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CV exam 1 AP > BSC physiology > Flashcards

BSC physiology Flashcards

1
Q

what are the characteristics of 1st degree AV block

A

long PR interval

PR interval greater than .2 seconds

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2
Q

sinus bradycardia

A

less than 60

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3
Q

what is the normal PR interval

A

.12-.2

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4
Q

atrial flutter

A

multiple p waves before every QRS and looks fairly regular

abnormal conduction

R-R interval is constant from beat to beat

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5
Q

atrial fibrillation

A

no distinct p waves

saw tooth

reentry is setting up this pathway (ectopic focus taking over normal SA rate of depolarization)

irregularly irregular

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6
Q

2:1 AV block Mobitz II

A

conduction system block

PR interval of conducted beats is normal

every other P wave is conducted

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7
Q

2:1 secondary AV block Mobitz I

A

longer PR interval with each cycle to the next until the AV node fails completely

slower rate

AV block meaning you drop a QRS because it doesn’t get to the ventricle

Wenckebach

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8
Q

third degree AV block

A

no pattern, no association
complete block

AV dissociation

regularly paced P waves
irregularly spaced QRS and T waves

completely variable PR interval

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9
Q

multiformed PVC’s

A

QRS complexes are irregular and not the same (the ones that are PVC’s)

PVC’s not preceded by p waves that don’t look the same so they are coming from different ectopic areas that are acting out

QRS duration is longer, ectopic foci are spreading depolarization cell to cell (via gap junctions and this is taking longer)

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10
Q

unifocal PVC

A

unusual QRS’s in the middle of everything

ectopic focus, originating in the ventricles

premature
No p wave precedes PVC QRS

QRS greater than .12 sec b/c cell to cell spread and not following the normal conduction system which takes longer

same shape PVC indicates one ectopic focus

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11
Q

torsades de pointes

A

different amplitudes of QRS’s

type of ventricular tachycardia

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12
Q

ventricular tachycardia

A

faster rate than normal originating in the ventricles

only seeing QRS’s

cell to cell spread b/c of wide QRSs

the QRS’s appear the same

more organized, probably have time for filling

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13
Q

ventricular fibrillation

A

abnormal conduction

no discernable P-waves

no discernable QRS complexes
bag of worms

not good!! NO FILLING DEAD

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14
Q

what does an AED do

A

resets putting everything into refractory

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15
Q

know***

A 
tachy
brady
atrial flutter
afib
uniformed multiformed pvcs
ventricular tachy
v-fib
one more
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16
Q

case 56 year old female with heart palpitations
light headedness shortness of breath
bp 95/70
her ECG shows supraventricular tachycardia
what does this mean

normal p wave?

A

no normal p wave (covered by t wave)

SA node is not the pacemaker

17
Q

how can the automaticity of the SA node be over-riden

A

site with intrinsic rate of depolarization that is greater than the SA node

18
Q

what does an essentially normal PR interval suggest about the location of an ectopic focus

A

located near the AV node, allowing AP’s to reach ventricles via the normal pathway

ventricular rate is matching ectopic rate w

19
Q

which factor most likely promotes an ectopic focus to develop into a re-entrant circuit

A

decreased conduction velocity

b/c there is time for the area to get out of refractory

20
Q

3 requirements for reentry

A

partial depolarization of a conduction pathway

unidirectional block

timing : reentrant current must occur beyond the ERP

21
Q

what 3 things promote reentry

A

lengthened conduction pathway
decreased conduction velocity (hyperkalemia)
reduced refractory period

22
Q

why does a patient with supraventricular tachycardia lightheadedness, dizzy, and short of breath

A

because she was hypotensive b/c her CO is decreased

23
Q

MAP how do you calculate

A

DBP + 1/3 (Pulse pressure) (SBP- DBP)

24
Q

which variable best explains the girl’s audible murmur in a left to right shunting (patent ovale) LA to RA

A

increased blood flow velocity (narrowing opening) that is audible as a murmur

25
Q

decreased viscosity

A

anemia

causes increased turbulence

26
Q

the largest decrease in blood pressure across a given segment of peripheral vasculature occurs in the arterioles due to the fact that they have the greatest …

A

resistance

arterioles are the resistance vessels

greatest area of regulation (with vasodilation and all that jazz)

27
Q

an increase in which starling force is most likely contributing to edema

A

capillary hydrostatic pressure

28
Q

why does the guy have increased capillary hydrostatic pressure?

A

b/c he has pooling in his venous system, so the pressure is higher and maintained in the capillary beds AND he has low blood pressure

he has a fistula– arteriole side right to venous side and getting backed up

29
Q

what could explain hypotension (when discussing ohm’s law)

A

total peripheral resistance

30
Q

why is radius so key to distributing CO is because….

A

radius to the 4th power is key for blow flow

31
Q

which most directly contributes to the functional syctium of the heart

A

intercalated disks consist of low-resistance pathways through which a depolarizing current is spread

GAP junctions - allow depolarizing current not to die out

32
Q

what best describes the characteristic of an AP that is generated earlier than normal within the relative refractory period before repolarization is complete

A

lower amplitude of upstroke

33
Q

longer duration of the AP of the heart contributes to…

A

the hearts inability to produce tetanus

34
Q

which change would increase the liklihood of his aneurysm to rupture

A

increased wall tension

increased vessel radius

decreased wall thickness

35
Q

augmented Ca channel opening
hyperkalemia
k channel blockers
na inactivation gate mutations

all do what?

A

all promote long QT syndrome

all ventricular events

36
Q

what is afterdepolarizations

A

occur in refractory period and set up series of extra ventricular contractions

can lead to Vfib

both early afterdepolarization and delayed afterdepolarizations

stay depolarized longer

37
Q

in wolf-parkinson white syndrome with an accessory conduction pathway that bypasses the AV node and relies on ventricular depolarization cell-to- cell via gap junctions

what would you expect to see?

A

widening of the QRS complex

alternate path around the AV node (bundle of kent)

AP conducted directly from atria to ventricle

why spread to atria to ventricles via an accessory pathway in WPW syndrome compared to AP conduction via the AV node? –> because the cells in the atria itself (myocytes and ventricular cells are fast AP type) and the nodal cells are slow type AP

38
Q

what physical properties of AV nodal cells contribute to slower conduction velocity

A

smaller diameter, increased internal resistance to current flow

39
Q

how do you calculate the total peripheral resistance

A

first determine MAP then use the equation

TPR= MAP/CO

CV exam 1 AP (12 decks)

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