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Fall 2014 - CM Cardio > Cardio Intro (Cardio 1) > Flashcards

Cardio Intro (Cardio 1) Flashcards

1
Q

Path of Blood Flow Through the Heart

A

SVC and IVC –> right atrium –> right ventricle –> pulmonary trunk/arteries –> lungs –> pulmonary veins –> left atrium –> left ventricle

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2
Q

Sequence of Electrical Activity of Heart

A
  1. SA node produces signal that causes atria to contract
  2. signal reaches AV node
  3. Bundle of His
  4. Purkinje fibers
  5. ventricles contract
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3
Q

EKG/ECG

A

recording of the electrical activity of the heart

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4
Q

What is an EKG machine reading?

A

the change in polarity/electrical activity in the heart

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5
Q

12 Lead

A
  • 12 “pictures” of the heart to get a “3D rendering” of the heart on a piece of paper
  • only use 10 leads, but get 12 views
  • always looks at electrical movement from negative to positive
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6
Q

What are the types of leads?

A
  • 6 limb leads: 3 simple/standard and 3 augmented

- 6 precordial leads (chest)

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7
Q

Lead I

A

electrical movement from right arm (-) to left arm (+)

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8
Q

Lead II

A

electrical movement from R arm (-) to left leg (+)

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9
Q

What is the most monitored lead and why?

A
  • lead II

- it shows how the electricity is supposed to move through the heart normally

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10
Q

Lead III

A

movement from left arm (-) to left leg (+)

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11
Q

Lead aVR

A

movement from the left arm and left leg to the right arm (+)

**the only lead where the R arm is positive!

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12
Q

Lead aVL

A

movement from right arm and left leg to left arm (+)

similar to lead I (goes to a positive at the left arm)

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13
Q

Lead aVF

A

movement from the arms to the left leg (+)

similar to lead II (goes to a positive at the left leg)

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14
Q

Positive Deflection

A

-an upward spike on the EKG when electrical activity moves toward a positive lead

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15
Q

Negative Deflection

A

-a downward spike on the EKG when electrical activity moves away from a positive lead

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16
Q

P Wave

A

atrial DEpolarization

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17
Q

QRS

A

ventricular DEpolarization

-also hides the atrial repolarization

18
Q

T Wave

A

ventricular REpolarization

19
Q

PR Interval

A

time from the start of atrial depolarization (P wave) to the start of ventricular depolarization

20
Q

ST Segment

A

time between end of ventricular depolarization to start of ventricular repolarization

21
Q

What does depolarization do to heart muscle?

A

stimulates it to contract

22
Q

Which heart structure has more electrical changes/depolarization and why?

A

the ventricles b/c they have more muscle mass

23
Q

What is on the horizontal axis of an EKG?

A

time

24
Q

What is on the vertical axis of an EKG?

A

voltage/electrical activity

25
Q
  1. What is the width of one small box on an EKG?

2. Large box?

A
  1. 0.04 seconds (1 mm)

2. 0.2 seconds (5 mm)

26
Q
  1. What is the height of one small box on an EKG?

2. Large box?

A
  1. 0.1 mV or 1 mm

2. 0.5 mV or 5 mm

27
Q

In the circle of axes/quadrant system, what 2 leads are you looking at?

A

lead I and lead aVF

28
Q

In the circle of axes/quadrant system, which quadrant has both leads negative?

What does this represent?

A
  1. upper right quadrant (of the pt, so it’s opposite of on a paper)
  2. extreme right axis deviation, aka no man’s land
29
Q

In the circle of axes/quadrant system, which quadrant has both leads positive?

What does this represent?

A
  1. lower left quadrant

2. this quadrant is normal and where you would expect the heart’s electrical vector to be

30
Q

In the circle of axes/quadrant system, which quadrant has lead I POSITIVE and aVF NEGATIVE?

What does this represent?

A
  1. upper left quadrant

2. left axis deviation LAD

31
Q

In the circle of axes/quadrant system, which quadrant has lead I NEGATIVE and aVF POSITIVE?

What does this represent?

A
  1. lower right quadrant

2. right axis deviation RAD

32
Q

Causes of LAD

A
  • left anterior hemiblock: electrical activity blocked from passing through His bundle
  • Q waves of inferior MI
  • artificial cardiac pacing
  • emphysema
  • hyperkalemia
  • Wolff Parkinson White syndrome
  • tricuspid atresia
  • injection of contrast into left coronary artery
33
Q

Is left ventricular hypertrophy cause left axis deviation?

A

NO!

they can be correlated, but not always

34
Q

Causes of RAD

A
  • normal finding in kids and tall thin adults (heart sits more up and down than tilted
  • right ventricular hypertrophy
  • chronic lung dz
  • anterolateral MI
  • left posterior hemiblock
  • pulmonary embolus
  • Wolff Parkinson White syndrome
  • atrial or ventricular septal defect
35
Q

Causes of Extreme RAD

A
  • emphysema
  • hyperkalemia
  • lead transposition (most common!)
  • artificial cardiac pacing
  • ventricular tachycardia
36
Q

Steps 1, 2 and 3 of EKG Interpretation

A
  1. regular or irregular
  2. fast, slow, normal
  3. what is the rate (bpm)
37
Q

Steps 4 and 5 of EKG Interpretation

A
  1. is there a P with every QRS (find each QRS then check for P)
  2. is there a QRS with every P (find each P then check for QRS)

**if one or both of these answer NO, then look for weird/extra beats!!!

38
Q

Steps 6 and 7 of EKG Interpretation

A
  1. what is the PR interval

7. what is the width of the QRS complex

39
Q

Step 8 of EKG interpretation

A
  1. what is the rhythm (eg normal sinus rhythm)
40
Q

Steps 9, 10, 11 of EKG Interpretation

A
  1. what is the axis
  2. are there any funny or extra beats (if so, what are they and why)
  3. any other changes: ST, T or Q wave changes; indication of hypertrophy, etc
41
Q

What is a normal PR interval?

A

.12 - .20 seconds (3-5 little boxes or w/in one large box)

42
Q

What is a normal QRS width?

A

.08 - .12 seconds (2-3 little boxes)

Fall 2014 - CM Cardio (5 decks)

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