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