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Ekg Module 1&2 > ekg module 2, chapter 5 Dublin > Flashcards

ekg module 2, chapter 5 Dublin Flashcards

(109 cards)

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1
Q

arrhythmia means without ______

A

rhythm

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2
Q

The SA node generates the regular cadence of depolarization for _____ activity

A

pace making

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3
Q

normally SA node discharges regular pacing impulses from ___ to ___ bpm

A

60-100 bpm

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4
Q

on ekg there is consistent distance between waves during ____ cardiac rhythm

A

regular

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5
Q

sinus arrythmia sounds pathological but is normal in humans at all times, and represents variations in association with _______

A

respiration

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6
Q

atrial conduction system consists of ___ internodal tracts in right atrium called _____, _____, and the _____

A

3
anterior, the middle, and the posterior

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7
Q

atrial depolarization (p wave) reaches the AV node, and slows within the AV node and records as a ____ on ekg

A

pause

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8
Q

the av node produces pause is shown on ekg as the horizontal pieve of baseline between the p wave and the ___ complex

A

qrs

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9
Q

depolarization proceeds rapidly through the ___ bundle, bund;e branches and through purkinje filaments

A

his

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10
Q

three levels of automaticity, provide backup if pacemaker fails, these include ___, _____, _____

A

atrial foci which is from (60-80), junctional foci (40-60) and the ventricular foci (20-40)

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11
Q

wandering pacemaker is an irregular rhythm produced by the pacemaker activity wandering from the SA node to nearby _______ foci

A

atrial

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12
Q

during wandering pacemaker, the __ wave morphology shape varies as the pacemaking center moves

A

p

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13
Q

wandering pacemaker characteristics

A

P wave shape varies
atrial rate is less than 100
irregular ventricular rhythm

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14
Q

multifocal atrial tachycardia

A

P wave shape varies
atrial rate exceeds 100
irregular ventricular rhythm

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15
Q

multifocal atrial tachycardia is a rhythym of patients with ______

A

COPD

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16
Q

atrial fibrillation caused by rapid firing of the _______ automaticity foci

A

atrial

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17
Q

during atrial fibrillation, no impulse completely depolarizes both ____ so there are NO __ waves

A

atria.
p waves

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18
Q

how to determine ventricular rate in a fib

A

QRS complexes per 6 second strip times 10

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19
Q

afib is an _____ rhythm with no __ waves, and chaotic atrial spikes

A

irregular ventricular, p

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20
Q

if there are p waves the irregular rhythm cannot be what ?

A

a fib

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21
Q

on ekg there is p waves of different shapes, and the rate is less than 100, what do you suspect?

A

wandering pacemaker

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22
Q

what is an escape rhythm

what are the kinds?

A

an automaticity focus escapes overdrive supression to pace at its own inherent rate. (if SA node pacing ceases)

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23
Q

what is escape beat?
what are the kinds

A

an automaticity focus, transiently escapes overdrive suppression to emit one beat

atrial escape beat
junctional escape beat
ventricular escape beat

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24
Q

escape refers to response in automaticity focus due to pause in ______

A

pacemaking activity

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25
sinus arrest occurs when sa node ______, heart responds how
ceases pacemaking heart responds with 3 levels of automaticity foci for backup
26
in a sinus arrest, the highest automaticity foci, ____ becomes the active pacemaker at __ to __ bpm
atria, 60 to 80
27
in atrial escape rhythm, p waves are not identical to the previous ____ waves, and it is at its inherent rate from ___ to ___ bpm
p 60-80
28
with sinus arrest, a __ focus occurs
atrial
29
junctional focus escapes overdrive suppression, if sinus arrest and ___ fail to function
atria
30
junctional rhythm inherent range
40-60
31
junctional rhythm conducts mainly to the ________ producing lone QRS complexes
ventricles
32
junctional rhythym p wave will appear _____ with an upright QRS
inverted
33
three junctional patterns
inverted p wave before each QRS inverted p wave after qrs inverted p wave buried into each qrs
34
ventricular escape rhythm characteristics
slow - 20-40 bpm wide qrs complexes
35
pacing from ventricular focus is often so slow that blood flow to brain is reduved and to the pont of unconscousness, known as ______ syndrome
stokes, adam
36
last attempt to sustain life rhythm
ventricular escape rhythm
37
during sinus rhythm a ____ makes SA node miss a pacing stimulus producing a pause
sinus blocks
38
atrial escape beat the __ waves differ from sinus generated p waves
p
39
normal sinus rhythm has upright p wave in what leads
I, II, avf
40
normal sinus rhythm characteristics
rate from 60-100 p wave upright in leads I, II, avf
41
high heart variability the better _____
cardiovascular health one has
42
respiratory sinus arrythmia most common
arryhtmia
43
when heart rate changes in synchrony in respiration is knoiwn as
sinus arythmia
44
inspiration ____ heart rate
increases
45
expiration _____ heart rate
decreases
46
sinus arrythmia p-p interval vary and is greater than
>.12 sec or > 3 small boxes
47
what can cause sinus bradycardia
carotid massage, vomiting, gag relex beta blocker, amiodaorne sleep apnea, MI in the right coronary artery
48
sinus rhythm what to look for
p wave upright I, II, avf, regular rhythm p wave same shape pr interval is fixed 60-100 bpm
49
sinus tachycardia look that rate is greater than ____
100
50
sinus tachycardia can occur due to
exercise pain pe anxiety
51
deep breath in changes vagal tone, increase hr occurs in what rhythm
respiratory sinus arrhythmia
52
respiratory sinus arrhythmia p-p interval is greater than ___
.12
53
atrial escape beat, the hr will be _____, qrs remain narrow (same)
slower,
54
atrial bigeminy is PAC occurring every _______
2nd beat
55
PACs are isolated p waves occuring _____
early
56
multifocal atrial tachycardia and wandering pacemaker require at least __ different p wave morphology
3
57
atrial flutter occurs due to
re entrant cycle in a tight circuit in the right atrium
58
a flutter risk factor
cardiac surgery, cardiomyopahty
59
a flutter occurs from a ____
2:1 conduction can over 4:1, , every other depolarization reaches the ventricles
60
a flutter produces _____ waves, "F waves"
sawtooth like waves
61
carotid massage will change ventricular response, but will not _____ a flutter
not change
62
a flutter ventricular rate will be ____, and a ____ rhythym
around 150., regular
63
what limits atrium ability to conduct 1:1 to the ventricle in a flutter
refractory period to the AV node
64
atrial flutter discharges at ____ bpm, which would be fatal, the av node protects, from this with refractory period
300
65
rate of 150 what might be suspecting
a flutter, always if 150, check for a flutter look v1, one every large square300 per minute, = a flutter
66
ekg for a fib will show
irregular rhythm and NO p waves
67
regularly irregular rhythm
pattern that can be identtified with pauses
68
a fib is decribed as _____ with no coordinated wave of depolarization across the atria
chaotic,
69
a flutter is what
rentry loop. in right atrium, wave of depolarization in left atrium of 300 bpm F sawtooth waves
70
a flutter, ventricle depolaraization is ____ a fib, ventricular depolarization is ____
regular irregular
71
ventricular rate for afib hpw do u calculate
if 6 second strip, want to mulitply by 10 if 10 sec strip multiply by 6 since it is irregular needs to be determined by how many qrs and how many seconds
72
ectopic junctional beats occurs in __
AV junction
73
in ectopic junctional beat, p wave will be _____
inverted
74
if ectopic foci, occurs hgih up in junction, p wave will be inverted occuring ___ qrs
before
75
is ectopic foci is in the middle of junction, the inverted p wave, will _____
not be seen mpst common
76
if ectopic foci occurs low in junction, the inverted p wave will occur ___ qrs
after
77
junctional escape beat, and premature junctional beat difference due to ____
timing junctional escape beat- occuring due to failure of SA node or atrial myocardium premarture junctional beat occur early before next beat
78
junctional escape rhythm is betwwen
40-60 bpm
79
accelerated junctional rhythm is between
60-100
80
avnrt is between ___ to ____
140-240
81
av nodal reentry tachycardia occurs after a _____
premature atrial contraction
82
av nodal reentry tachycardia looks similar to junctional but rate is
140-240
83
is arthymia is less than 130.is it avnrt, or junctional tachycardia
junctional tachycardia' avnrt, over 140
84
supraventricular tachycardia occurs above
bundle of his
85
paraxyzmal supraventricular tachycardias do include
AVNRT AVRT focal AT
86
paraxyzmal supraventricular tachycardias are ____ and over ___- bpm
abrupt, sudden onset and termination pver 150 'cannot see p waves, merged with t
87
ventricular escape rhythm
no p wave slow, 20-40 wide qrs complexes
88
PVC ekg recognition
qrs are bizarre, and disconcordant, meaning if qrs is upward then the t wave will be downward
89
pvc tx
if asymptamatic in healthy heart, no treatment if occuring too constant can lead to cardiomyopathy
90
r on t phenomenon occurs when
pvc occurs at the end of refractory period on the t wave
91
ventricular bigemny
pvcs occur every other beat
92
ventricular trigemini
pvcs occur every third beat
93
ventricular tachycardia
no discrete qrs complexes, or t waves, broad R waves
94
polymorphic vt
morphology is changing
95
hallmark of ventricular tachycardia is ____ dissosociation
AV
96
v tach characteristics (2) that highlight av dissociation
1. fusion beats, qrs comples, appearing like sinus qrs along with tach complex 2. capture beats, normal complex occuring within ventricular tachycardia
97
torsades can be due to
low potassium, congenital
98
torsades baseline ekg typically will show prior ____
qt prolongation
99
torsades is no effective -_____ pumping and goes at ___-____ bpm
ventricular 250-350 bpm
100
ventricular fibrillation is a ___ rhythm and goes into cardiac arrest
fatal
101
v fib on ekg will appear how
chaotic, absense of qrs complexes, no p or t waves
102
artifact can mimic _____
v fib
103
v fib is characterized as a irregularly irregular rhythm firing at ____ to _____ bpm
350-450
104
v fib can only be terminated by
defibrillation
105
distinguish torsades from ventricular tachycardia (Vtach)
previous ekg shows qt prolongation
106
two most lethal arythmias are
v tac and v fib
107
pvcs can trigger
v tac and v fib
108
monomorphic ventricullar tachycardia
monomorphic, qrs is the same, from one single side, and moving through in a constant pattern
109
v tach occurs when more than __ consecutive complexes occur at a rate of greater than ____ bpm
3 100

Ekg Module 1&2 (5 decks)

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