Physiology 11.30.12 ECG Flashcards

(65 cards)

1
Q

what are Gap Junctions made from

A

6 connexon subunits, that surround a central pore and allow ions to easily pass through

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2
Q

What happens with connexon when H+ and Ca2+ added

A

Both acidosis and increase in Ca (myocardial ischemia or hypoxia) can reduce the open state fo teh chanel, and increase reistance between two cells –> leading to abnormal conduction

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3
Q

what is a dipole

A

an electrical source consisting of an asymmetrically distributed electrical charge

heart- one position of myocardiumis depolarized while remaining regions are still in resting state at any isntand during spread of a wave of depolarization

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4
Q

P wave

A

atrial depolarization (AP beings in atria)

simultaneus contraction in both atria

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5
Q

QRS wave

A

Ventricular depolarization (large mass means greaters size)
\
beginning of ventricular conttaction

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6
Q

T wave

A

ventricular repolarization (K chanels)

end of T wave is end of ventricular systole

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7
Q

why is T wave an upward reflection?

A

B/c Epicardium repolarizez before Endocardium so negative charge is going towards negative electrode –> upward deflection

AP duration is shorter in epicardial than in endocardial tissue

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8
Q

U wave

A

believed to be due to repolarization of papillary muscle

last ventricualr muscle to depolarize- typeically don’t see it; hypertrophied

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9
Q

P-R interval

A

time taken from first atrial depolarzation to first ventricaul depolarization

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10
Q

Q wave

A

definition the first downward deflection of QRS, and my or may not be present

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11
Q

what is isoeletric pause between P wave and QRS complex

A

caused by slow depolarization of AV node –> allows time for blood in atria to fill ventricles

slow conduction through AV node carried by Ca2+

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12
Q

ST segment

A

“Plateau” of ventricular repolarization ; nothign happening; cells starts to repolarize

if elevated or depressed –> usually sign of serious pathology

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13
Q

Sequence of depolarization in the heart

A

SA node –> AV node (slow) –> His Bundle (fast) –> R/L Bundle Branches (Purkinje fibers = HIs and R/L branches )

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14
Q

What is Vm at rest?

A

-85 mV

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15
Q

what doees the voltmeter read when all the cells are depolarized

A

0! isoeletric line

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16
Q

WHat type of deflection if Depolarization goign towards _ve electrode

A

upward deflection

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17
Q

depolarization moving towards -ve electrode

A

downward deflection

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18
Q

Repolarization moving towards positive electrode

A

downward deflection

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19
Q

repolarization moving towards -ve electrode

A

upward deflection

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20
Q

What is an “ischemic curren”

A

Em of ischemic tissue is ~0 mV (suppose to be -85mV)b/c ion channel are not workign properly

therefore during phase 4, there is a net flow of current towards teh -ve electrode , producing a signal below the zero level

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21
Q

During phase 2

A

Em is ~0, in both helathy and ischemic tissue (as tehya re all depoalrized)

no net current directed to either electrode

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22
Q

What does it mean when you see elevated “ST” segment

A

indicative of myocardial ishemia

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23
Q

Wolff-Parkinson-White Syndrome

A

If there’s an extra conduction pathway between atria and ventricle, electrical signal may arrive at ventricles too soon (b/c it bypasses teh AV nosde)

“pre-excitiation syndomes”`

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24
Q

Depoalrization conduction pathway

A

pacemaker cells –> atria stimulate –> AV node –> left

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25
How fast is conduction in SA node
<0.01 m/s (very slow)
26
How fast is conduction in atria
1 m/s fast
27
How fast is conduction in AV node
0.02-0.05 m/s (slow)
28
How fast is Bundle Branches
2-4 m/s (fast)
29
How fast is Purkinje Network
(2-4 m/s) fast
30
How fast is Ventricular muscle
0.5 m/s
31
What is S wave
downward Ventricular depolarization is going toward (-) electrode --> goes downward
32
What is T?
ventricular repolarization Repol from Epi --> Endo --> negative repolarization towards negative electrode --> upward reflection
33
Is action potential shorter in epicardial or endocardial region?
Repolarization begins in eicardial region of ventricle! Therefore T wave is upward in Lead II
34
Why is AP shorter in epicardium than endocardium
b/c transient outward current is gerater in epicardium than in endocardium Bigger drop during Phase I in Epicrardium
35
What happens if you block ITo (transient) in epicardium?
can make it like endocardium !
36
What does it mean if P-R interval in longer than normal?
result in A-V block (indicates taht conduction through AV node is slow)
37
What is normal time of PR interval
0.12-.20 s
38
What does it mean if QRS interval is longer than normal?
conductino in ventrcile is not normal!
39
what does QT interval indicate?
AP duration
40
what does it mean if QT interval is long (what is condsidered "long"
>430 ms, "long QT syndrome"
41
NOrmal QRS complex timing
0.06- 0.10s
42
What is the mean QRS vector?
It represents mean electrical vector
43
What is normal degree for QRS
-30 - +105 degrees
44
What type of pathologies would happen if there is a RAS (righ axis shfit)
1. right ventricular hypertrophy (towards hypertrophy) | 2. Left ventricular infarction
45
What pathologies would occur with LAS (left axis shift)
left hypertrophy right ventricular infarction
46
What happns iwf ther eis pulmonary hypertsinon
enlarged right ventricular muscle
47
What would happen if Aortic Stenosis happen
Left ventricuular hypertrophy and shift axis to left
48
Which leads are "left lateral leads"
Lead I Lead aVL
49
What leads are "inferior leads"
Lead II Lead aVF Lead III
50
How many degrees apart are 6 standard limb leads
30 degrees
51
Placement of V1
4th intercostal space- right of sternum
52
Placement of V2
4th intercostal space to left of sternum
53
V3
halfway between V2 and V4
54
V4
left midclavicular line in teh 5h intercostal space (MI)
55
V5
left anterior axillary line in the 5th intercostal space
56
V6
left midaxilalry line in 5h intercostal space
57
What chest leads show the highest peaks? WHy?
V4 and V5 b/c depolarization wave moves directly toward these electrodes
58
Which has greater amplitude? Standard leads or chest leads
Chest leads closer to heart
59
V5
left anterior axillary line in the 5th intercostal space
60
V6
left midaxilalry line in 5h intercostal space
61
What chest leads show the highest peaks? WHy?
V4 and V5 b/c depolarization wavemoves directly toward these electodes
62
Which has greater amplitude? Standard leads or chest leads
Chest leads closer to heart
63
During systole when all parts of the heart is depolarized (including ishcmiec or infarcted area) , what is the reading for ST segment?
It is at 0 level b/c all is depolarizaed!
64
What does ST segent look like if Subepicardial MI
ST segment elevation! inuured segment is partially depolarized (therefore baseline is lower b/c difference is Baseline is shfiten downward
65
What does ST segment look like if Sub Endocardial MI (non-transmural MI)
ST segment Depression baseline is shifted upward