Cardio Intro (Cardio 1)

Question 1

Path of Blood Flow Through the Heart

Answer 1

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

Question 2

Sequence of Electrical Activity of Heart

Answer 2

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

Question 3

EKG/ECG

Answer 3

recording of the electrical activity of the heart

Question 4

What is an EKG machine reading?

Answer 4

the change in polarity/electrical activity in the heart

Question 5

12 Lead

Answer 5

• 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

Question 6

What are the types of leads?

Answer 6

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

- 6 precordial leads (chest)

Question 7

Lead I

Answer 7

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

Question 8

Lead II

Answer 8

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

Question 9

What is the most monitored lead and why?

Answer 9

• lead II

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

Question 10

Lead III

Answer 10

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

Question 11

Lead aVR

Answer 11

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

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

Question 12

Lead aVL

Answer 12

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

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

Question 13

Lead aVF

Answer 13

movement from the arms to the left leg (+)

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

Question 14

Positive Deflection

Answer 14

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

Question 15

Negative Deflection

Answer 15

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

Question 16

P Wave

Answer 16

atrial DEpolarization

Question 17

QRS

Answer 17

ventricular DEpolarization

-also hides the atrial repolarization

Question 18

T Wave

Answer 18

ventricular REpolarization

Question 19

PR Interval

Answer 19

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

Question 20

ST Segment

Answer 20

time between end of ventricular depolarization to start of ventricular repolarization

Question 21

What does depolarization do to heart muscle?

Answer 21

stimulates it to contract

Question 22

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

Answer 22

the ventricles b/c they have more muscle mass

Question 23

What is on the horizontal axis of an EKG?

Answer 23

time

Question 24

What is on the vertical axis of an EKG?

Answer 24

voltage/electrical activity

Question 25

1. What is the width of one small box on an EKG? | 2. Large box?

Answer 25

1. 0.04 seconds (1 mm) | 2. 0.2 seconds (5 mm)

Question 26

1. What is the height of one small box on an EKG? | 2. Large box?

Answer 26

1. 0.1 mV or 1 mm | 2. 0.5 mV or 5 mm

Question 27

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

Answer 27

lead I and lead aVF

Question 28

In the circle of axes/quadrant system, which quadrant has both leads negative? What does this represent?

Answer 28

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

Question 29

In the circle of axes/quadrant system, which quadrant has both leads positive? What does this represent?

Answer 29

1. lower left quadrant | 2. this quadrant is normal and where you would expect the heart's electrical vector to be

Question 30

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

Answer 30

1. upper left quadrant | 2. left axis deviation LAD

Question 31

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

Answer 31

1. lower right quadrant | 2. right axis deviation RAD

Question 32

Causes of LAD

Answer 32

- 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

Question 33

Is left ventricular hypertrophy cause left axis deviation?

Answer 33

NO! | they can be correlated, but not always

Question 34

Causes of RAD

Answer 34

- 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

Question 35

Causes of Extreme RAD

Answer 35

- emphysema - hyperkalemia - lead transposition (most common!) - artificial cardiac pacing - ventricular tachycardia

Question 36

Steps 1, 2 and 3 of EKG Interpretation

Answer 36

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

Question 37

Steps 4 and 5 of EKG Interpretation

Answer 37

4. is there a P with every QRS (find each QRS then check for P) 5. 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!!!

Question 38

Steps 6 and 7 of EKG Interpretation

Answer 38

6. what is the PR interval | 7. what is the width of the QRS complex

Question 39

Step 8 of EKG interpretation

Answer 39

8. what is the rhythm (eg normal sinus rhythm)

Question 40

Steps 9, 10, 11 of EKG Interpretation

Answer 40

9. what is the axis 10. are there any funny or extra beats (if so, what are they and why) 11. any other changes: ST, T or Q wave changes; indication of hypertrophy, etc

Question 41

What is a normal PR interval?

Answer 41

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

Question 42

What is a normal QRS width?

Answer 42

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