2. Health Assessment > Exam 1 Basic EKG > Flashcards

Exam 1 Basic EKG Flashcards

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1
Q

The heart has the innate ability to generate its own spontaneous action potentials without any external stimuli, a phenomenon known as __________.

A

Automaticity

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2
Q

What are the two types of cells in the heart?

A

Pacemaker Cells (spontaneous action potentials)
Contractile Cells

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3
Q

When there is a stimulation above the threshold, __________ channels cause cell-to-cell conduction resulting in depolarization.

This will release ________ to interior myocytes and causes contraction.

_______ outflow causes repolarization.

A

Sodium Channels

Calcium

Potassium

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4
Q

What can cause Hypercalcemia

A

HyperThyroidism or hyperparathyroidism

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5
Q

What causes hypokalemia

A

Diuretics, laxative use, SIADH, fluids (dilutional)

SIADH can cause both depending on what stage

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6
Q

Once the action potential is generated by the SA node, conduction will go to the right atrium via the __________ pathway.

Conduction will also travel from the right atrium to the left atrium via ____________.

A

Internodal Pathway

Bachman’s Bundle

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7
Q

The inherent pace of the SA node.

The inherent pace of AV node.

A

60-100 bpm

40-60 bpm

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8
Q

Atrial fibrillation will result in a _______% decrease in cardiac output.

A

20-25% decrease in CO

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9
Q

The bundle of His is located in the __________.
The bundle of His has pacemaker cells that can generate an action potential at _________ beats/minute.

A

interventricular septum

40 to 60 bpm

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10
Q

The bundle branch consists of pacemakers cells that can generate _________ bpm.

A

20 to 40 bpm

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11
Q

How many mV are the large boxes?
How many mV are the small boxes?

How many seconds are the small boxes?
How many seconds are the larges boxes?

A

0.5 mV
0.1 mV

0.04 seconds
0.20 seconds

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12
Q

What does the P-wave represent?

What is the normal duration of P-waves?

A

Atrial Depolarization

less than 0.12 seconds

Positive: I,II,aVF,V4-V6

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13
Q

What does the PR interval represent?

What is a normal PR interval?

What is a PR interval greater than 0.20 seconds called?

A

PR interval represents the time from the onset of atrial depolarization (contraction) to the onset of ventricular depolarization. The pause for the blood to go from the atria to the ventricles.

0.12 to 0.20 seconds

First-degree AV block

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14
Q

What does the QRS complex represent?

What is the duration of the QRS complex?

A

Ventricular depolarization

<0.12 seconds

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15
Q

What does the ST segment represent?

A

ST segment represents the interval between depolarization and repolarization of the ventricles.

Early stages of ventricular repolarization.

Elevation > 1mm is significant (injury/ischemia)

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16
Q

What does the T wave represent?

A

Repolarization of the ventricle

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17
Q

What rhythms will have retrograde p-waves?

A

Junction rhythms

(Rhythm is coming from the AV node and back up to SA node)

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18
Q

Why is the latter PR interval flat?

A

No contraction, so the blood can continue to flow down the ventricles.

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19
Q

What do we associate with a QRS complex wider than 0.12 seconds?

A

Bundle branch block

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20
Q

What causes elevated T-waves?

A

Hyperkalemia

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21
Q

When is atrial repolarization?

A

During QRS complex

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22
Q

What is the rhythm?

A

Sinus Rhythm

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23
Q

What is the rhythm?

A

Sinus Bradycardia

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24
Q

What is the rhythm?

A

Sinus Tachycardia

(100-150 bpm)

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25
What is the rhythm?
Junctional Rhythm HR 40-60 bpm *Signal starts in AV node* (look for the inverted p-wave)
26
What is the rhythm?
Junctional tachycardia HR >60 bpm *Signal starts in AV node*
27
What is the rhythm?
PSVT (HR>150)
28
What does paroxysmal mean?
"comes and goes"
29
What is the rhythm?
Premature atrial contraction (find the underlying rhythm and then figure out the accessory rhythm and look for compensatory pause)
30
What is the rhythm?
A-fib (Think irregularly irregular)
31
What is the rhythm?
A-flutter (Sawtooth pattern) ## Footnote 2:1 or 3:1
32
What is the rhythm?
Premature ventricular contraction ## Footnote big wide beat - coming from ventricle 3 different cells in the heart that are pissed off Treatment: O2 (could be due to hypoxia), electrolyte imbalances
33
What is the rhythm?
1st-degree AV Block ## Footnote PR interval >.2
34
What is the rhythm?
Bigeminy PVC (PVC after every other normal beat)
35
What is the rhythm?
Trigeminy PVC (PCV on the 3rd beat)
36
What is the rhythm?
2nd degree Type 1 AV Block or Wenckebach ## Footnote PR interval increasing until a drop
37
What is the rhythm?
2nd degree Type 2 AV Block ## Footnote PR interval is fixed
38
What is the rhythm?
Complete heart block or 3rd degree AVB ## Footnote A - V dissacosiation (PR fixed, QRS fixed)
39
What is the rhythm?
Vtach (150-180 bpm) ## Footnote monomorphic
40
What is the rhythm?
Vfib
41
Polymorphic vtach is also known as _________-
Torsades de Pointes
42
How do you treat V-fib?
Defibrillation (electricity)
43
How do you treat polymorphic vtach?
Mag and Electricity
44
What general anesthetics will cause sensitive myocardium?
Halothane and enflurane
45
How does cocaine and ketamine cause tachycardia?
Norepinephrine reuptake inhibitors
46
What anesthetic gas can cause bradycardia in infants?
Too much Sevoflurane
47
What anesthetic gas can cause prolonged QT during induction?
Desflurane ## Footnote also causes environmental factors
48
Smashing the face mask will cause pressure to build up in the eye and will result in bradycardia due to what reflex?
Oculocardiac Reflex *Five and Dime Reflex*
49
A local anesthetic will cause a _____________ block. Which will result in ___________.
Sympathetic Severe Bradycardia
50
What happens if you inject local anesthetic into the blood vessel? What is the treatment?
Patient will become asystolic (*and so will you*) Treat with lipid rescue
51
Endotracheal intubation can put pressure on the _________, resulting in bradycardia and other hemodynamic disturbances.
vagus nerve.
52
There can be autonomic reflexes during a surgical case stimulation of the carotid baroreceptors can cause_________.
Bradycardia *Prevent this by asking the surgeon to put more local anesthetic around the area or slap their hand*
53
During a laparoscopic case, insufflation can cause ____________ due to _________________.
Bradycardia due to loss of venous return.
54
Tugging the ___________ or _________ will cause bradycardia.
Peritoneum; Cervix *Hysterectomy*
55
What cannulation procedure can cause dysrhythmias?
Central line placement ## Footnote tickling the atrium
56
What is the rhythm?
Sinus Rhythm with Trigeminy
57
Most common parasympathetic blockers?
Atropine and Glyco ## Footnote Can cause IOP though
58
What can cause Catecholamine Excess?
Tumor, meth/cocaine, other anesthetics ## Footnote Perfusion time can effect onset of drugs
59
What is the rhythm?
PSVT
60
What is going on here?
Ventricular Paced
61
What is the rhythm?
2nd degree AV Block Type II
62
What is the rhythm?
Artifact
63
What is the rhythm?
PAC
64
What is the rhythm?
A-fib *Rhythm is irregularly irregular*
65
What is the rhythm?
Atrial Paced
66
What is the rhythm?
Atrial Flutter
67
What is the rhythm?
A-fib *Rhythm is irregularly irregular*
68
What is the rhythm?
Sinus Brady
69
What is the rhythm?
Sinus Rhythm with PJC *See the retrograde p-wave?*
70
What is the rhythm?
V-fib
71
What is the rhythm?
A-fib
72
What is the rhythm?
SVT
73
What is the rhythm?
Junctional Tachy *Sometimes there might not be the classic retrograde p-wave*
74
What is the rhythm?
Idioventricular Rhythm or IVR
75
What is the rhythm?
AV Sequential Pacer
76
What is the rhythm?
Idioventricular Rhythm or IVR
77
What is the rhythm?
Artifact *Look at both leads, they do not correlate.*
78
What is the rhythm?
A-fib with Bigeminy
79
What is the rhythm?
Sinus with Junctional Escape *Look at the fourth beat, no p-wave*
80
What is the rhythm?
Torsades de Pointes *Treat with mag and electricity*
81
What is the rhythm?
Junctional Rhythm
82
What is the rhythm?
Sinus Rhythm with Hyperkalemia
83
What is the rhythm?
A-fib
84
What is the rhythm?
2nd degree Type 2 AVB
85
What is the rhythm?
NSR with PVC
86
What is the rhythm?
Sinus Arrest *Can be caused by adenosine or the patient being hypoxic*
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