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4154 Applied Science IV > Hemodynamics (Part 1) > Flashcards

Hemodynamics (Part 1) Flashcards

1
Q

What does the P wave represent?

A

Artial depolarization

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2
Q

What does P-R interval represent?

A

Beginning of P wave to beginning of QRS

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3
Q

What does the ST segment represents?

A

Represents the period when the ventricles remain depolarized

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4
Q

What does the T wave represent?

A

Represents ventricular repolarization

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5
Q

What is the flow of Cardiac Conduction?

A

SA node–> AV node–> Bundle of His–> Bundle branch (LBB & RBB)–> Purkinje fibers

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6
Q

What is the conduction pathway (bpm) of the cardiac system?

A

SA (60-100 bpm)
AV (40-60 bpm)
Ventricle (20-40 bpm)

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7
Q

What does the ECG show?

A

Electrical activity of the heart (recorded by skin electrodes)

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8
Q

What happens during diastole?

A

ventricles empty and relax

Tricuspid and mitral valves open

Blood leaves the atria and fills the ventricles

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9
Q

What happens during systole?

A

Ventricles contract

Increasing BP in ventricles forces (mitral tricuspid) valves closes

Pulmonic & Aortic valves open

Blood is ejected from ventricles into pulmonary artery and aorta

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10
Q

How long is the cardiac cycle?

A

Ventricular contraction (systole)— 1/3 of the cycle

Ventricular relaxation (diastole)— 2/3 of the cycle

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11
Q

What effect does rapid HR have on filling time?

A

Ventricles fill during diastole

The ventricles doesn’t fill as much and doesn’t eject as much blood so diastolic time shortens

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12
Q

What process happens first, Electrical or mechanical?

A

The electrical occurs first then mechanical

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13
Q

What does the arteries do?

A

Carries blood AWAY from the heart

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14
Q

What does veins do?

A

Carries blood towards the heart

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15
Q

How many layers does the heart have?

A

3-Epicardium, myocardium, endocardium

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16
Q

What is the myocardium composed of?
TEST Q

A

Its the middle and most prominent layer that’s composed of cardiac muscle

17
Q

What valves close to make the S1 sound?

A

Tricuspid and mitral valves

18
Q

How does the blood flows through the heart?

A

Superior vena cava–>R-artium–> tricuspid valve–> R-atrium–> pulmonic valve–> pulmonary artery–> lungs–> pulmonic veins–> L-artium–> mitral valve–> L-ventricle–> aortic valve

19
Q

What valve control blood flow from L-artium/L-ventricle
TEST Q

A

Mitral valve

20
Q

What does Sinus Bradycardia look like?

A

HR less than 60bpm (originating form the sinus node)
Regular rhythm
P wave for each QRS

21
Q

What is Sinus Tachycardia?

What are the causes? (Test Q)

A

Heart rate >100bmp, originating from th SA node
Regular rhythm
Rate (100-180 bpm)
P wave for each QRS
PR interval regular

Causes: fever/infection, stress, exercise, fear/anxiety, drugs, pain, anemia, low BP, hypothermia (TEST Q)

22
Q

What does Atrial Fibrillation (A-fib) look like?

A

Disorganized, uncoordinated twitching of atria muscles caused by rapid production of atrial impulses

Rate may be rapid (uncontrolled-over 100bpm) or slower (controlled-under 100bpm)

23
Q

How does A-fib look on an EKG/monitor?

A

P wave not identifiable, irregular baseline (irregular irregular)

PR interval not measurable

Patients may be asymptomatic

No A-V synchromy

24
Q

What does the loss of AV synchrony result in?

A

Decreased ventricular filling

25
Q

How would A-fib be described as?

A

irregularly irregular,

no identifiable P waves (so no organized atrial depolarization)

narrow QRS

26
Q

How would A-flutter be described?

A

Abnormal rhythm that occurs in atria. Atrial rhythm is regular, but fast.

Sawtooth appearance

Atrial rate: 250-400 bpm

QRS complexes uniform in shape, irregular in rate (more Ps than QRS)

*No A-V synchrony
*Anticoagulation may be necessary (pooling of blood in atria)

27
Q

What is etiology behind AV blocks?

A

Conduction defects within the AV junction that impair conduction of artia impulses to ventricular pathways

28
Q

What are the type of AV blocks?

A

1st Degree

2nd Degree (I or II)

3rd degree

29
Q

What is different about rhythms above the AV junction?

What about below the AV junction?

A

They usually have a narrow QRS (ABOVE)

They usually have a WIDE QRS (below)

30
Q

What does a 1st AV block look like?

A

Regular rate (60-100 bpm)

PR interval is regular but PROLONGED (> 0.2 secs)

Pts are ASYMPTOMATIC

Management: correction of underlying cause

31
Q

What does a 2nd degree AV type II (Mobitz II)
block look like?

A

ATRIAL rhythm regular

VENTRICULAR rhythm
can be regular or irregular

QRS periodically absent or disappears (IMPORTANT DIFFERENCE)

Management: Transvenous pacemaker (or transcutaneous) is needed because this rhythm can rapidly progress to complete heart block

treat underlying cause

atropine

32
Q

What does 3rd degree heart block looks like?

A

Artial & ventricular rhythm regular (but ventricular slower)

No relation between P waves and QRS complexes

No constant PR interval, QRS normal or wide/bizarre

Pt. will need a pacemaker

Symptoms: HTN, angina, HF

33
Q

What does a junctional rhythm look like?

A

Originates from AV node

Narrow complex (normal QRS conduction)

P wave absent (IMPORTANT DIFFERENCE)

Junctional rhythm (40-60bpm)

Loss of AV synchromy!!

Management: treat cause if possible, meds, may require permanent pacemaker

34
Q

What are ventricular rhythms?

A

V-tach or V-fib

35
Q

What does Ventricular tachycardia (V-tach) looks like?

A

Any rhythm faster than 100 bpm with 3 or > irregular beats in a row that originates distal to the Bundle of His

Responsible for most of the sudden cardiac deaths in the US

May try medications or synchronized cardioversion

Pulseless- treatment is IMMEDIATE DEFIBRILITION

36
Q

What does V-fib look likes?

A

Disordered electrical activity causes ventricles to quiver instead of contracting normally

w/o treatment, FATAL in mins

Treatment: immediate defib, followed by anti-arrythmic meds

Surviviors will likely require placement of implantable cardioverter-defibiliator (ICD)

Most identified arrhythmia in cardiac arrest patients. Survival rate low (particularly out of hospital).

Coarse easier to convert.

37
Q

What does Pre-mature Ventricular Contractions (PVCs) looks like?

A

One of the most common dysrhythmias

Can occurs in pts. with or without heart disease

Clinical significance depends on frequency, complexity, and hemodynamics response

38
Q

What does Pre-mature Artial contractions (PACs)?

A

Contractions of the atria that are triggerede by artial myocardium, but don’t originate from SA node

Typically have normal QRS complex

Often symptomatic

39
Q

What does a 2nd degree AV type I (Mobitz I)
block look like?

A

Atrial regular
Ventricular irregular

PR interval progressively lengthens w/ each cycle until QRS is dropped a cycle

Pts. can be asymptomatic or cause weakness

Management: treat underlying cause, atropine or temp pacemaker if symptomatic

4154 Applied Science IV (20 decks)

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