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EKG REVIEW
EKG/MHS
| Question | Answer |
|---|---|
| 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
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