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Understanding EKGs-3
Based on the book by Beasley, 2nd Edition
Question | Answer |
---|---|
What is cardiac dysrhythmia? | Any abnormality in the rate, regularity or sequence of cardiac activation. |
What are the two myocardial cell groups? | Myocardial cell groups: 1. The myocardial working cells 2. The specialized pacemaker cells of the electrical conduction system |
What are myocardial working cells? | Myocardial working cells are responsible for generating the physical contraction of the heart muscle. |
What are the functions of myocardial working cells? | 1. contraction 2. relaxation |
What are the walls of the atria and ventricles constructed of? | Myocardial working cells |
How is a myocardial contraction produced? | When the permeated contractile filaments of the myocardial working cells are electrically stimulated, a contraction is produced. |
What generates blood flow? | The physical contraction of myocardial tissue |
What is required to produce the physical contraction in a heart? | Organized electrical activity |
What happens to the size of the atria and ventricles when the myocardial tissue contracts and blood is ejected from the chambers? | The size of the atria and ventrical decreases |
How are the myocardial working cells and specialized pacemaker cells different? | The specialized pacemaker cells DO NOT contain contractile filaments & DO NOT have the ability to contract. |
What are the specialized pacemaker cells (aka specialized group) responsible for? | Controlling the rate & rythm of the heart by coordinating regular depolarization. |
Where are the specialized group cells found? | In the electrical conduction system of the heart. |
What are the primary functions of the specialized myocardial pacemaker cells? | The generation and conduction of electrical impulses |
Cardiac muscle cells have the ability to contract in response to which stimuli? (Hint: 4) | 1.Thermal 2.Chemical 3.Electrical 4.Mechanical |
True or False:Atrial muscles contract simultaneously. | True |
True or False: Ventrical muscles do NOT contract together. | False. Ventrical muscles contract together. |
What does threshold refer to in heart anatomy? | A threshold refers to the point at which a stimulus will produce a response. |
Why does cardiac muscle function on an all-or-none principle? | When a stimulus is strong enough for a cardiac cell to reach the threshold, ALL the cells will respond and will contract. If no stimulus, none of the cardiac muscles will contract. |
What is high sodium (Na) blood levels? | Hypernatremia |
What is low sodium (Na) blood levels? | Hyponatremia |
What are the four primary characteristics of cardiac cells? | 1. Automaticity 2. Excitability (irritability) 3. Conductivity 4. Contractility (rhythmicity) |
Which characteristic of cardiac cells is automatic and mechanical? | Contractility |
Pertaining to cardiac cells, what are the electrical functions of the heart? | 1.Automaticity 2.Excitability 3.Conductivity |
What is the ability of the cardiac pacemaker cells to generate their own electrical impulses spontaneously without external (or nervous) stimulation? | Automaticity |
What intrinsic spontaneous depolarization frequency produces contraction of myocardial muscle cells? | Automaticity |
What characteristic is specific to the pacemaker cell sites of the electrical conduction system (i.e., the SA node, AV junction, and the Purkinje network fibers)? | Automaticity |
What is the ability of cardiac cells to respond to an electrical stimulus? | Excitability (or irritability) |
What characteristic is SHARED by all cardiac cells? | Excitability and Conductivity |
True or False: A weaker stiumulus can cause a contraction when a cardiac cell is highly irritabile. | True |
What is the ability of cardiac cells to receive an electrical stimulus and then transmit it to other cardiac cells? | Conductivity |
What characteristic of cardiac cells form synctium, because they function collectively as a unit? | Conductivity |
When there is more than one unit, what is the correct term to describe synctium? | Syncytia |
What is the ability of cardiac cells to shorten and cause cardiac muscle contraction in response to an electrical stimulus? | Contractility |
What is the coordination of cardiac muscle cells to produce a regular heartbeat? | Contractility |
What is the mechanical function of the heart? | Contractility |
Why are both mechanical and electrical cardiac function influenced by electrolyte imbalances? | Because myocardial cells are bathed in electrolyte solutions. |
What is an electrolyte? | An electrolyte is a substance (compound) whose molecules dissociate into charged components (ions) when placed in water. |
What happens when electrolytes are placed in water? | Positive or negative charged ions are produced. |
What is an ion with a positive (+)charge? | cation (pronounced kation) |
What is an ion with a negative (-) charge? | anion (pronounced aneon) |
What are the THREE major cations that affect cardiac function? | 1.Potassium (K) 2.Sodium (Na) 3.Calcium (Ca) |
What is the fourth cation? | 4.Magnesium (Mg) |
What are the three intracellular (inside the cell) cations? | 1.Potassium (K) 2.Magnesium (Mg) 3.Calcium (Ca) |
What is the extracellular (outside the cell)cation? | Sodium (Na) |
How does K (Potassium) affect major cardiac function? | Potassium performs a major function in cardiac depolarization and repolarization. |
What is an increase in potassium blood levels? | Hyperkalemia |
What is a decrease in potassium blood levels? | Hypokalemia |
What role does Sodium (Na) play in cardiac function? | Na (Sodium) plays a vital part in depolarization of the myocardium. |
An increase in sodium blood levels is known as: | Hypernatremia |
A decrease in sodium blood levels is known as: | Hyponatremia |
What role does Calcium (Ca) play in cardica muscle? | Calcium has an important function in myocardial depolarization and myocardial contraction. |
What is an increase in calcium blood levels? | Hypercalcemia |
What is a decrease in calcium blood levels? | Hypocalcemia |
When the cardiac cells are at rest, what is happening to the Potassium (K) and Sodium (Na)ions? | In their resting state, K is greater on the inside and Sodium is greater on the outside of the cardiac cell. |
Which ions diffuse through the membrane more readily? (Hint: Potassium or Sodium) | Potassium |
What is the sodium-potassium exchange pump? | Potassium and Sodium ions are moved in and out of the cell through the cell membrane. |
What is the charge of the inside of a cardiac cell during the polarized or resting state? | Negative |
What is recorded on the EKG strip during the resting period? | A baseline or isoelectric line |
What happens to the sodium at the end of cardiac depolarization? | The sodium actively returns to the outside of the cell and potassium returns to the inside of the cell. |
How does the sodium and potassium exchange occur? | This exchange takes place via the sodium-potassium exchange pump. |
What happens to the cardiac cell when they have returned to the recovered, or repolarized state? | The cardiac cell is now read to be stimulated again. |
Which is slower, repolarization or depolarization? | Repolarization |
Which is faster, depolarization or repolarization? | Depolarization |
What is the LAST area to be depolarized in a healthy cardiac muscle? | The first area to be repolarized |
True or False: Cardiac muscle tissue has a refractory period to ensure that the muscle is totally relaxed before another action potential or depolarization can be initiated. | TRUE |
What is the refractory period of atrial muscle? | Approximately .15 seconds |
What is the refactory period of the ventricle muscle? | Approximately .25 - .3 seconds |
Which rate of contractions are potentially faster, ventricles or atria? | Atria |
When do the cardiac cells have a brief resting period? | After electrical impulse stimulation and myocardial contraction |
What is this brief resting period of the cardiac cells? | Cardiac repolarization |
During the repolarization period, what two stages does the heart go through? | 1. Absolute refractory period 2. Relative refractory period |
During most of the process of repolarization, the cardiac cell: (Hint: 2 responses) | 1. Is unable to respond to a new electrical stimulus.2. Cannot spontaneously depolarize |
What is the state of an activity in which the cardiac cell cannot spontaneously depolarize? | Absolute Refractory Period |
What is the period when repolarization is almost complete & the cardiac cell can be stimulated to contract prematurely if the stimulus to contract prematurely if the stiumulus is much stronger than normal? | Relative refractory period |
What is the second part of the refractory period that follows the absolute refractory period? | Relative refractory period |
Where is the relative refractory period shown on the EKG strip? | The downslope of the T wave |
What is another name for the relative refractory period? | Vulnerable period of the cardiac cells |
Where is the absolute refractory period on the EKG strip? | The beginning of the QRX complex to the peak of the T wave |