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Exam2 ECG/Basic Labs/Pharm > ECG I & II > Flashcards

ECG I & II Flashcards

(83 cards)

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1
Q

Aberrancy/Aberrant conduction

A

abnormal pathway of an impulse traveling through the heart’s conduction system

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2
Q

Arrhythmia

A

disturbance of the normal cardiac rhythm from the abnormal origin, discharge, or conduction of electrical impulses

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3
Q

automaticity

A

ability of cardiac cell to initiate an impulse on its own

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4
Q

Biphasic

A

Having an electrical impulse that is shown as deflections above and below the isoelectric line

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5
Q

chronotropy

A

neural, chemical, or physical factor that influences heart rate; referring to rate or time, such as the rate of cardiac contraction

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6
Q

positive chronotropic agent

A

increase heart rate

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7
Q

negative chronotropic agent

A

decrease heart rate

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8
Q

dromotropy

A

agent the affects the conduction speed of the AV node and subsequently the rate of electrical impulse; referring to the conductivity of a nerve fiber, such as the ability to conduct through the AV node

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9
Q

positive dromotropic agent

A

increase velocity

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10
Q

negative dromotropic agent

A

decrease velocity

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11
Q

inotropy

A

chemicals that influence contractility of the heart

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12
Q

positive inotropic agents

A

increase contractility

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13
Q

negative inotropic agents

A

decrease contractility

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14
Q

conductivity

A

ability of one cardiac cell to transmit and electrical impulse to another cell; the reciprocal of resistivity

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15
Q

depolarization

A

response of a myocardial cell to an electrical impulse that causes movement of ions across the cell membrane, which triggers myocardial contraction; the process or act of reversing the resting potential in excitable cell membranes when stimulated

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16
Q

deviation

A

major direction of the overall electrical activity of the heart. It can be normal, leftward (left axis deviation, or LAD), rightward (right axis deviation; RAD) or indeterminate (northwest axis). The QRS is the most important to determine; however, the P wave or T wave axis can also be measured

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17
Q

escape rhythm

A

a self-generated electrical discharge initiated by, and causing contraction of, the ventricles of the heart; this beat usually follows a long pause in ventricular rhythm and acts to prevent cardiac arrest

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18
Q

excitability

A

ability of a cardiac cell to respond to an electrical stimulus

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19
Q

infarction

A

tissue death due to inadequate blood supply to the tissue

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20
Q

intrinsic/inherent

A

naturally occurring electrical stimulus from within the heart’s conduction system

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21
Q

interval

A

duration of time that includes one segment and one or more waves

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22
Q

ischemia

A

local decrease in blood supply

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23
Q

monomorphic

A

form of ventricular tachycardia in which the QRS complexes have a uniform appearance from beat to beat

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24
Q

multifocal/multiform

A

type of premature ventricular contractions that have differing QRS configurations as a result of their originating from different irritable site in the ventricle

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25
paroxysmal
episode of an arrhythmia that starts and stops suddenly
26
polymorphic
type of ventricular tachycardia in which the QRS complexes change from beat to beat
27
reciprocal leads
leads that take a view of an infarcted area of the heart opposite that taken by indicative leads
28
pre-excitation
an abnormal heart rhythm in which the ventricles of the heart become depolarized too early, which leads to their partial premature contraction
29
Threshold
the minimum level to which a membrane potential must be depolarized to initiate an action potential
30
ST segment
part of the ECG between the QRS complex and the T wave
31
sympathetic innervation "the gas pedal"
via thoracolumbar spinal nerve (T1-L2) increase in SA nodal chronotropy (rate), AV nodal dromotropy (speed of AV node conduction) and myocardial intropy (contractility)
32
parasympathetic innervation "the break pedal"
via vagus nerve | Decreased SA nodal chronotropy and decreased AV nodal dromotropy
33
Reentry
normally impulse goes from AV to SA node but sometimes it turns around and goes backwards -reactivation of tissue by a returning impulse
34
accessory pathway
a form of reentry- a delayed or blocked impulse may travel through a different tract (no regulation)
35
reentry-orthodromic-antidromic
the impulse may travel down the normal pathway and then back up the accessory pathway (orthodromic) or vice versa (antidromic)
36
causes of reentry
myocardial ischemia certain medications hyperkalemia
37
horizontal plane values
measures time one small box-0.04 seconds one large box-0.20 seconds
38
p wave
atrial depolarization | electrical current generated by the SA node or atrial tissue
39
duration of p wave
less than 0.12 seconds
40
PR interval
impulse transmission time from SA node throughout the atria and to the AV node
41
PR duration
range 0.12 to .20 seconds 3-5 small boxes
42
QRS complex
depolarization of the ventricular myocardium
43
QRS duration
less than 0.12 seconds
44
Q wave
first downward deflection
45
pathological q wave
can tell if it is pathological if you can drop a little box into it
46
R wave
first positive upward deflection | more than one positive deflection noted as R'
47
S wave
first downward deflection after the R wave
48
ST segment
excited state of the ventricular myocardium follows QRS ventricular contractility starts here
49
j point
landmark for MI to measure elevation or depression
50
t wave
electrical repolarization of the ventricular myocardium | following the QRS complex
51
QT interval
represents the return of stimulated ventricular myocardium to a resting state
52
normal QT
normal if QT interval is less than half distance of R-R interval
53
U wave
repolarization of the purkinje system
54
causes of prominent U wave
profound bradycardias hypokalemia hypothermia
55
Define Bachman's bundle.
The anterior tract that divides and extends into the LA.
56
Where is the triangle of Koch located?
In the floor of the right atrium superior to the septal leaflet of the tricuspid valve.
57
What is the only pathway to the ventricles called (in a normal person)?
Triangle of Koch
58
Why is the AV node delayed?
1. to allow for atrial contraction (increase preload and subsequent contraction due to Frank-Starling mechanism) 2. protects the ventricles from inappropriate high atrial rates (ie atrial fibrillation and flutter)
59
Is the refractory period longer for the SA or the AV node?
The AV node refractory period is longer.
60
Why is Ca++ important for electrical conduction in the heart?
Calcium is the major ion responsible for the action potential.
61
Define automaticity
Self-excitation (accomplished by P cells which are located in the SA node, atrial tissue, AV node, and ventricular tissue ---they have different rates bc different refractory periods)
62
What maintains the negative resting potential?
The sodium-potassium ATPase pump
63
How does the ATPase pump reset the membrane to pre-depolarizing electrolyte levels?
It exchanges 3 Na+ ions OUT of the cell for | 2 K+ ions INTO the cell
64
Using the sodium-potassium ATPase pump is an active process. What does it require?
Magnesium and ATP(energy)
65
Which phase of the action potential plot corresponds with the resting membrane potential?
Phase 4
66
Describe phase 4 of the action potential
resting membrane potential (-80 to -90mV) negativity maintained by the sodium/potassium pump sodium out/potassium in (corresponds with the baseline between the T and P wave)
67
Where happens during phase 0 of the action potential?
Rapid depolarization of the cell (stimulus applied) Sodium rushes out of the cell making it less negative (Potassium leaks out of the cell)
68
In what phase do the drugs lidocaine and procainamide work?
Phase 0
69
Describe phase 1 of the action potential.
(Brief rapid initiation of repolarization) (closure of the sodium channels) Chloride ions enter the cell (makes it more negative)
70
Describe Phase 2 of the action potential.
"Plateau" phase Slowing of repolarization Calcium enters the cell, leading to contraction of the muscle in a sustained, slower manner
71
Which class of antiarrhythmics work at phase 2 of the action potential?
Class IV antiarrhythmics (calcium channel blockers) | Verapamil, Diltiazem
72
Describe Phase 3 of the action potential.
Sudden acceleration in the rate of repolarization. Potassium movement into the cell causes this rapid return in intracellular negativity Sodium-potassium pump operates at this phase
73
What class of antiarrhythmics work in phase 3?
Class III | Amiodarone, sotalol (by prolonging the return to a resting potential)
74
Bachman's bundle
anterior tract divided and extends into L atrium (near intra-atrial pathways)
75
intra-atrial pathway
conduct impulse through atria from SA--> AV
76
triangle of koch
septal leaflet of the tricuspid valve (below AV node)
77
major ion responsible for AP
Ca
78
orthodromic
AV node cycling
79
antidromic
down AV node then backup through accessary pathway
80
conduction velocity
necessary for synchronized myocardial contraction
81
funny channels (If)
unstable membrane potential (-60mV) gradually drifts toward threshold due to opening of ___
82
what ion do funny channels (If) permeable to?
K+ and Na+
83
absolute refractory period
cell can't depolarized again, no matter how strong the impulse AP: phase 0- mid-phase3 ECG: QRS-to peak of T wave

Exam2 ECG/Basic Labs/Pharm (5 decks)

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