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Cardiac Circulation, Conduction and Rhythm Defects
Terms in this set (53)
AV and SA node location
Bachman's bundle location
anterior - causes atria to contract
Wenckebach's bundle location
Thorel's bundle location
Where are the bundle branches located?
Where are the purkingie fibers located?
in the myometrium, causing ventricles to contract
What is the process of conduction?
1. SA node sends electrical signal to
- bachman's bundle
- wenckebach's bundle
- thorel's bundle
2. AV node
3. bundle of HIS
4. RT & LT bundle branches
5. purkingie fibers
atrial depolarization (contraction)
ventricular depolarization (contraction)
time it takes from atrial contraction to ventricular contraction
time it takes from ventricular contraction to atrial contraction
time during which the ventricles are contracting and emptying
time during which ventricles are relaxing and filling
Ductus venosus definiton
carries blood from umbilical vein to IVC
Foramen ovale defintion
carries blood from rt atrium to left atrium
Ductus arteriosus defintion
carries blood from pulmonary artery to the descending aorta
When does the foramen ovale close?
at birth, functionally. may persist beyond neonatal period.
When does the ductus arteriosus close?
begins to narrow in first 2-7 hours. closes completely in 3-4 days.
When does the ductus venosus close?
functionally immediately at birth, becomes ligamentum venosum
What is the normal fetal heart rate?
What is the most common fetal arrhythmia?
What causes PAC's?
1. maternal consumption of caffeine, nicotine or alcohol
2. redundant foramenal flap
What can PAC's progress to?
What is a conducted PAC?
a premature contraction of the atria followed by a premature contraction of the ventricle
What is a non-conducted PAC?
A premature atrial contraction not followed by a ventricular contraction
What is a PVC?
A premature ventricular contraction, not in response to atria
What is the most common type of tachycardia?
What is the atrial and conduction rate in SVT?
Atrial rate is >180 BPM, with a 1:1 conduction rate
What can cause SVT?
1. multiple sustained PAC's
2. accessory pathways in the atria and ventricles (either due to wolff-parkinson white syndrome, or a structural abnormality)
What rhythm abnormality is associated with wolff-parkinson white syndrome?
What is the most frequently associated structural defect associated with SVT?
What kind of treatment is done for SVT?
1. close observation if arrhythmia is intermittent and not associated with CHF
2. antiarrhythmic drugs
If the RP interval is shorter than the PR interval in SVT, what is this considered?
Re-entrant tachycardia. (wolff-parkinson white syndrome)
If the RP interval is longer than the PR interval in SVT, what is this considered?
Permanent junctional reciprocating tachycardia (PJRT)
What is the atrial and conduction rate in atrial flutter?
Atrial rate is 300-500 BPM, with a variable conduction rate (2:1 or 3:1)
What can cause atrial flutter?
30% are associated with structural CHD, chromosomal anomaly or other pathology
What is typical in the rate and conduction of ventricular tachycardia?
Ventricular rate < 180 BPM, exceeds the atrial rate. May exhibit periods of sinus bradycardia between periods of ventricular tachycardia
What arrhythmia is associated with long QT syndrome?
How does transient bradycardia present?
heart rate is periodically below 120 BPM, then returns to normal.
What is transient bradycardia due to?
Cord compression, like nuchal cord. Or transducer pressure.
How does sustained bradycardia present?
sustained heart rate below 120 BPM. === HEART BLOCK
What is the appearance of 1st degree heart block?
1. prolonged PR interval
2. not appreciated in utero unless the PR interval is measured
What is the appearance of 2nd degree heart block?
1. ventricular rate less than 120 BPM
2. 2:1, 3:1 conduction (atrial rate is normal, faster than ventricular rate)
What is the appearance of 3rd degree heart block?
1. ventricular rate of less than 120 BPM
2. complete dissociation between atria and ventricles
What type of heart block is associated with long QT syndrome?
2nd degree heart block
What can you confuse 2nd degree heart block with?
multiple non-conducted PAC'S or atrial bigeminy
How does atrial bigeminy present?
a couplet, a normal atrial beat followed by a PAC. the ventricles will be regular and slow
How does 2nd degree heart block differ from atrial bigeminy?
The atria are normal and regular. The ventricles are independent and slow. (look at the distance between atria contractions)
What percentage of fetuses with CHB also have a structural CHD?
What percentage of CHB is isolated?
60% - these are associated with maternal autoimmune disorders like sjrogens or lupus
What are the most common CHD's associated with CHB?
1. left atrial isomerism
AVSD + CHB =
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