patho 2 arrhythmias
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Cardiac arrhythmias result from disturbances of? | heart rate, which result from disorders of impulse formation or disorders of impulse conduction(block)
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intrinsic rates of SA, AV, ventricle | SA-60-100, AV-40-60, V 20-40
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The dominant pacemaker of the heart | The fastest one, normally SA node. If it slows down or any other speeds up than the new fastest one takes over and becomes dominant
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P wave | depolarization of Atria(both)
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P-R segment | after atrial depol. elect impulse spreads to the AV node, bundle of HIS, and bundle branches...flat line recorded, from end of p wave to beg. of qrs complex
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PR interval | includes P wave and PR segment represents the time of transmission of elect. impulse from atria to ventricle
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QRS complex | Ventricular depolarization
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ST segment | end of the qrs to the beg of the t wave. Earlier phase of repolarization, of both vent. flat isoelectric line.
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J point | point where the st segment joins the qrs complex
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T wave | later vent repolarization
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QT interval | beg. of Q wave to the end of T wave
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What does each lead of an electrocardiogram record? | The difference in potential between the 2 connected limbs
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What are the bipolar leads?and where are + and - | I, II, and III Right arm(-) Left arm(+)foot(+)
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lead I | 2 arms
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Lead II | right arm=>left leg
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lead III | left arm=>left leg
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how many frontal leads and how many precordial? | 6 and 6
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___of the frontal leads are bipolar and ___are unipolar | 3 and 3
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How do the unipolar leads work | connect all 3 extremities to a central terminal connected to an explorer electrode, place exploring elect on one limb it'll record the potential at the root of that limb
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on unipolar leads if the connection if the connection between the central lead and the explorer electrode is lost what happens? | The signal is amplified, which gives you avr(right arm), avl(left arm), and avf(left leg) (a=amplified)
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How many seconds are represented in a horizontal box? | .04second
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How many mV are represented in a verticle box? | .1mV
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T or F The only purpose of the R leg lead is to ground the system | True
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The Q wave is always____ | negative
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The R wave is always___ | positive
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The S wave is always____ | negative
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placement of precordial lead V1 | 4th ICS R sternum
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placement of precordial lead V2 | 4th ICS L sternum
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placement of precordial lead V3 | midway btwn 2 and 4
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placement of precordial lead V4 | midclavicular line 5th ICS
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placement of precordial lead V5 | level of v4 anterior axillary line
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placement of precordial lead V6 | level of V5 midaxillary line
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Normal Sinus Rhythm | 60-100bpm, each complex complete, and all intervals within normal limits
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Sinus arrhythmia | variation in HR synchronized with breathing, slowing with exp and accelerating with insp. All intervals except R-R within normal limits, complete complexes, 60-100 bpm
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Sinus Brady | <60bpm. all mcomplexes complete, all intervals except rate within normal limits
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sinus tach | 100-160bpm, complexes complete and intervals in normal limits
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PAC | ectopic beat that occur in the context of other rhythms. Teh p waves are smaller or peaked and the qrs may be normal or conducted differently
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A flutter | rapid fireing of an ectopic focus, atrial rte 240-360bpm, no P waves, F waves instead, ventricular rate depends on conduction ratio (60-100)complexes incomplete, t wave buried in F wave
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A Fib | f waves uncoordinated fast atrial activity (350-600bpm)ventricular rate (100-160bpm)irregular R-R
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junctional Rhythm(nodal) | from the AV node 40-60bpm,no preceding P waves(from AV) retrograde atrial depolarization makes them inverted either before or after the qrs or not at all.
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SVT | 160-250bpm complete complexes, p waves may be absent or buried in the preceding complex
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V tach | 100-250bpm qrs >.12 sec
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1st degree AVB | PR int longer than .20sec (fixed), all coming from atria
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2nd degree AVB Type I (mobitz I/wenckebach) | PR interval lengthens until it eventually drops a QRS
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2nd degree AVB Type II (mobitz II) | PR int constant and normal.. some p waves not followed by qrs b/c complex is blocked
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3rd degree AVB | no relationship btwn p waves and qrs complexes atrial rate 60-100bpm, vent rate 20-40bpm
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T or F AV dissociation is a primary disorder | False, It is always a result of a basic disturbance in impulse formation or conduction
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In a pace maker I means | Inhibited- the charge is supressed b/c it senses the patients own intrinsic beat
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In a pacer T means | Triggered-
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In a pacer O means | none (DOO) has no sensing
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first position | chamber placed
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second position | chamber sensed
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Third position | response to sensing, if any
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#1 reason for pacer insertion | sick sinus syndrome
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VAT | Wire in the ventrical Atrial triggered, ventricular paced beat. always follow a p wave at a fixed interval
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Ventricular triggered | The blip is on not immed. before the QRS of a natural beat. If no qrs is sensed , the pacer delivers an impulse at the end of the interval corresponding ro rhe programmed rate
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