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WVSOM - Physio


Arrhythmia an abnormality of impulse initiation, impulse conduction or both
Normal automaticity arrhythmias associated with normal automatic pacemakers
abnormal automaticity arrhythmias associated with non pacemaker cells that develop automaticity
triggered activity oscillations in membrane potential that trigger an action potential
Normal SAN pacemaker 60-100 bpm
Atrial conduction fibers 60-80 bpm
AV junction 40-60
Ventricular Purkinje 20-40
True normal pacemaker SA node
What makes the latent pacemakers emerge? High parasympathetic tone High catecholamine concentration hypoxemia ischemia electrolyte distrbances drug toxicities
Abnormal automaticity tissue that is not normally automatic becomes automatic; often cannot be overdrive suppressed
Triggered activity early afterdepolarizations delayed afterdepolarizations
EAD occur before full phase 3 repolarization
DAD occur after phase 3 repolarizations
Digoxin Blocks Na/K pump. Dig toxicity will lead to DADs and has increase in intracellular Na+ which will inhibit Na/Ca pump leading to increased Ca in the SR.
1st degree block every pulse conducts
2nd degree block some, not all pulses conduct
3rd degree block no pulses conduct
2nd degree type I Wenkebach; progressive prolongation thru the av node with an eventual dropped beat
2nd degree type II Mobitz II; dropped beats without the prolongation of the PR interval
2:1 Morbitz block dropping every other beat. Every other P wave has a QRS
3:1 Morbitz 3 P's for every QRS
What are some of the mechanisms that could contribute to block in the AV node? block Ca+ channel Increase vagal outflow Digitalis Hyperkalemia Adenosine
Re-entry circus movement; an impulse that does not die out, it instead continues to circulate and re-excite tissue
Conditions that are necessary for re-entry to occur. 1. unidirectional block, or transient block 2. slowed conduction over an alternate pathway 3. Proximal re-excitation
Re-entry may be promoted by ______________ things that slow conduction velocity, shorten the refractory period or a combination of both
Examples of random re-entry Ventricular Fibrillation
Is re-entry ordered or random? both
Re-entry may accur around _______ or it may be ______________. anatomical;functional
Classic example of re-entry wolff-parkinson-white syndrome
WPW pre-excitation; has an accessory pathway; result is supraventricular tachycardia
Pre-excitation shows what kind of wave? Delta wave
3 Examples of re-entry V-Fib A-Fib WPW
Created by: tjamrose