CRAT
What color is the chest lead?
Brown
The atria and ventricles beat independently in 3rd degree AV block and what else?
Complete AV dissociation
The type of AV block that could cause cardiovascular collapse would be?
Complete heart block (3rd degree)
Prolonged PR intervals are associated with?
Conduction delays
In the QRS complex what does the S Wave represent?
Conduction of the electrical impulses through both ventricles
_________is a condition where the heart cannot meet the demands of the body
Congestive heart failure
What might be considered a sign of hyperkalemia on an EKG?
A peaked T wave
The space between two waves would be considered?
A segment
Describe what the T wave looks like on an EKG
A short broad hump It represents the rapid phase of ventricular repolarization
Originating above the ventricles, what will cause the heart to beat between 150 and 250 bpm?
Atrial tachycardia
Where do junctional arrhythmias originate?
Atrioventricular junction
What could be administered to a patient to correct a junctional escape rhythm?
Atropine
If a patient is in ventricular fibrillation what would be the the preferred treatment
Defibrillation
The atria relax and fill with blood during?
Diastole
The ventricles relax, the atria contracts, and the blood is forced through the open tricuspid and mitral valves during________
Diastole
Systolic and ______best describes the physiologic movements of the heart?
Diastolic
As an electrical current travels toward the negative pole on an ecg, the waveform defects in which direction?
Downward
When setting up limb leads and placing them in equal distances from the heart, it is typically known as?
Eithoven's triangle
What is the thin layer that covers the myocardium?
Epicardium
True or False The SA node protects the ventricles from the 400-609 erratic atrial impulses that occur during atrial fibrillation
False The AV Node
The left bundle branch splits into two branches known as?
Fasciculi
________controls increases or decreases of the EKG tracings on the rhythm paper
Gain
The semilunar valves are called such because the cusps on these caves resemble?
Half moons
Sinus arrest occurs when the SA node fails to generate an impulse which can be caused by?
Heart disease
If a premature ventricular contraction comes from different foci what kind of Premature ventricular contraction would it be?
Multifocal PVC
If the ST segment is elevated what might that indicate?
Myocardial infarction
What might be indicated if the Q wave is deep and wide?
Myocardial infarction
Supaventricular tachycardia has _______complexes and a rate of_________
Narrow, 150
What would you see on an ekg when looking for 2nd degree type 2
Occasionally dropped beat with normal AV node conduction
If there is a preconfigured group of orders which are commonly ordered together for a specific diagnosis or condition would be?
Order set
Sinus tachycardia can worsen myocardial ischemia by increasing the hearts demand for?
Oxygen
In a cardiac complex what would be considered the first wave that is seen?
P wave
The heart activity that begins with atrial depolarization and ends with the start of ventricular depolarization is know as?
PR interval
What starts at the beginning of the p wave and stops at the begging of the QRS complex?
PR interval
A first degree atrial ventricular block is determined by measurement of the __________
PR interval (.21 or greater)
What should also be checked in addition to the three methods of calculating atrial or ventricular heart rate?
Patient pulse
The initial phase of ventricular repolarization is know as?
Plateau phase
What condition would be a biventricualr pacer typically be used for?
Pre cardiac transplant patients
Short PR intervals are associated with?
Pre-excitation syndromes and junctional arrhythmias
The stretching of the muscle fibers in the ventricles is known as?
Preload
paroxysmal atrial tachycardia commonly follows?
Premature atrial contractions
What is an extra beat that causes the irregular rhythm because it happens before the regular beat?
Premature junctional contractions
___________is the only vein that carries high oxygen blood
Pulmonary vein
The right ventricle pumps blood through what valve into the pulmonary arteries?
Pulmonic valve
What is the rhythm that would be included in the algorithms for adult cardiac arrest?
Pulseless electrical activity (PEA)
If the bundle of His becomes blocked, what can be activated as a pacemaker?
Purkinje fibers
From the start of the QRS to the finishing of the T wave what is that considered?
QT interval
If the Q wave is absent, the QRS complex should be measured from the beginning of which wave?
R
A PVC that occurs during the relative refractory periods and can cause a patient go into VTACH is referred to as?
R on T phenomenon
When applying the 10 times method to calculate the ventricular rate, which waves do you count on the rhythm strip?
R wave
Impulses causing depolarization twice in a row in a faster than normal rate are referred to as which of the following?
Re-entry events
The steps to most effectively analyze an EKG are?
Regularity, Rate, P wave, PR interval, and QRS complex
What is the main cause of sinus arrhythmia in adults?
Respirations
Deoxygenated blood returns to the heart through the inferior and superior vena cava and empties into?
Right atrium
What can occur with coronary artery disease, cardiomyopathy, cor pulmonale, and pulmonary embolism?
Right bundle branch block
Which part of the heart supplies the most blood to the SA node?
Right coronary arteries
What does the term detrocardia mean?
Right sided heart It's a rare congenital condition when the apex of the heart is actually on the right side of the body
A single chamber pacemaker has one lead inserted into either the right atrium or?
Right ventricle
late ventricular depolarization is represented by?
S wave
sinus rhythm is the pacemaker action for?
SA node
What are symptoms of 3rd degree av block?
Severe fatigue,chest pain, pulmary edema
Dyspnea is best described as?
Shortness of breath
What syndrome in which the sinus node isn't properly functioning?
Sick sinus node
What is it called when theres a wide spectrum of SA node abnormalities that are caused by disturbance sleep in the way impulses are generated or the inability to conduct impulses to the atrium
Sick sinus syndrome
What is it called when there is lack of electrical activity in the atrium?
Sinus arrest
What rhythm has an effect on the respiratory cycle and causing the heart rate to increase and decrease
Sinus arrhythmia
What rhythm is less than 60bpm but the measurements are within normal range?
Sinus bradycardia
Atrial standstill is called________ if only one or two beats are not formed
Sinus pause
What carries the cell to cell condition of depolarization through the myocardium?
Sodium ions
A common cause of artificial on a cardiac rhythm strip would be considered?
Somatic tremors
Each time the heart beats the amount of blood that is ejected from the ventricles would be considered?
Stroke volume
Atrial flutter, multi focal atrial tachycardia, and junctional tachycardia are all examples of?
Supraventricular tachycardia
Ventricular repolarization is represented by which cardiac complex?
T wave
In measuring ventricular regularity if there is no R wave what could be measured instead?
The Q and S wave junction
From the beginning of the QRS complex to the highest point in the T wave what would that be considered?
The absolute refactory period
The R wave represents what on an ECG?
The electrical flow of the signal through the muscle in the ventricles is
In the pacemaker codes the first letter represents what?
The heart chamber being paced
The P wave will come after the QRS complex if what happens?
The ventricles depolarize first
What if the patient has spontaneous atrial activity leading the VVI pacemaker to not synchronize the ventricle activity with it?
There are will be no relationship between the P and paced QRS complex. Tricuspid and mitral regurgitation can develop
What are the two entrance cables of the heart?
Tricuspid and bicuspid valves
True or False SA node failure could cause sinus arrest
True
When the AV node delays an impulse from the SA node a little longer it would be?
Type 1 second degree AV block
If the patient is experiencing hypokalemia, what might be seen on an EKG?
U wave
What regulates the blood flow in the heart?
Valves
If one idioventricular beat happens at a time it is referred to as?
Ventricular escape beat
In most cases of sudden cardiac death in people outside the hospital what is the cause?
Ventricular fibrillation
Sinus tachycardia can reduce cardiac output by lowering?
Ventricular refilling time
When three or more PVCs happen in a row, it's considered what?
Ventricular tachycardia
Artifact that occurs when the tracing drifts away from the center of the graph paper is known as?
Wandering baseline
Another name for second degree AV block type 1 is?
Wenckehbach or mobitz type 1
When would sinus tachycardia not be considered normal?
When sleeping
How would a compensatory pause be defined?
When the interval that is between normal beats contains a premature ventricular contraction which is as large as two normal beats
When would a patient typically have a U wave?
When the patient has very low potassium
What does WAP stand for?
Wondering atrial pacemaker
If the contact on an electrode is not conducting well or placement is wrong, what can occur?
Wondering baseline
Lead 2 would be considered a combination of which leads?
aVR and aVF
What does SCD stand for?
sudden cardiac death Not a heart attack but can be caused by V-tach or V-fib
A compensatory pause may cause what on an EKG strip?
A PVC that is equal to 2 sinus intervals
When interpreting a rhythm which one should always be irregular
Atrial fibrillation
______________is described as chaotic, asynchronous, electrical activity in the atrial tissue
Atrial fibrillation
What contributes to approximately 30% of the cardiac output?
Atrial kick
How much does the average human heart weigh?
6-11oz
What is the normal o2saturation of the blood in the right atrium?
60-75% This is deoxygenated blood that returns to the body so it has a high concentration of C02
What is the approximate diameter of the coronary arteries?
1/8 inch
What is considered a normal volume of pericardial fluid around the heart?
10 to 20 ml
Sinus Tachycardia is characterized by heart rate above?
100 bpm
What is the normal rate for a junctional tachycardia rhythm?
100-200 bpm
How many different types of atrial tachycardia are there?
3 Atrial tachycardia with block Mutifocal atrial tachycardia Paroxysmal atrial tachycardia
Sinus tachycardia occurs in approximately what percentage of patients following an acute myocardial infarction?
30%
Of the heart blocks which is considered the most serious?
3rd degree It is life threatening and can lead to cardiac arrest if not treated immediately
What artifact setting is commonly used to reduced artifact due to muscle tremor and slight patient movement?
40 Hz
The AV node normally generates how many impulses in a minute?
40-60
What is the normal speed for a junctional escape rhythm?
40-60 bpm
In atrial fibrillation how many times does it fire a minute?
400-600 bpm
The ectopic impulses fire at what rate ranges in atrial fibrillation?
400-600 times/min
How many leads does a 24 hour holter monitor have?
5
In a 12 lead ECG how many limb leads are there?
6
What is the largest artery in the body?
Ascending aorta
Generally, the chest leads are oriented through_____to project through the patients back
AV node
___________blocks the conduction of some of the atrial impulses if the atrial beats are conducted only periodically
AV node
If a patient is diagnosed with a differential diagnosis of junctional tachycardia, they should be treated with?
Ablation therapy and a permanent pacemaker
____________is caused by an irritable focus in the AV junction that speeds up to take over as the hearts pacemaker
Accelerated junctional rhythm
Premature atrial contractions are rarely dangerous but with what condition could this be an early sign of heart failure or electrolyte imbalance?
Acute myocardial infarction
vagal maneuvers and medications such as which of the following can be employed to slow the heart rate on symptomatic junctional tachycardia patients?
Adenosine
The magnitude in millimeters of upward or downward deflection in an EKG is known as?
Amplitude
Potassium and __________ are needed in order for the heart to function normally
Calcium
If a patients shock has been caused by a cardiac tamponade it would be considered _______ shock
Cardiogenic
In the cardiac conduction system, why can't impulses flow backwards through the system?
Cells can't respond to another stimulus directly following depolarization
A pediatric patient will have a shorter PR interval because?
Children have smaller ventricular size
Generally there's no treatment necessary for bradycardia unless the patient shows symptoms of——-
Decrease cardiac output
If the T wave is bumpy instead of smooth what might it indicate?
Hidden p wave
The PR interval is measured on the ________ axis of the electrocardiogram
Horizontal
If the cardiac output falls and compensatory mechanisms fail a tachycardia patient may experience?
Hypotension,syncope,blurted vision,chest pain, palpitations, nervousness or anxiety
What acts as a safety net to prevent the ventricles from going into standstill?
Idioventricular rhythm
What acts as a safety mechanism to protect the heart from ventricular standstill?
Idioventricular rhythms
The _______brings blood from below the diaphragm
Inferior vena cava
What does the W wave represent?
Initial negative pulse of ventricular depolarization
The data that is entered into an EKG machine would be considered?
Input
When there is no electrical activity occurring or there is too little activity, the wave resembles a straight line and is called?
Isoelectric waveform
Atrial diastole occurs in which phase of the cardiac cycle?
Isovolumetric relaxation
Why is the left side of the heart thicker than the right?
It pumps blood back to all the parts of the body
A string of beats that occur after a conduction delay from the atria is________
Junctional escape rhythm
Nodal tissue itself does not have a pacemaker cells but the tissue surround it which is called?
Junctional tissue
The circumflex coronary artery feed which potion of the heart?
Lateral walls of the left ventricle
What is the receiving chamber of the heart?
Left atrium
What chamber of the heart has the thickest walls?
Left ventricular
What pacemaker complications involves irregular pacemaker intervals with slower that set rate impulses and no visual packer spike?
Malfuctioning
What would it be if the pacemaker is sending current to the heart during relaxation phase?
Malsensing
If a patient is experiencing ventricular fibrillation where in the heart would the electrical impulses come from?
Many different foci