Cardiology & EKG
irregular heartbeat, any term used to refer to any of your hearts rate or rhythm.
any type of interference during EKG (environment)
-contraction of the Systole -the first part of the cardiac cycle -P wave.
-T wave on the graph. - relaxing of the heart --> diastole
ventricle depolarization (contraction systole)
Tool used to record the electrical activity of the heart.
a device that amplifies low-voltage electric impulses detected on the skin and produces a printed record of that electrical activity
Standard bipolar limb Lead 1
records the electrical activity of the Left arm and right arm
(LA & RA)
Standard bipolar limb Lead 2
records the electrical activity of the Left Leg and Right Arm
(LL & RA)
Standard bipolar limb Lead 3
records the electrical activity of Left leg & Left arm
(LL & LA)
Augmented limb leads: aVR
records the electrical activity from RA & (LA - LL)
Augmented limb leads: aVL
records the electrical activity from LA & (RA - LL)
Augmented limb leads: aVF
records the electrical activity from LL & (RA - LA)
Reasons for performing an EKG
It can detect damage from previous heart attacks, enlargement of the heart muscle, disturbances in the rhythm & other abnormal conditions.
How often is an EKG preformed?
an EKG is preformed along with the routine annual physical examination every 5-10 years.
the EKG is interpreted by the?
the tracing paper is normally running at a speed of?
P-R interval (normal)
0.12 - 0.2 seconds
QRS complex (normal)
0.06 - 0.12 seconds
measures 1 mm by 1 mm 0.04 seconds
measures 5 mm by 5 mm -0.2 seconds
when there is a P wave before every QRS it is called?
measuring more than 1 movement
device on electrocardiograph that enlarges EKG impulses
instrument that measures current by electromagnetic action.
pen like instrument, produces printed representation on the EKG paper.
section of the EKG
Remind patient to eat?
a low-fat, low cholesterol diet and keep their salt and sodium intake at minimum
Advise patient to get...
proper rest, perform approved exercise, and keep weight at an acceptable level.
Instruct patients to take their prescribed medication..
regularly and immediately to report to the provider any problems they might experience and remind them not to take OTC meds w/ out permission.
Remind them to keep their scheduled....
appointments an make a list of questions for the doctor to review w/them at that time.
Advise patients not to use and avoid?
the use of tobacco and alcohol
Advise patient to practice?
Stress reducing behaviors
fourth intercostal space at right margin of the sternum
fourth intercostal space at left margin of sternum
fifth intercostal space on left midclavicular line
midway between V2 and V4 (V3 is placed after V4)
Horizontal to V4 at left anterior axillary line
Horizontal to V4 at midaxillary line
process of bringing into conformity w/ a standard; pertaining to an EKG. a mark made at the beginning of each lead to establish a standard.
the usual standardization mark is?
2 mm wide by 10 mm high & the sensitivity setting should be set at 1.
the standardization mark should be indicated where?
in front of each lead to provide reliable reading.
if the tracing is too large
the sensitivity dials should be turned down to?, 1/2 to produce a standardization mark 5 mm high and 2 mm wide.
if the tracing is too small
the sensitivity dial can be turned up to 2, making the impulse 20 mm high and 2 mm wide.
if the EKG cycles are too close together the speed can be changed to?
50 mm per second this adjustment should be noted in pen on the tracing
-muscle voltage artifacts-caused by shivering from nervousness or cold, Parkinsons
caused by improperly applied electrodes/ improperly cleaned skin
Somatic tremor or involuntary muscle movement
Caused by shivering or twitching
caused by an electrode becoming separated from the wire or by a broken lead wire.
A heart rate less than 60 BPM
heart rate above 100 BPM
Normal Sinus rhythm
the P-wave, QRS complex, and T-wave continually repeat their patterns.
a patients Normal heart rate?
ranges between 60 and 100 beats per min
Premature Atrial contractions (PACs)
Atrium contracts early. P-wave is shaped diff. than on a normal EKG. when atrium contracts a P-wave appears.
Paroxysmal Atrial Tachycardia (PAT)
an episode during which the heart ranges from 160 to 250 BPM and lasts momentarily. Flutter in heart.
Atrial fibrillation (A-fib)
it caused rapid multiple electrical signals that fire from areas in the atria other than the SA node the heart can range from 400 to 500 BPM, some causes are myocardial infarction, hypertension, heart failure, thyroid disorders. P-waves can't be identified because of irregular complexes.
Premature Ventricular contractions (PVCs)
Ventricle is contracting early & followed by a pause before the next cycle occurs. also seen in patients with hypertension, coronary artery disease, and lung disease.
Ventricle is beating super-fast. Seen in patients with cardiac disease/myocardial infarction. Life threatening condition. There are no P-waves and the QRS complexes are imprecise. PVCs occurring at 150-250 BPM
Ventricular fibrillation (V-Fib)
seen in patients with cardiac disease, or ppl experiencing myocardial infarction. Ventricles appear to tremor, there is no cardiac output. Referred to jagged rhythm as sawtooth rhythm. life threatening/ unconscious
count number of small squares between two consecutive R-raves and divide that number by 1500, it is the most accurate method of obtaining a heart rate, used on regular rhythms.
PR interval is greater than 0.2
*Type1 second degree AV Block
P-R interval progressively gets wider until QRS drops
Heart *Type 2 second degree AV Block (wenckebach
Mobitz 2), 2:1 conduction ratio P-R is constant for 2 or more consecutive PR's every 3rd beat QRS Drops.
atrium & ventricle are beating consistently, but no together at the same time.
How are EKGs read?
electrical waves, intervals, and segments
EKG on patients leg the wire is going?
toward the patient’s heart.
an EKG is preformed along with the routine annual physical examination every
-The innermost layer of the heart. -The function is to prevent blood cell destruction and clotting. It is also the layer in which the heart's condition system is embedded.
The middle and contractile layer of the heart.
Outermost layer of the heart. It is attached with ligaments to the spinal column & diaphragm fixing the heart position.
A structure in the middle of the heart called the sputum, divides the heart into 2 sides. The right side pumps Deoxygenated blood with low pressure from the veins into the lungs (pulmonary circulation) and left side, that pumps oxygenated blood with high pressure toward the tissues through arteries (systemic circulation).
Receives deoxygenated blood returning to the heart from the body via the superior vena cava which carries blood from the upper body and the inferior vena cava which carries blood from the lower body. Right atrium (RA) receives blood from coronary sinus, the largest vein that drains the heart muscles deoxygenated blood.
Receives deoxygenated blood from the right atrium which it pumps to the lungs for oxygenation through the pulmonary trunk and then to the pulmonary arteries.
Are the only arteries in the body that carry deoxygenated blood ( bcuz there going away from the heart)
Receives oxygenated blood returning from the lungs via the right and left pulmonary veins.
Are the only veins that carry oxygenated blood? ( because they are going towards the heart )
receives the oxygenated blood from the left atrium and pumps it through the aorta, the largest artery of the body.
The purpose of the heart valves is to prevent backflow of blood.....assuring uni-directional flow thru the heart.
Period of contractions of both atrial/ventricles
Period of relaxation and filling all cardiac chambers.
Caused by the closure of the heart valves
S1 first heart sound (Lubb)
Occurs during ventricle contraction & the closure of the AV valves
S2 second heart sound (Dupp)
Occurs during ventricular relaxation. Pulmonary aortic valves close. Murmurs are caused by diseases of the valves or other structural abnormalities.
# of contractions per min. Normal heart rate is 60/100 BPM
Graphical presentation of heart electricity over time.
Measures the hearts electricity traveling through the system. Important tool for the patients diagnosis & evaluation. Monitoring patients HR. evaluates injuries to the heart muscle, and pacemakers and conductive system muscle. Evaluates the response toward medication & provides a baseline record for medical procedures.
Standard bipolar Limb leads record?
Electrical activity in the frontal plane.
Pericardial chest unipolar leads; V1-V6
These electrodes are positive and record the heart electricity in the horizontal plane. ******
Records electrical activity in the frontal plane.
Vertical axis |
1 small square: 1mm , 1 large square: 5 mm
Horizontal axis -------
1 small square: 0.04, 1 large square: 0.2
Asses’ rhythm and regularity Heart rate is
considered regular if all RR & PP on EKG leads are equal. If there are changes in their durations the rhythm is irregular.
12 Lead EKG Chest
V1, V2, V3, V4, V5, V6
12 Lead EKG 3 AV
AVR, AVL, AVF
12 Lead EKG LIMB LEADS
I, II, III
STANDARD LIMB LEADS/BI-POLAR (2 POLES)
WHAT VESSEL CARRIES DEOXINGINAATED BLOOD
SUPPERIOR/INFERIOR VENA CAVA
WHATS DIFFERENT W/THE PULMONARY ARTERY?
THE BLOOD IS DEOXYGENIATED BLOOD
ARTERIES DO WHAT?
CARRY BLOOD AWAY FROM THE HEART
VEINS DO WHAT
CARRY BLOOD INTO THE HEART
Contraction of the heart- Depolarization
relaxation - recovery
Heart Risk Factors
No oxygen in your bloos, you turn blue, hypoxia
The cardiac cycle is
1 heart beat
Blood supply does what?
Supplies oxygen through the heart
Rheumatic Fever is?
caused by tonsillitis and streptococcus, can cause Rheumatic heart disease
Heart Disease MI
Corenary artery desease?
reduction of blood supply to the heart.
fast heart rate over 100
what do you take for an angina?
coronary heart disease
Coronary Heart Disease (CAD)
damage to the artery
Conduction part of the heart
1. Sinoarterial node (SA)/Pacemaker
2. AV Node (Arterial ventricular node
3. Bundle of his
4. penjerky fibers
Another word for standard leads?
Bi-Polar leads; I, II, III
Another word for body?
Somatic artifact is
body movement, Parkensens Disease, chewing gum, talking not plugged in
WHAT COMES AFTER THE SA NODE?
what are the sticky pads called that are stuck to you in an EKG?
What are AVL, AVF, AVR known for?
Augmented, Left ventricle, leg & pQRS. Augmented and are UNI_POLAR
underneath through (sublingual) does what, dilates blood vessels.
Miltral Valve is also known as?
Arterial Sclerosis is
hardening of the arteries
yellow plaque buildup in the arterial walss.
You loose collogen because?
because of elastysity , because of age and blood is heald back and elastyty of the arterial walls.