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KIN 311 > Cardiovascular Assessment > Flashcards

Cardiovascular Assessment Flashcards

1
Q

ECG =

A
  • EKG

- electrocardiography

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2
Q

Electrocardiograph:

A

the machine (oscilloscope/chart recorder)

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3
Q

Electrocardiogram:

A

the tracing

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4
Q

ECG measures the _____ ____ of the heart along different _____.

A
  • electrical activity

- vectors

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5
Q

ECG is used to assess …

A

basic abnormalities in heart function

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6
Q

A 12-lead ECG requires ___ electrodes and provides ___ leads.

A
  • 10

- 12

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7
Q

A lead consists of ___ ____ that form an ____ to provide a different view or tracing of the heart’s ____ ____.

A
  • 2 terminals (eg. a pair of electrodes)
  • axis
  • electrical activity
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8
Q

A lead is _____ and aligned with a particular ____ from the _____ electrode towards the _____ electrode.

A
  • directional
  • vector
  • negative
  • positive
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9
Q

What produces the ECG waveform?

A

the orientation of the lead (vector) in relation to the electrical current of the heart

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10
Q

When the direction of current is towards the positive electrode (negative to positive), the resulting waveform is…

A

positive

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11
Q

When the direction of current is away from the positive electrode (positive to negative), the resulting waveform is…

A

negative

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12
Q

Why should we avoid musculature as much as possible when setting up a ECG?

A

neuromotor control/ movement = activity is picked up

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13
Q

Phrase to remember set up of ECG:

A
  • white on right

- smoke over fire (black over red)

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14
Q

12-lead ECG provides ____ information about the heart’s ____ ____ in 3 orthogonal planes:

A
  • spatial
  • electrical activity
  • right - left
  • superior - inferior
  • anterior - posterior
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15
Q

__ important vectors (leads) derived from the “limb” electrodes:

A
  • 6
  • RA to LA (lead I)
  • RA to LL (lead II)
  • LA to LL (lead III)
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16
Q

Describe lead I:

A
  • travels across the heart from right to left
  • positive depolarization
  • QRS complex
  • heart is on axis that is tilted from right to left = positive depolarization associated with the fact that activity is travelling in the same direction
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17
Q

Describe lead II:

A
  • positive QRS complex
  • positive depolarization T wave
  • along axis
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18
Q

Describe lead III:

A
  • across axis of heart

- positive and then negative component to QRS

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19
Q

Why not put leads on the legs?

A
  • practicality (can do it with just shirt off)

- tripping hazards

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20
Q

RA location:

A

upper right arm-chest region immediately below the midpoint of the clavicle

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21
Q

LA location:

A

upper left arm-chest region immediately below the midpoint of the clavicle

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22
Q

LL location:

A

lower left abdominal region, at the midclavicular line at the level of the last rib

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23
Q

V1 location:

A

on the right sternal border in the 4th intercostal space

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24
Q

How can we find the 4th intercostal space?

A
  • locate sternoclavicular joint
  • clavicle counts as rib 1
  • index finger in the space immediately below first rib is first intercostal space
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25
Q

Know where ____, ____ and ____ is and fill in the rest.

A
  • V1
  • V2
  • V4
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26
Q

V2 location:

A

on the left sternal border in the 4th intercostal space

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27
Q

V3 location:

A

at the midpoint on a straight line between V2 and V4

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28
Q

V4 location:

A

on the 5th intercostal space at the midclavicular line

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29
Q

V5 location:

A

on the anterior axillary line, horizontal to V4

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30
Q

V6 location:

A

on the midaxillary line, horizontal to both V4 and V5

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31
Q

Augmented (unipolar) limb

leads:

A

use two electrodes to
create a “null point” which is
compared to the 3rd electrode.

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32
Q

aVR uses which 2 electrodes to create a null point? What is the third electrode it is compared to?

A
  • LA and LL

- RA

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33
Q

aVL uses which 2 electrodes to create a null point? What is the third electrode it is compared to?

A
  • RA and LL

- LA

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34
Q

aVF uses which 2 electrodes to create a null point? What is the third electrode it is compared to?

A
  • RA and LA

- LL

35
Q

Precordial leads:

A
  • V1
  • V2
  • V3
  • V4
  • V5
  • V6
36
Q

Limb leads:

A
  • RA
  • LA
  • LL
37
Q

Limb leads are ____, while precordial leads are _____.

A
  • bipolar

- unipolar

38
Q

Precordial leads are in close proximity to the _____, and measure …

A
  • heart

- the change in electrical potential along a vector from the heart towards the electrode

39
Q

P wave:

A

atria depolarization

40
Q

QRS complex:

A

ventricle depolarization

41
Q

T wave:

A

ventricle repolarization

42
Q

U wave:

A

repolarization of purkinje cells and/or papillary muscle of valves

43
Q

R-R:

A

1 heart beat

44
Q

J point:

A

transition point between QRS complex and the ST segment

45
Q

Grid divided into _____ and ____ ____.

A

large and small squares

46
Q

1 large square = ___ small squares.

A

5

47
Q

Standard chart recorder speed:

A

25 mm/sec

48
Q

One large square = _____ sec.

A

0.20

49
Q

One small square = ___ sec.

A

0.04

50
Q

Tachycardia:

A

rapid beating greater than 100 bpm at rest in an untrained adult

51
Q

Bradycardia:

A

beating < 60 bpm at rest in an untrained adult (symptomatic < 50 bpm)

52
Q

Arrhythmia:

A

abnormal rate, rhythm or conduction of electrical impulse in the heart

53
Q

Cause of arrhythmias:

A
  • multifaceted
  • several types
  • fever
  • dehydration
  • shock
  • hormonal imbalance
  • stress
  • various types of cardiac abnormalities
  • heart failure
54
Q

Premature ventricular contraction is caused by:

A
  • depolarization of ventricle before atria can contract

- absence of P wave before another QRS complex

55
Q

Sinus pause:

A
  • failure of S-A node firing
  • no P (atrial depolarization)
  • electrolyte abnormality
  • ventricle waits, if it doesn’t get a signal, it depolarizes on it’s own to make sure the heart keeps beating
56
Q

Third degree heart block:

A
  • nothing at SA node
  • ventricles start to beat on their own
  • P wave with no response
57
Q

Fibrillation:

A
  • uncoordinated atria or ventricle contractions caused by re-entry of electrical impulses and requires defibrillation
  • emergency
58
Q

ECG is highly recommended in ____ ____ centres especially with….

A
  • exercise testing

- untrained, older, diseased individuals

59
Q

In exercise testing centres, you must…

A
  • establish a resting ECG looking for abnormalities

- record a tracing every workload during exercise

60
Q

It is difficult to obtain ____ ___ during high intensity exercise.

A

clear traces

61
Q

_____ is qualified to conduct an ECG evaluation during exercise to identify (but not ____) irregularities. Stress testing must be done in the presence of a _____.

A
  • CSEP - CEP
  • diagnose
  • physician
62
Q

Elevated BP increases the _____ on the heart.

A

“afterload”

63
Q

Afterload:

A

the pressure the heart needs to overcome to eject blood during systole

64
Q

Stroke work =

A

sv*map

65
Q

Cardiac work =

A

sw*hr

66
Q

Auscultation method:

A
  • BP

- listening to bodily sounds using a stethoscope

67
Q

What are we listening to when taking blood pressure?

A
  • laminar flow

- turbulence of blood underneath the cuff

68
Q

Korotkoff sounds phases:

A
  • phase I: clear tapping (systolic pressure)
  • phase II: softer tapping
  • phase III: clear tapping
  • phase IV: muffled tapping
  • phase V: tapping disappears (diastole)
69
Q

BP is normally taken from the ____ ____. Why?

A
  • brachial artery
  • it is close to the heart
  • easily accessible
70
Q

When taking BP, individual should be …… Why?

A
  • seated
  • relaxed
  • legs not crossed
  • not talking
  • don’t want muscular activity
71
Q

Muscular activity during the measuring of BP can..

A

influence the ability to hear sounds and BP in general

72
Q

When taking BP, the cuff should be at the level if the ____ (____ supported).

A
  • heart

- arm

73
Q

Appropriate size of cuff:

A
  • length of bladder = 80% of arm circumference
  • width of bladder = 40% of arm circumference
  • size must apply enough pressure to stop blood flow
74
Q

Cuff should be inflated to ____ mmHg above _____ pressure.

A
  • ~30

- systolic

75
Q

Cuff should be deflated at rate of ___ mmHg/s.

A

2-3

76
Q

Systolic pressure tends to be ______. Why?

A
  • underestimated

- if you deflate too fast, you might miss the first sound

77
Q

Diastolic pressure tends to be ______.

A

overestimated

78
Q

When taking BP, repeated measures should be separated by ____ mins.

A

1+

79
Q

Hydrostatic pressure is _____ mmHg for every cm.

A

~ +/- 0.8 mmHg

80
Q

Pressure =

A

pgh

81
Q

p =

A

Rho - density of liquid (blood)

82
Q

g =

A

9.81 m/s^2 (gravity)

83
Q

h =

A

height

KIN 311 (19 decks)

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