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KIN 429 > 5.1 ECG1 > Flashcards

5.1 ECG1 Flashcards

(45 cards)

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1
Q

What are the 2 main coronary arteries?
Where do they supply blood to?

A

LMCA - supplies blood to left side of heart
- divides into LAD (supplies to front of left side of heart and bulk of LV) and LCx (supples left lateral and posterior)

RCA - supplies blood to right atrium, right ventricle, and SA and AV nodes that regulate heart rhythm

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2
Q

What coronary artery is most likely to contain electrical conduction system?

A

right coronary artery

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3
Q

What are the intrinsic factors of the autonomic control?

A

SA node - pacemaker of the heart

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4
Q

What are the extrinsic factors of the autonomic control?

A

neural function (chronotropic)
- balance of sympathetic and parasympathetic stimulation
- hormonal control (catecholamines)

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5
Q

Sympathetic vs. parasympathetic?

A

sympathetic = fight or flight
parasympathetic = rest and digest

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6
Q

What is the conduction system?

A

special electrical (pacemaker) cells in the heart that are arranged in a system of pathways.

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7
Q

What controls the heart?

A

Normally, the pacemaker site with the fastest firing rate

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8
Q

What is the idea around vectors in the heart?

A

Electrical activity goes off in many different directions - we sum them up to get an average of the vectors

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9
Q

In a healthy heart, the sum of vectors should lead through where?
What is this called?

A

the left ventricle
called the electrical axis

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10
Q

What does lead 2 / rhythm strip look at?

A

Blood going towards the LV

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11
Q

What does p-wave represent?

A

atrial contraction (atrial depolarization)

SA node is firing off

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12
Q

What does the QRS complex represent?

A

ventricular depolarization

(atrial repolarization occurs too, but isn’t seen b/c it is lesser magnitude)

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13
Q

What does the T-wave represent?

A

ventricular repolarization

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14
Q

When does diastole occur in an ECG?

A

between the beats

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15
Q

What are the intrinsic rates of pacing cells?

SA node?
Atrial cells?
AV node?
His bundle?
Bundle branch?
Purkinje cells?
Myocardial cells?

A

SA node = 60-100 BPM
Atrial cells = 55-60 BPM
AV node = 45-50 BPM
His bundle = 40-45 BPM
Bundle branch = 40-45 BMP
Purkinje cells = 35-40 BMP
Myocardial cells = 30-35 BMP

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16
Q

Which direction does a current flowing towards a positive electrode deflect?
Current flowing away from positive electrode?

A

Current flowing towards a positive electrode deflects upward

Current flowing away from positive electrode deflects downward

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17
Q

On an ECG recording paper, what do/does 1 square, 3 small squares, and 5 small squares measure?

A

1 small square = 0.04s
3 small squares = 0.12s
5 small squares = 0.20s

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18
Q

What numbers demonstrate heart rate from thick-lined box to the next thick line?

A

300
150
100
75
60
50
43
38
33
30

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19
Q

What are sinus rhythms?

What are the 7 called?

Study These Flashcards
A

all rhythms whose origin is the sinus node

sinus ryhthm
sinus bradycardia
sinus tachycardia
sinus arrhythmia
sick sinus syndrome
sinus arrest
sinus block

20
Q

What are sinus bradycardia
and sinus tachycardia?

Study These Flashcards
A

sinus bradycardia <60bpm
sinus tachycardia >100bpm

21
Q

How do you calculate atrial rate vs ventricular rate?

Study These Flashcards
A

Atrial rate - calculate from p-wave to p-wave
Ventricular rate - QRS to QRS

22
Q

What is sinus arrhythmia?

Describe rate, regularity, p-wave, QRS ratio, PR interval, QRS width, grouping, and dropped width.

Study These Flashcards
A

Rate: 60-100 bpm
Regularity: changes with breathing; Slower during exhalation and faster during inhalation
P-wave = normal
QRS ratio: 1:1
PR interval = normal; 0.12-0.20s
QRS width: normal
grouping: none
dropped beats: none

23
Q

What is the length for a normal PR interval?

24
Q

Sinus arrhythmia has identical features to a normal sinus rhythm except what?

Study These Flashcards
A

except the rate varies more than 10%

(shorter and longer distances between beats / diastole)

25
What is sinus bradycardia?
Rate <60bpm Normal otherwise PR interval and QRS width are normal to slightly prolonged
26
What can cause sinus bradycardia?
vagal stimulation leading to nodal slowing or medicines such as beta blockers also seen in some highly conditioned athletes
27
What is sinus tachycardia?
Rate >100 bpm Normal otherwise; PR interval and QRS width may be normal to slightly shortened
28
What has caused sinus tachycardia?
can be caused by medications or by conditions that require increased cardiac output, such as exercise, hypoxemia, hypovolemia, hemorrhage and acidosis
29
What is hypoxemia and hypovolemia?
Hypoxemia – low level of oxygen in the blood Hypovolemia – a decreased volume of circulating blood in the body
30
What is premature atrial contraction?
- rate depends on sinus rate - irregular - p-wave is present but may be in a different shape - P-P intervals are different lengths - multifocal p-wave stimuli - sometimes grouping
31
What are multifocal PACs?
premature atrial contractions that are generated in different places of the atria so they have different shapes
32
What is ectopic atrial tachycardia?
- rate of 100-180bpm - ectopic = in abnormal place - p-wave --> different ectopic focus - QRS width can be abnormal
33
What is SVT?
supraventricular tachycardia - regular rhythm - 160-250bpm - p-wave is often not visible - PR interval is usually not measurable - QRS is usually normal
34
What are the causes of supraventricular tachycardia?
atrial flutter with rapid ventricular response atrial fibrillation with rapid vent response atrial tachycardia AV node re-entry tachycardia accessory pathway mediated SVT
35
What is atrial flutter?
a single irritated focus of the atria that is firing rapidly; creates a reentry circuit that depolarizes the atria and gains control as pacemaker of the heart p-wave appears saw-toothed (very peaked) atrial rate is often 250-250bpm ventricular rate is commonly 125-175 bpm variable QRS width
36
Describe how the AV node works as a gatekeeper.
AV node = gatekeeper to the ventricle that comes in as it determines how many impulses reach the ventricles
37
What might cause atrial flutter?
often occurs in people with heart disease acute myocardial infarct, congestive cardiomyopathy, hyperthyroidism, cor pulmonale (right-sided heart failure), valve disease
38
What is occurring in atrial fibrillation?
multiple ectopic foci in the atria firing, causing the atria to depolarize in a chaotic manner atria is quivering AV node is bombarded with many impulses always irregularly irregular wavy baseline, can't see p-wave
39
A-fib versus A-flutter... which is irregularly irregular and which is regularly irregular?
A-fib = irregularly irregular A-flutter = regularly irregular
40
What is a controlled rate of atrial fibrillation?
rate <100bpm = controlled with medication
41
What are causes of artifact?
Patient Movement Muscle Tremor Poor or Lost Electrode Contact Electrical Interference from Other Electrical Equipment External chest compressions Or: muscle tremor, alternating current (AC) interference, poor electrode contact with the skin, interference related to biotelemetry, and external chest compression
42
What is artifact?
Abnormal waves and spikes in an ECG that result from sources other than the electrical activity of the heart and interfere with or distort the components of the ECG.
43
What is the difference between sinus pause and sinus block?
sinus pause = varied time period of which there is no sinus pacemaker working; tie interval is not a multiple of the normal P-P interval sinus block = picks back up on time in some multiple of the P-P interval; after a dropped beat, cycle continues as scheduled - sinus has fired but the impulse has not made it out of the SA node
44
What is a WAP? What is occurring? regularly irregular or irregularly irregular?
wandering atrial pacemaker - multiple atrial pacemakers are firing at their own pace. Results in an ECG with at least 3 different p-wave morphologies. 100bpm irregularly irregular variable PR interval
45
What is multifocal atrial tachycardia?
>100bpm (lower than Afib) irregularly irregular clear p-wave but different morphologies

KIN 429 (10 decks)

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