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Cardiac Dynamics
Test 1
158
Physiology
Graduate
09/30/2011

Additional Physiology Flashcards

 


 

Cards

Term
Cardiac Output
Definition

 

 

The volume of blood ejected by EACH ventricle per UNIT of TIME

Term

 

 

Cardiac Output =

Definition

HR x SV

 

= beats/min x mL/beat

 

=L/min

Term

 

 

Cardiac Output at rest

Definition

 

 

5L/min

Term

 

Cardiac output to -->

 

1) the brain

2) the kidneys

3) cardiac muscle

Definition

 

 

1) 13%

 

2) 20-25%

 

3) 4%

Term

 

 

Normal HR =

Definition

 

 

 

80 beats/min

Term

 

 

Normal SV =

Definition

 

 

70-80 mL/beat

Term

 

 

Cardiac output usually refers to which ventricle?

Definition

 

 

The left! but SV is usually the same for both :)

Term

 

 

Stroke Volume is affected by ?

Definition

 

 

1) venous return 2) peripheral resistance and 3) the ANS

Term

 

 

If HR increases to 90 beats/min, the result of CO is?

Definition

 

 

 

increased proportionally

Term

 

 

 

If HR increases from 90-140 beats/min, the result of CO is?

Definition

 

 

 

CO stays the same, because SV decreases in proportion. This is because the ventricles have LESS TIME to fill during diastole

Term

 

 

 

If HR increases over 140 beats/min, the result of CO is?

Definition

 

 

CO decreases because the SV decreases faster than the HR is increasing!

Term

 

 

Starling's Law of the Heart-

Definition

 

 

If all other factors remain constant, the stroke volume is determined by the force of the contraction. The heart will automatically eject ALL of the blood that enters it over a BROAD range of volume.

Term

 

 

The force of contraction of cardiac and striated muscle is proportional to the ?

Definition

 

 

degree of stretch

 

 

UP TO A LIMIT!!!

Term

 

 

The strength of contraction increases in proportion to the  ____ of the ventricle muscle fibers? This implies ___?

Definition

 

 

length of the fibers, this implies that all the extra blood from an increased venous return is pumped out!

Term

 

 

 

End-Diastolic volume -

Definition

 

 

The quantity of blood in the ventricles just prior to their contraction. This amount determines the length of the ventricle muscle fibers.

Term

 

 

 

Pre-Load -

Definition

 

 

The degree of tension of the muscle when it begins to contract. It is determined by the end-diastolic volume.

Term

 

 

According to Starling, any change in ____ has a direct effect on the SV and therefore ____.

Definition

 

 

Any change in the venous return, ultimately the CO is effected.

Term

 

 

 

Increase in the venous return causes?

Definition

 

 

An increase in the strength of the contraction, which causes an increases the SV, which increases the CO.

Term

 

 

Even though the change is indirect, changing BP has similar results as changing ____?

Definition

 

 

 

Venous return

 

Term

 

 

Increased blood pressure, increases the ____ Which decreases the ___? This causes an increases in _____ Which _______ the strength of myocardial contraction, which increases the ____.

Definition

 

BP increases the resistance, which decreases  the SV. This increases the end diastolic volume which increases the myocardial contraction strength, which increases the SV.

Term

 

 

After the initial adjustment by the starling law what happens?

Definition

 

 

other factors begin to regulate the strength of the contraction and thus the CO.

Term

 

 

 

The factors that regulate the strength of contraction- (what do they involve and how are they defined)?

Definition

 

Involve the metabolism of the myocardium and DON'T depend on the degree of stretch of the fibers. These are considered homeometric regulation. Once they take over the heart size and degree of muscle stretch is returned to normal.

Term

 

 

 

Blood flow can go in which direction?

Definition

 

 

 

ONLY ONE DIRECTION

Term

 

 

 

A-V valves are also known as -

Definition

 

 

 cuspid valves

Term

 

 

The valves between ventricles and the great arteries are known as -

Definition

 

 

 

Semi- lunar

Term

 

 

Heart sounds are from?

Definition

 

 

closing of the valves

Term

 

 

The first heart sound ____ corresponds to _____?

Definition

 

 

Lub, closure of the A-V valves

Term

 

 

The second heart sound ____ corresponds to ______?

Definition

 

 

Dup, closure of the semilunar valves

Term

 

 

The second heart sound has a _____ frequency compared to the first sound.

Definition

 

 

 

  Higher frequency

Term

 

 

 

Sounds of the aortic semilunar valve are heard in the ___ intercostal space at ___ sternal margin.

Definition

 

 

 

2nd, right

Term

 

 

 

Sounds of the _______ valve are heard in the ___ intercostal space at left margin.

Definition

 

 

 

Pulmonary semilunar valve, in the 2nd space.

Term

 

 

Sounds of the mitral valve are heard _____ in the 5th intercostal space in line with _____.

Definition

 

 

over heart appex. in the 5th intercostal space, in line with middle of clavicle

Term

 

 

Sounds of ______ valve are typically heard in right sternal margin of 5th intercostal space. ______ include over the sternum or ______ in 5th intercostal space.

Definition

 

 

tricuspid valve, variations include over the sternum or over the left sternal margin.

Term

 

 

Bicuspid closes before or after tricuspid valve?

Definition

 

 

 

slighty before.

Term

 

 

This valve is the 1st "lub" of ventricle systole

Definition

 

 

 

Mitral/bicuspid valve

Term

 

 

Accounts for the "dub" sound

Definition

 

 

 

aortic/pulmonary valves in ventricle diastole

Term

 

 

 

Connective tissue covered with endothelial tissue?

Definition

 

 

 

The leaflets of the valves

Term

 

 

 

What is a commissure?

Definition

 

 

Division between the cusps

Term

 

 

 

What does the Chordae Tendinae anchor and to what??

Definition

 

 

Anchors ventricular surface of the A-V valves to the ventricular wall.

Term

 

 

 

What is the Chordae Tendinae made up of and what is its function?

Definition

 

 

Elastic cords that are inserted into the papillary muscles, composed of myocardial tissue. It contracts simultaneously with the ventricles assuring their proper closure during ventricular contraction, preventing blood reflux.  

Term

 

 

 

Chordae tendinae is attached to?

Definition

 

 

 

the A-V valves, the tricuspid valve flap and papillary muscles

Term

 

 

The cardiac CYCLE is divided into?

Definition

 

 

 

Diastole and Systole

Term

 

 

 

 

Cardiac cycle is defined as -

Definition

 

 

 

The cardiac events that occur from the Beginning of one cycle to the beginning of the next!

Term

 

 

 

Each cycle is initiated by ______, in the _____?

Definition

 

 

 

spontaneous generation of an action potential, in the sinus node (S-A node).

Term

 

 

 

Describe the path that an action potential of the heart cycle takes -

Definition

 

 

1) travels through both atria. 2)reaches the A-V node 3) goes to the bundle of his, 4) then bundle branches then 5) purkinjie fibers and finally 6) ALL cardiac fibers

Term

 

 

 

Why is there a delay in the impulse from the atria to the ventricles?

Definition

 

 

 

This delay allows the atria to contract a little before the ventricles, contributing to ventricle filling.

Term

 

 

 

What is the conductive system composed of?

Definition

 

 

 

Specialized muscle tissue. It function is NOT contraction but IMPULSE GENERATION and TRANSMISSION.

Term

 

 

 

How many components are in the cardiac cycle?

Definition

 

 

 

4, they are all typically accomplished in less than 1 second

Term

 

 

 

What passive process determines the opening and closing of the valves?

Definition

 

 

 

The pressure gradient across them.

Term

 

 

 

When does the cycle technically begin?

Definition

 

 

 

At the end of systole, when all valves are closed and BOTH atria are being filled.

Term

 

 

 

Describe the atria at the start of the cycle.

Definition

 

 

Both atria are being filled with blood returning to the heart. Pressure within the atria increases until it is higher than in the relaxed ventricles. This leads to the opening of the A-V valves, starting ventricular filling.

Term

 

 

 

What prevents the closing of the A-V valves during ventricular filling?

Definition

 

 

Atrial contraction that completes emptying of the atria. (helps in better ventricular filling). In this case, the valves stay open even though intraVENTRICULAR pressure is greater than atrial pressure.

Term

 

 

 

How effective is atrial contraction?

Definition

 

 

 

Technically the heart can stil function without atrial contraction but it increases ventricular pumping efficiency by 40-50%

Term

 

 

 

What phases does systole consist of?

Definition

 

 

The contraction phase (I)

and the

Ejection phase (II)

 

 

Term

 

 

 

What phase is the contraction phase?

Definition

 

 

 

I

Term

 

 

 

What phase is the ejection phase, and what part of the cardiac cycle is it in?

Definition

 

 

 

 

II, systole

Term

 

 

 

What phases are in the diastole phase?

 

Definition

 

 

The relaxation phase (III)

and the

Filling phase (IV)

Term

 

 

 

What does P wave represent?

Definition

 

 

 

Atrial depolarization. It occurs just before atrial contraction

Term

 


What does the QRS complex represent?

Definition

 

 

 

Ventricular contraction

Term

 

 

 

 

What does the T wave represent?

 

Definition

 

 

 

Repolarization of the ventricles :)

Term

 

 

 

Where is the impulse generated and what happens?

Definition

 

 

 

At the S-A node, atrial excitation begins.

 

Term

 

 

 

 

The impulse is delayed where?

Definition

 

 

 

At the A-V node.

Term

 

 

 

The impulse passes to the heart apex where, and what happens?

Definition

 

 

 

Through the bundle branches, ventricular excitation begins.

Term

 

 

 

 

Ventricular excitation is complete at the?

Definition

 

 

 

Purkinjie fibers

Term

 

 

 

The cardiac cycle can also be described in terms of the _____ of _____?

Definition

 

 

 

phases of ventricular pumping, there are 8 phases.

Term

 

 

 

How many phases of ventricular pumping are there in diastole?

Definition

 

 

 

5, protodiastole, isometric relaxation, rapid inflow, diastasis, and atrial systole 

Term

 

 

 

 

Protodiastole is:

Definition

 

 

 

The fall in intraventricular pressure and closing of the aortic valve.

Term

 

 

 

 

Isometric relaxation is:

Definition

 

 

A phase in ventricular pumping diastole, ventricle is closed, muscle is relaxing but NOT lengthening. Also called isovulmetric relaxation.

Term

 

 

 

 

Rapid inflow:

Definition

 

 

A phase in ventricular pumping diastole. Occurs immediately after the opening of the AV valves. (also called rapid filling/ ventricular filling)

Term

 

 

 

Diastasis:

Definition

 

 

 

A phase in ventricular pumping diastole. Almost no blood is flowing from the atria. Ventricular filling?

Term

 

 

 

Atrial Systole:

Definition

 

 

 

A phase in ventricular pumping diastole. Atrial contraction leads to increase in ventricular filling. Atrial contraction.

Term

 

 

 

3 Phases during systole:

Definition

 

 

 

1) Isometric contraction 2) Rapid ejection and 3) Reduced ejection.

Term

 

 

 

Isometric Contraction:

Definition

 

 

Phase during systole, just after the beginning of ventricular systole BUT before the opening of the semilunar valves. Also known as isovulumetric contraction phase.

Term

 

 

 

 Rapid ejection phase:

Definition

 

 

 

A phase in systole. Semi-lunar valves open and blood is pushed into the great artery. Ventricular ejection phase.

 

 

Term

 

 

 

Reduced ejeciton phase:

Definition

 

 

 

A phase in systole. Ventricles remain contracted but LITTLE blood is pumped out.

Term

 

 

 

Isovulumic contraction: Semi-lunar and AV valves are____?

Definition

 

 

 

 

closed, this is systole

Term

 

 

 

Period of ejection: Semi-lunar and AV valves are____?

Definition

 

 

Semi-lunar valves are opened

 AV valves are closed

This phase is during systole

Term

 

 

 

Period Isovolumic relaxation: Semi-lunar and AV valves are____?

Definition

 

 

 

Closed. This is phase is during diastole

Term

 

 

 

Pressure ventricular filling: Semi-lunar and AV valves are____?

Definition

 

 

 

Semi-lunar valves are closed. AV valves are open. This is during diastole.

Term

 

 

 

Active Ventricular Filling: Semi-lunar and AV valves are____?

Definition

 

 

 

Semi-lunar vavles closed and AV valves are open. This is during diastole.

Term

 

 

Sensors that respond to distention of artery wall as a result of increase in pressure. They send impulses and activates the cardioinhibitor center, which triggers parasympathetic stimulation

Definition

 

 

 

Baroreceptors

Term

 

 

 

Baroreceptor stimulation leads to:

Definition

 

 

 

Stimulation of the parasympathetic system. HR, cardiac contraction, CO  and BP decreases

Term

 

 

 

If baroreceptors are not stimulated, what is?

Definition

 

 

If baroreceptors are not stimulated this means BP has decreased, there is no parasympathetic discharge and sympathetic system acts through cardioacclerator center.

Term

 

 

 

There are ___ baroreceptors that are basically nervous endings located in the _____ and _____. These receptors are known as____?

Definition

 

 

 

2 baroreceptors: in the AORTA and the CAROTID ARTERIES.  They are known as the aortic sinus and the carotid sinuses.

Term

 

 

 

The aortic sinus is located where and is innervated by what CN?

 

Definition

 

 

 

located in the aortic arch and inervated by the vagus CN.

Term

 

 

 

The carotid sinuses are located _____ and are innverated by the _____.

Definition

 

 

 

at the bifurcation of each common carotid innervated by the carotid sinus nerves or nerves of Hering.

Term

 

 

 

Homeostasis for increase in arterial blood pressure:

Definition
The stimulus is rising blood pressure. Baroreceptors in carotid sinuses and aortic arch are stimulated, inhibit vasomoter center. Impulse travels along afferent nerves from baroreceptors- stimulate cardio inhibitory center (inhibit cardio acceleratory center), sympathetic and vasomoter impulses decline. Allows decrease in HR and vasodilation declines respectively. These factors lead to decreased CO and PR, returning BP to normal.
Term

 

 

 

Homeostasis for decreased arterial blood pressure:

Definition
The stimulus is declining blood pressure. Baroreceptors in carotid sinuses AND aortic arch are inhibited. The vasomotor center is stimulated.Cardioacceletory center is stimulated and cardioinhibitory center is inhibited. Sympathetic efferents stimulate increased HR and force. This increases CO. Vasomoter fibers stimulate vasoconstriction, this increases Peripheral Resistance. Total result is increased CO and PR to return back to normal BP.
Term

 

 

 

These receptors respond to O2 and CO2 concentrations in the blood and not to variations in pressure

Definition

 

 

 

chemoreceptors, they are located NEAR the aortic and carotid and aortic bodies

Term

 

 

 

Chemoreceptors in the PNS respond to:

Definition

 

 

 

decrease in O2, increase in CO2 and increase in H+

Term

 

 

 

 

Chemoreceptors in the CNS respond to:

Definition

 

 

 

increase in CO2 and increase in H+ but NOT O2

Term

 

 

 

 

Carotid bodies are immediately rostral to ____?

Definition

 

 

 

 

The bifurcation of EACH common carotid artery

Term

 

 

 

 

Aortic Bodies are located:

Definition

 

 

 

They are scattered in the tissue BETWEEN the aorta and the pulmonary arteries.

Term

 

 

The exact relationship between chemoreceptors and cardiac function is unknown. Hypoxia causes ____ in CO but it is thought to be the result of _______. If hypoxemia is limited to the carotid and aortic bodies the heart action is _____ or ______.

Definition

 

 

 

increase, stimulation of the medulla oblongata.

 

decreased or unchanged.

Term

 

 

 

 

This value adjusts the CO to the individual person's body size by representing ______ relative to _________ of body surface area. 

Definition

 

 

 

 

= Cardiac index. adjusts CO by representing blood flow relative to a square meter of body surface area.

Term

 

 

 

 

The normal adult cardiac index range is -

Definition

 

 

 

 

2.5 to 4.2 L/min/m2

Term

 

 

 

 

Cardiac index =

Definition

 

 

 

CO (l/min)

___________

 

Body surface area m2

Term

 

 

 

 

Body surface area=

Definition

 

 

 

 

Height (cm) x Weight (kg)

-----------------------------------

3600

Term

 

 

 

 

Blood flow - (def)

Definition

 

 

 

 

is the amount of blood that passes a given point in the circulation in a given period of time.

Term

 

 

 

 

Blood flow (Q) =

Definition

 

 

 

change in pressure

----------------------------

resistance

Term

 

 

 

 

Resistance is expressed in:

Definition

 

 

 

 

Peripheral resistance unit

 

IF change in pressure = 1mmHg AND Q=1 ml/sec THEN PRU = 1

Term

 

 

 

 

Which factor plays the greatest role when determining the rate of blood flow through a vessel?

Definition

 

 

 

 

The diameter of blood vessel

Term

 

 

 

 

Poiseuille's law:

Definition

 

 

 

This law demonstrates that the rate of blood flow is directly proportional to the 4TH power of the radius of the vessel

Term

 

 

 

 

The heart has a specialized system for:

Definition

 

 

1) generating rhythmical impulses to trigger contraction of the heart muscle

 

2) conducting these impulses quickly throughout the heart

Term

 

 

 

 

When working properly, the atria contract how long before ventricle contractions?

Definition

 

 

 

 

 

1/6 th of a second

Term

 

 

 

 

The heart also has a system that allows all portions of the ______ to contract ALMOST simultaneously.

Definition

 

 

 

 

ventricles

Term

 

 

 

 

Cardiac fibers have the capacity to ____. This can cause _______ and _____. This is especially ture for these fibers____?

Definition

 

 

 

 

self-excitation, this can cause automatic rhytmical discharge and contraction. This is especially true for the SA node fibers of the conduction system.

Term

 

 

 

 

The potential of the SA fibers between discharges = 

 

This is because??

Definition

 

 

 

 

-55-60, because they are naturally leaky to Na+

Term

 

 

 

 

Potential for the ventricles muscle fibers

Definition

 

 

 

 

-85-90 mv

Term

 

 

 

 

SA fibers conduct potentials _____ than ventricular muscle fibers.

Definition
Term

 

 

 

There are ____ types of membrane ion channels that play an important role in causing the voltage changes of the action potential.

Definition

 

 

 

3,  fast sodium channels, slow calcium-sodium AND potassium channels

Term

 

 

 

 

What membrane ion channel is responsible for the spike-line onset of the action potential in the ventricular muscle

Definition

 

 

 

 

The fast Na+ channels, because of the rapid influx of Na+ to the interior of the fiber

Term

 

 

 

 

The plateau of the ventricular action potential is due to:

Definition

 

 

 

 

The slower opening of the slow Ca2+/ Na+ channels

Term

 

 

 

 

What happens to the K+ channels and what is the result?

Definition

 

 

 

They have increased opening that allows for large amounts of diffusion of K+ out of the fiber, This returns the membrane potential to its resting level

Term

 

 

 

 

At resting level describe the Na+ and Na+/Ca+ channels-

Definition

 

 

 

The Na+ are permanently closed and only the slow Na+/Ca+ channels can open.

Term

 

Because [Na+] outside is high AND because of the _____ inside, there is a tendency for Na+ to leak inside. The ____ fibers have a moderate # of channels open to Na+. This influx in Na+ causes a rise in membrane potential. The threshold for these fibers is ______. Once threshold is met ______ is activated.

Definition

 

 

 

 

1) negative charge inside. 2) SA fibers 3) -40 mv

 4) Ca+/Na+ channels are activated and the sudden entrance of Ca2+ and Na+ causes an action potential :)

Term

 

 

 

The natural leakiness of SA fibers to Na+ causes their self-excitation. But they are not depolarized all of the time because ______?

Definition

 

 

 

Because the Ca2+/Na+ channels close within 100-150 miliseconds AFTER opening, almost immediately and to the same time that the K+ channels are opening!

Term

 

 

 

 

Hyperpolarization is due to ___ and it signals the ____?

Definition

 

 

 

1) the K+ channels remaining open for a little more time forcing more K+ out and a more negative (hyperpolarized) charge inside.  It signals a -55 -(-60) mV, 2) The end of action potential.

Term

 

 

 

 

Hyperpolarization doesn't last because ____?

Definition

 

 

 

 

The K+ channels are closing while Na+ is still leaking in. (slowly climbing to the -40 mV threshold)

Term

 

 

 

 

Rhytmicity is possible because?

Definition

 

 

 

It is never negative enough in the cell to keep all of the channels closed.

Term

 

 

 

 

Standard limb leads =

Definition

 

 

 

I, II, and III

Term

 

 

 

 

Positive and negative input for I lead?

Definition

 

 

 

 

left arm and right arm

Term

 

 

 

 

Positive and negative input for II lead?

Definition

 

 

 

 

Left Leg, Right Arm

Term

 

 

 

 

Positive and negative input for III lead?

Definition

 

 

 

 

Left leg, left arm

Term

 

 

 

 

Augmented limb leads?

Definition

 

 

 

 

aVR, aVL, aVF

Term

 

 

 

 

Positive and negative input for aVR?

Definition

 

 

 

 

right arm, left arm +left leg

Term

 

 

 

 

Positive and negative input for aVL?

Definition

 

 

 

Left arm, right arm plus left leg

Term

 

 

 

 

Positive and negative input for aVF?

Definition

 

 

 

 

left leg, left arm + left arm? :P

Term

 

 

 

Precordial leads =

Definition

 

 

 

V1- V9, wilson central terminal is the negative input for all.

 

Term

 

 

 

 

Positive input for V1?

Definition

 

 

 

 

right sternal margin, 4th intercostal space

Term

 

 

 

 

Positive input for V2?

Definition

 

 

 

 

Left sternal margin, 4th intercostal space

Term

 

 

 

 

Positive input for V3?

Definition

 

 

 

 

midway between v2 and v4

 

Term

 

 

 

 

Positive input for V4?

Definition

 

 

 

 

left midclavicular line, 5th intercostal space

Term

 

 

 

 

Positive input for V5?

Definition

 

 

 

 

left anterior axillary line

Term

 

 

 

Positive input for V6?

Definition

 

 

 

 

left midaxillary line

Term

 

 

 

 

Positive input for V7?

Definition

 

 

 

 

posterior axillary line

 

Term

 

 

 

 

Positive input for V8?

Definition

 

 

 

 

Posterior scapular line

Term

 

 

 

 

Positive input for V9?

Definition

 

 

 

 

Left border of spine

Term

 

question slide:

 

The right sided precordial leads V3R to V6R are taken in mirror image positions on the right side of the chest

Definition

 

 

 

 

 

 

leads v5 to v9 are taken in the same horizontal plane as....?

Term

 

q is ______ negative

 

R is always _____

 

S is _____ ______

 

P and T________

Definition

 

1) ALWAYS

 

2) POSITIVE

 

3) ALWAYS NEGATIVE

 

4) may be + or -

Term

 

 

 

 

When no R wave is present......

Definition

 

 

 

 

one large negative QS wave exists.

Term

 

 

 

 

How much voltage does 1 mm box represent?

Definition

 

 

 

0.1 mV, 5 boxes carries 0.5 mV

Term

Normal Sinus Rhythm:

 

Description-

Treatment-

Questions-

Next steps-

Definition

 

 

1) 60-100 bpm

each complex is complete

no wide, bizzare, ectopic, early or late complexes

2)monitor vital signs, check bp

3)ampler?

4)monitor pts. condition

Term

 

 

 

Arrhythmias originating in the sinus node?

Definition

 

1) sinus tachycardia

2) sinus bradycardia

3)sinus arrhythmia

4) sinus arrest

 5) sinus exit block

6) SA reentry

 

 

These arrhythmias (in the SA node) are physioogical or pathological

Term

 

 

 

 

Physiological sinus node arrhythmias

Definition

 

 

 

these arrhythmias are the responses to fevers and sympathetic stimulation

Term

 

 

 

 

Pathological sinus node arrhythmias

Definition

 

 

 

 

 

are associated with sinus nodal disease

Term

Sinus arrhythmia

 

Name-

Description-

Treatment-

Question-

Next Step-

Definition

 

 

1) sinus arrhythmia (normal variation)

2)60-100 beats per min

all intervals except R-R are within normal limits

3)monitor vital signs

4)AMPLER?

5)monitor this. however, this is a natural variation caused by normal breathing!

 

Term

Sinus Tachycardia-

 

Name-

Description-

Treatmet-

Question-

Next Step-

Definition

 

1) sinus tachycardia (normal fast)

2) 100 -160 bpm

p waves may be buried in the previous t wave and all intervals except rate are within normal limits

3) AMPLER do you take digoxin?

4) monitor and treat underlying condition

Term

Sinus bradycardia

 

Name-

Description-

Treatment-

 

 

Definition

1)sinus bradycardia (normal slow)

2) less than 60 bpm, everything but rate is normal

3)treatment - monitor, check bp, normal in young healthy pts if normal bp. if pt is hypotensive,cool clammy, shocky, chest pain or change in mental status  consider Atropine. IF ecotopic activity is present consider atropine b4 lidocaine.

Term

Premature Atrial contractions -

 

Name-

Description-

Definition

1) premature atrial contractions (early ectopic atrial activity)

 

2) usually 60-100 bpm but varies on atrial beats created

 

premature atrial contractions are ectopic beats that occur in the context of other rhythms

 

P waves look different, may be smaller or peaked vs. normal p waves.

Term

 

 

 

Atrial tachycardia -

Definition

 

 

160 - 250 bpm

 

the SA node is no longer the dominant pacemaker

 

characterized by rapid rate and regular rhythm, sudden in onset and often terminates abruptly. May be followed by a pause.

 

the p waves in this case are different from sinus p waves because atrial pacemaker is ectopic?

 

Term

 

Atrial Flutter -

 

Name -

 

Description -

 

Definition

 

1) F waves, very rapid atrial rate, think of atrial fluuuuutttter!

 this is a rapid, remarkable form of  atrial tachycardia, it is usually paroxysmal, lasting for periods varying from seconds to hours and maybe even days.

2) fast, constant, firing of an ectopic focus, 240-360 bpm, has f waves instead of p waves,

the ventricular rate depends on the conduction raio

 

complexes are incomplete

 

upside down resembles a saw tooth pattern

 

Term

Atrial fibrilation -

 

Name -

 

Description-

 

Definition

1) atrial fibrilation (f waves) (uncoordinated, fast atrial activity)

 

2) atrial rate appears at a baseline 350 -600 beats per minute may be coarse and easy to count or fine and hard.

no p waves but f waves

rate is 100-160 bpm

R-R interval is always irregular because of chaotic stimulation from atria

Term

 

atrial fibrilation is the disorganized ______ of the atria resulting in irregular heartbeat, hemodynamic compromise, risk of ______, and an increased mortality. It may be acute (onset) within 24-48 hours, rapid heart rate. Subacute _______ rate or chronic (paroxysmal, persistent, or permanent)

 

Treatment involves -

Definition

 

1) electrical activity

2) thromboembolism

3) (controlled heart rate)

 

treatment involves - antithrombotic therapy, ventricular rate control, attempts to convert to normal sinus rhythm.

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