Electric Conduction Flashcards by Sheneika Williams

Electric pathways Conduction

SA
AV
BUNDLE OF HIS
BUNDLE BRANCHES
PURKINJE FIBERS

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SA node

Initiates the heart beat

Located in the right atrium, called the pacemaker. Electrical impulses of 60-100bpm

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Delays the electrical Conduction through the heart
Atria contract/ ventricles fill with blood
Electrical impulses decreases 40-60bpm

AV node

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Bundle of his

Connects av node to bundle branches
Travel rapidly 0.03-0.05 sec.
Conducts electrical impulses from atria to ventricles

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Bundle branch

Conducts impulses down both sides of the interventricular septum

Branches off the bundle of his conduct impulses to left and right ventricle

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Distribute the electrical impulses through the right and left ventricular.
Travel 0.01 sec

PURKINJE fibers

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Polarization

Heart at rest, no stimulation

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Electrophysiology

Electrical impulses of the heart that are responsible for contraction and relaxation of myocardial cells.
Positively charged ions(na+ and k)

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An electrical current that initiates the contraction of a heart

Depolarization

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Repolarization

Heart muscle cells return to their resting electrical state and the heart muscle relaxes

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Upright small curve, atrial contraction.

With out it, heart no longer has a synose rhythm

P wave

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QRS COMPLEX

Ventricular depolarization (ventricular contraction) larger then a p wave
0.06-0.10 anything greater is a block

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T wave

Small upward sloping curve

Ventricular repolarization

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U wave

Small upward curve
Repolarization of bundle of his and PURKINJE fibers
Not always seen
In instance of electrolyte imbalances

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0.12-0.20 normal limit
P wave before QRS
Beginning of atrial depolarization to beginning of ventricular depolarization

PR interval

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Automaticity

Ability of the heart to initiate an electrical impulse without being stimulated by another source

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Conductivity

Ability of heart cells to receive and transmit an electrical impulse

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Contractility

Ability of heart muscles cells to shorten in response to an electrical stimulus

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Excitability

Ability of heart muscle cells to respond to an impulse or stimulus
Also called irritability

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Sympathetic

Increase in heart rate

Happens when under stress or frightened

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Parasympathetic

Helps slow the heart rate

Acts like a break to the heart, bring abnormal rhythms back to normal

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Artery that transports blood to the entire body

Aorta

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Valve located in the aorta and pulmonary artery

Semilunar valve

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Valve between left atrium and left ventricle

Mitral(bicuspid) valve

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Heart chamber that pumps blood to the body

Left ventricle

Heart chamber that receives blood from the lungs

Left atrium

Chamber of the heart that receives blood from the body

Right atrium

Chamber of the heart that pumps blood to the lungs

Right ventricle

Blood vessel that transport blood from the lungs to the left atrium

Pulmonary vein

Valve located between right atrium and left ventricle

Tricuspid valve

Blood vessel that provides a pathway for deoxygenated blood to return to the lungs

Pulmonary trunk

PR interval normal time

0.12-0.20

Part of the ecg that represent repolarization in the purkinje fibers

U wave

ECG tracing that represent the time from the start of the atrial activity to the start of ventricular activity

PR interval

ECG tracing that is measured from the end of the S wave to the beginning of the t wave

ST segment

ECG tracing not always seen but when do indicates electrolyte imbalance

U wave

When stimulated. The sympathetic system causes the heart to

Increase

Vessel contains highest concentration of oxygen

Aorta

Heart contained in a sac called

Pericardial sac

What can decrease the heart rate

Increased blood pressure

Electrodes

Small sensors placed on skin to detect electrical activity of the heart

Covered wires that conduct the electrical impulse to the ecg machine

Leads

Einthoven triangle

Triangle formed by three of the limb electrodes Left arm, right arm, left leg

Measures the flow of electrical current in both directions. Both positive and negative electrodes placed on pt body

Bipolar leads

aVR, aVL, aVF

Augmented(unipolar) leads

V1-V6 leads are called

Precordial leads, placed on the chest in front of heart

Records three leads or more at a time

Multichannel recorder

Input

Data entered into ecg machine usually through electrodes on the skin

Amplifies the electrical impulse and converts it to a mechanical action that appears as a waveform on the output display

Signal processing

Displays the tracing for electrical activity of the heart

Output display

Speed control

Control on the ekg machine that regulates how fast or slow the paper runs during tracing

A control that Increases or decreases the size on the ekg machine

Gain

Measurement to indicate voltage on ecg tracing

Millivolt (mv)

Artifacts

Unwanted marks caused by other activity then the heart

Bradycardia

Slow heart rate less than 60bpm

Tachycardia

Fast heart rate usually more than 100bpm

Limb leads

I, II, III

EKG machine have 3 basic functions

Input, signaling ,and output display

The best source to obtain specific information about the ecg machine is

Manufactures directions

Most commonly used electrodes are ____ and they are used ___

Disposable, once

Purpose of the LCD display

Allow entry and display of pt information

Standard paper speed for ecg

25mm/sec

Computerized interpretations always have to be

Validated by physician

Horizontal reading on the ecg machine paper represents

Time

Vertical readings on ecg represent

Voltage

Five heavy lines or boxes

1 sec

One vertical heavy line or box

0.2sec

Smallest vertical line or box

0.04 sec

V1 lead placement

Fourth intercostal space , right sternal border

V2 lead placement

Fourth intercostal space, left sternal border

V3 lead placement

Half way between v2 and v4

V4 lead placement

Fifth intercostal space midclavicular line

V5 lead placement

Anterior auxiliary line same horizontal level as v4

V6 lead placement

Midaxillary line on the same horizontal level as v4

Artifacts drift away from center of graph paper

Wandering baseline

Normal sinus rhythm

Consistent pattern, rate between 60-100bpm pwaves have same shape, normal limit 0.12-0.20sec, QRS normal limit 0.06-0.10

Sinus bradycardia

Less than 60 bpm , have p waves, QRS waves that are normal in size and sec Give atropine may require pacemaker

Sinus tachycardia

Heart Rate is 100-150 bpm p waves QRS are normal

Sinus dysrrythmia

Heart rate 60-100 bpm, rhythm is irregular normal p and QRS wave

Premature atrial contraction(PAC)

Contractions occur earlier than expected, p wave is irregular in rhythm seen closer together

Has no pwaves but f waves or unmeasurable QRS is normal 250-350bpm very organized f waves

Atrial flutter

Rapid electrical impulse atria rate >350bpm, rhythm is irregular no pwaves chaotic f waves no pr interval QRS normal limit

Atrial fibrillation

Ectopic impulse that occur to early, no p or t wave, bizzare QRS complex

Premature ventricular contractions | PVC

Ventricular tachycardia

``` Check pt. If there is a pulse give amiodarone then determine cause No pulse start cpr Pwaves absent 100-200bpm ```

Ventricular fibrillation

Absence of organized electrical activity | Disorganized chaotic in appearance

Straight line | Absence of activity

Asystole

Electric generator that mimics the normal pacemaker of the heart

Electronic cardiac pacemaker

Inserted in the jugular outside of the body

Temporary trans venous pacemaker

Permanent pacemaker

Implanted under clavicle

External electrical stimulation that interrupts irregular induction patterns of the heart and restores the rhythm

``` Cardio version -Atrial fibrillation -atrial flutter -ventricular tachycardia with pulse - ```

Stops heart temporarily to allow a normal rhythm Electrical shock wave sent through gel pads Make sure all personnel stand clear

Defibrillation Ventricular tachycardia without pulse Ventricular fibrillation

Send an electrical shock when a life threatening abnormal heart beat. Treats reoccurring ventricular arrhythmia

Automatic implantable cardioverter defibrillator | Very painful feels like a horse kicking in chest

Atrial fibrillation and atrial flutter can cause

Stroke Pulmonary embolism Kidney renal failure MI

Pregnant place the lower limb leads on

Thigh, place pt slight on their left side

With geriatric pt how to remove leads

Remove gently, you can use adhesive removals

When applying electrodes you want to?

Remove as much clothes as possible, Remove watches Jewelry and phones

Pt have breast implants how would you place leads

V1 and V2 move higher on chest

S/s of decrease cardiac output | Symptomatic bradycardia

``` Decrease in mental status Dizziness Lightheadedness Chest pain S.o.b Hypotension Pale skin cool and clammy ```

Antiarrhythemic medications

``` Amiodarone, Digoxin Cardiazepam Metoprolol Beta pace Multag Tikosyn ```

Diltiazem/ cardizem drip

Decrease heart rate cause vasodilation | Check vs do not exceed 10mg/hr

DysRhythmia causes

``` P- pulmonary embolism/edema A-acidosis T-tension pneumothorax C-cardiac tamponade H-hypoxia, hypovolemia, hyper/hypocolemia, hypothermia, hypoglycemia ``` M-myocardial infarction D-drug over dose or drowning

Electric Conduction Flashcards

(101 cards)