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EKG PART 1.
Paramedic
| Question | Answer |
|---|---|
| What can weaken the left ventricle? | Excessice Preload |
| What color does the pericardial sac need to be? | Staw colored |
| Starlings Law | Law of physiology statin that the more myocardium is stretched up to a certain amount the more forceful the subsequent contraction will be. |
| Blood Pressure equation | stroke volume times heart rate times systemic vascular reisitance. |
| Tricuspid valve location | Between the atrium and right ventricle |
| Pulmonary Valve location | between the ventricle and pulmonary artery |
| Mitral valve or bicupsid valve location | Left atrium to left ventricle |
| Aortic valve location | Left ventricle to the aortic valve. |
| Excitability | the cells can respond to an electrical stimulous, like other myocardial cells |
| Conductivity | The cells can propogate the impluse from one cell to another |
| Automaticity | Pacemaker cells capability of self depolarization |
| Contractility | Ability of muscle cells to contract, or shorten |
| What does a pathological Q wave on an EKG indicate? | Tissue death, may also indicate extensive transient ischemia |
| What happens when stroke volume decreases? | The systemic vascular resistance will increase to maintain blood pressure and heart rate will increase |
| During resting potention the cardiac cell should be doing what? | The inside of the cell should be more negativly charged. |
| Resting potential | The normal electrical state of a cardiac cell |
| Describe the s1 heart sound | Produced by the closure of the AV valve during ventricular systole |
| Describe the s2 heart sound | produced by the closure of the aortic and pulmonary valves |
| What are normal heart sounds> | s1 and s2 |
| when you educate the public on heart disease you should include what? | Risk factorssigns and symptomshear disease |
| How many seconds is a small box and a big box on a EKG | Small = 0.04Big= 0.20 |
| What does the left coronary artery supply? | Left ventricle, the interventricular septum, part of the right ventricle, and the hearts conduction system. |
| What does the right coronary artery supply? | Portion of the right artium and left ventricle and part of the conduction system |
| What is the first phaze of the cardiac cycle? | Diastole |
| What are the early signs of hyperkalemia? | Pointed T wave |
| What is a EKG useful for? | Rate and heartbeatregularity of the heartbeattimes to take the conduct the impluse through the various parts of the heart |
| Things an EKG cannot detect? | Presence of location of an infarct, axis deviatioin or chamber enlargement, right to left differences or impluse formation, quatily or presenceof the pumping action. |
| What does ST elevation mean? | Injury, most often the early sign of a MI |
| Pulseless Paradox | Abnormally large decrease in systolic b.p more than 10 torr |
| What might pulseless paradox mean? | Tamponade, adhesive pericarditis and sever ling disease and advanced heart failure |
| What part of the EKG represents ventricular depolarization? | QRS complex |
| Define a postive inotropic agent | Strengthens cardiac contraction |
| Deince negative inotropic effects | Weakens cardiac contraction |
| Define a positive chronotropix agent | Insreses heart rate |
| DEfine a negative chronotropic agent | Decreases h.r |
| DEfine a postive dromotropic agent | Speeds impulse conduction |
| Define a negative dromotropic agent | slows conduction |
| SA node firing rate | 60-100 |
| AV node firing rate | 40-60 |
| Purkinje system firing rate | 15-40 |
| What is the myocradium | The thick middle layer of the heart |
| how many cells does the capillary wall consist of ? | a single layer thick |
| The aterty and veins innermost layer | The tunica intima |
| The middle layer of arteries and veins | Tunica media it consists of elastic fibers and muscle |
| The outermost layer of arterys? | Tunica adventitia, a fibrous tissue covering gives the muscle strength to withstand the pressure of heart contractions |
| The cavity inside the vessel | Lumen |
| How big does the q wave have to be to be significant? | at least one small square wide lasting 0.04 sec or is more than one third the height of the qrs complex |
| What would the ekg of a hypokalemix pt be? | A flattened t wave and a prominent u waveS |
| What is the approproate way the heart fires? | 1.sa node2. av node3. bundle of his4. right and left bundle brances5. purkinje system |
| Ejection Fraction definition | Ratio of blood pumped from the ventrcles to the amount remaining at the end of diastole |
| Stroke volume | Amount of blood ejected by the heart in one cardiac contraction |
| Preload | The pressure within the ventricles at the end of diastole, commonly called the end of diastole volume |
| Afterload | The resistane against which the heart must pump |
| Cardiac Deploarization | The cell is more positive, a reversal od changes at the cell membrane so that he inside of the cell becomes positive in relation to the outside. |
| Where are the sympathetic nerves of the cardiac plexus located?? | Thoracic and lumbar regions |
| If your looking at a ekg where would you see the relative refractory period? | The downslope of the T wave |
| Equation for cardiac output | Venous return stroke volume and preload |
| Things that increase the risk of cardiac disease | smokingolder agefamily historyhypertensionhypercholesteroemiacarbohydrate intolerancecocainemaleslack of exersice |
| What does the QRS complex represent | Ventricular depolarization |
| What fraction is stroke volume of the left ventricle | 2/3 |
| Relative refractory period | a period in the cardiac cycle when a sufficently strong stimulous may produce depolarization |
| Absoloute Refractory period | A period in the cardiac cycle when the stimulation will not produce and depolarization |
| what are the pericardium layers? | Vicseral and pariteal |
| Normal QT interval? | 0.42 |
| Where the Apex is located? | just above the diaphragm, left of the midline |
| Where is the base located? | Approx at the level of the second rib |
| what is a pacing rhythm | Wife QRS complex |
| Where is the Av node located? | Lower part of the right atrium |
| how many people each year die from CVD | 466,000 |
| Factors that are though to increase the rish of cvd | dietobesitytype a personailitystressbirth control |
| The only vein that carrys oxygenated blood? | Pulmonary veins |
| The hearts two sets of valves | Atrioventricular and semilunar |
| What is the right atrioventricular valve called? | TRicuspid |
| What is the left atriovent valve called? | Mitral |
| What are the mital and tricuspif valce connected too? | special papillary muschles in the ventricles aka chordae tendonae |
| What is atrial systole | Relativly quick boost occurs right before vent contracttions right before cardiac output |
| bipolar limb leads | Leads 1, 2 and 3 applied to the arms and legs contains two electrodes of opposite polarity |
| What are the augmented leads? | aVR aVL aVF |
| Normal PR interva;? | 0,12-0.20 |
| Normal QRS | 0.08-0.12 |
| Normal QT | o.33-0.42 |
| Dysrhythmia | Any deviation from the normal electrical rhythm of the heart |
| Arhythmia | The absence of cardiac electrical activity |
| Cardiovascualr diease | Disease affectiong the heart and blood vesels or both |
| Coronary hear disease | a type of cvd the singlemost largest killer of americans |
| Poiseullies law | blood flow through a vessel is directly porportionate to the radius if the vessek ti tge fourht power |
| A group of cardiac muscle that function as one unit | syncytium |
| Special bands if tissue insereted between myocarduak cekks that increase the ate at which the action potential is spread from cell to cell | intercallated discs |
| action potential | stimulation of cells spreads across the myocardium |
| What is corrected QT | qt divided by the square root of the rr |
| Ectopic focus | nonpacemaker heart cell that automatically depolarizes |
| Ectopic beat | cardiac depolarization resulting from depolarization of ectopic focus |
| noncompensatory pause | pause folliwng an ectopic beat where the sa node is depolarized and the unerlyingcadence of the heart is interupted |
| aberrant conduction | condustion of the electrial impulse through the heards conductive system in an abnormal fashion |
| bundle brance block | a kind of interventricular heart block in which conduction through either the right of left bundle brach is blocked |
| bundle of kent | an accesory av conductuon path that is thought to be responsibe for the ecg fingings of preexcitation syndrome |
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