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Flashcards in Exam 2 Deck (45):
1

What is the first thing estimated when plotting a treadmill or bike submax test?

Estimated max workload

2

What are the assumptions that allow us to predict VO2max?

Max HR can be predicted accurately
A linear relationship exists between HR, workload, and VO2max.
VO2max is the same at any given workload.

3

What is occurring at the P wave?

Atrial contraction
SA node begins electrical impulse, which spreads in wave motion, stimulating atria and sets heart rate

4

What is the PR segment?

Flat line between P wave and Q wave
When the impulse reaches the AV node but there is a 1/10 second pause before impulse stimulates AV node so blood can enter ventricles

5

What is the QRS complex?

Made up of R, S and sometimes Q wave
Ventricular contraction
Impulse travels from the AV node down the AV bundle, to left and right bundle branches.

6

Left ventricle sends blood to the

Body

7

Right ventricle sends blood to the

Lungs

8

ST segment

Flat line between QRS complex and T wave
Pause before ventricles repolarize so they can contract again

9

T wave

Ventricle repolarization

10

What are the 6 limb leads?

I, II, III, aVR, aVL, and aVF

11

What view do the limb leads provide?

Frontal

12

What are the 6 chest leads?

V1, V2, V3, V4, V5, V6

13

What view do the chest leads provide?

Horizontal

14

What are the normal EKG responses to exercise?

P-wave had increased magnitudes among inferior leads
PR segment shortens and slopes downward among inferior leads
QRS duration decreases
J point depresses below isometric line with upsloping DT segments
T wave decreases in amplitude in early exercise and returns to preexercise intensities
QT interval decreases

15

What are the 6 steps if interpreting EKG data?

Heart rate
Rhythm
Calculating intervals
Axis
ST segment and abnormal waves
Hypertrophy

16

What are the two ways to interpret heart rate?

On a machine
With a ruler

17

What is tachycardia?

Fast HR
Greater than 100 bpm

18

What is bradycardia?

Slowed heart rate
Less than 60 bpm

19

What are the ways to determine regular rhythm?

Single P wage for every QRS
p upright in I, II, V3 and V6, biphasic in V1
Normal regular rhythm has equal distance apart and similar waves

20

What are the overall types of rhythm problems an individual can have?

Varying rhythm
Extra beats and skips
Rapid rhythm
Heart blocks

21

What are two types of varying rhythm?

Sinus arrhythmia
Atrial fibrillation

22

What is sinus arrhythmia?

Unequal distances between Ps
Problem in the atrium

23

What is atrial fibrillation?

No real P waves
Continuous contraction of atrium
Never fully fills or contracts

24

What is a premature beat?

Wide QRS followed by a pause
Ventricles fire too soon
Stands out
Only a problem if there are multiple

25

What are multifocal PVCs?

Multiple PVCs

26

What does PVC stand for?

Premature ventricular contraction

27

What is V tach?

Not having any regular filling or emptying
Looks like a lot of PVCs
Person can be conscious
Absolute reason to terminate

28

What is V FIB?

Totally irregular appearance, no effective pumping of ventricles
No blood movement
Needs AED
Absolute reason to terminate

29

What are the three types of heart blocks?

SA block
AV block
Left or right bundle branch block

30

What is the normal range for a PR interval?

.12-.20 seconds

31

What is the PR interval representing?

The time it takes for blood to go from the SA node to ventricles
Start of P wave to start of QRS complex

32

What is the normal range for the QRS complex?

33

What is being measured in the QRS complex?

Start of Q or R wave to end of S or R
The initial deviation from the baseline

34

What is being measured at the QT interval?

Start of QRS to the end of the T wave
Depolarization and repolarization of ventricles, interval times are dependent on rate

35

What does axis refer to?

The direction of depolarization which spreads throughout the heart to stimulate the muscle fibers to contract

36

What is the direction of electrical activity called?

Vector

37

What must occur for a personal to have a normal axis?

Lead I should have a positive QRS vector
aVF should have mainly positive QRS

38

What occurs when an individual has left axis deviation (LAD)?

QRS is negative in aVF but positive in lead I

39

What occurs when a person has right axis deviation?

They have positive QRS in aVF and negative QRS in lead I

40

What occurs when a person has extreme right axis deviation?

QRS is negative in both

41

What does it mean when there is a depression in the the ST segment?

Positive for ischemia
Relative reason for termination when dips below 1 mm

42

What happens when there is an elevation in the ST segment?

Heart attack
Absolute reason to terminate

43

Describe hypertrophy

Can be detected on an EKG but not an exercise testing issue
Walls on the ventricles are too thick
Doesn't have full contraction and doesn't have as much or enough room/space

44

What are absolute reasons to terminate an exercise test?

Sustained V-Tach with 3 or more PVCs in a row
ST elevation (>1mm)

45

What are relative reasons to terminate?

ST depression greater than 2mm or a marked axis shift
Multifocal PVCs
PVC triplets
Supraventricular tachycardia (sinus arrhythmia, a fib, atrial flutter
Heart block
Bradyarrythmias (slow and irregular$
LBBB/RBBB