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Cardiology
Paramedic: Cardiology
| Question/Definition | Term/Answer |
|---|---|
| Vessels of the circulatory system that carry blood away from the heart. | Arteries |
| Small, thin-walled, chambers of the heart that act as priming pumps for the ventricles. | Atria |
| Part of the electrical conduction system responsible for slowing down conduction from the atria to the ventricles just long enough for atrial contraction to occur. Allows the atria to "overfill" the ventricles & helps maintain cardiac output | Atrioventricular (AV) Node |
| Large, thick-muscled chambers of the heart, the primary pumping chambers. | Ventricles |
| Part of the electrical conduction system that originates in the AV node and ends in the bundle branches. | Bundle of His |
| The amount of blood that the heart pumps per minute from either the left or right ventricles. Q = SV x HR | Cardiac Output |
| The normal “resting” phase of the heart when the heart is not actively contracting. | Diastole |
| A specialized collection of cells that coordinate the bioelectrical activity of the heart and is involved in initiating (pacemaking) and conducting electrical impulses as well as coordinating atrial and ventricular contractions | Electrical Conduction System |
| The rate at which the heart contracts per minute. | Heart Rate |
| Three pathways of the electrical conduction system found in the atria that transmit the impulse from the SA node to the AV node. | Internodal Pathways |
| An accessory pathway between the atria and the ventricles that can be found in patients with Wolff-Parkinson-White syndrome. | Kent Bundle |
| Part of the electrical conduction system. Responsible for innervating the anterior and superior areas of the left ventricle. It is a single-stranded cord terminating in the Purkinje cells. | Left Anterior Fascicle (LAF) |
| Responsible for depolarizing the left side of the interventricular septum and the left ventricle. | Left Bundle Branch (LBB) |
| Part of the electrical conduction system. Responsible for innervating the posterior and inferior areas of the left ventricle. It is a widely distributed, fan-like structure terminating in the Purkinje cells. | Left Posterior Fascicle (LPF) |
| An individual heart muscle cell. | Myocyte |
| Another term for the individual muscle cells or myocytes. | Myofibrils |
| A type of MI that affects only the deeper levels of the myocardium and typically does not present in a significant Q wave in the affected lead | Non-ST-Segment Elevation Myocardial Infarction (NSTEMI) |
| Main function of the SA node (although any myocardial cell can perform this function) initiates cardiac depolarization and dictates the rate at which the heart will cycle. | Pacemaker |
| The normal delay period in the conduction of the electrical impulse caused by the AV node in order to allow the atria and the ventricles to contract synchronously. | Physiologic Block |
| Specialized cells that act as the final pathway of the electrical conduction system of the heart. They directly innervate the ventricular myocytes. | Purkinje System |
| Responsible for depolarizing the right side of the interventricular septum and the right ventricle. | Right Bundle Branch (RBB) |
| The muscular or fibrous wall that separates the atria or the ventricles in the heart. | Septum |
| The main pacemaker of the heart. Located anatomically in the right atrium. | Sinoatrial (SA) Node |
| The amount of blood ejected from the ventricle during a single ventricular contraction. | Stroke Volume |
| Refers to an impulse or rhythm that originated above the ventricles. | Supraventricular |
| A chemical neurotransmitter used by the parasympathetic system. | Acetylcholine (ACh) |
| Both the left and right coronary arteries arise from the root of the ascending ___ | Aorta |
| The electrical firing of the myocyte, which leads to contraction. Consists of four phases. | Action Potential |
| Nerves that bring information into the CNS. | Afferent Nerves |
| The part of the nervous system that is responsible for unconscious or involuntary body functions | Autonomic Nervous System |
| System composed of the brain and spinal cord | Central Nervous System |
| A state in which the cell becomes more positive, moving toward equilibrium with the extracellular fluid. Takes place during the latter part of resting state and is completed during activation by the action potential. | Depolarization |
| The difference between the charges on the outside and the inside of the cell wall. | Electrical Potential |
| Chemical neurotransmitters used by the sympathetic system | Epi and Norepi |
| An atom or molecule that carries an electrical charge. | Ion |
| The limb leads aVR, aVL, and aVF are known as ___. | Augmented Limb Leads |
| The part of the nervous system that causes a slowing down or calming effect. Its main chemical messenger is acetylcholine. | Parasympathetic Nervous System |
| The nerves that are outside of the central nervous system and are responsible for bringing information to and from the brain and spinal cord. | Peripheral Nerves |
| A state in which the cell becomes more negative, moving away from equilibrium with the extracellular fluid. This is an active process. | Repolarization |
| The part of the nervous system that is responsible for conscious and controllable muscle movement and functions. | Somatic Nervous System |
| Interfering with or inhibiting the effect of the impulses from the sympathetic nervous system. | Sympatholytic |
| Effects resembling those caused by stimulation of the sympathetic nervous system, such as the effects seen following the injection of epinephrine into a patient. | Sympathomimetic |
| The parasympathetic nervous system controls the heart via the ____ nerve by slowing heart rate and AV conduction. This nerve also primarily innervates the atria | Vagus Nerve |
| The part of the nervous system that is responsible for the fight-or-flight response. Uses epi and norepi as the chemical messengers. | Sympathetic Nervous System |
| Part of the electrical conduction system that transmits the impulses through the interatrial septum. | Bachman Bundle |
| A term used to describe a wave with both negative and positive components. Usually used in conjunction with P and T waves. | Biphasic |
| The summation of the individualized vectors for all of the ventricular myocytes during activation. | Electrical Axis |
| A recording used to evaluate the heart and its rhythm. | Electrocardiogram (ECG) |
| The electrical sensors placed on the chest to record the bioelectrical activity of the heart. | Electrode |
| The innermost layer of the heart that lines the atria and ventricles and consists of smooth muscle and elastic fibers | Endocardium |
| The system developed to describe the coronal plane that is created by the limb leads (I, II, III, aVR, aVL, and aVF). | Hexaxial System |
| Elevated potassium level | Hyperkalemia |
| Activation of the myocardial cells by an electrical impulse. | Innervation |
| The amount of time it takes the electrical impulse to travel from the Purkinje system in the endocardium to the surface of the epicardium. | Intrinsicoid Deflection |
| The leads that form the hexaxial system, dividing the heart along a coronal plane into anterior and posterior segments. These leads include I, II, III, aVR, aVL, and aVF. | Limb Leads |
| The thick middle layer of the heart that consists of cells that resemble skeletal muscle, but have electrical properties similar to smooth muscle | Myocardium |
| The deflection used to identify atrial depolarization. It is the first wave of a complex or beat. | P Wave |
| The interval represented by the space between the P waves of two consecutive complexes. | P-P Interval |
| The external lining or surface of the heart; the double-walled sac containing the heart and the roots of the great vessels | Pericardium |
| The interval of time that occupies the space between the beginning of the P wave and the beginning of the QRS complex. | PR Interval |
| The segment of the complex that occupies the space between the end of the P wave and the beginning of the QRS complex. | PR Segment |
| Another term used to describe the chest leads. They are labeled from V1 through V6. They divide the heart along a sagittal plane. | Precordial Leads |
| The first negative wave of the QRS complex. | Q Wave |
| The wave complex represented by ventricular depolarization. It may consist of individual or multiple waves in succession, which may appear in any combination | QRS Complex |
| The interval of time occupied by the QRS complex. | QRS Interval |
| The interval of time represented by the space from the beginning of the QRS complex to the end of the T wave; may vary with heart rate. | QT Interval |
| The first positive wave of the QRS complex. | R Wave |
| The wave that represents ventricular repolarization. | T Wave |
| The second negative wave of the QRS complex. | S Wave |
| The section of the complex from the end of the QRS complex to the beginning of the T wave. Represents the period of inactivity between ventricular depolarization & repolarization & the time that the myocardium is maintaining contraction. | ST Segment |
| The area of baseline between the end of the T wave and the beginning of the next P wave. | TP Segment |
| A wave representing the repolarization of the atria. It usually presents as PR depression or the ST segment depression seen in very fast tachycardias. | Tp Wave |
| A small, flat wave sometimes seen after the T wave and before the next P wave. It could represent ventricular afterdepolarization and endocardial repolarization. | U Wave |
| "comb-like" muscle fibers located mostly in the right atrium | Pectinate Muscles |
| A deflection from the baseline in either a positive or negative direction, representing an electrical event of the cardiac cycle. | Wave |
| The number of beats per minute | Rate |
| Small marks at the bottom of the ECG to represent an interval of time. They are usually found every 3 or 6 seconds, depending on the system. | Second Marks |
| The abnormal conduction of an electrical impulse through the heart | Aberrancy |
| An abnormal rhythm of the heart | Arrhythmia |
| Events that do NOT occur at the same time | Asynchronous |
| A premature complex that occurs at every second beat. The complexes can be either supraventricular or ventricular. | Bigeminy |
| A beat that occurs after the normal pacemaker fails to fire | Escape Complex |
| A rhythm that occurs after a normal pacemaker fails to fire. | Escape Rhythm |
| A beat that occurs when two complexes with different inciting pacemakers fuse to form a complex unlike either the normal or the ectopic complex. Commonly seen in VTach. | Fusion Beat |
| A complex that occurs when two complexes with different inciting pacemakers fuse to form a complex unlike either the normal or the ectopic complex. Commonly seen in premature complexes, VTach, idioventricular rhythms, and multifocal atrial tachycardias | Fusion Complex |
| The physical appearance of a wave or complex | Morphology |
| A HR > 100BPM | Tachycardic |
| A complex that arrives earlier than expected for the cadence of the rhythm. | Premature Complex |
| A premature complex every fourth beat. The complexes can be either supraventricular or ventricular. | Quadrigeminy |
| A short period of time, immediately after depolarization, in which the myocytes are not yet repolarized and are unable to fire or conduct an impulse | Refractory State |
| Cells interconnected by gap junctions which are synchronized electronically | Synctium |
| A premature complex every third beat. The complexes can be either supraventricular or ventricular. | Trigeminy |
| Before or toward the front | Anterior |
| Leads V5 and V6 view the ____ wall of the heart | Low Lateral |
| A physiologic block of either the left or right bundle branch of the electrical conduction system. | Bundle Branch Block (BBB) |
| All going in the same direction, either positive or negative. | Concordance |
| A HR < 60BPM | Bradycardic |
| An axis between 0° and 90° and appears as positive deflections in Leads I, II, and III | Normal Axis |
| A wave that is neither positive nor negative. It is usually the lead with the smallest amplitude and the one that is the closest to being neither positive nor negative. | Isoelectric |
| A physiologic block of the left bundle branch causing the characteristic ECG pattern of a QRS complex greater than 0.12 seconds, monomorphic S wave in V1 and monomorphic R wave in leads I and V6. | Left Bundle Branch Block (LBBB) |
| One morphological appearance | Monomorphic |
| A slang term for the RSR' pattern traditionally found in V1 in an RBBB | Rabbit Ears |
| A physiologic block of the right bundle branch causing the characteristic ECG pattern of a QRS complex greater than 0.12 seconds, slurred S wave in leads I and V6 and an RSR' pattern in V1 | Right Bundle Branch Block (RBBB) |
| The acid state on the pH balance scale | Acidosis |
| A pause immediately following a premature complex that is longer than the interval between two normally conducted beats, allowing the rhythm to proceed, without any alteration of cycle length, around the premature complex | Compensatory Pause |
| Low fluid or volume of the blood or circulatory system | Hypovolemia |
| Low oxygen level in the blood | Hypoxemia |
| The period during which it is impossible to restimulate a cell to fire off another impulse | Absolute Refractory Period |
| Can potentiate arrhythmias | Arrhythmogenic |
| The ability of a pacemaker to repolarize and automatically trigger another interval by itself. | Automaticity |
| Part of the cardiac filling cycle that occurs during early diastole. It starts when the AV valves open and blood rushes in to fill the ventricles. The phase ends when the atria begin to contract. Most of the blood enters the ventricles during this period. | Rapid Filling Phase |
| The period during which a stronger than normal stimulus is needed in order to elicit an action potential | Relative Refractory Period |
| The total height of a wave or complex | Amplitude |
| Relative or absolute hypoxemia of the innermost layer at the surface of the heart | Endocardial Ischemia |
| A process, acute or chronic, that is characterized by the formation or presence of dead myocardial tissue | Myocardial Infarction (MI) |
| A diseased state of the SA node that leads to multiple abnormal rhythm states. In this diseased state, the rhythms can quickly alternate between tachycardia and bradycardia, and atrial flutter and fibrillation are common. | Sick Sinus Syndrome (SSS) |
| Normal conduction of the electrical impulse through the AV node from the atria to the ventricles | Antegrade Conduction |
| A pause, immediately following a premature complex, that alters the rhythm, causing a resetting of the pacemaker and an alteration of cycle length, after the premature complex. | Noncompensatory Pause |
| A chemical agent or molecule that can conduct an electrical current | Electrolyte |
| The conduction of the electrical impulse backward through the AV node, from the ventricles or AV node to the atria | Retrograde Conduction |
| A self-propagating, recurrent looping pattern of impulse transmission in which the depolarization wave continuously restimulates itself (aka circus movement) | Reentry |
| Obstruction to flow of the impulse or depolarization wave | Block |
| The sawtooth waves formed by the circus movements found in atrial flutter. They can be either in a positive or negative direction. | Flutter (F) Waves |
| If there is a long pause and then a short pause (the premature complex), the QRS complex of the short pause is usually transmitted aberrantly. | Ashman's Phenomenon |
| A morphological type of atrial fibrillation in which the baseline shows grossly large fibrillatory (f) waves | Coarse Afib |
| Atrial fibrillation at normal rates | Controlled Afib |
| Atrial fibrillation with rates between 100 and 200 BPM (aka decompensated atrial fibrillation) | Uncontrolled Afib |
| A scooped-out appearance of the ST segment and the T waves in patients taking digoxin or other related substances | Digitalis Effect |
| The fine or coarse waves caused by the wavelet depolarizations in atrial fibrillation | Fibrillatory (f) Waves |
| A morphological type of atrial fibrillation in which the baseline shows very small fibrillatory (f) waves. | Fine Afib |
| A rhythm that switches often between atrial flutter and atrial fibrillation | Flutter-Fibrillation Pattern |
| A small depolarization wave that is found in cases of atrial fibrillation | Wavelet |
| The pathway(s) that lead to the AV Node (aka tract) | Approach |
| The area immediately surrounding and encompassing the AV node | AV Junction |
| The center or core zone of the AV node. This area is composed of cells very similar in histologic appearance and function to those cells found in the sinoatrial node. | Compact Zone |
| A small area of tissue that surrounds the tip of the AV node. This zone is full of autonomic fibers and is very arrhythmogenic | Transitional Cell Zone |
| The fusion of the P wave with the QRS complex of another complex to give the appearance of the presence of an R wave | Pseudo-R Wave |
| A slow upstroke of the __ wave noted in RBBB in leads I and V6 that can have various morphologies | Slurred S Wave |
| A pathway, other than the AV node, for the transmission of the impulse from the atria to the ventricles | Accessory Pathway |
| A circus movement of the electrical impulse found in patients with Wolff-Parkinson-White syndrome in which the impulse travels down the Kent bundle and then reenters the atria via the AV node. Leads to a wide-complex morphology of the QRS complexes. | Antidromic Conduction |
| Conduction through an accessory pathway that does not create a delta wave. Undetected on ECG's and the most common presentation for patients with accessory pathways | Concealed Conduction Pathway |
| A slurring of the upstroke of the first part of the QRS complex that occurs in Wolff-Parkinson-White syndrome | Delta Wave |
| A circus movement of the electrical impulse found in patients with Wolff-Parkinson-White syndrome, in which the impulse travels normally down the AV node and then reenters the atria via the Kent bundle. | Orthodromic Conduction |
| A syndrome characterized by short PR intervals, delta waves, nonspecific ST-T wave changes, and paroxysmal episodes of tachycardia caused by the presence of an accessory pathway. | Wolf-Parkinson-White Syndrome (WPW) |
| Morphological occurrence on an ECG due to JVD that is caused by extra blood volume regurgitating back up the jugular system when the atria contract against closed AV valves (mitral and tricuspid) | Cannon A Waves |
| The presence of an abnormally long interval from the R wave to the bottom of the S wave greater than or equal to 0.10 seconds long | Brugada's Sign |
| A small notching near the low point of the S wave in ectopic ventricular complexes | Joseph's Sign |
| Two PVCs occurring sequentially | Couplet |
| PVCs that are morphologically different because they either originate in separate ventricular ectopic foci or are transmitted through different depolarization routes | Multifocal PVCs |
| Singly occurring PVCs or PVCs that share the same common morphological appearance because they originate in the same ectopic focus. | Unifocal PVCs |
| When a premature ventricular contraction falls on the T wave of the previous complex | R-on-T Phenomenon |
| Three PVCs occurring sequentially | Triplet |
| An arrhythmia that develops in a patient after a thrombolytic or an external device has reopened a clotted artery in a patient undergoing an acute myocardial infarction | Reperfusion Arrhythmia |
| A "normal looking" complex that occurs unintentionally during AV dissociation that causes the electrical impulse to be transmitted down the normal conduction pathway. | Capture Beat |
| Protective mechanism that provides an alternative path for blood flow when there is a blockage in the system | Collateral Circulation |
| The small area between a nerve ending and the muscle tissue that communicates via neurotransmitters released in the extracellular space | Gap Junction |
| One area of the heart that is perfused by multiple different arterioles | Microcollateral Circulation |
| A form of V-tach that lasts greater than 30 seconds or is shorter than 30 seconds, but required either electrical or pharmaceutical intervention to terminate | Sustained Ventricular Tachycardia |
| Low level of calcium | Hypocalcemia |
| Low level of magnesium | Hypomagnesium |
| Alternating polarity of the T wave between positive and negative that occurs on an ECG or rhythm strip | T-Wave Alternans |
| An incomplete block of the AV node leading to the independent firing of the atria and the ventricles. The atrial impulse exerts some minimal control over the ventricular rate and the atrial rate is the same, if not close to, the ventricular rate. | AV Dissociation |
| A hypoperfusion state that occurs in hypertensive patients due to their need for higher perfusion pressures. | Relative Hypotension |
| Single electrical impulse originating in the AV node that occurs before the next expected sinus beat | Premature Junctional Contraction (PJC) |
| The process by which bioelectricity is transferred through the myocardial tissue. It refers to a successive stimulation of cells which, in essence, creates an electrical current. | Conduction |
| A type of response from a pulse generator or pacemaker in which the device responds in a triggered manner for some pre-programmed cases and in an inhibitory manner for other pre-programmed events. | Dual Response |
| The pacemaker responds to a sensed event by not firing a response for a certain interval of time (the VEI). | Inhibited Response |
| A disorder that occurs due to a lack of atrial contribution to ventricular filling. The inability of the heart rate to compensate for any form of exertion or exercise causing decreased cardiac output and hypotension | Pacemaker Syndrome |
| The pacemaker activates a depolarization wave or “fires” to a sensed event | Triggered Response |
| The interval of time during which a pacemaker is dormant before triggering the next response. | Ventricular Escape Interval (VEI) |
| The number of seconds it takes for the normal pink color to return after pushing down on a fingernail | Capillary Refill |
| Chaotic ventricular rhythm usually resulting from the presence of many reentry circuits within the ventricles | Ventricular Fibrillation |
| Occurs when the sinus node fires on time but the impulse is blocked before it exits the sinus node. This results in a pause that varies in length depending on how many sinus beats are blocked. | Sinus Block |
| Results from regular cardiac stimulation by an electrode implanted in the heart and connected to a power source | Artificial Pacemaker Rhythm |
| Results from slowing of the SA node | Sinus Bradycardia |
| Passive transfer of pacemaker sites from the sinus node to other latent pacemaker sites in the atria and AV junction. | Wandering Atrial Pacemaker (WAP) |
| Intermittent block characterized by P waves that are not conducted to the ventricles but without associated lengthening of the PR interval before the dropped beats. | Second-Degree Type II AV Block |
| Delay in conduction at the level of the AV node rather than an actual block. This is a condition superimposed on another rhythm. | First-Degree AV Block |
| a form of polymorphic V-tach that results in a long QT interval and is characterized by rapid, irregular QRS complexes, which appear to be twisting around the electrocardiogram (ECG) baseline. | Torsades de Pointes |
| Single ectopic impulse arising from an irritable focus in either ventricle that occurs earlier than the next expected beat | Premature Ventricular Contractions |
| Results from an increased rate of SA node discharge | Sinus Tachycardia |
| Results from an ectopic beat that comes early in the cardiac cycle and originates in the atria | Premature Atrial Contractions (PAC) |
| Often results from a variation of the R-R interval | Sinus Dysrhythmia |
| Results from increased automaticity in the AV junction, causing the AV junction to discharge faster than its intrinsic rate | Accelerated Junctional Rhythm |
| A type of arrhythmia in which the heart rate is less than the intrinsic rate of the AV node | Junctional Bradycardia |
| Refers to tachycardias that originate above the ventricles. The pacemaker site is often difficult to determine because of the heart rate | Supraventricular Tachycardia (SVT) |
| Wandering pacemaker rhythm with a rate greater than 100 | Multifocal Atrial Tachycardia (MAT) |
| Results from multiple areas of reentry within the atria or from multiple ectopic foci bombarding an AV node that physiologically cannot handle all of the incoming impulses | Atrial Fibrillation |
| An intermittent block at the level of the AV node in which it produces a characteristic cyclic pattern of progressively longer PR intervals until an impulse is blocked | Second-Degree Type I AV Block |
| Results from a rapid atrial reentry circuit and an AV node that physiologically cannot conduct all impulses through to the ventricles | Atrial Flutter |
| the absence of conduction between the atria and the ventricles resulting from complete electrical block at or below the AV node. The atria and ventricles subsequently pace the heart independently of each other | Third-Degree AV Block |
| a dysrrhythmia that results when the rate of the primary pacemaker, usually the SA node, is slower than that of the AV node. The AV node then becomes the pacemaker. | Junctional Escape Rhythm |
| A type of second-degree AV block in which there are two P waves for each QRS complex. The first P wave of each pair of P waves is blocked | 2:1 AV Block |
| Occurs when rapid atrial depolarization overrides the SA node. It often occurs with a sudden onset, may last minutes to hours, and terminates abruptly | Paroxysmal Supraventricular Tachycardia |
| Results either when impulses from higher pacemakers fail to reach the ventricles or when the discharge rate of higher pacemakers becomes less than that of the ventricles | Ventricular Escape Rhythm |
| A form of abnormally wide ventricular dysrrhythmia that usually occurs during an acute myocardial infarction. Typically, the rate is 60 to 100 beats per minute | Accelerated Idioventricular Rhythm |
| Occurs when the sinus node fails to discharge for a brief period, resulting in missing a single PQRST complex | Sinus Pause |
| Three or more ventricular complexes in succession at a rate of 100 beats per minute or more | Ventricular Tachycardia |
| When the SA Node fails to discharge for a brief period, resulting in short periods of cardiac standstill. Three or more of the subsequent PQRST complexes will be missing | Sinus Arrest |
| Absence of all cardiac electrical activity | Asystole |
| What formula is used to determine cardiac output? | Q = SV x HR |
| Which branch of the autonomic nervous system primarily affects atrial tissue and has minimal effect on the ventricles? | Parasympathetic Nervous System |
| Where are the pectinate muscles found? | The Atria |
| What is the approximate resting potential of a cardiac contractile cell? | -90mV |
| Approximately ___% of ventricular filling occurs passively | 80 |
| A systemic artery disease in which plaque builds up inside the walls of the arteries | Atherosclerosis |
| What are the 2 main components of the Cardiovascular System? | Heart and peripheral blood vessels |
| A type of disease affecting the heart, peripheral blood vessels, or both. | Cardiovascular Disease (CVD) |
| A type of disease that is classified as a narrowing or blockage to the coronary arteries | Coronary Artery Disease (CAD) |
| Disease process that causes the loss of elasticity in the vascular walls from thickening and hardening of the blood vessels | Arteriosclerosis |
| The bottom of the heart that comes to a point and lies just above the diaphragm | Apex |
| The top of the heart that lies near the second rib | Base |
| A component of the thoracic cavity that is located between the lungs and contains the heart and great vessels | Mediastinum |
| A serous membrane that forms the innermost layer of the pericardium and outer surface of the heart. AKA the visceral pericardium | Epicardium |
| What is the approximate resting potential of an autorhythmic cell? | -60mV |
| Refers to heart rate | Chronotropy |
| Refers to conduction speed | Dromotrophy |
| Refers to the force of contraction | Inotropy |
| The pressure or volume of blood within the ventricles at the end of diastole | Preload |
| The resistance against which the left ventricle must pump to eject blood | Afterload |
| What ion is primarily responsible for the Depolarization of a Contractile Cell? | Sodium (Na+) |
| What ion is primarily responsible for the Depolarization of an Autorhythmic Cell? | Calcium (Ca++) |
| A law that states that the more the heart is stretched, the greater its force of contraction will be | Starling's Law |
| Structure that stores and/or releases Calcium ions based on the needs of the cells | Sarcoplasmic Reticulum |
| Structures found in-between the myocardial cells of the heart that play a vital role in bonding cardiac muscle cells together and help transmit signals between cells | Intercalated Discs |
| Thick filament of the myofilaments | Myosin |
| Thin filament of the myofilaments | Actin |
| When the heart muscle contracts and pumps blood from the chambers into the arteries | Systole |
| The percentage of blood that is ejected from the ventricles with each contraction | Ejection Fraction |
| How many seconds is 1 small box equivalent to? | 0.04 seconds |
| How many seconds is 1 big box equivalent to? | 0.20 seconds |
| What is the "normal" duration of the QRS complex? | 0.04 - 0.12 seconds |
| Leads V1 and V2 are placed in which intercostal space? | The 4th intercostal space on either side of the sternum |
| What is the default speed for ECG paper? | 25mm/second |
| What is the "normal" duration of the PR interval? | 0.12 - 0.20 seconds |
| Specialized fibers that connect the valves to the papillary muscles and prevent the valves from prolapsing into the atria during ventricular contraction | Chordae Tendineae |
| a connection between two or more blood vessels to facilitate communication | Anastomosis |
| states that the blood flow through a vessel is directly proportional to the vessel's radius to the 4th power; the larger the diameter, the greater the blood flow | Poiseuille's Law |
| Phase of the Cardiac Cycle in which the atria and ventricles are relaxed and expanded, causing blood to passively flow into the ventricles | Ventricular Filling (A) |
| Phase of the Cardiac cycle in which the AV valves close at the end of ventricular diastole, blood flow stops, and the ventricles begin to contract simultaneously | Isovolumetric Contraction |
| Phase of the Cardiac Cycle in which the ventricles contract, causing blood to flow from the heart, to the lungs, and the rest of the body | Rapid Ventricular Ejection |
| Phase of the Cardiac Cycle in which the semilunar valves close at the end of the ejection phase and blood flow stops | Isovolumetric Relaxation |
| During the Ventricular Filling Phase of the cardiac cycle, the AV valves are ___ and the Semilunar valves are ___ | Open; Closed |
| During the Isovolumetric Contraction Phase of the Cardiac Cycle, the AV valves are ___ and the Semilunar valves are ___. | Closed; Closed |
| During the Rapid Ventricular Ejection Phase of the Cardiac Cycle, the AV valves are ___ and the Semilunar valves are ___. | Closed; Open |
| During the Isovolumetric Relaxation Phase of the Cardiac Cycle, the Av valves are ___ and the Semilunar valves are ___. | Closed; Closed |
| What is the average amount of blood that the heart ejects during any one contraction? | 70 mL |
| What formula is used to determine Blood Pressure? | BP = Q x SVR |
| What ion is primarily responsible for Repolarization of a Contractile Cell? | Potassium (K+) |
| What ion is primarily responsible for Repolarization of an Autorhythmic Cell? | Potassium (K+) |
| What is the Action Potential Phase (4) of a Cardiac Contractile Cell? | Resting Phase |
| What is the Action Potential Phase (0) of a Cardiac Contractile Cell? | Rapid Depolarization Phase |
| What is the Action Potential Phase (1) of a Cardiac Contractile Cell? | Initial Repolarization Phase |
| What is the Action Potential Phase (2) of a Cardiac Contractile Cell? | Plateau Phase |
| What is the Action Potential Phase (3) of a Cardiac Contractile Cell? | Rapid Repolarization Phase |
| What is the Action Potential Phase (4) of an Autorhythmic Cell? | Pacemaker Potential Phase |
| What is the Action Potential Phase 0 of an Autorhythmic Cell? | Depolarization Phase |
| What is the Action Potential Phase (3) of an Autorhythmic Cell? | Repolarization Phase |
| What is the Intrinsic Rate of the SA Node? | 60 - 100 BPM |
| What is the Intrinsic Rate of the AV Node? | 40 - 60 BPM |
| What is the Intrinsic Rate of the Ventricles? | 20 - 40 BPM |
| A diagrammatic way to show the strength and direction of an electrical impulse | Vectors |
| Limb leads should be at least ___cm from the heart | 10 |
| When referring to the augmented limb leads, the ____ serves as the positive pole | Electrode |
| When referring to the augmented limb leads, the ____ serves as the negative pole | Center (Heart) |
| The precordial leads are used to evaluate a patient for signs of the "3 I's." What are the "3 I's"? | Ischemia, Infarct, Injury |
| The point in which the QRS Complex ends and the ST Segment begins | J Point |
| False abnormalities on the baseline of an ECG rhythm strip | Artifact |
| Leads I and aVL view the ____ wall of the heart | High Lateral |
| Leads II, III, and aVF view the ___ wall of the heart | Inferior |
| Leads V1 and V2 view the ____ wall of the heart | Septal |
| Leads V3 and V4 view the ____ wall of the heart | Anterior Wall |
| When determining if a rhythm is Atrial or Junctional in origin, a PR Interval >0.12 seconds indicates the rhythm is ____. | Atrial |
| When determining if a rhythm is Atrial or Junctional in origin, a PR Interval <0.12 seconds indicates the rhythm is ____. | Junctional |
| What are the 6 H's? | Hypovolemia, Hypoxia, Hydrogen ions (acidosis), Hypo/Hyperkalemia, Hypothermia, Hypoglycemia |
| What are the 6 T's? | Tension pneumothorax, Tamponade (cardiac), Toxins, Thrombosis (pulmonary), Thrombosis (coronary), Trauma |
| A type of MI that affects the full thickness of the myocardium and almost always results in a pathological Q wave in the affected leads | ST-Segment Elevation Myocardial Infarction (STEMI) |
| Death and subsequent necrosis of the heart muscle caused by inadequate blood supply | Infarction |
| Damage to the heart muscle that results from loss of blood and oxygen supply to the tissue. The damaged tissue tends to be partially or completely depolarized | Injury |
| Deprivation of oxygen and other nutrients to the heart muscle that typically causes abnormalities in repolarization | Ischemia |
| What is the normal Ejection Fraction of an adult? | 55-70% |
| During Phase 4 of an Autorhythmic Cell Action Potential, ____ is slowly moving into the cell until it reaches Threshold Potential. | Sodium (Na+) |
| What is the threshold potential of a cardiac contractile cell? | -70mV |
| What is the threshold potential of an autorhythmic cell? | -40mV |
| What is the treatment plan for a patient with CHF exacerbation? | ACE Inhibitors, CPAP, Nitroglycerin |
| What structure does a fetal heart utilize to shunt blood from the right to the left atrium and bypasses the lungs? | Foramen Ovale |
| During Phase 0 of an Autorhythmic Cell Action Potential, there is a rapid influx of _____. At the peak of this phase, _____ channels open, causing an efflux of these ions. | Calcium (Ca++); Potassium (K+) |
| During Phase 3 of an Autorhythmic Cell Action Potential, the efflux of ____ causes the membrane potential to return to -60mV. This results in the ____ channels opening, causing a slow influx of these ions to return the cell to its threshold potential. | Potassium (K+); Sodium (Na+) |
| The sodium-potassium pump of an Autorhythmic Cell exchanges 3 ____ for 2 ____ until the original ionic gradients are restored | Sodium (Na+); Potassium (K+) |
| A depressed structure located in the right atrium that forms when the septum primum and septum secundum fuse together during fetal development. | Fossa Ovalis |
| During Phase 0 of a Cardiac Contractile Cell's Action Potential, a rapid influx of ___ causes a sharp rise in voltage. Once membrane potential reaches -40mV, ____ channels open and cause a slow but steady influx of these ions. | Sodium (Na+); Calcium (Ca++) |
| During Phase 1 of a Cardiac Contractile Cell's Action Potential, ___ channels close quickly, while ____ channels open, causing a small decrease in membrane potential as these ion leave the cell. | Sodium (Na+); Potassium (K+) |
| During Phase 2 of a Cardiac Contractile Cell's Action Potential, the continuous, but slow influx of ___ helps balance out the membrane potential as ___ continues to leave the cell. | Calcium (Ca++); Potassium (K+) |
| During the end of Phase 2 of a Cardiac Contractile Cell's Action Potential, there is still not enough ___ inside the cell to induce muscle contraction. The sarcoplasmic reticulum senses this and releases more of these ions to facilitate contraction. | Calcium (Ca++) |
| During Phase 3 of a Cardiac Contractile Cell's Action Potential, the ___ channels slowly close while ___ efflux continues until membrane voltage returns to its resting value. | Calcium (Ca++); Potassium (K+) |
| During the end of Phase 3 of a Cardiac Contractile Cell's Action Potential, Once resting value is met ___ channels close and excess ____ is actively transported back to the SR for future use. | Potassium (K+); Calcium (Ca++) |
| The ___ pericardium is the most superficial layer of the pericardium that consists of dense and loose connective tissue | Fibrous |
| The ___ pericardium can be divided into 2 layers | Serous |
| The ___ pericardium is the layer of the serous pericardium that is fused to the fibrous pericardium | Parietal |
| The ___ pericardium is the protective layer of the serous pericardium that comes into contact with the heart. AKA the Epicardium | Visceral |
| What are the 3 functions of the Pericardium? | 1. affixes the heart to the mediastinum, 2. protects against infection, 3. provides lubrication to the heart |
| What are the 3 functions of the Fibrous Pericardium? | 1. protects the heart, 2. anchors the heart to the surrounding walls, 3. prevents overfilling with blood |
| Vessels that wrap around the outside of the heart and supply blood to the heart muscle | Coronary Arteries |
| Valves that prevent backflow of blood into the atria during systole | Atrioventricular Valves |
| Valves that control blood flow between the ventricles and the arteries they feed | Semilunar Valves |
| The 2 AV valves of the heart are the ___ valve and the ___ valve. | Tricuspid; Mitral (bicupsid) |
| The 2 Semilunar valves of that heart are the ___ valve and the ___ valve. | Pulmonic; Aortic |
| Specialized muscles located in the ventricles that are connected to the cusps of the AV valves via specialized fibers that prevent the valves from becoming inverted during systole | Papillary Muscles |
| The arteries and veins consists of 3 layers. What is the name of the innermost layer that is made up of endothelial goblet cells? | Tunica Intima |
| Blood vessels that serve as a "bridge" between arteries and veins and are made up of a single layer of endothelial cells | Capillaries |
| The arteries and veins consists of 3 layers. What is the name of the middle layer that is made up of smooth muscle and elastic fibers? | Tunica Media |
| The arteries and veins consists of 3 layers. What is the name of the outermost layer that is made up of collagen fibers? | Tunica Externa |
| Phase of the Cardiac Cycle in which the ventricles are relaxed and expanded. During this phase the atria perform an "atrial kick" to finish filling up the ventricles | Ventricular Filling (B) |
| What is the average volume of blood the adult heart can pump in 1 minute? | 5 L/min |
| Hormones secreted from the heart that counteract the effects of the stimulatory systems and prevent long-term damage | Natriuretic Peptides |
| A peptide that is manufactured, stored, and released by atrial muscle cells in response to atrial distension and/or sympathetic stimulation. | ANP |
| A peptide that was originally discovered in the brain and is mainly secreted by the ventricles in response to ventricular distension due to volume overload | BNP |
| A peptide that is secreted by endothelial cells of blood vessels in response to inflammatory mediators and has a vasodilatory effect | CNP |
| When ventricular dysfunction occurs, the Sympathetic Nervous System and the ____ System activate in order to maintain perfusion and blood pressure. | Renin-Angiotensin-Aldosterone System (RAAS) |
| A wall of nonconductive tissue that lies between the atria and the ventricles | Atrioventricular Septum |
| The heart sound "lubb" that is produced when the tricuspid and bicuspid valves close is referred to as ___ | S1 |
| The heart sound "dubb" that is produced when the aortic and pulmonic valves close is referred to as ___ | S2 |
| Phase during the first 0-4 mins of cardiac arrest | Electrical Phase |
| Phase that occurs after 4-10 mins of cardiac arrest | Circulatory Phase |
| Phase that occurs after 10+ mins of cardiac arrest | Metabolic Phase |
| an umbrella term for when blood supplied to the heart muscle is suddenly blocked | Acute Coronary Syndrome |
| During cardiac arrest, how much and how often do you administer Epinephrine 1:10,000? | 1mg every 3-5 mins |
| During cardiac arrest, what is the initial dose of Amiodarone? | 300mg |
| What 2 rhythms are you unable to shock when performing CPR? | Asystole and PEA |
| After obtaining ROSC, the first step in treating hypotension is: | Administer 1-2L of NS or LR |
| After obtaining ROSC, the second step in treating hypotension is to administer a vasopressor infusion. At what dose and rate would you administer an Epinephrine/Norepinephrine IV infusion? | 0.1-0.5mcg/kg/min (in 70kg adults: administer 7-35mcg/min) |
| After obtaining ROSC, the second step in treating hypotension is to administer a vasopressor infusion. At what dose and rate would you administer a Dopamine IV infusion? | 5-10mcg/kg/min |
| When treating adult bradycardia, what 1st-line medication is used? | Atropine |
| Least invasive method and 1st-line treatment for stable, narrow-complex tachycardia | Vagal Maneuver |
| an abnormal sound heard over an artery that typically reflects turbulent blood flow. This is caused by narrowing of the vessel due to plaque build up | Bruit |
| When performing a carotid sinus massage, the artery should not be massaged for more than ___ | 15-20secs |
| 1st-line medication for stable, narrow-complex SVT that is refractory to vagal maneuvers. Does not convert patients with A-fib, A-flutter, or pre-excitation syndromes (WPW) | Adenosine |
| After administering Adenosine to treat SVT, each dose should be followed by ____ via RIVP | 20mL of NS |
| a shock that is timed with the R wave of the QRS complex to prevent shocking during the refractory period; used to treat unstable narrow and wide-complex tachycardias | Synchronized Cardioversion |
| When performing a synchronized cardioversion to treat unstable SVT and A-flutter, how many Joules should your initial shock be? | 50-100J |
| When performing a synchronized cardioversion to treat unstable monomorphic VTach, how many Joules should you initial shock be? | 100J |
| When performing a synchronized cardioversion to treat unstable A-fib, how many Joules should your initial shock be? | 120J |
| When treating Torsade de Pointes with a pulse, at what dose and rate would you administer Magnesium Sulfate? | 1-2g mixed in 50-100mL of diluent over 5-60mins |
| When treating Torsade de Pointes without a pulse (cardiac arrest), at what dose and rate would you administer Magnesium Sulfate? | 1-2g mixed in 10mL of diluent |
| When treating adult bradycardia with Epinephrine, at what dose and rate can this medication be administered? | 2-10mcg/min infusion (titrate to effect) |
| When treating adult bradycardia with Dopamine, at what dose and rate would this medication cause an increase in HR and contractility? | 2-5mcg/kg/min |
| When treating adult bradycardia with Dopamine, at what dose and rate would this medication cause an increase in HR, contractility, and blood pressure? | 5-10mcg/kg/min |
| At what dose and rate would Dopamine cause a decrease in cardiac output and a decrease in peripheral perfusion? | >10mcg/kg/min |
| Class: Ia Antiarrhythmic Sodium Channel Blocker | Procainamide |
| Class: Ib Antiarrhythmic Sodium Channel Blocker | Lidocaine |
| Class: II Antiarrhythmic Beta Blockers | Labetalol, Metoprolol |
| Class: III Antiarrhythmic Potassium Channel Blockers | Amiodarone, Sotalol |
| Class: IV Antiarrhythmic Calcium Channel Blocker | Diltiazem |
| Class:V Antiarrhythmic that works by unknown or other mechanisms | Adenosine, Digoxin |
| When treating adult bradycardia, at what dose and rate would you administer Atropine? What is the max dose? | 0.5mg bolus (repeat every 3-5mins), max dose of 3mg |
| What is the acceptable rate range when pacing a patient? | 60-80 |
| When pacing a patient, the pacemaker spike should be before or after the paced complex? | Before |
| What is the 1st dose of Adenosine when treating stable, narrow-complex tachycardia? | 0.6mg RIVP |
| What is the 2nd dose of Adenosine when treating stable, narrow-complex tachycardia? | 12mg RIVP |
| Class of 2nd-line medications that are used to treat stable, narrow-complex tachycardia in patients with A-fib, A-flutter, and pre-excitation syndromes (WPW) that are refractory to Adenosine. (Class II Antiarrhythmic) | Beta Blockers |
| Class of 1st-line medications that are used to treat stable, narrow-complex tachycardia in patients with A-fib and A-flutter that is refractory to Adenosine (Class IV Antiarrhythmic) | Calcium Channel Blockers |
| Class of medications that prolong repolarization and can be used to treat wide-complex tachycardias that are refractory to Adenosine (Class III Antiarrhythmic) | Potassium Channel Blockers |
| Class of medications that prolong action potential duration and can be used to treat wide-complex tachycardias that are refractory to Adenosine (Class Ia-c Antiarrhythmic) | Sodium Channel Blockers |
| When performing a synchronized cardioversion to treat unstable A-fib, how many Joules should your 2nd (follow-up) shock be? | 200J |
| 1st-line medication for A-fib and A-flutter with RVR, 2nd-line medication for narrow-complex tachycardia that is refractory to Adenosine | Diltiazem |
| When treating adult tachycardia with Diltiazem, at what rate and dose would you administer the 1st dose? What is the max dose? | 0.25mg/kg; Max: 20mg |
| When treating adult tachycardia with Diltiazem, at what rate and dose would you administer the 2nd dose? What is the max dose? | 0.35mg/kg; Max: 25mg |
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sarah.thomas32
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