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Patho > Dysrhythmias > Flashcards

Dysrhythmias Flashcards

1
Q

dysrhythmias

A

alterations in cardiac rhythm

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2
Q

arrhythmias

A

loss of rhythm

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3
Q

cardiac dysrhythmias appears as what in ECG?

A

appear as variations

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4
Q

when is dysrhythmias harmful

A

when it interfers w/ heart’s pumping ability

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5
Q

what cells possess automaticity

A

cells of SA node, AV node and purkinje fibers

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6
Q

automaticity

A

ability to spontaneously generate action potential

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7
Q

normal dysrhythmias include

A

sinus bradycardia & tachycardia

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8
Q

sinus bradycardia

A

seen in trained athletes or during sleep

may occur in acute MI or respiratory depression

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9
Q

sinus tachycardia

A

seen w/ exercise or fever

may occur w/ CHF, MI, hyperthyroidism, certain drugs, hypovolemia

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10
Q

atrial dysrhythmias result from?

A

abnormal electrical activity in atrium

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11
Q

atrial dysrhythmias causes

A

mitral stenosis
ischemia
cardiac surgery
hyperthyroidism
alcohol or caffeine consumption

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12
Q

atrial dysrhythmias include

A

premature atrial contraction
atrial flutter
atrial fibrillation

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13
Q

premature atrial contraction is
d/t

A

↑automaticity in cells other than SA or AV node (ectopic foci)

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14
Q

atrial flutter

A

rapid, regular atrial ectopic tachycardia

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15
Q

atrial fibrillation is d/t

A

multiple uncontrolled, depolarizations of atrium

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16
Q

heart block occurs when?

A

when there is conduction defect in AV node or bundle branches

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17
Q

kinds of heart block

A

1st degree AV block
2nd degree AV block
3rd degree AV block
Bundle Branch block

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18
Q

1st degree AV block

A

delayed conduction through AV node
but
impulses are conducted through ventricles

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19
Q

2nd degree AV block

A

when some impulses from atria are NOT conducted to ventricles

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20
Q

localized MI in 2nd degree block

A

infarction in His bundle that has a poor prognosis d/t fewer ventricular contractions => ↓CO

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21
Q

3rd degree AV block

A

complete AV block

NO atrial impulses are conducted to ventricle

requires pacemaker

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22
Q

stroke-adams attack

A

sudden brief loss of consciousness from a large drop in cardiac output

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23
Q

bundle branch block

A

interruption of conduction through bundle branches
- carries impulses to myocardium of ventricles

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24
Q

how does bundle branch block appear in ECG?

A

wider QRS complex since it DOES NOT affect rhythm, and cells DO NOT contract together

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25
Q

kinds of ventricular dysrhythmias

A

premature ventricular contraction (PVC)
ventricular tachycardia
ventricular fibrillation
pulseless electrical activity
asystole

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26
Q

PVC cause

A

ventricular ectopic pacemakers

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27
Q

PVC often occurs when?

A

secondary to ischemia, infarction or electrolyte imbalances

28
Q

PVC characterization

A

broad, distorted QRS complexes and large T waves followed by a compensatory pause where ventricles are unable to respond to incoming SA node impulses

ie. are refractionary

29
Q

ventricular tachycardia & ventricular fibrillation are considered what?

A

considered cardiac arrest rhythm since they often DO NOT generate a cardiac output or palpable pulse

30
Q

ventricular tachycardia treatment

A

treated immediately w/ defibrillation and CPR

31
Q

ventricular tachycardia cause

A

caused by re-entry secondary to ischemia, infarction, fibrosis, dilated myopathy, electrolyte imbalance

32
Q

ventricular tachycardia characterization

A

broad, tall QRS complexes, inverted T-waves
rate of 70-250beats/min

33
Q

ventricular tachycardia can progress to what?

A

progress to ventricular fibrillation especially if following an MI

34
Q

when does ventricular fibrillation occur

A

occurs w/ firing of multiple ectopic foci in ventricles

35
Q

ventricles in ventricular fibrillation

A

ventricles quiver but DO NOT contract => no CO

36
Q

ventricular fibrillation results to what?

A

=> unconsciousness, absence of pulse, apnea, death

37
Q

ventricular fibrillation characterization

A

grossly distorted w/ shallow, unidentifiable waves

38
Q

pulseless electrical activity

A

shows electrical activity, but there is no mechanical ventricular fixation or pulse

have corrective and uncorrectable causes

poor prognosis unless corrected

39
Q

pulseless electrical activity corrective causes

A

hypovolemia
hypoxemia
hypothermia
acidosis

40
Q

pulseless electrical activity uncorrectable causes

A

massive infarction
ischemia during resuscitation
pulmonary embolism

41
Q

asystole

A

total absence of ventricular electrical activity and contraction (flat line)

no ventricular depolarization

poor prognosis

42
Q

ST segment of ECG represents what?

A

represents repolarization phase of ventricular myocytes

43
Q

current that creates ST segment is sensitive to what?

A

sensitive to changes in coronary blood flow and is therefore used to assess myocardial ischemia and infarction

44
Q

two kinds of ST segment

A

ST segment depression & elevation

45
Q

ST segment depression occurs as a result of what?

A

result of myocardial ischemia

46
Q

ST segment depression occurs d/t what?

A

occur d/t slowed repolarization rate secondary to ↓cellular ATP or potassium efflux

47
Q

mechanism of ST depression

A

exact mechanism for ST segment depression is not known

48
Q

cardiac dysrhythmias indicate what?

A

may indicate alterations in automaticity, excitability, conductivity or refraction d/t ischemia and infarction, electrolyte imbalances, drug effects or defects in conduction

49
Q

what is common in atrial dysrhythmias

A

palpitations and tachycardia

50
Q

premature atrial contraction in ECG

A

appears as an abnormal P wave - abnormal conduction pathway and irregular heart beat

51
Q

atrial flutter cause

A

caused by large circular re-entrant current in atrium at a rate of 300beats/min
- current creates a “sawtooth” pattern

52
Q

what happens to atrial contribution in arrhythmias?

A

atrial contribution to ventricular filling is lost and quite often ↓CO

53
Q

how does ventricle contract in atrial flutter?

A

ventricle contract regularly but ↑rate (150beats/min) => ↓CO and possibly myocardial ischemia, HF

54
Q

how does atria contract in atrial fibrillation?

A

atria contract in a continuous, uncoordinated fashion at 350-600beats/min

55
Q

ventricle in atrial fibrillation

A

ventricle do not fill or contract properly => ↓CO, may cause syncope or cardiac arrest

56
Q

how is blood flow in atrial fibrillation

A

stasis of blood in atrium => ↑risk of cerebral embolism

57
Q

heart blocks may be what?

A

may be:
normal - vagal tone
pathological - ischemia, infarction, fibrosis, inflammation, surgery, potassium imbalance

58
Q

rhythm in 1st degree AV block

A

regular

59
Q

cause of 1st degree AV block

A

caused by ischemia or MI of AV node, rheumatic fever, myocarditis

60
Q

how is each region in 3rd degree AV block?

A

each region controlled by independent pacemakers => regular but dissociated rates

61
Q

ventricular rhythm in 3rd degree AV block

A

ventricular rhythm is slow (30-40beats/min)

62
Q

3rd degree AV block can arise from?

A

impaired conduction at AV node, His bundle or purkinje fibers

63
Q

3rd degree AV block results in?

A

results in ↓CO w/ syncope (stroke-adams attack), dizziness, episodes of acute HF

64
Q

how does 1st degree AV block appear in ECG?

A

prolonged PR interval

65
Q

how does 2nd degree block appear in ECG?

A

some P waves w/ no corresponding QRS complexes

66
Q

ST segment elevation occurs during?

A

occurs during myocardial infarction

67
Q

ST segment elevation results from what?

A

loss of potassium from cells - ie. hyperrepolarization and ↓resting membrane potential

accumulation of intracellular sodium - ie. delayed depolarization

Patho (11 decks)

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