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CardioPulm > EKG stuff > Flashcards

EKG stuff Flashcards

1
Q

What is a holter monitor?

A

a portable EKG unit that CONTINUOUSLY records heart signal for about a day (25 hrs)
- pt presses button when theres symptoms or when theyre intentionally exercising

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2
Q

reasons to use a holter monitor

A
  • palpitations
  • SOP
  • syncope
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3
Q

BIG boxes on EKG time
little boxes on EKG time

A
  • .2 seconds = 5mm
  • .04 seconds = 1mm
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4
Q

What does the PR interval represent & why is it important

A

the PAUSE at the AV node

for refractory interval

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5
Q

What does the QT interval represent

A

the time it takes to depolarize and repolarize the VENTRICLES

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6
Q

Isoelectric Conditions (baseline) should occur what 3 times ?

A
  • after P wave
  • After QRS
  • After t wave
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7
Q

What does it mean if there is ST elevation? Depression?

A

Elevation: Myocardial infarction

Depression: Myocardial ischemia

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8
Q

What is the path and vector of depolarization in the heart

A
  • SA node
    ATRIA
  • AV node
    PAUSE
  • Bundle of His
  • Bundle branches
    APEX
  • Perkenjie fibres
    BASE

Vector must go down and to the L bc more muscle mass on left (towards L ventricle)

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9
Q

What can wandering baseline be due to?

A
  • loose wires
  • moving clothes
  • poor prep of electrode on skin
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10
Q

60 Cycle interference ???

A
  • produced by wall current
  • superimposed on tracing
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11
Q

Normal amplitude for P, QRS, and T wave

A

-P : upright and symmetrical

  • QRS : R is always first upward deflection
  • T : upright and symmetrical
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12
Q

Explain what each thing represents :

P wave
PR interval
QRS
ST Wave
T
QT Interval

A

P wave: produced by atrial depolarization

  • PR interval: pause in AV node; time between atrial depolarization and ventricular depolarization
  • QRS: ventricular systole/depolarization AND HIDDEN atrial repolarization
  • ST Wave: ventricular depolarization/diastole
  • T : ventricular repolarization
  • QT Interval: time for depolarization and repolarization to occur
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13
Q

What does inverted T wave represent?

A

Myocardial Ischemia

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14
Q

Pacemaker rates

A

SA node: 60-100 bpm
AV node: 40-60 bpm
Ventricular cells/Bundle of His: 40-60 bpm

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15
Q

Bradycardia vs tachycardia cause

A

Bradycardia < 60 ; caused by enhanced SV or BETA blockers, TBI

Tachycardia >100 ; normal w/ exertion

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16
Q

Ectopic Foci

A

an area in the heart that can generate a depolarization signal
- other than SA or AV

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17
Q

what part of the heart is the workhorse of the heart

A

bottom L Ventricle

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18
Q

what does a magnitude of > 1/3 QRS complex represent

A

an old MI

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19
Q

What is R’ (R prime?)

A
  • second upward deflection indicating abnormality when one ventricle depolarizes later than normal
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20
Q

what nerve slows HR below 100bpm?

A

vagus

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21
Q

How is HR increased?

A

by decreasing vagal and increasing sympathetic inputs

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22
Q

What is regular rhythm (time and boxes) ? whats the analogy that it looks like?

PR Interval
QRS Complex

A

PR interval: .1-.2 seconds OR 3-5 small boxes

QRS Complex: .01-.1 seconds 1.5-2.5 small boxes

LOOKS LIKE A PICKET FENCE

23
Q

Regularly Irregular

A

EKG not the same every time; there IS a PATTERN

24
Q

Irregularly Irregular
- what is it usually?

A

no consistent pattern; changes from one cardiac cycle to the next
- usually A Fib

25
Q

Sinus Arrhythmia

A

Cause: increases w/ inspiration
Tx: goes away w/ activity

26
Q

Sinus Pause

A

damage to SA node
Cause: infection, infarction, sick sinus syndrome, ischemia

27
Q

Sinus pause vs Sinus arrest

A

Sinus pause : <2 sec
Sinus arrest: >2 sec !STOP and REPORT!

28
Q

Wandering atrial pacemaker

A

when there is more than one node initiating heart beat

29
Q

PAC Premature atrial contraction

A

beats that occus earlier than normal and are generated by ectopic foci in the atria

Cause: stress, nicotine, alcohol, caffine

30
Q

Atrial Tachycardia

A

when theres 3+ PACs in a row w/ increased HR

Cause: pH issues, hypoxia
Tx: beta blockers, holding breath, valsalva maneuver

31
Q

PAT - Paroxysmal Atrial Tachycardia

A

sudden increase in HR w/ normal looking complexes

Cause: digital toxicity

32
Q

Atrial Flutter

A

Multiple depolarization of atria caused by ectopic focus rate >250x/min

Sawtooth pattern with F waves- no p waves

33
Q

Atrial Fibrillation

A

no real pacemaker
no p wave
Tx: anticoagulant - warfarin

34
Q

Artial Issues all have normal ____

A

QRST complexes

35
Q

Significant Q represents

A

previous MI

36
Q

Escape beat vs repeated beat

A
37
Q

Junctional Tachycardia

A

no p before qrs
- faster than 100

38
Q

Premature Ventricle Contraction PVC

A
  • wide unbalanced QRS
  • occurs when ectopic focus originates from an impulse in one of the ventricles
  • VERY SLOW conduction therefore giving large and weird
39
Q

Psysiological consequences of a PVC (hint: SV AND BP

A

a weak contraction when BP drops
increased preload and SV
bc frank starling effect

  • pvc feels like pause followed by a stronger beat
40
Q

What to do if you see V FIB

A

stop and call code
stop and get defib

41
Q

what to do if you see V Tach

A

stop pt and see if it resolve
get help if it doesnt

42
Q

Bigeminy PVC

A

when every other beat is a PVC

43
Q

Trigeminy PVC

A

when every 3rd beat is PVC

44
Q

Couplet

A

When 2 pvcs are paired together

45
Q

Automaticity

A

altered pacemaker functionC

46
Q

Conduction:

A
  • blocks
  • abnormal propagation of AP
47
Q

First Degree Block

A

pr interval longer than .2 sec
- 5 little boxes or 1 big box

depolarizes slowly

48
Q

Second Degree Block: Mobitz type 1 (Wenckebach)

A
  1. AV becomes more refractory w/ beats
  2. PR interval lengthens
  3. AV node fails
    DROPS QRS
49
Q

Second Degree Block: Mobitz type 2

A
  1. AV node slow to repolarize
  2. blocks on next beat
  3. AV node recovers
  4. 2:1, 3:1 ratio of P:QRS

REGULARLY DROPS QRS

50
Q

Third Degree Block

A

no relationship between P and QRS
- separate rates and rhythms for the atria (p waves) and ventricles (QRS)

51
Q

Bundle Branch Block

A

one, both or part of one bundle branch conducts slowly

  • qrs wider than .12 (3 little boxes)
52
Q

Wolff Parkinson White

A
  • depolarization of atria and pause at AV node
    BUT theres an alternate pathway it takes without pause
  • causes delta shaped wave
  • can cause tachycardia
53
Q

Atrial PAC
nodial or av PJC
Ventricle:

A

atrial: weird P wave
ventricle:absent p after qrs or short pr interval
junctional: p wave hidden, t missing

54
Q
A

CardioPulm (17 decks)

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