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50 Cards in this Set
- Front
- Back
Name and Location of the Top of the Heart
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Base and in level with the second intercostal space
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The name and location of the bottom of the heart.
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Apex and is formed by the tip of the left ventricle and is to the left of the sternum, above the diaphram, and level with 5th intercostal space midclavicular line
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What do the Atria do
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Receives incoming blood
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What do the Ventricles do
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pump blood out of the heart.
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How many valves control blood flow in the heart?
What are they named |
4; Tricuspid, pulmonic, mitral, aortic
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Three layers of the heart
outermost, middle, inner |
Pericardium, Myocardium, Endocardium
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Automaticity
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ability of the pacemaker cells to generate their own electrical impulse
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Excitability
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ability of cardiac cells to respond to an electrical impulse.
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Conductivity
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ability of cardiac cells to conduct an electrical impulse
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contractility
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ability of cardiac cell to cause contraction of cardiac muscle
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Primary Cation inside the cardiac cell
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K+
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Primary Cation outside the cardiac cell
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Na+
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This was is caused by depolarization of right and left atria.
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Pwave- first deflection of cardiac cycle.
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Isoelectric line
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baseline, or flat line that occurs on EKG when no electrical activity is present
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Ectopic Pacemaker
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A pacemaker other than the sinus node
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Altered Automaticity
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An ectopic pacemaker site can take over the role of the pacemaker either because it ursurps control from the sinus node by accelerating its own (enhanced) automaticity; or because the sinus node relinquishes its role by decreasing it automaticity.
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Altered Automaticity: Causes:
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causes myocardial ischemia or injury, hypoxia, increase in sympathetic tone, digitalis toxicity, hypokalemia, and hypocalcemia.
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Triggered Activity: definition
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results from abnormal electrical impulses that occur during repolarization when cells are normally quiet. May result in:
Atrial, Junctional, or Ventricular beats occuring singularly, in pairs, or in runs. |
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Triggered Activity: causes
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causes may include myocardial ischemia or injury, hypoxia, increase in sympathetic tone, digitalis toxicity.
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Digitalis Toxicity
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Too much of the medication Digitalis ingested
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Reentry definition
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An impulse can travel through an area of myocardium, depolarize it, and then reenter that same area to depolarize it again. Involves a circular movement of the impulse, which continues as long as it encounters receptive cells.
May also result in Atrial, Ventricular, Junctional beats occuring single, in pairs or in runs. |
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Reentry Causes
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causes include: myocardial ischemia or injury, hyperkalemia, and presence of an accessory conduction pathway between atria and ventricles.
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How would you distinguish between and normal and ectopic pwave
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ectopic pwaves from the atria differ in morphology
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Examples of slower atrial rhythms
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premature atrial contractions, wandering atrial pacemaker
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Examples of faster Atrial Rhythms
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Atrial Flutter and Atrial Fibrulation
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Wandering Atrial Pacemaker: indication & Treatment
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Rhythm: regular or irregular
Rate: Normal or Slow Pwaves: vary in size, shape and direction across strip everything else is normal Treatment: if HR is slow review and eliminate meds if possible. if symptomatic bradycardia- treat for that |
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Wandering Atrial Pacemaker: definition
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Occurs when pacemaker site shifts back and forth between SA node and ectopic atrial sites.
Commonly seen in COPD patients. |
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WAP distinguishing feature
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distinguishing figure of this rhythm is changing pwave morphology across rhythm strip
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Multifocal Atrial Tachycardia: definition
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Occurs when WAP is associated with a HR > 100bpm. occurs in Severe COPD Patients.
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Premature Atrial Contraction: definition
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an early beat originating from an ectopic site in the atrium which interrupts the regularity of the basic rhythm.
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Premature Atrial Contraction: identification
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Rhythm: usually regular, irregular with PACs
Rate: whatever the underlying rhythm is Pwaves: the one associated with ectopic beat is usually irregular in shape etc. sometimes hidden in twave |
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Abberancy: definition & cause
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this results in a wide QRS complex of .12 second or greater. Indicating that conduction through the ventricles is abnormal.
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Noncompensatory Pause (usually seen with PAC)
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the measurement form the R wave before ectopic beat to the R wave after ectopic beat is less than two R-R intervals of the underlying rhythm.
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Compensatory Pause (usually seen with PVC)
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A pause that is equal to two R-R intervals
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To differentiate between the 2 different types of pauses, what is necessary?
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underlying rhythm must be regular.
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Bigeminal
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Ectopic beat appearing every other beat
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Trigemial
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Ectopic beat appearing every third beat.
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Quadrigeminal
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Ectopic beat appearing every fourth beat
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Couplets
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Ectopic beats appearing in pairs.
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Atrial Escape Beat
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occurs when an ectopic beat appears late instead of early. Usually during a pause in the uderlying rhythm when SA node fails to initiate an impulse or when conduction is blocked for any reason.
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Nonconducted Premature Atrial Contraction: indictation
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Rhythm: underlying rhythm regular until ectopic beat.
Rate: that of underlying rhythm Pwaves: same as any PAC PR interval:absent with this particular PAC QRS Complex: absent with this particular PAC EXAMINE PREVIOUS T WAVES |
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Paroxysmal Atrial Tachycardia
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Rhythm: regular
Rate: 140-250 bpm Pwaves: abnormal PR- usually not measurable QRS- normal (A run of three or more PACs) |
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Paroxysmal Atrial Tachycardia treatment
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priorities of treatment depend on patients tolerance to the rhythm. If patient if symptomatic, vegal nerve stimulation or sedation may be needed
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Palpatations
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rapid heart rate.
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Cardioversion
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synchronized electrical shock.
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Vegal Maneuvers
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works by slowing heart rate through increasing parasympathetic tone:
coughing, bearing down(valsalva maneuver), squatting, breath holding, carotid sinus pressure, stimulation of gag reflex, immersion of face in ice water |
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Meds to slow HR when Vegal Maneuvers fail
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3 intermittent 10-10-12 mL doses of adenosine
or Ca channel blocker (block conduction, or terminates reentry mechanism) |
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Atrial Flutter: identify
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Rhythm: regular and irregular
Rate: 250-400 bpm Pwaves: sawtooth deflections with baseline so effected that there is no isoelectric line PR: not measurable QRS normal |
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Atrial Flutter: Definition
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originates in an ectopic pacemaker site in the atria, typically depolarizing at a rate between 250-400 bpm
Also, measure _:_ AV conduction ...^...^ = 3:1 AV conduction |
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How would one determine Atrial rate in the circumstance of Atrial Flutter
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if the underlying R-R is regular, calculate the rate of R-R and then multiply this by the number of preceding Flutter (atria) waves
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