Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Echo > Module 8 : ECG and Rhythm Recognition > Flashcards

Module 8 : ECG and Rhythm Recognition Flashcards

1
Q

12 lead ECG

A
  • measurement of the electricity produced from the heart is sensed by 10 different electrodes over the body
  • electricity is organized into leads that can tell the reader what area the heart signal is coming from
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Electrocardiogram ECG

A
  • measuring electricity of the heart
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

parts of the ECG waveform

A
  • P wave
  • T wave
  • QRS complex
  • PR interval
  • PR segment
  • QT interval
  • ST interval
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

The ECG - 2 electrical planes

A
  • ECG electrodes on 12 lead ECG senses the electricity of the heart in 2 planes
    1) frontal plane
    2) horizontal plane
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Frontal Plane / Vertical Axis

A
  • the LIMB LEADS (right arm left arm left leg) (I II III) and the AUGMENTED VECTOR LEADS (aVR, aVL, aVF) produce signal in the frontal plane
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

horizontal plane

A
  • the V leads (chest, V1-V6) produce the signal in the horizontal plane
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

the limb leads in the frontal plane

A

Lead I
Lead II
Lead III

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

frontal plane limb leads - Lead I

A
  • Right arm (RA) (-)

- Left arm (LA) (+)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

frontal plane limb leads - Lead II

A
  • Right Arm (-)

- left foot (LF) (+)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

frontal plane limb leads - Lead III

A
  • left arm (-)

- left foot (+)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

leads

A

the path between the electrodes on the chest

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

einthovens triangle

A
  • the triangle formed by the leads and electrodes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

The P wave

A
  • represents atrial depolarization (NOT CONTRACTION)
  • ATRIAL CONTRACTION OCCURS DURING PR SEGMENT
  • SA (sinotrial) node passes the signal through the inter–nodal tracts to the LA and RA muscle
  • may be totally absent or very disorganized in some arrhythmias (atrial fibrillation)
  • must have pause after the P wave to allow the atria to contract and eject its contents into the ventricle (PR INTERVAL)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

LENGTH OF THE PR INTERVAL

A

LESS THAN 200ms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

stages of the ECG wave - Stage 1

A
  • depolarization of atrial contractile fibres produce P wave
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

stages of the ECG wave - stage 2

A
  • atrial systole

- in the PR segment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

stages of the ECG wave - stage 3

A
  • depolarization of the ventricular contractile fibres produces QRS complex
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

stages of the ECG wave - stage 4

A
  • ventricular systole ( contraction )

- ST segment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

stages of the ECG wave - stage 5

A
  • repolarization of ventricular contractile fibres produces the T wave
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

stages of the ECG wave - stage 6

A
  • ventricular diastole (relaxation)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

P wave reacted to hemodynamics

A
  • the P wave corresponds to the late filling portion of the cardiac cycle
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

The PR interval

A
  • covers the time from when the beginning of the P wave to the end of the PR sement / beginning of QRS complec
  • covers atrial depolarization and contraction
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

the PR segment

A
  • the atria are now contracting (mechanical) while the signal is sitting at the bundle of His (electrical)
    + waiting to go into bundle branches
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

The Atrioventricular Node (AV Node)

A
  • the AV node and Bundle of His slow the conduction speed considerably
  • slowing conduction allows the atria to have time to contract
  • once atria contract and fill the ventricles then the signal gets the green light to go into the left and right bundle branches and on the ventricles
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

the QRS complex

A
  • involves the depolarization of different parts of both ventricles in sequence
  • REPRESETNS VENTRICULAR DEPOLARIZATION
  • NOT WHEN VENTRICLE CONTRACTS
  • combination between conduction through bundle branches, purkinjie fibres
    and ventricle muscle cells
  • each segment of the QRS represents a different segment (of the heart) of conduction
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

left bundle branch (LBB)

A
  • has 2 fascicles
    + left anterior and left posterior fascicle
  • fascicles are like wires
  • left has more fascicles because left ventricle more complex and thicker
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

right bundle branch (RBB)

A
  • only has 1 fascicle
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

speed of impulse in bundle branches

A
  • the speed of travel through the BB impact the QRS duration
  • if signal is blocked the QRS duration gets wider
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

normal QRS duration

A

< 100ms

30
Q

Abnormal QRS duration

A

> 120ms

31
Q

Left Bundle Branch Block (LBBB)

A
  • impulse normally travels very fast through the BB’s
  • get blocked by dead tissue
  • usually wider and below the line in V1 (-)
  • very negative
32
Q

Right Bundle Branch Block (RBBB)

A
  • (+) in V1

- makes lead V1 had Rabbit ears

33
Q

QRS amplitude

A
  • voltage/height of QRS complex
34
Q

QRS amplitude - influencing factors

A
  • muscle thickness
  • body habitus
  • pericardium
35
Q

muscle thickness affecting QRS amplitude

A

more muscle = more QRS amplitude

36
Q

body habitus affecting QRS amplitude

A
  • impedance of electricity
  • obese = small amplitude signal, fat tissue acts as an insulator so it can’t get through
  • small = large amplitude signal
37
Q

pericardium habitus affecting QRS amplitude

A
  • excess pericardial fluid or thickened pericardium may shrink the QRS amplitude
    + inflamed, fibroised muffles ECG
38
Q

the ST segment

A
  • represents the gap between ventricular depolarization and repolarization
  • period of time when the ventricles start to contract
  • ST segment is isoelectric and should be same level as PR segment
  • if it changes up or down compared to PR segment something is wrong
39
Q

ST segment decreased

A
  • indicates myocardial ischemia

- tissue not dead but not enough blood flow

40
Q

ST segment increased

A
  • indicates myocardial infarction
  • blocked artery
  • having a heart attack
  • not always symptomatic
41
Q

the T wave

A
  • represents
    + electrically = ventricular repolarization
    + mechanically = coincides with ventricular systole
  • may be merged with ST segment
  • may have positive or negative polarity
  • negative T wave may be caused by ischemia, digoxin (given for atrial fib), electrolyte imbalance
42
Q

Normal Sinus Rhythm (NSR)

A
  • ## impulse is originating from the sinus node travels through NORMAL CONDUCTION PATHWAY through the heart
43
Q

NSR rate

A

60-90 bpm

44
Q

bradycardia

A

50-60 bpm

45
Q

tachycardia

A

90-100 bpm

46
Q

5 step method for diagnosing rhythms

A

1) heart rate
2) rhythm (regular and irregular)
3) P waves (before QRS, identical?)
4) PR interval (long or short)
5) QRS (wide or normal)

47
Q

step 1 - heart rate

A
  • between 60-90 bpm normal

- regular

48
Q

step 2 - rhythm

A

R-R interval should be regular

- same beat to beat

49
Q

step 3 - P waves

A
  • one P wave for every QRS complex
50
Q

step 4 - PR interval

A
  • normal PR interval
  • 170 ms
    260 is prolonged
51
Q

step 5 - QRS complex width

A
  • needs to be narrow too wide may be LBBB
52
Q

first degree AV block

A
  • long PR interval
  • p waves before each QRS complex but AV node holding the impulse too long
  • don’t need a pace maker
53
Q

atrial fibrillation

A
  • no detectable P waves
  • disorganized atrial contraction
  • baseline undulates with no defined P waves
  • ventricles contract when they can
  • irregular R-R intervals
54
Q

premature atrial contraction (PAC)

A
  • MOST BENIGN ARRHYTHMIAS
  • atrial tissue produces its own impulse leading ti atrial contraction followed by ventricular contraction
  • may be result of too much catecholamines (stress hormones or caffeine)
  • ectopic focus
55
Q

PAC on ECG

A
  • during a compensatory pause pause the timing is reset with the SA node takin over rhythm again
  • biphasic P wave
56
Q

premature ventricular contration (PVC)

A
  • similar causes as the PAC
    + catecholamines, stress
  • however may also be caused by PARTIALLY BLACKED ARTERY CAUSING ZONE OF ISCHEMIA
57
Q

zone of ischemia

A
  • has altered ions within it which alters the impulse formation and propagation properties leading to PVCs
  • usually follows by compensatory pause
58
Q

PVC on ECG

A
  • no P wave
  • PVC usually has higher voltage than normal beats
  • repolarization is messed up because depolarization is messed up
59
Q

atrial flutter

A
  • atrial contraction is semi-organized so P waves look similar to normal P waves
  • electrical re-entry loop through the atrial tissue which allow it to depolarize repeatedly
60
Q

ventricle response to atrial flutter

A

2: 1 3:1 4:1

- for every 2,3,4 P waves one QRS complex occurs

61
Q

atrial rate in atrial flutter

A
  • 250-300 bpm
62
Q

atrial flutter on ECG

A
  • SAW TOOTH
  • atrial and ventricles do not talk to each other very well each do their own thing
  • the atria contract all crazy and the ventricle contract with the bundle of his allows a impulse to them
63
Q

atrial fibrillation ( af, afib)

A
  • caused by very disorganized atrial contraction
  • many ectopic electrical atrial foci competing to pace the heart
  • R-R interval always changing
  • LV outflow always changes as preload changes
  • patient lose atrial kick
  • early ventricular filling okay but loss of late filling
  • atria QUIVERING not CONTRACTING
64
Q

atrial fibrillation factors

A
  • congestive heart failure (CHF)

- atrial enlargement (ALMOST ALWAYS)

65
Q

afib characteristics

A
  • in PLAX the MV appears to bounce many times before the LV contracts
  • ventricles respond to atrial stimuli from the his bundle whenever it can leading to conduction down the bundle branches soit can contract
66
Q

atrio-venricular blocks

A

first degree AV block
second degree AV block
third degree AV block

67
Q

second degree AV block

A
  • points of non contracting P waves

- some QRS beats are dropped

68
Q

third degree AV block

A
  • atrio-ventricular dissociation
  • atria not speaking to ventricle at all
  • prolonged P waves without QRS complex until QRS comes back
  • lead II is the best lead to see P waves
69
Q

multiple PVC’s

A
  • can occur in 2’s 3’s or 4’s
  • these are unifocal (from one focus) the mechanism is a re entry loop in the ventricles
  • the ectopic focus where the impulse originates may be in a zone of ischemia
70
Q

multifocal PVC’s

A
  • impulse originates from more than one focus within the ventricles
  • the shape of the QRS complex looks different beat to beat
71
Q

ventricular tachycardia

A
  • no blood to brain
  • no blood to heart
  • coronaries aren’t filling
  • very rapid ventricular beats
  • re entry loops through ventricles only
  • very bad need the shock
72
Q

ventricular fibrillation (vfib)

A
  • very bad the absolute worst
  • can sshock but not good outcome
  • ventricles just fluttering not contracting at all

Echo (19 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions