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Definition
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Term
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Definition
| the atria and ventricles were electorally insulated from each other by the fibrous trigone and there is only one way to get a signal from the atria to ventricles and that is the bundle of his. However I have an accessory pathway called the bundle of kent. And there are other ones as well. What happens here is while the signal is going from the SA to AV node I can actually jump around and bypass the AV node and send a signal into the ventricles and send a signal into the electrical conductive system. |
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Term
| WHEN WE DEFIBRILLATE A PT WHAT EXACTLY ARE WE DOING? |
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Definition
| WE ARE DEPOLARIZING EVERY MYOCYTE AT THE SAME TIME NO MATTER WHAT STATE THAT THEY ARE IN. |
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Term
| WHY DOES A VENTRICULAR PACEMAKER LOOK LIKE A PVC? |
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Definition
| BECAUSE WE ARE PACING THROUGH A VENTRICULAR MYOCYTE |
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Term
| FOR A 1ST DEGREE AV BLOCK WHERE IS THE PROBLEM? |
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Definition
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| DESCRIBE THE SENSATION OF THE PULSE AFTER THE DROPPED BEAT WITH 2ND DEGREE TYPE 1 AND TYPE 2. WHY? |
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Definition
| IT WILL BE STRONGER. THIS IS RELATED TO AN INCREASE IN PRELOAD. IF PRELOAD IS INCREASED WE END UP WITH A STRONGER FORCE OF CONTRACTION AND WE ARE FOLLOWING FRANK-STARLING LAW. |
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Term
| CAN YOU DISTINGUISH BETWEEN THE PULSES OF 2ND DEGREE TYPE 1 AND TYPE 2? |
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Definition
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Term
| WITH 3RD DEGREE HB DESCRIBE THE ATRIAL AND VENTRICULAR RATES. |
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Definition
| THE SA NODE IS DRIVING THE ATRIA AND THE AV NODE ARE DRIVING THE VENTRICLES. THE P TO P AND R TO R ARE NML ALTHOUGH THEY ARE NOT IN SEQUENCE. |
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Term
| HOW CAN YOU DETERMINE THAT FOR A 3RD DEGREE HB THAT THE PM FOR THE VENTRICLES IS NOT THE AV NODE? |
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Definition
| THE QRS COMPLEX IS WIDENED WITHOUT THE TYPICAL SHAPE AND YOU HAVE INVERTED T WAVES. VENTRICULAR MYOCYTES ARE THE ECTOPIC PM. |
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Term
| WHAT WILL WE SEE WITH A PAC? |
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Definition
| SHORTENED R TO R INTERVAL BECAUSE THE SA NODE FIRED TOO QUICKLY. YOU ALSO DON'T HAVE A NML T-P INTERVAL. |
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Term
| HOW DO YOU KNOW THAT THE SA NODE IS NOT SENDING THE SIGNAL FOR A PAC? |
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Definition
| BECAUSE THE P WAVE IS DIFFERENT THEN THE OTHERS. THE ECTOPIC BEAT IS COMING FROM A DIFFERENT PART OF THE ATRIA. |
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Term
| DESCRIBE THE PULSE THAT IS AFTER THE PAC. WHY IS THAT? |
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Definition
| IT IS WEAKER. DECREASED DIASTOLIC FILLING TIME AND ON TOP OF THAT I MAY HAVE AN ABNORMAL CONTRACTION BECAUSE I'M NOT COMING FROM THE SA NODE TO THE AV NODE. |
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Term
| HOW DOES A PAC BECOME BACK TO A NSR? |
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Definition
| So, what happens is during this abnormal beat, the SA node is going to get the signal. But it’s going to get the signal at a retrograde fashion and that’s going to reset and come back into a normal rhythm. Ok, called a compensatory pause and we will see that again. |
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Term
| DESCRIBE A JUNCTIONAL BEAT. |
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Definition
| YOU END UP WITH AN INVERTED P WAVE DEPENDING ON WHERE THE AV NODE FIRES AT. |
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Term
| DESCTRIBE THE APPEARANCE OF A PVC. |
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Definition
| WIDER QRS THEN NML AND DISTORTED IN SHAPE. USUALLY NO P WAVES. |
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Term
| HOW DO YOU DETERMINE THE MEAN ELECTRICAL AXIS? |
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Definition
| When you determine the main electrical access on a patient the only thing you have to do is find which lead has the largest R wave deflection. The lead that is perpendicular to that lead should have 0 deflection. That gives you your mean electrical access. |
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Term
| DESCTRIBE THE AXIS NUMBERS YOU GET WITH LEAD I AND AVF DEFLECTIONS. |
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Definition
| + LEAD I AND AVF YOU ARE IN THE BOTTOM RIGHT QUADRANT. - LEAD I AND AVF YOU ARE IN LEFT UPPER QUADRANT (EXTREME RIGTH AXIS DEVIATION). - LEAD 1 AND + AVF YOU ARE IN LEFT LOWER QUADRANT (RIGHT AXIS DEVIATION). +LEAD 1 AND NEGATIVE AVF YOU ARE RIGHT UPPER QUADRANT (LEFT AXIS DEVIATION). |
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Term
| WHAT IS THE EASIEST WAY YOU CEN DETERMINE THE MEAN ELECTRICAL AXIS? |
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Definition
| FIND THE LARGEST WAVE AND AT THAT DEGREE THAT IS WHERE IT SHOULD BE AT. |
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Term
| LEFT AXIS DEVEIATION MEANS 1 OF 2 THINGS. WHAT ARE THEY? |
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Definition
| either the apex of the heart has been shifted towards the left armpit or the apex of the heart still sits there at 60 degrees but I have increased ventricular mass on this side. |
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Term
| DESCRIBE WHAT WILL THE VECTOR BE WITH RIGHT VENTRICULAR HYPERTROPHY. |
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Definition
| So whereas, that apical depolarization that used to be at 60 degrees, the more muscle mass I put on the right side, the more that axis is going to shift 90 to 100 to 120, etc, etc. |
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Term
| WHAT CAN CAUSE RIGHT VENTRICULAR HYPERTROPHY? |
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Definition
| PULMONARY HTN OR PULMONARY STENOSIS. YOU HAVE A RIGHT VENTRICULAR CONCENTRIC PRESSURE OVERLOAD HYPERTROPHY. |
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Term
| WE SEE AN EXAMPLE OF INCREASE AMPLITUDE OF P WAVES IN LEAD II, III, I, AND AVF FOR A PT WITH RIGHT VENTRCULAR HYPERTROPHY. WHY IS THAT? |
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Definition
| TYPICALLY IF WE HAVE VENTRICULAR HYPERTROPHY WE END UP WITH ATRIAL HYPERTROPHY RIGHT BEHIND IT. |
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Term
| WHAT IS THE ONLY CIRCULATION IN THE BODY THAT GETS BLOOD DURING DIASTOLE? |
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Definition
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Term
| DESCTIBE THE LEAFLETS WITH CORONARY CIRCULATION. |
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Definition
| AORTIC VALVE HAS 3 LEAFLETS. THE RIGHT LEAFLET COVERS THE RCA. THE LEFT LEAFLET COVERS THE LEFT MAIN. THE POSTERIOR LEAFLET DOESN'T COVER ANYTHING. |
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Term
| WHAT DOES THE LEFT MAIN BRANCH OFF INTO? |
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Definition
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Term
| WHEN IS CORONARY RESISTANCE THE HIGHEST AND WHY? |
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Definition
| DURING SYSTOLE BECAUSE OF THE CONTRACTION OF MYOCYTES |
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Term
| WHICH WAY WILL MYOCARDIAL ISCHEMIA DEVELOP? |
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Definition
| FROM ENDOCARDIUM TO EPICARDIUM |
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