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Heart Structures heart wall consists of three layers: endocardium, myocardium, and epicardium
Endocardium innermost layer of the heart. lines inside of heart muscle and covers the heart valves.
Myocardium middle and thickest layer of heart. Responsible for contraction of the heart.
Epicardium a visceral pericardium. outermost layer of heart.
Heart valves two types: atrioventricular (A-V), consisting of bicuspid/mitral and tricuspid, and semilunar, consisting of pulmonic and aortic.
Tricuspid valve separates right atrium and right ventricle.
Mitral valve separates the left atrium and left ventricle. akak bicuspid valve
Aortic valve located between left ventricle and aorta
Pulmonic valve located between right ventricle and pulmonary artery.
Conduction system specialized electrical or pacemaker cells in heart that are arranged in system of pathyways.
Coronary arteries supply blood and oxygen to myocardium. two arteries: right and left. coronary sinus empties into right atrium
Cardiac cells two types: meyocardial cells and pacemaker cells. have four primary characteristics: excitability (irritability), automaticity, conductivity, and contractility.
Pacemaker cells described as slow cells because their depolarization is dependent on calcium entry into the cells through slow channels. primary properties of these of the heart are automaticity and conductivity.
Myocardial cells described as fast cells because their depolarization is dependent on sodium entry into cells through fast channels. primary property of myocardial cells is contractility.
Excitability ability of cardiac muscle cells to respond to an outside stimulus. Excitability may be increased as a result of epinephrine and norepinephrine secretion by adrenal medulla. all cardiac cells are characterized by excitability.
Automaticity ability of cardiac pacemaker cells to spontaneously initiate an electrical impulse without being stimulated from another source.
Contractility ability of cardiac cells to shorten, causing cardiac muscle contraction in response to an electrical stimulus. can be enhanced through use of certain medications such as dopamine, epinephrine, and digitalis.
Conductivity ability of a cardiac cell to receive an electrical stimulus and conduct that impulse to an adjacent cell.
Action potential each muscle cell in heart is stimulated to contract by going through an electrical process.
Base of the heart top of the heart, located approx the level of the second intercostal space.
Septum separates left and right halves of heart(each containing one atriium and one ventricle)
Apex point of a cone or conical structure, such as distal point of the left ventricle of the heart at level of the fifth intercostal space.
Atrial kick surge of blood pushed into ventricles as result of atrial contraction.
cardiac cycle each beat of heart has two phases that indicate the contraction and the relaxation periods of the hearts. contraction and relaction of heart together make this up
Electrocardiograph instrument that measures the waves of electrical impulses that are responsible for the cardiac cycles.
12-lead electrocardiograph standard machine, which simultaneously records the electrical activity of heart from 12 different views.
Single-channel electrocardiograph records information from one lead, giving one view of the heart's electrical activity.
Electrocardiogram (ECG or EKG) record of electrical impulses associated with cardiac contraction and relaxation.
Lead electrical connector (wire) between a specific combination of electrodes (sensors) attached to body. used to record electrical acitivity.
Limb lead There are six. monitor electrodes on arms and legs. 3 standard and 3 augmented leads.
Standard lead also called bipolar lead because it directly monitor two electrodes. Leads I, II, and III
Augemented lead also called unipolar lead because it directly monitors only one electrode (and two others less directly). aVR, aVL, and aVF
Precordial lead also called chest lead. anodes, or positive electrodes, of these six unipolar leads are placed across the chest in specific pattern, along specific intercostal spaces.
Unconventional leads if P waves cannot be seen on conventional 12-lead ECG, unconventional leads can be created. intra-atrial lead is example
Intra-atrial lead specifically designed electrode wire (V lead) advanced intravenously (from internal jugular, subclavian, or femoral vein) into right atrial cavity.
Stylus pen-like insturment that moves on ECG paper to record the impulses that are received through electrodes a s a result of the electrical activity of the heart.
Telemetry transmission of ECG signals via radio waves.
Oscilloscope monitor or TV-type device that shows the tracing of the electrical activity of the heart
electrocardiograph controls standardization control, speed selector, sensitivity control, lead selector, centering control, stylus temperature control, marker control, and on/off switch
preparing the pt's skin clean skin with alcohol and rub it vigorously.
electrode device that detects electrical charges. resusable electrode may be cleaned with steel wool, warm water, or alcohol. aka sensors
Types of electrodes metal plate, suction bulb and siposable electrodes.
Anode positive electrode of an ECG lead
applying electrodes apply first to fleshy portions of limbs: then precordial electrodes. 10 positions
Electrolyte material applied to skin to enhance contact between the skin and electrode
Einthoven's triangle electrodes placed on right arm, left arm, and left leg. Leads I, II, and III record electrical activity between their two respective electrodes.
Attaching wires coonect limb wires first, then precordial wires in sequence from V! to V6. make sure that wires follow pt's body contours and lie flat against the body.
Polarity positive or negative electrical state.
Polarization electrical sate of heart at rest, in which electrical charge on outside of muscle cells is negative in relation to inside.
Depolarization change of polarity. electrical discharge that precedes contraction.
Baseline indication, as on ECG tracing, of no electrical charge or activity. aka isoelectric line.
Repolarization restoration of a cell to its original pattern of charge. return to polarization from depolarized state (a return to rest)
Cardiac cycle complete phase of atrial contraction and ventricular contraction, followed by relaxation. occurs about 60-100 times per minute. contraction of heart muscle is systole. ECG tracing of one heartbeat produces pattern of waves P, Q, R, S, T and sometimes U.
P wave small upward curve and represents contraction of atria and is thus a measure of atrial rate.
lead I positive electrode (left arm) , negative electrode (right arm)
Lead II positive electrode (left leg), negative electrode (right arm)
Lead III positive electrode (left leg), negative electrode (left arm)
MCL1 positive electrode (right side of sternum, fourth intercostal space), negative electrode (left arm)
QRS complex X, R, and S waves. correlate with contraction of ventricles
Q wave downward deflection
R wave large upward spike
S wave downward deflection
T Wave upward curve that represents recovery (or repolarization) of ventricles.
U Wave small upward curve sometimes found after the T wave. represents slow recovery (or repolarization)of purkinje fibers, as seen in patients who have low potassium levels in blood.
P-R interval includes P wave and straight line connecting it to QRS complex. represents the time it takes for electrical impulse to travel from sinoatrial (SA) node to A-V node.
Q-T interval includes QRS complex, S-T segment, and T wave. represents time it takes for ventricles to contract and recover, or repolarize.
S-T segment connects the end of the QRS complex with beginning of the T wave. represents the times between contraction of the ventricles and recovery.
Asystole absence of cardiac electrical activity, represented as a straight (isoelectric) line on ECG.
Code Blue term used for an emergency in hospital or other health-care facility when a person has a cardiac or respiratory arrest.
Cardiac rate pulse rate; number of beats or contractions per minute
Deflection deviation up or down from zero on the isoelectric line
Refractory period period during repolarization when cells cannot respond normally to a second stimulus
Cardiac output amount of blood ejected by left ventricle into the aorta in 1 minute.
Amplitude height of a waveform on ECG, showing degree of voltage variation from zero (baseline) up or down.
Pediatric ECG performed with same lead placement as for an adult.
Artifacts deflections caused by electrical activity from sources other than the heart. irregular and erratic markings caused by poor conduction, outside interference, improper handling of a tracing, a pt's movement (or talking), or dirty sensors.
artifacts three types wandering baseline, flat line, extraneous marks
Wandering baseline shift in baseline from center position for that lead. causes include muscle movement and mechanical problems.
Flat line caused by loose or disconnected wire. if occur on more than one lead, two of the wires may have been switched.
Extraneous marks any marks that are not part of the tracing.
heart rate can easily be determined by counting the number of QRS complexes in a 6-second strip of ECG tracing and multiplying by 10
heart thythm ECG is best way to assess heart thythm and regularity of hearbeat.
Arrhythmia irregularity, disturbance, or abnormality in heart thythm. aka dysrhythmia.
Ectopy placement outside usual location
Extopic beat beat having an extopic focus
ectopic focus site of impulse formation located somewhere other than the SA node.
Bigeminy type of arrhythmia in which every other beat is extopic or premature (or both)
Premature beat or premature contraction contraction that occurs early. premature contractions are of three types: premature atrial contrractions (PACs), premature junctional contractions (PJCs), and premature ventricular contractions (PVCs)
Acardia absence of heart
Acardiac rhythm absence of cardiac rhythm. aka systole
Bradyarrhythmia abnormally slow and irregular cardiac rhythm; irregular bradycardia.
Bradycardia heart rate slower than 60 beats per minute.
Tachyarrhythmia abnormally fast and irregular cardiac rhythm; irregular tachycardia
Tachycardia heart rate faster than 100 beats per minute
Atrial fibrillation incomplete, irregular, and rapid contraction of atria between 350 and 500 times per minute. ventricular rate also may be rapid, or it may be relatively normal.
Atrial flutter contraction of atria between 250 and 350 beats per minute.
Ventricular fibrillation incomplete, irregular, and rapid contraction of atria between 350 and 500 times per minute. ventricular rate also may be rapid, or it may be relatively normal.
Ventricular flutter contraction of the ventricles between 150 and 300 times per minute. dangerous rhythm and should be reported immediately.
Sinus rhythm heart rhythm established by impulses from SA node. Irregularities include sinus bradycardia, sinus tachycardia, sinus arrest, and sinus arrhythmia.
Sinus arrest failure of the SA node to function. aka sinus pause. complete cardiac complex is absent form ECG tracing.
Sinus arrhythmia usually benign fluctuation of heart rate occuring within normal range of 60-100 beats per minute, distingueshed by a vagally influenced slowing of cardiac rate during respiratory expiration and increse in cardiac rate during inspiration.
Agonal rhythm rhythm of a dying heart, usually ventricular, extremely slow and irregular and becoming slower to the point of asystole. rate of less than 10 beats per minute is common.
Defibrillator machine that produces and sends an electrical shock to the heart, intended to correct the electrical pattern of the heart.
Pacemaker (electronic) device that delivers a small measured amount of electrical energy to cause myocardial depolarization
holter monitor portable (ambulatory) electrocardiography device that includes a small cassette recorder worn around a pt's waist to record the heart's electrical activity
exercise electrocardiography assessment of heart's conduction system during physical exertion such as exercise.
Echocardiography tests the structure and function of heart through the use of reflected sound waves, or echoes. can indicate structural defects and fluid accumulation, among other conditions.
Heart catheterization diagnostic method in which a catheter is inserted into a vein or artery in an arm or leg and passed through blood vessels into heart, so blood samples may be taken, pressure in heart's chambers measured, and/or hearts motions viewed.
exercise electrocardiography assessment of heart's conduction system during physical exertion such as exercise.
angiography x-ray exam of blood vessel, after injection of a contrast medium, to evaluate function and structure.
Cardiac stress test aka treadmill stress test because exercise is usually performed on exercise treadmill.
Cardioptosis drooping or falling of heart at normal location
Cardiodynia pain in the heart. aka cardialgia.
Cardiomegaly enlargement of heart. often occurs during course of congestive heart failure.
Capture successful depolarization of an atrium or ventricle achieved, for example, by an artificial pacemaker.
Heart blocks damage to conduction system of heart results in abnormal conduction patterns, causing dysrhythmias known as heart bloacks.
Medical term emaning transmission of ECG signals via radio waves is telemetry
ECG tracing, an indication of absence of electrical charge or activity represents baseline
a beat arising from a focus outside the heart is known as ectopic beat
Cardioversion administration of timed electrical shcoks for purpose of correcting certain arrhythmias or restoring normal rhythm, particularly in ventricular beat.
epicardium outermost layer of heart
Cardioplasty surgical repair of the heart.
atrial kick sudden rush of blood pushed into ventricles as result of atrial contraction is known as
U wave represents repolarization
Not necessary in administering an ECG sterilizing the leads
Medical term emaning transmission of ECG signals via radio waves is telemetry
type of lead is lead III bipolar limb lead
measurement of atrial rate on ECG tracing P waves
Heart's conduction system is measured by Exercise electrocardiography
Patient's lims serves as an electrical ground Right leg
Depolarization of fast cells is dependent on what electrolyte sodium
device that may deliver a small amount of electrical energy to cause myocardial depolarization electronic pacemaker
what waves on an ECG represents the slow recovery or repolarization U wave
Created by: MHS/Laura