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45 Cards in this Set
- Front
- Back
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Everyday cardiac rhythm
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Normal Sinus Rhythm
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Any rhythm that is not a normal sinus rhythm
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Arrhythmia
(also dysrhythmia) |
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True or False:
All arrythmias are abnormal and potentially dangerous. |
False.
Some are quite normal and frequently occur in healthy individuals. |
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foremost clinical manifestation of a possible arrhythimia
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palpitations
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an awareness of one's own heartbeat
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palpitations
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Name two symptoms of possible decreased cardiac function secondary to an arrhythmia.
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light-headedness
syncope |
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hypoxic chest pain
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angina
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This term refers to an abrupt, fatal arrhythmia.
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sudden death
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What is the mnemonic used to remember arrhythmogenic factors to be considered whenever encountering a patient with an arryhythmia?
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HIS DEBS
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Name the factors to be considered when encountering a patient with an arrhythmia.
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Hypoxia
Ischemia/Irritability Sympathetic Stimulation Drugs Electrolyte disturbances Bradycardia Stretch (enlargement) |
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When an arrhythmia is suspected, it is standard practice to run a long tracing of a single or multiple leads called what?
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a rhythm strip
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an ambulatory device worn by a patient that provides a complete record of the patient's rhythm activity
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Holter monitor
(ambulatory monitor) |
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a monitor worn by a patient that is activated when palpitations are experienced
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event monitor
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Name the five basic types of arrhythmias.
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arrhythmias of sinus origin
ectopic rhythms reentrant arrhythmias conduction blocks preexitation syndromes |
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sinus rhythm in excess of 100 beats per minute
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sinus tachycardia
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sinus rhythm below 60 beats per minute
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sinus bradycardia
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Name the most common rhythm seen in the early stages of acute myocardial infarction.
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sinus bradycardia
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Name the rhythm that is a normal phenomenon, reflecting a variation in heartrate with inspiration and expiration.
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sinus arrhythmia
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This occurs when the sinus node stops firing.
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sinus arrest
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prolonged electrical inactivity
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asystole
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Which myocardial cells have the inherent ability to function as pacemakers?
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Virtually all myocardial cells have the ability to function as pacemakers.
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Which pacemaker ordinarily drives the heart?
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The fastest pacemaker drives the heart. Under normal circumstances, the fastest pacemaker is the sinus node.
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rescue beats that originate outside the sinus node when sinus arrest occurs
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escape beats
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typical firing rate of the sinus node
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60 to 100 beats per minute
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typical firing rate of atrial pacemakers
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60 to 75 beats per minute
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typical firing rate of junctional pacemakers
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40 to 60 beats per minute
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typical firing rate of ventricular pacemakers
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30 to 45 beats per minute
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Of all the available escape mechanisms from sinus arrest, name the most common one.
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junctional escape
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With junctional escape, where does depolarization originate?
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AV node
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True or False:
In most cases, retrograde P-waves are seen in a junctional rhythm. |
False.
Most often there are no P-waves at all, but in some cases a retrograde P-wave may be seen. |
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What is the mean electrical axis of a retrograde P-wave with respect to a normal P-wave?
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reversed 180 degrees
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Why are retrograde P-waves most often not seen in junctional rhythms?
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They are masked by the more prominent QRS complexes.
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True or False:
Sinus arrest and sinus exit block are usually not distiguishable on EKG. |
True.
Sinus arrest is a failure of sinus depolarization, whereas sinus exit block is a failure of current delivery to the surrounding tissue. Since sinus node firing is not visible, the two conditions are usually indistinguishable on EKG. |
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True or False:
Transient sinus arrest and sinus exit block can sometimes be distinguished on EKG. |
True.
Resumption of transient sinus arrest is usually random, whereas resumption of exit block is usually sinchronized with the underlying sinus rate. |
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abnormal rhythms that orginate outside of the sinus node
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ectopic rhythms
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difference between escape beats and ectopic rhythms
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Ectopic rhythms are sustained, whereas escape beats refer to one or a few rescue beats.
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True or False:
Ectopic rhythms often arise from enhanced automaticity of a nonsinus site. |
True.
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True or False:
Any of the pacemakers scattered throughout the heart can be stimulated to depolarized faster than and override the heart's normal pacemaker. |
True.
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Name one of the most common causes of enhanced automaticity.
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digitalis toxicity
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Is enhanced automaticity a disorder of impulse formation or impulse transmission?
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impulse formation
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Is reentry a disorder of impulse formation or impulse transmission?
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impulse transmission
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Name the phenomenon in which electrical current spins as if in a closed racetrack to provide a source of electrical activation that can override the sinus mechanism and run the heart.
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reentry loop
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an uninterrupted, revolving circuit often setup by a delay or block through one side of parallel conduction pathways
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reentry loop
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Four Questions for assessing any rhythm disturbance on EKG
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(1) Are Normal P Waves Present?
(2) Are the QRS Complexes Narrow or Wide? (3) What is the Relationship Between the P Waves and the QRS Complexes? (4) Is the Rhythm Regular or Irregular? |
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All clinically important arrythmias fall into which two categories of origin?
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(1) ectopic
(2) reentrant |
