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ECG Flashcards

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1
Q

the general line of ECG

A
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2
Q

ECG stands for

A

electrocardiogram

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3
Q

P wave

A

atrial depolarization

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4
Q

QRS complex

A

ventricular depolarization (contracting)

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5
Q

T wave

A

ventricular repolarization (ventricles relax)

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6
Q

where is atrial repolarization?

A

within QRS complex (covered)

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7
Q

define ECG

A

assesses the NET cardiac electrical activity measured between two points on the body’s surface

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8
Q

ECG: Cell-to-cell propagation of cardiac AP occur because of the ability of _______ to provide extremely efficient electrical connectivity between cardiac muscle cells that allow them to beat in a functional _________

A

Cell-to-cell propagation of cardiac AP occur because of the ability of GAP JUNCTIONS to provide extremely efficient electrical connectivity between cardiac muscle cells that allow them to beat in a functional SYNCYNCTIUM

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9
Q

ECG is the primary clinical tool for the diagnosis of: 2

A

— cardiac arrhythmias (abnormal electrical patterns in the heart)
— myocardial injuries that cause disturbances in heart rate (HR), rhythm, and/or wave-front propagation

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10
Q

ECG: strength of cardiac muscle contraction is _____ _______ to the intracellular Ca2+ concentration

A

directly proportional

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11
Q

ECG: after action potential, ________ Ca2+ channels opening causing a 1000-fold rise in the intracellular free Ca2+

A

L-type slow Ca2+ channels

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12
Q

ECG: sliding filament theory

A
  • Depolarization conducts along membrane to T- tubules
  • Calcium influx induces more Ca2+ release from the SR stores into intracellular fluid
  • Ca2+ binds with troponin causing shift to reveals the binding site for myosin heads
  • Cross-bridge formation between the actin and myosin filaments of the sarcomere
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13
Q

study heart (no question)

A
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14
Q

Trace blood flow from SVC/IVC (in words)

A
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15
Q

Order of Valves opening in heart: Tiny Penguins Marching Along

A

tricuspid, pulmonary, mitral, aortic

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16
Q

normal blood pressure

A

systolic: <120
diastolic: <80

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17
Q

elevated blood pressure

A

systolic: 120-129
diastolic: <80

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18
Q

High blood pressure (hypertension) Stage 1

A

systolic: 130-139
diastolic: 80-89

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19
Q

High blood pressure (hypertension) Stage 2

A

systolic: >140
diastolic: >90

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20
Q

Hypertensive crisis

A

systolic: >180
diastolic: >120

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21
Q

ECG: systole

A

during ventricular contraction to pump blood flow

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22
Q

ECG: diastole

A

occurs after contraction when the heart relaxes (ventricles fill with blood)

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23
Q

study

A
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24
Q

ECG: “lub”

A

S1
First heart sound “Lub, dub”
Closure of the tricuspid and mitral valves
Beginning of ventricular systole (ventricular contraction)

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25
ECG: "dub"
S2 Second heart sound "lub, dub" Closure of the aortic and pulmonary valves beginning of ventricular diastole
26
ECG: heart cells
Pacemaker cells: - SA node - AV node - His bundle - Bundle branches - Purkinjie fibers working myocardial cells
27
ECG: what do pacemaker cells do in the heart?
responsible for the initiation & conduction of electrical signaling through the heart
28
ECG: electrical conduction sequence
SA node Atria AV node His bundle Bundle branches Purkinjie fibers Ventricles
29
ECG: what is the fastest conduction cell?
SA node
30
ECG: what does the AV node do?
create a slight delay between atrial contraction and ventricular contraction
31
ECG: what do Purkinje fibers do?
ensure that all ventricular cells contract at nearly the same instant (rapid conduction)
32
ECG: what cell is the Heart Rate (HR) normally controlled by?
SA nodal cells
33
ECG: Automaticity
property of the specialized cardiac cells to spontaneously fire APs o SA node has fastest rate (dominant pacemaker) o Sinoatrial rhythm is 60-100 bpm o latent pacemakers (all other cells)
34
ECG: what is the AV rhythm range
Atrioventricular (AV) rhythm is only 40-60 beats per minute.
35
ECG: five phases of AP in Myocardium
Phase 0: upstroke, rapid depolarization Phase 1: rapid repolarization following the peak (hidden) Phase 2: depolarized plateau Phase 3: rapid repolarization following the plateau Phase 4: a.k.a., resting potential, which can be stable or unstable
36
ECG: what stage of the Action potential graph is unstable in slow-response (pacemaker)?
phase 4: resting potential (slowly repolarizing) Pacemaker cells set the pace
37
ECG: fast-response VS slow-response AP graphs
38
ECG: in cardiomyocytes, the fast influx of Na+ causes very rapid/short-lived phase ___
phase 0 *stable phase 4
39
ECG: what does the AP graph look like for cardiomyocytes?
fast-response
40
ECG: what does the AP graph look like for pacemaker cells?
slow-response
41
ECG: in pacemaker cells, during phase 0 the ____ influx of Ca2+ causes a slow Na+ influx
slow???????? Phase 4 is depolarising due to slow influx of Na+
42
ECG: in both fast/slow-response APs, repolarization (phase 3) due to the return of ____ permeability
K+
43
ECG: what is RP
refractory periods Refractory periods in cardiac muscle allow complete emptying of the ventricle prior to the next contraction
44
ECG: during absolute RP, the working myocardial cells can/cannot be stimulated to fire another action potential
cannot *Coincides with systole (contraction) to prevent summated contractions (tetanus) from occurring in the heart
45
ECG: during relative RP, the excitability recovers to ____ values
normal values *Coincides with the period of rapid repolarization following plateau
46
ECG: CO
cardiac output blood volume pumped by the heart per unit time ~5.6 L/min
47
ECG: CO=
CO = Stroke Volume (SV) x Heart rate (HR)
48
ECG: SV?
Stroke Volume volume of blood pumped out of one ventricle of the heart in a single beat; May be calculated as End diastolic volume – End systolic volume (~70-80 mL)
49
ECG: TPR?
Total Peripheral Resistance Blood pressure = CO x TPR
50
ECG: homeostatic control of the heart
51
ECG: blood pressure can be maintain by altering either the ____ and/or ____
CO and/or TPR
52
ECG: Bainbridge reflex and baroreceptor reflex
feedback mechanisms to homeostatically regulate HR
53
ECG: what is normal sinus rhythm?
when the sinoatrial Node (SA) node is pacemaker, the Normal Heart Rate (HR) should be between 60-100 beats/min. Trachycardia: >100 beats/m Bradycardia: <60 beats/m
54
Tachycardia vs Bradycardia
Tachycardia: >100 beats/m Bradycardia: <60 beats/m
55
ECG: lead
the electrical potential difference between 2 electrodes
56
just study
57
ECG: waves and events
58
ECG: what intervals/segments are isoelectric?
PR interval ST segment
59
ECG: physiological events (8)
60
ECG: when does SA node fire on an ECG?
61
when does the AV node pause on the ECG graph?
62
when do the ventricles squeeze on the ECG graph?
63
when do the ventricles relax on the ECG graph?
64
ECG: what is the only electrical link between the atria and the ventricles?
AV node
65
ECG: what does the AV node electrically link?
atria and ventricles
66
ECG: where is atrial depolarisation, ventricular depolarization, and ventricular repolarization on the ECG graph?
67
ECG: is the ST segment isoelectric?
yes
68
What's wrong with B?
PR interval is too long (normally 0.12-0.2 seconds) A long PR interval might indicate something wrong with the AV node
69
what's wrong with B?
Split R wave (R wave represents depolarization of the ventricles) A split R wave may indicate damaged or undernourished bundle branches (due to poor blood supply and one of the ventricles depolarizing later)
70
What's wrong with B?
Exaggerated/long QRS QRS represents the rapid depolarization of the ventricles A long QRS may indicate Purkinje fibers are damaged or poorly supplied with blood this causes slow depolarization of ventricles *long Q: heart attack may have occurred
71
ECG: If the pair of electrodes is oriented _____ to the dipole, the recorded potential difference (voltage difference) will be maximal.
parallel In other words, if the positive recording electrode faces a wave of depolarization, it will record an upward signal.
72
ECG: how do you calculate HR?
HR = 60/R-R interval
73
ECG: where are leads I, II, III on body?
74
ECG: charge of electrodes Leads I-III
* Lead I: (-) electrode on RA and (+) electrode on LA * Lead II: (-) electrode on RA and (+) electrode on LL * Lead III: (-) electrode on LA and (+) electrode on LL
75
ECG: Einthoven's Law
Dipole calculation Lead I + Lead III = Lead II
76
ECG: Einthoven's Law- calculate Lead II using I and II
* +R * - Q,S Lead II = I + III II = ((+6-3)+(+12-4)) II = 3 + 8 II = 11
77
ECG: indicators of normal Sinus ECG
1. QRS complex occur app. 1 per second 2. QRS complex: when R wave is upright in Lead II with a duration is <120 ms 3. QRS is preceded by only one P wave 5. QT interval is less than half the R-R interval 6. no extra P waves
78
when reading an ECG, ask yourself?
79
ECG: Atrial Fibrillation
irregular heart rhythm no clear P waves can cause clots in the atrium --emboli Tx: anticoagulant therapy
80
ECG: Third-degree (complete) AV block
Normal P waves R waves irregular (dropped QRS complex) Needs pacemaker- atria and ventricles contracting at own rates
81
examples of ventricular arrhythmias
82
ECG: Long QT syndrome
the electrical system in ventricles is taking longer to recover/recharge between beats leads to --- ventricular tachycardia
83
ventricular tachycardia
ventricles beat too fast wide QRS complex
84
Torsade de pointes
starts with Long QT syndrome and progresses High risk of sudden cardiac death if sustained rapidly degenerates into ventricular fibrillation and hemodynamic collapse
85
AV valves Semilunar valves
AV valves: Tricuspid Mitral (bicuspid) Semilunar valves: Aortic Pulmonary
86
calculate the HR
HR = 60/R+R 4(0.2) + 3(0.04) = 0.92 HR = 60/0.92 HR = 65 BPM

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