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1

Graphic representation of the heart's electrical activity.

EKG

2

When interpreting an EKG, what should you look at?

1. Your Patient
2. Clinical Correlation
3. Comparison with old tracing (if available)

3

How should you approach reading an EKG?

Systematically

4

Anatomically, what chamber of the heart dominates the anterior surface?

Right Ventricle

5

Electrically, what chamber of the heart dominates?

Left Ventricle

6

All cardiac cells have the ability to create action potentials. This is called:

Automaticity

7

Cells in the electrical conduction system can:

Create Impulses (pacemakers) and/or trasmit impulses

8

What is the main function of the electrical conduction system?

Create an electrical impulse and transmit it to the rest of the myocardium.

P.S. This is the electrical energy picked up by an EKG

9

Where does the conduction system occur?

Inside the myocardium

10

How are atrial myocytes innervated?

Direct Contact from one cell to another

11

What is responsible for transmitting the impulse from the SA node to the AV Node

Internodal pathways

12

What is the final component of the conduction system that innervates the ventricular myocytes?

Purkinje Fiber System

13

The term for when a pacemaker cell with the highest rate sets the pace for all the subsequent cells?

Overdrive Suppression

14

What does overdrive suppression accomplish?

Organized beating of all cardiac cells in specialized sequence --> effective pumping action

15

Order of Pacemaker Cells

SA Nodes (60-100)
Atrial Cells (55-60)
AV Node (45-50)
Bundle of His (40-45)
Bundle Branch (40-45)
Purkinje Cells (35-40)
Myocardial Cells (30-35)

16

What is the primary pacemaker? It controls the heart beat based on information it receives from the nervous, circulatory and endocrine systems

Sinoatrial (SA) Node

17

What is the general bpm for the SA Node

60-100 bpm

18

If a heart rhythm originates in the SA Node, what is it called?

Sinus Rhythm

19

Where is the SA Node located?

The wall of the right atrium at its junction with the SVC

20

Where does the blood supply for the SA node come from? Why is this important?

Right Coronary Artery (sometimes left). It's important because if there is a disruption in blood supply then there needs to be compensation for it -- aka another node in function, or an arrhythmia is occurring (SA Node dysfunction)

21

What is the main purpose of the Internodal Pathways?

Transmit the pacing impulse from the SA node to the AV node.

22

Where are the internodal pathways located?

Walls of the Right atrium and inter-atrial septum

23

What are the three main internodal pathways?

Anterior
Middle
Posterior

24

This node is located in the wall of the right atrium next to the opening of the coronary sinus and tricuspid valve. It is responsible for slowing down conduction from atria to ventricles long enough for atrial contraction.

AV Node

25

What does the AV node help do (by slowing down conduction from atria to ventricles)?

Maximizes Cardiac Output

26

The AV node is supplied by? (Blood)

Right Coronary Artery

27

Where does the Bundle of His begin?

At the AV node

28

Where is the Bundle of His located?

Partially in the right atrium as well as the interventricular septum

29

What is the only route of electrical communication between the atria and the ventricles?

The Bundle of His

30

Where is the Left Bundle Branch located?

Begins at the Bundle of His and travels through the interventricular septum.

Ends at the beginning of the left anterior and left posterior fascicles (LAF, LPF)