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At rest the interior of a muscle cell has what kind of charge? The outside of the cell has what charge? |
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During depolarization the interior of the muscles cell takes on what charge? |
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The recovery phase that follows depolarization is called this |
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Atrial depolarization shows up on the EKG as this |
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Definition
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T/F. A normal EKG has 2 separate waves to represent the two atrial contractions. |
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Definition
False, the 1 P wave represents the simultaneous atrial contraction |
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These structures electrically insulate the ventricles from the atria |
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Definition
AV valves - mitral and tricuspid valves |
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T/F. There is a brief pause between atrial and ventricular contractions because depolarization slows within the AV node |
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Definition
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The atria are depolarized by what ion? |
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Definition
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The AV node is depolarized by what ion? |
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Definition
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When depolarization normally occurs the electrical impulse goes through what structures from beginning to end of cardiac cycle. |
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Definition
SA node > AV node > Bundle of His > Bundle Branches > Purkinje fibers |
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T/F. The QRS complex represents the depolarization down the ventricular conducting system. |
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Definition
False, the depolarization down the ventricular conducting system is too weak to show up on EKG. The QRS complex represents the depolarization of the ventricular myocardium |
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What ion depolarizes the ventricular myocardium rapidly? |
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Definition
Na+ - in general this ion is responsible for rapid depolarization and Ca+ is a slower moving ion and does not depolarize as quickly |
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Term
T/F. The purkinje fibers depolarize the ventricular myocardium from the outside in (epicardium to the endocardium)to create a squeezing effect. |
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Definition
False, the purkinje fibers are located beneath the endocardium so depolarization occurs from the inside out towards the epicardium |
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What is the benefit of using 12 leads? |
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Definition
This allows you to trace electric vector in all three planes of interest |
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On ECG paper what does one small box represent horizontally? |
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Definition
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On ECG paper what does one large box represent horizontally? |
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On ECG paper what does one large box represent vertically? |
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How much time is represented between hashes on ECG paper? |
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Definition
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T/F. During myocardial infarction the infarct portion of the heart is electrically silent. |
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Definition
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The T wave represents what? |
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Definition
Ventricular repolarization |
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What does the PR interval represent? |
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Definition
Atrial depolarization to the delay in AV junction (AV node/Bundle of His) |
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What are the 5 steps of Rhythm Analysis |
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Definition
1. Calculate rate
2. Determine regularity
3. Assess the P waves
4. Determine PR interval
5. Determine QRS duration |
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There are 45mm between 3 beats on a ECG strip. What is the pulse? |
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Definition
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In 6 seconds a PT finds 7 R waves. What is the pulse? |
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Definition
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You find a R wave on a bold line on the ECG strip and the next R wave is 3 1/2 large boxes away. What is the pulse |
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Definition
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How do you determine regularity? |
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Definition
Look at R-R wave distances using a caliper or markings on a pen or paper |
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T/F. There should be two P waves for each QRS. |
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Definition
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What is the normal time range for a PR interval? |
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Definition
.12-.20 seconds or 3-5 small boxes |
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What is the normal time range for QRS duration? |
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Definition
.04-.12 seconds or 1-3 small boxes |
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If a QRS is wide what does that indicate about the electrical system of the heart? |
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Definition
The heart is not using the His-purkinje system. The heart is using a slower conduction method. |
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Normal Sinus Rhythm parameters: Rate, Regularity and P waves |
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Definition
Rate: 60-100 bpm
Regularity: regular
P waves: normal |
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Term
Normal Sinus Rhythm parameters: PR interval and QRS duration |
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Definition
PR interval: .12-.20 seconds
QRS duration: .04-.12 seconds |
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Term
Condition where SA node fires too fast but other parameters are normal. |
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Definition
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Condition where parameters are normal but then there is a brief pause in electrical activity |
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Definition
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Rhythm with an early beat and the P wave may change shape |
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Definition
Premature Atrial Contraction (PAC) |
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A rhythm with three premature atrial contractions in a row |
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Definition
Paroxysmal Atrial Tachycardia (PAT) |
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Term
A rhythm where the atria fires 200-300 times per minute at a regular rate |
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Definition
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What is Premature Atrial Contraction Trigeminy? Bigeminy? |
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Definition
A PAC every third beat
A PAC every other beat |
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Rhythm where there is a wavy baseline and there are no clear cut P waves (can be described as irregularly irregular) |
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Definition
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Rhythm where P to P waves vary and the P waves change shape |
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Definition
Wandering Atrial Pacemaker |
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Term
T/F. During atrial fibrillation the heart has a bigger atrial kick. |
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Definition
False the heart loses the atrial kick. This can be seen since no p waves are present (the equivalent of 2 units of blood are lost when no atrial kick) |
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Term
What is a re-entrant pathway? |
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Definition
Occurs when an impulse loops and results in a self-perpetuating impulse formation |
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Term
A possible explanation for atrial flutter |
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Definition
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A ECG strip has a late, narrow QRS. There is also an inverted P wave. What is the rhythm? |
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Definition
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On a ECG strip there are 3 early narrow QRS complexes, 2 inverted P waves and 1 absent P wave. What is the rhythm? |
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Definition
Paroxysmal Tachycardia - made up of 3 premature junctional contractions |
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Term
What catch all term is used when the QRS is narrow but PAT, PJT, and Atrial Fibrillation with Rapid Ventricular Response cannot be differentiated? |
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Definition
Supraventricular Tachycardia (SVT) |
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On a ECG strip the p wave is absent and the QRS complex is wider than normal. The intrinsic rate is 20-40. What is the rhythm? |
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Definition
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What rhythm has a run of three ventricular escape beat with a rate above 40? |
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Definition
Accelerated Idioventricular Rhythm (AIVR) |
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Term
On an ECG strip there are two early ventricular beats in a row. What is the rhythm? |
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Definition
A pair of Premature Ventricular Contractions(PVC) |
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Term
PVCs that look alike are described as...?
PVCs that look different from each other are referred to as....? |
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Definition
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What is an ICD and what does it do? |
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Definition
Implantable Cardioverter Defibrillator - it detects Ventricular Tachycardia and after 15 seconds shocks the heart to try to restore normal rhythm |
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Term
What is generally the cause of ventricular tachycardia? |
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Definition
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Term
This rhythm is characterized by chaotic ventricular depolarization and is ineffective at pumping blood. |
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Definition
Ventricular Fibrillation - death can occur within minutes |
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Term
What is the probable cardiac output during ventricular fibrillation? |
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Definition
0 - life cannot be sustained |
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Term
What rhythms do you not want to see a patient have? (4) |
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Definition
1. Ventricular Fibrillation
2. Idioventricular Rhythm
3. Ventricular Standstill
4. Asystole |
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Term
This rhythm is characterized by nothing but P waves |
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Definition
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Definition
Flat line aka go get a nurse asap |
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Term
What are 4 reasons for a wide QRS? |
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Definition
1. Ventricular beat such as PVC
2. Bundle Branch block
3. Aberrant conduction
4. Pacemaker |
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Term
A QRS over .12 seconds is referred to as what kind of rhythm? What is a it called if the QRS is .10 to .12 seconds? |
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Definition
Complete Bundle Branch Block
Incomplete Bundle Branch Block |
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Term
What two things can cause Left Bundle Branch Block? |
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Definition
1. Hypertension
2. Cardiomyopathy |
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Term
What 3 things can cause Right Bundle Branch Block? |
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Definition
1. Congenital
2. Pulmonary Disease
3. Pulmonary Emboli |
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Term
What 2 things can cause a bundle branch block on either side? |
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Definition
1. Ischemia
2. Myocarditis |
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Term
During ventricular repolarization there are 2 phases, the ST interval and the T wave. Which is the rapid phase and what ion regulates repolarization? |
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Definition
T wave and both phases are regulated by the K+ ions leaving the ventricles |
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What is the Rhythm if there are 3+ of these in a series?
[image] |
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Definition
Idiopathic Ventricular Rhythm |
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