EKG State Test - Study Guide

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A U wave usually occurs when

a patient has a very low K+ (Potassium)

The ORS complex occurs when

the ventricles contract

On an EKG machine, the Standard checks

the voltage that the instrument is using

The heart has 4 valves that are made up of

endocardium

Blood leaves the heart through the

pulmonic and aortic valves

Pulmonic and Aortic valves are also called

semilunar valves

As blood returns to the heart from the body

it enters the right atrium

Where does the superior vena cava get its blood from?

the head, neck and upper extremeties

The innermost layer of the heart is called the

endocardium

Congestive heart failure (CHF) is a condition when the heart

cannot meet the demands of the body. The body compensates in three major ways

The two entrance valves of the heart are the

tricuspid and bicuspid valves

The semilunar valves are the

pulmonic and aortic valves

The pericardium is the

fibrous outer fluid filled layer that covers the heart and separates it from the contents in the chest cavity

The EKG records the electrical impulses called the

cardiac cycle

The cardiac cycle is represented by the

P Wave, QRS complex and the T Wave.

The P Wave represents the

contraction of the atrium

QRS Complex represents the

contraction of the ventricles

T wave represents the

relaxation of the ventricles

U wave is

not always seen but represents possible low potassium

The right and left atria are known as the

"receiving" chambers

When blood is on its way from the left atrium to the left ventricle

it goes through the mitral valve

The only way to oxygenate the blood is through the

alveoli and capillaries in the lungs

The right and left side of the heart is

separated by the septum

The speed that an EKG is normally run is

25 mm/sec

The color of the ground lead is

Green

the approximate diameter of the coronary arteries is

1/8 inch

Another name for the bicuspid valve is

mitral valve

The purpose of the gel on the elctrode is

to conduct electricity

The myocardium will get nourishment from

the coronary arteries

If the blood supply to the myocardium stops the

area that doesnt receive a blood supply dies

The myocardium is the

thickest layer of the heart

The size of a normal heart is

about the size of your fist

the heart functions as a

pump to pump blood to all the body's cells

Blood returns to the heart through the

inferior and superior vena cava

The inferior vena cava brings

blood from below the diaphragm

the superior vena cava gets blood from

the head, neck and upper extremeties

Pulmonary vein is the only vein that carries

high oxygen blood; comes from the lungs and returns blood back to the left atrium for eventual circulation to body organs and cells

the term for "rapid heart beat" is

tachycardia

Coronary insufficiency

flow is considered insufficient if it cannot meet the needs of the heart

The purpose of the conduction system is to

initiate the heart beat and regulate the cardiac cycle

Ectopic is an adjective reerring to

an event or tissue occuring at a place other than its normal location

Ectopic heart beats are generated from an

impulse originating some other place than the SA node

The SA node is located on

the upper wall of the right atrium

The SA nodes function is to

generate the stimulus to make the heart beat

The order of the impulse in the conduction pathway is:

1. first it travels to the SA node also known as the sinoatrial node.
2. Next the impulse moves to the AV node also known as the atrioventricular node
3. Then on to the bundle of His
4. Throught the bundle of His where the impulse separates to travel through the right and left bundle branches
5. and finally the impulses reach the purkinje fibers
6. Once th electrical stimulus is in the purkinje fibers the ventricles contract.

The term for the heart when it is contracting is

systole

Fibrillation is a nonsynchronous contraction of

muscle tissue, with individual cells firing at their own rate

Fibrillation can be isolated to the

atria or ventricles.

Ventricle fibrillation is not compatible with

life

A heart in fibrillation has been described as looking and feeling like a

bag of worms

In the heart, when the atria contract

the blood is squeezed into the ventricles

When the heart beats too slow

the patient can suffer from syncope

The heart is lociated in the

Mediastinum

The function of the heart is to

pump sufficient amounts of blood to all of the cells in the body

The U wave usually appears after the

T Wave

Ischemia is

reduced (isch) blood (emia)

Ischemia is a condition of

inadequate blood flow to a tissue.

Ischemia to the heart can cause

angina and if present long enough, infarction

Precordial leads are

chest leads

The right leg electrode shows

no cardiac information, and serves as a ground electrode

A muscle tremor would look like a

fuzzy irregular baseline on an EKG

A broken cable wire would cause a

wandering baseline

Mediumstinum is

the space between the lungs in the chest cavity; holds the heart and other respiratory units

Electrodes are

plates that come between patient and the current

Augmented lead aVR goes to the

right arm

When the myocardium is stimulated its

muscle contracts

The myocardium is made of

muscle

If the patient has the right arm amputated above the elbow place the lead on the

upper part of the that arm

If the patient has an amputation, the important thing to do is to be sure that wherever you place the lead, you use the

same corresponding spot on the opposite limb

You standardize an EKG

before and after you run the EKG

Pulmonary Artery is the only artery that

carries low oxygen blood; leaves right ventricle and goes to the lungs

Normal sinus rhythm has a rate of

60-100 beats per minute and each complex is complete and normal in appearance

The term bradycardia means the

heart rate is below 60 beats per minute

A sinus arrhythmia can be caused by

changes in breathing

Asystole is a flat line associate with

death

Pulmonary circulation is

circulation that goes to the heart's right atrium to the lungs where it is oxygenated and releases built up carbon dioxide

If the heart beat fires ectopically its means the

One oft

Chordae tendinea holds the

heart valves in place

A heart murmur is the sound of

faulty avtion when the valves close

Ischemia is the lack of

sufficient blood supply to an area of the myocardium

A patient may feel heart pain due to an

inadequate blood flow to the heart muscle

An MI is a myocardial infarct and occurs when the

myocardial tissue suffers death to the area because of insufficient blood flow

One of the major causes of heart failure is

untreated high blood pressure

You calculate the heart rate from an EKG strip by

counting the number of complete complexes in 3, or 6 seconds and multiply by 20 or 10

The difference between agonal and asystole on an EKG is that

asystole on an EKG ia flat line, while agonal is less than 20 beats per minute

An electrocardiogram is a

recording or tracing of an EKG

Ten electrodes are used for a

12 Lead EKG

A cardiac cycle is the beginning of a beat

until the beginning of the next beat

PQRST complex represents

one entire cardiac cycle

The T Wave shows the

relaxation of the ventricles

An artificial pacemaker looks like a

straight, hard vertical line or spike on an EKG

The apex of the heart is the

pointed bottom end of the heart

The apex lies

on the diaphragm

The base of the heart is the

upper border of the heart and is broad in shape

The blood in the pumonary veins

goes to the left atrium

The pericardial sac encloses

the heart

There are many things that happen to an artery that contribute to having a heart attack. The following is a list of how it starts and how it ends

1. the first thing in the process is plaque builds up in the arteries, which narrows the artery
2. Then is a piece of this plaque breaks off, it bleeds and causes a clot to form
3. After which the clot travels along until it comes to an artery that is too narrow for it to pass through
4. Last thing that happens is that this cuts the blood supply off to that area and the area dies. A heart attack has occurred.

Repolarization is the

relaxation phase

Depolarization is he

contraction phase

The base of the heart is located just below the

2nd rib

A heart chamber empties the blood during the

contraction and systolic phase

When the ventricles are in the systole phase, they are

pumping the blood out of the chamber by contraction

The left ventricle is the

largest chamber in the heart

The left ventricle is the largest chamber in the heart because is has the job of

pumping blood out to all parts of the body

The receiving chambers of the heart are the

right atrium and left atrium and th etwo chambers that push the blood out of the heart called the left and right ventricles

The left ventricle is the largest chamber of the heart because it

pushes the blood out of the heart throughout the body

The cardiac tissue is unique because

it is all fused together so it acts as one

Lead aVF goes to the

left leg

A major cause of artherosclerosis is the

build-up of fat deposits on the walls of the arteries

Angina is heart pain from

lack of circulation to coronary arteries

When the heart rate goes down to 40-60 beats per minute

the impulse is usually generated in the AV node

The aorta leaves the heart and

carries blood to all parts of the body

The bottom umber of blood pressure represents the

relaxing or diastolic phase

When measuring the height of peaks in an EKG

each large square represents 5mm x 5mm

Each small square represents

.04 seconds on EKG paper

atrioventricular (AV) node is

specialized conduction tissue found in the right atrium

In a healthy heart the AV node is the

only electrical connection between the atria and ventricles.

By having a relatively slow conduction rate, the AV node allows the atria to

empty more blood into the ventricles before they contract

The purkinje fibers are

specialized conducting cells found in the ventricular septum of the heart

The purkinje fibers transmit the impulse from

the AV node to the myocardium.

Purkinjie fibers are organized in such a way as to

mediate a smooth contraction that wrings the blood from the apex out toward the base of the heart.

Vagal tone is virtually synonymous with

parasympathetic tone in regards to the heart.

Stimulation of the vagus causes a

decreased heart rate, which in turn causes a drop in blood pressure.

Wolff-Parkinson-White syndrome

a conduction disorder of the heart where electrical pathways other than the AV nodal system connect the atria with the ventricles. This type of disorder can lead to reentrant arryhthmias

Tricuspid Valve

located between the right atrium and the right ventricle. Has three cusps

Mitral Valve

located between the left atrium and the left ventricle. It has two cusps and it is also called the bicuspid valve

The Primary characteristics of the cardia cells are:

automaticity, excitability, conductivity, contractility

Automaticity

this is the ability of the cardiac pacemaker cells to spontaneously initiate their own electrical impulse without being stimulated from another source. Sites that possess this characteristic are the SA node, AV junction and the purkinje fibers

Excitability

also referred to as irritability. This characteristic is shared by all cardiac cells and it is the ability to respond to external stimulus; electrical, chemical ad mechanical

Conductivity

This is the ability of all cardiac cells to receive an electrical stimulus and transmit the stimulus to the other cardiac cells.

Contractility

this is the ability of the cardiac cells to shorten and cause cardiac muscle contraction in response to an electrical stimulus

The heart is classified a

hollow, muscular organ

The heart is made up of four layers

endocardium
myocardium
epicardium
pericardium

Endocardium

inner layer of the heart

myocardium

the muscular layer of the heart

epicardium

is the outer layer of the heart

pericardium

outer sac surrounding the heart that separates the heart from the rest of the chest cavity

A lead is

the gel or pad that conducts electricity

the cardiac muscle has three stages and can be called different terms

1. Contraction or Systole or Depolarization
2. Relaxation or diastole or repolarization
3. Baseline or polarization

The normal standard is

10mm/mv

Another name for the resting phase on an EKG is the

baseline

the term electrocardiograph is the instrument used for

recording the heart's activity

The P wave shows the

atrial contraction

Another name for Leads aVF, a VL, aVR is

augmented

Sympathetic nerves are the

fight or flight response

The sympathetic system prepares the body for action by:

increasing heart rate
increasing contractility
increasing blood pressure
blood flow increased to the skeletal muscle
blood flow decreased to the viscera
release of catacholamines by adrenal gland
retention of sodium and water ( secretion of renin from the kidney)
relaxation of bronchiolar smooth muscle

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