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EKG Flashcards

(85 cards)

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1
Q

each small square on an EKG is?

A

1mm on each side

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2
Q

each 5th square on a EGK is…

A

is a larger darker sq. measuring 5mm

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3
Q

at normal speed one small square passes the stylus every

A

0.04 seconds

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4
Q

How many seconds is one large square on an EKG?

A

0.2 seconds

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5
Q

1 second on an EKG equals to?

A

5 large square passing the stylus (25 mm/ second)

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6
Q

standard speed on an EKG is…

A

25 mm/ second

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7
Q

standard speed may …

A

altered per providers request
-slow/fast heartbeat
spread the wave form out over a farther distance
allow interpretation of the tracing
otherwise use standard speed

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8
Q

What is standard amplitude (gain) on an EKG

A

measure voltage
one millivolt (mv) of electrical activity move the stylus upward 10 mm
2 large squares

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9
Q

EKG machine can…

A

vary in size & shape but have the same parts

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10
Q

12 leads on EKG’S can record

A

3,4,6 leads @ a time on one sheet of paper

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11
Q

What channel EKG do you use with Ambulatory care?

A

uses 3 channel EKG which records 3 leads @ once

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12
Q

What type of EKG machine do hospitals usually use?

A

use telemetry
single channel EKG records one lead @ a time & produces a running strip

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13
Q

EKG Electrodes

A

placed on 10 areas of the body
records heart activity from 12 different angles & planes
contains electrolyte gel that serves as conductor

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14
Q

Electrolyte gel

A

serves as conductor
apply first
expired gel & electrodes can produce artifacts

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15
Q

EKG Machine Calibration

A

you can adjust sensitivity
1 STD= deflection of the stylus 10 mm (2 Lg Sq)
1/2 STD = deflection of the styylus of 5 mm (1 Lg Sq)
2 STD= deflection of the stylus of 20 mm (4Lg Sq)

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16
Q

Example of EKG Machine Calibration

A

QRS is so tall the stylus is moving off the paper, change STD to 1/2
if too short change to 2 STD

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17
Q

heart layers

A

Pericardium
epicardium
myocardium
endocardium

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18
Q

pericardium

A

double sac encloses the heart and consists of a visceral pericardium and a parietal pericardium

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19
Q

epicardium

A

outermost layer of heart
inner most layer of pericardium
strong fibrous layers
connects diaphragm & mediastinum protection, stability, & lubrication between heart & organs in chest

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20
Q

myocardium

A

middle layer
involuntary straited muscle
physical contraction of heart

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21
Q

endocardium

A

inner most layer
lines chambers of heart & forms surface valves
smooth structure
protects inner surface
falicilites flow of blood through the heart

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22
Q

heart valves

A

control direction of blood flow through the heart
flaps make up a valve
extremely strong but also floppy require support to ensure tight close of flaps

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23
Q

chordae

A

special filaments connect the tricuspicl & mitral valves to the papillary muscle along the inside wall of the ventricles`

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24
Q

What are the valves in the heart?

A

tricuspid
mitral or bicuspid
pulmonary
aortic

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25
tricuspid valve
seperates right artium and right ventricle
26
mitral valve
seperates left artium from the left ventricle
27
pulmonary valve
lies between right ventricle and pulmonary artery
28
aortic valve
lies between the left ventricle and the aorta
29
atrioventricular vavlves
tricuspid & mitral valves lies between atrium and ventricles semilunar valves synchronized closure prevents blood from flowing backwards
30
semilunar valves
aortic & pulmonary synchronized closure prevent backward blood flow
31
coronary circulation
most important circulation supplies oxygenated blood to the myocardium (muscle of the heart) happens during diastole
32
right & left coronary arteries do what ?
supply the heart blood ( nutrients & oxygen)
33
diastole
period of relaxation of the heart
34
systole
period of contraction of the heart
35
coronary vessels
right & left coronary arteries originate in the root of the aorta
36
what happens during ventricular systole
semilunar flaps of the aortic valve occlude ( closses off ) THE ARIFICES ( OPENINGS)
37
pressure inside the ventricles
high causing high pressure on the epicardium compressing the coronary vessels
38
coronary vessels on the epicardium during systole become?
during systole tortuous (bending) b/c it is contracting attempting to perfuse is going to be hard
39
right coronary artery
main artery (RCA) carries oxygenated blood to right atrium, right ventricle, part of the left atrium & interior wall of left ventricle perfuses sinoatrial node (SA node)
40
left main coronary artery
(LMAC) 2nd main artery carries blood to myocardium snort & branches into the left cirumflex (LEX) & left anterior decending artery (LAD)
41
left circumflex artery
carries oxygenated blood to postlateral back side as part of the left ventricle
42
left anterior decending artery
(LAD) supplies anterior wall of the left ventricle occlusion of LAD can lead to ventricular dysrhythmia & death
43
ventricular dysrthyhmia
out of normal sinus rythm
44
sinoatrial artery
perfuses SA node branches from RCA (right coronary artery) occulsion can manifest as sinus bradycardia ( low heart rate) on EKG
45
atrioventricular node artery
2nd path way AV node artery perfuses the AV node arises from RCA in vast majority of people occulsion = high degree blook on EKG
46
collateral circulation
alternate or "back up" blood vessels that take over when another artery or vein becomes blocked or damaged large coronary artires are not interconnected small arteries grow & connect when blood flow decreases coliateral vessels help give back for decreased o2 supply
47
AV node
holds electrical signal from SA node for short period to allow ventricles to fill completely with blood following atrial depolarization PR interval P wave ends & Q wave begins 0.12- 0.02 seconds
48
SA node
cluster of cells in right atrial wall natural pacemaker of heart deploarization in R utium 1st left P wave on EKG = atrial deploarzation
49
P wave on EKG
atrial depolarization
50
internal pathways
electrical impluses travel from SA Av via intervocal pathways connect SA/VA node
51
3 internodal pathways
anterior medial posterior
52
internal pathways transmit impulses from SA node to L atrium is?
bachmann's bundle
53
complete heart block of AV node means?
AV node is unable to conduct and electrical impulses from SA node
54
bundle of his
next to AV node transmits from atria to ventricles divides into bundle branches on either side of septum between the ventricles
55
right bundle branch
RBB carries impulses from bundle of his to purkinje fibers causes R ventricular deplorazation RBB recives blood supply from LAD
56
what is the difference between the right/left bundle branches?
the workload right ventricle pumps blood = lungs left ventricle pumps blood= entire body b/c it has a greater muscular thickness
57
left bundle branch
LBB located in intraventricular septum carries electrical impluses from bundle of his to purkinje fibers of the L ventricle short divides L anterior & L posterior fascicle
58
purkinje fibers
network of wide diameter & junctional conduction pathways depolarizes ventricles initates myocardial contraction
59
without the SA/AV nodes stimulation the purkinje fibers fire @ how many BPM?
20-40 BPM
60
polarization
resting state of the myocarcial wall no electric activity occurs flat line on EKG rythm strip
61
depolarization
electrical system in the heart stimulates myocardial cells
62
repolrization
reaching a resting state
63
QRS
grouped together in the QRS complex Big Wave
64
P wave
contraction of atria beginning of cardiac deploriarzation begins when SA node fires occurs before QRS complex positive deflection
65
one cycle
PQRST complex
66
PR segment/ interval
return to baseline after atrial contraction PR internal= time from beginning of atrial contraction depolarization to beginning of ventricular contraction depolrization
67
P=P internal
time between the P waves time between atrial depolrization cycles analyzing rate and rythm
68
R-R intervals
time between R waves time between ventricular depolrization cycles analyzing rate & rhythm
69
T wave
ventricular repolrization follows QRS complex peak towards the end of the wave instead of middle
70
U wave
not always visible repolrization of bundle of his and purkinje fibers small upward curve following T wave can be cause of electrolyte imbalances
71
QT interval
time between the beginning of QRS complex through the T wave ventricles contract and relax one complete ventricular cycle
72
What kind of terminology should you use with pediatric patients
Age appropriate - electrodes are “stickers” - EKG is a “picture” of the energy or movement of the heart
73
Are there pediatric electrodes
Yes
74
Where do you put V6 on a pediatric patient when space is limited
Midaxillary line
75
Where do you place V3 on a pediatric patient when space is limited
The right side in the same position - document this as V3R
76
Where should electrodes go on a patient with extremity amputations
Arm- upper chest Leg- lower abdomen
77
Should you be careful when placing electrodes on a patient that has had a mastectomy?
Yes, skin is fragile
78
Where do you place V1 and V2 on a patient with breast implants
Place higher above implant
79
If a patient has larger breast where should place the electrodes
Lift the breast up and place under
80
Where should you never place the electrode on a patient that is pregnant
Never on the abdomen
81
If your patient is in the later stages of pregnancy, how should you position them for a EKG
Place them slightly turned to left and put a small pillow/rolled towel under their right hip - helps keep the weight of the uterus off the inferior vena cava
82
Holter monitor
Portable cardiac monitor that the patient wheres for generally 24 hours, to diagnose problems - patient carry’s a diary - avoids high voltage magnets and metal detectors
83
Telemetry
Constantly monitors the electrical activity of the heart - 3 or 5 lead
84
3 lead electrode placement
White - right shoulder Black- left shoulder Red - left right abdomen
85
5 lead electrode placement
White- right shoulder Black - left shoulder Red- left Lower abdomen Green- lower right abdomen Brown- just to the right of the bottom of the sternum (similar info of the V1 in 12 lead tracing)

Patient care (9 decks)

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