Brainscape's Knowledge GenomeTM

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


See full index

EMRG1230 > Cardiac > Flashcards

Cardiac Flashcards

1
Q

What are the intrinsic rates of the heart

A

SA node 60-100

Atrial cells 55-60

AV node 40-60

Bundle of His 40-45

Bundle branch 40-45

Purkinje fibers 20-40

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

What are the cardiac cells

A

Automaticity- generates own electrical impulses

Excitability- irritability and ability to respond to a charge

Conductivity- pass a charge onto next cell

Contractility- ability to shorten and contract

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

Refractory period

A

Approx. 0.5ms

Absolute refractory- won’t respond to any stimulus no matter how strong

Relative refractory- the membrane only responds to very strong stimulus and a few secs after absolute where the membrane repolarizes

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

Polarization of an ECG

A

P wave- atrial polarization

QRS- ventricular depolarization

T wave- ventricular polarization

U wave (if present)- repolarization of Purkinje fibers

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

Limb leads

A

bipolar

White electrode- RA

Red electrode- LL

Black electrode- LA

Green electrode- RL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Chest leads

A

unipolar

V1- right side of sternum 4th intercostal

V2- left side of sternum 4th intercostal

V3- between V2, V4

V4- 5th intercostal direct below the nipple

V5- between V4, V6

V6- 6th intercostal mid auxiliary line

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Baroreceptors

A

Sense pressure changes

Aortic and carotid receptors and aortic and carotid bodies

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

Chemoreceptors

A

Impulses sent via receptors to medulla when excess CO2 or low O2 levels are in the blood

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

Atherosclerosis

A

Thickening of the artery wall due to accumulation of fatty tissues

Chronic can be asymptomatic until the blockage impacts blood flow then becomes symptomatic

Acute rupture/ thrombus formation causes acute infarction- no blood flow distal to block

Affects predominantly coronary, renal, aortic, femoral, carotid artery

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

Types of anginas

A

Stable, unstable, variant angina

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

Stable angina

A

Follows the same pattern for the patient

Lasts 1-5 min and is relieved by rest

When the person is at rest there is enough blood flow to meet sedentary needs but when demands increased and is not met angina occurs

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

Unstable angina

A

Same etiology as stable but the pain is more severe and isn’t as easily relieved by meds/ rest

Lasts >15 min and indicative of pre-MI angina

Greater degree of obstruction in coronary arteries leading to an increased risk of imminent MI that could benefit from early treatment and prevention

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

P wave

A

precedes QRS, less than 110ms, amplitude <2.5mm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

PR interval

A

normally between 0.12 seconds and 0.20 seconds, shorter= wolff, longer= 1st degree block

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

QRS complex-

A

less than 0.12 sec

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

J point-

A

QRS ends, and ST segment begins

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

ST segment

A

line between QRS and t wave

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

T wave

A

asymmetric, less than half the height of QRS and in the same direction, faster downstroke than upstroke

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

TP segment-

A

isoelectric line (baseline) that is flat, straight, horizontal that begins at T and ends at P

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

QT interval-

A

0.36s- 0.44s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Starlings law

A

the greater amount of blood volume (preload) into the ventricle of the heart during diastole (the relaxed phase) the greater the amount of blood volume ejected out of the heart during the systolic(contraction phase)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Aplastic anemia

A

Failure of bone marrow to function causing a loss of stem cells and a decreased number of RBCs, leukocytes, and platelets

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Sickel cell anemia

A

Altered hemoglobin changes to a sickle cell shape and crystalizes, changing the life span to 20 days from 120. The altered shape causes less oxygen to be carried and a risk of thrombi and necrosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Hemolytic anemia

A

Premature destruction of RBCs that is inherited of acquired. May not appear as anemia if bone marrow can produce enough RBCs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Polycythemia

A

Primary: increased production of RBCs in bone marrow for no reason

Secondary: increased RBC secondary to hypoxia (needs more RBCs for o2 carrying capacity)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Hemophilia

A

Deficiency of clotting factors that can be mild where only bleeding occurs after an accident or severe where bleeding is frequent and spontaneous

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Disseminated intravascular coagulation (DIC)

A

Excessive bleeding and clotting factors that causes unneeded clots and the factors are unavailable during excessive bleeding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Multiple myeloma

A

Cancer of plasma cells that causes affected plasma cells to rapidly multiply and infiltrate marrow leading to organ death/ failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Leukemia

A

Leukocytes multiply uncontrollably in marrow and are released into circulation suppressing production of other cells leading to anemia

30
Q

Hodgkins’s lymphoma

A

Involves a single lymph node that spreads to two or more regions on the same side of the diaphragm, then affects lymph nodes on both sides of the diaphragm then involves bones, liver, or lungs

31
Q

Non-Hodgkins lymphoma

A

Multiple lymph node involvement through the body that is non organized pattern of widespread metastases that involves intestinal nodes and organs

32
Q

HIV

A

Immune deficiency from a virus that affects lymphocytes and suppresses the immune system and attacks t cells leading to low numbers and increases the risk of infections and cancer

33
Q

Pathway of blood through the heart

A

Deoxygenated blood -> superior vena cava/ inferior vena cava -> right atrium -> tricuspid valve -> right ventricle -> pulmonary valve -> pulmonary artery -> lungs to collect O2/ dump CO2 -> pulmonary veins -> left atrium -> bicuspid valve -> left ventricle -> aortic valve -> aorta -> body

34
Q

Sodium potassium pump

A

It starts in polarization where potassium is inside, and sodium and calcium are outside. Moves to depolarization during a contraction causing the opening of sodium channels to allow sodium inside, calcium also moves inside, and potassium moves outside. Repolarization occurs during a termination of action potential where potassium channels open allowing potassium to leave the cell.

35
Q

Left ventricular failure

A

Most commonly damaged during an MI

Happens when the left side of the heart can’t pump blood from the pulmonary vessels so blood backs up behind the left side causing increased pressure in the left atrium and pulmonary veins and serum to be forced from pulmonary capillaries and into alveoli.

36
Q

Right side heart failure

A

A result of left sided heart failure where when blood is pumped back into the lungs the right side must work harder to pump blood back into the pulmonary arteries and eventually the right side cannot keep up and fails

37
Q

Respiratory distress standard

A

Consider life/limb/function threats like ACS, AMI, dissecting aorta, tension pneumo/ pneumothorax, respiratory disorders, pulmonary edema, pericarditis

Acquire a 12-lead and perform a secondary assessment of the chest for subcutaneous emphysema, accessory muscle use, urticaria, indrawing, shape, symmetry, and tenderness, assess the lungs for decreased air entry and adventitious sounds through auscultation, abdomen per standard, neck for tracheal position and JVD, and extremities for ankle/leg edema

38
Q

STEMI hospital bypass standard

A

> 18, have chest pain or equivalent consistent with cardiac ischemia or MI, current episode <12 hours from onset, 12 lead showing a STEMI: 1mm elevation in 2 anatomical leads or 2mm elevation in leads V1-V3 and the paramedic agrees

Contraindications: CTAS 1 w/ unstable airway/ ventilate, 12 lead is consistent with LBBB, ventricular paced or any other STEMI imitator, transport to hospital that performs percutaneous coronary intervention >60 min from pt contact, pt has a complication requiring primary care diversion like mod/sev resp distress or CPAP, hemodynamically unstable, symptomatic SBP is <90mmHg, VSA w/o ROSC

ACP diversion ventilation inadequate despite assistance, hemodynamic instability unresponsive to ACP treatment/ management, VSA w/o ROSC

39
Q

Oxygen therapy standard

A

Administer oxygen using a device and flow rate to attempt to maintain oxygen saturation between 92-96 as measured by SPO2 unless specified otherwise. Continuously administer oxygen for pts with CO, cyanide, noxious gas exposure, upper airway burns, scuba-diving related disorders, ongoing cardiopulmonary arrest, complete airway obstruction, sickle cell anemia w/ suspected Vaso-occlusive crisis. Also give oxygen to pts with critical findings like age-specific hypotension, respiratory distress, cyanosis/ ashen colour/ pallor, altered LOC, abnormal pregnancy/labour.

40
Q

Acute cardiogenic pulmonary edema medical directive

A

Nitro: >18, HR- 60-159bpm, SBP- normotension

Contraindications: allergy/ sensitivity to nitrates, phosphodiesterase inhibitor use within previous 48 hours, SBP drops by 1/3 or more of initial value after administration

SBP >100-<140, 0.4 mg, 5 min dose interval, max 6 doses

41
Q

Cardiac ischemia medical directive

A

ASA: >18, LOA- unaltered, other: able to chew and swallow

Contraindications: allergy/ sensitivity to NSAIDS, no prior use if asthmatic, current active bleed, CVA/TBI in previous 24 hours

ASA: dose- 160-162mg, max dose- 162mg, max # of doses-1

Nitro: >18, LOA- unaltered, HR- 60-159, SBP- normotension, other- prior med hx or iv access obtained

Contraindications: allergy/ sensitivity to nitrates, phosphodiesterase inhibitor use within previous 48 hours, SBP drops by 1/3 or more of initial value after administration, 12 lead compatible with RVI

STEMI- SBP- >100, 0.4mg, dose interval- 5 min, max # of doses- 3

No STEMI- SBP- >100mmhg, dose- 0.4 mg, dose interval- 5 min, max # of doses- 6

42
Q

Normal sinus rhythm

A

60-100 bpm

Regular

Present p wave that proceeds qrs

<0.12 qrs width

43
Q

Sinus bradycardia

A

<60 bpm

Regular

Present p wave that proceeds qrs

<0.12 qrs width

44
Q

Sinus tachycardia

A

> 100bpm

Regular

Present p wave that proceeds qrs

<0.12 qrs width

45
Q

Sinus arrest

A

The same as NSR but SA node fails to generate an impulse

46
Q

Sinus arrhythmia

A

Slight variation of a sinus rhythm- longer TP segment

47
Q

SA block

A

Rate varies

Irregular

Present p waves unless dropped

P:qrs- 1:1

Normal QRS

48
Q

Wandering atrial pacemaker

A

Regular

60-100 bpm

Normal qrs

P:qrs- 1:1

P waves present but inconsistent

49
Q

PAC

A

Underlying rhythm resets SA node firing and causes a “skipped beat”

QRS looks like it has a friend and they are social distancing from other QRS friends

50
Q

Supraventricular tachycardia (SVT)

A

P wave is there but inside T wave

140-280bpm

Regular

Qrs- <0.12

51
Q

Atrial flutter

A

250-350 bpm

Regular

Qrs normal

P waves present but saw toothy

P:qrs- 2:1 or more

52
Q

Atrial fibrillation

A

No discernable p waves

QRS- innervated but <0.12

Irregularly irregular

Bpm variable

53
Q

Multifocal atrial tachycardia (MAT)

A

100-150 bpm

Irregularly irregular

P waves: present but 3 distinct morphologies

QRS: <0.12

54
Q

Junctional rhythm

A

40-60 bpm

QRS: 0.12- but no relationship with atrial activity

Regular

P waves: inverted, retrograde/antegrade

55
Q

Accelerated junctional rhythm

A

60-100 bpm

Regular

P wave: absent, antegrade/ retrograde

QRS: normal

P:QRS: 1:1 if absent then none

56
Q

Junctional tachycardia

A

> 100bpm0- if exceeds 150 SVT may occur

P waves: retrograde

QRS: narrow

PR interval is short

Regular

57
Q

Premature junctional complex (PJC)

A

Narrow QRS w preceding p wave or retrograde P wave

Occurs sooner than next beat is expected

58
Q

First degree heart block

A

Rate is dependent on underlying rhythm

Regular

Normal p waves

PR interval increases with each beat (>0.20)

59
Q

2nd degree heart block type 1

A

Regularly irregular

PRI lengthens until the beat is dropped and it restarts

P:qrs- variable

60
Q

2nd degree heart block type 2

A

Irregular or regular

Grouped beats with one dropped beat between the groups

61
Q

Third degree heart block

A

<60bpm

Everything sends out its own impulses, so ventricles develop their own

Non conducted p waves

Absence of AV conduction

62
Q

Idioventricular

A

20-40 bpm

Regular

Absent p waves

P:QRS- n/a

QRS: >0.12

63
Q

Accelerated idioventricular

A

40-100 bpm

Regular

P waves: absent

QRS: >0.12

64
Q

Monomorphic v tach

A

Regular

Uniform QRS

64
Q

Ventricular tachycardia

A

> 100bpm

QRS: >0.12 and monomorphic

Regular with no variation

P waves: not visualized

Sustained: >30 sec or requires intervention from hemodynamic instability

Unsustained: non sustained: 3 or more consecutive ventricular complexes ending spontaneously in <30 sec

65
Q

Polymorphic v tach

A

QRS varies in size and shape

66
Q

Torsades de pointes

A

Prolonged QT interval

Type of polymorphic v tach

Can convert to NSR or v fib- notifier of death

67
Q

Premature ventricular complex (PVC)

A

Unifocal but occurs earlier than the next expected beat caused by a premature firing of the ventricle

The ventricle is in a refractory state when normal impulse tries to get through so ventricles don’t fire at normal time

68
Q

V fib

A

Cardiac death (straighter arctic monkeys’ wave)

69
Q

Asystole

A

Flatline

No more heart contracting so generally a confirmation of death

EMRG1230 (2 decks)

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