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Thorough ECG flashcards and brief Holter Monitor and Stress test flashcards

Location of the heart In the left side of the thoracic cavity
Pericardium Contains a lubricating fluid that reduces friction as the heart beats - outer layer of the heart
Epicardium Forms the innermost layer of the pericardium and the outer surface of the heart - serous membrane
Myocardium The middle layer of the heart wall - made of muscle tissue
Endocardium Lines the inside of the heart chambers and forms the surface of the valves - thin, smooth membrane
How many chambers are in the heart? 4 chambers 2 atria (on top) 2 ventricles (on bottom) 2 Atrioventricular valves (between atria and ventricles) 2 Semilunar valves ( between ventricles and blood vessels)
Order of blood flow - body to lungs Superior and inferior vena cava (from the body) -> Right atrium -> tricuspd valve -> right ventricle -> pulmonary valve -> pulmonary artery (to the lungs)
Order of blood flow - lungs to body pulmonary veins (from the lungs) -> left atrium -> bicuspid (mitral) valve) -> left ventricle -> aortic valve -> aorta (to the body)
Pulmonary circulation The blood flow between the heart and the lungs
Systemic circulation The blood flow between the heart and cells of the body
Atria The top two heart chambers where the blood enters the heart through
Right Atrium Receives deoxygenated blood from the body through the superior and inferior vena cava
Right Ventricle Contracts to send blood to through the pulmonary artery to the lungs
Left Atrium Receives oxygenated blood from the lungs through the pulmonary veins
Left Ventricles Contracts to send blood through the aorta to the body
Purpose of heart valves To keep blood flowing on only one direction
Electrical impulse path Sinoartial (SA) node -> atria -> atrioventricular (AV) node -> bundle of HIS -> purkinje fibers -> ventricles
SA node The body's natural pacemaker
Muscle contraction Caused by electrical impulses in the heart
Systole The contraction phase of a heart beat
Atrial depolarization When the impulse starts in the SA node and causes the atria to contract
Ventricle depolarization When the impulse moves through the AV node, bundle of His, and purkinje fibers and causes the ventricles to contract.
Repolarization Time of electrical recovery in the ventricles before the cycle starts
Electrocardiogram (ECG) Measures heart function
ECG waves Represent different states in the cardiac cycle
P Wave Shows atrial depolarization
QRS sequence Shows ventricular depolarization
T Wave Shows repolarization
What can an ECG not do? Measure the ability of the heart to pump blood
ECG during a physical exam Typically used for patient's between 35-40 years old and are usually advised to establish a base reading
Why is it important to know how to read an ECG? In order to spot urgent problems
What should be done when an urgent ECG problem is spotted? Notify the physician ASAP
Why are size and pattern of ECG graph lines standard? Any physician can read it
Calculate heart rate with the QRS sequence Count the number of QRS sequences in a 6 second span and multiply by 10
Calculate heart with the R wave Count the number of large squares between two R waves and divide by 300
Average length of a cardiac cycle 0.8 seconds
How does the line get on the ECG tracing paper? Heat from the stylus melts the coating paper
Heated stylus The part of an ECG machine that moves against the tracing paper to record the waves of the ECG cycle
What should be done if the ECG tracing line is too light? Increase the stylus heat
1 large square on an ECG tracing paper Equal to 25 small squares
Standard calibration Up 10 small squares and remain for 2 small squares and then down 10 small squares
Normal paper speed 25mm per second
What do the vertical lines represent on an ECG? Voltage or the strength of the impulse
Holder that forms a permanent record of the ECG for the patient's file Mount
For what must the tracing paper be cut for before mounting it? Single channel ECG machine
Uses a control knob to switch leads Manual ECG machine
In a standard ECG how many leads are used? 12
What do ECG leads show? A view of the heart from different angles
How did Augmented leads get their name? The impulses recorded by them must be increased to be read
Standard leads The lines between which form Einthoven's triangle They are also known as bipolar leads and each one monitors two limb electrodes
Electrodes Placed on a patients limbs and chest in an ECG to detect impulses
Right leg limb electrode Used as a reference point and is not part of the ECG recording
Limb leads Monitor electrodes placed on the patients arms and legs
A 12 lead ECG consists of 3 Bipolar limb leads - Leads I, II, and III 3 Unipolar limb leads - aVR, aVL, and aVF 6 Unipolar chest leads (also known as Precordial or V leads) - V1, V2, V3, V4, V5, and V6
Lead I Shows the voltage difference between the right arm and the left arm
Lead II Shows the voltage difference between the right arm and the left leg
Lead III Shows the voltage difference between the left arm and the left leg
Lead aVR Shows the voltage difference between the right arm and the midpoint of the left arm and left leg
Lead aVF Shows the voltage difference between the left leg and the midpoint of the right arm and left arm
Lead aVL Shows the voltage difference between the left arm and the midpoint of the right arm and the left leg
Precordial leads Monitor the electrodes placed on the chest and consist of leads V1, V2, V3, V4, V5, and V6
At what site does lead V1 monitor an electrode? 4th intercostal space on the right side of the sternum
At what site does lead V2 monitor an electrode? 4th intercostal space on the left side of the sternum
At what site does lead V3 monitor an electrode? Midway between V2 and V4 position - this is why V4 should be placed before V3
At what site does lead V4 monitor an electrode? 5th intercostal space on the left mid-clavicular line
At what site does lead V5 monitor an electrode? Horizontal to V4 at the left anterior axillary line
At what site does lead V6 monitor an electrode? Horizontal to V4 at the left mid axillary line
ECG artifacts on Lead I and II Check the right arm electrode
ECG artifacts on Lead II and III Check the left leg electrode
ECG artifacts on Lead I and III Check the left arm electrode
Artifact ECG interference
What causes AC interference? Electrical equipment and wires
What should be done for AC interference? Make sure power cords are not near the patient
What causes Somatic tremors? Muscle movement or shivering
What can be done for a nervous or tense patient? Explain the procedure and reassure the patient
What causes a wandering baseline? The stylus shifts from the center of the tracing paper
What causes an interrupted baseline? Broken or not secured ECG connections
What should be checked for an interrupted baseline? The lead wires to make sure they are attached to the electrodes
Abnormality Arrhythmia
Sinus Tachycardia 100+ beats per minute
Premature Ventricle Contraction (PVC) Common disruption in rhythm - Ventricles produce extra hear beats before expected
Premature Atrial Contractions (PAC) Atria produce extra heart beats before expected
Paroxysmal Atrial Tachycardia (PAT) Regular heart contractions with 160-250 beats per minute
Without immediate treatment will result in death Ventricular Fibrillation The ventricles of the heart can not properly pump blood to the rest of the body
Ventricular Fibrillation (V-fib) Rapid irregular fluttering/quivering heart rhythm in the ventricles of the heart
Which arrhythmia increases the risk of stroke? Atrial Fibrillation
Atrial Fibrillation (A-fib) Rapid irregular quivering/fluttering heart rhythm in the atria of the heart
What test records the activity of a patients heart for 24+ hours? Holter Monitor
How many leads does a Holter monitor have? Up to 5 leads
What are some of the assistants jobs during Holter monitoring? To check the battery, prepare and instruct the patient, and apply and remove the Holter monitor
What is the purpose of a patient diary during a Holter monitor test? To supply a link to patient activity at the time of abnormal results
What does a stress test measure? A heart's reaction to an increased need for oxygen
What does the assistant monitor during a stress test? Blood Pressure
Created by: Dott