blood flow Subendocardial infarct Angina Positive stress test Digitalis |
| Necrosis | Dead tissue Diagnostic Q wave (one mm wide 0.04/1/3 amp of QRS) |
| Infarct Review | 1. Q waves 2. Inverted T waves 3. ST seg elevation or depression 4. location of occluded coronary artery |
| Posterior leads and artery | V1/V2 right coronary artery |
| inferior leads and artery | II/III/aVF right or left coronary artery |
| Lateral leads and artery | I, AVL, V5, V6 Left circumflex |
| Anterior leads and artery | V1-V4 left anterior descending |
| Anterior infarction | V1-V4 |
| Antero-septal infarction | V1-V2 |
| Antero-lateral | V3-V4 |
| Lateral infarction | I AVL |
| inferior infarction | II III AVF |
| Posterior infarction | V1/V2 |
| Dominate coronary artery | LV receives blood from the dominate coronary artery Primary- right, but can be left also |
| COPD and EKG | low voltage amp in all leads multifocal atrial tachycardia |
| Pulmonary Embolism and EKG | Wide S-wave Lead 1 Large Q wave lead 2 Inverted t-wave lead 3 transient RBBB Inverted t-waves V1-V4 ST depression lead 2 S1Q3T3 |
| Hyperkalemia and EKG | P-wave flatten qrs- widen T-wave peaked |
| Hypokalemia and EKG | flatten/inverted T-waves U-wave can lead to torsades and vtach |
| hypercalcemia | QT shorten |
| Hypocalcemia | QT prolongs |
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