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intrinsic rate of the SA node
60-80
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intrinsic rate of the AV node
40-60
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the p wave represents what part of the cardiac cycle?
atrial depolarization
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what part of the cardiac cycle is represented by the QRS complex
ventricular depolarization
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what part of the cardiac cycle is represented by the T wave?
ventricular repolarization
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Which nerve(s) innervate only the sinus and atrioventricular nodes?
vagus nerve
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Which nerve(s) innervate all parts of the heart?
sympathetic
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what ECG findings are expected with sinoatrial block?
- regular pauses of the p wave
- Also known as sinus exit block
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what ECG irregularities/heart conditions can be benign
- sinoatrial block,
- Wenckebach AV block,
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what ECG findings are expected with 1st degree AV block?
PR interval > 0.2 seconds (one big box)
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three names for two types of second degree AV block
- Mobitz 1 = Wenckebach = 2:1 or less,
- Mobitz 2 = 2:1 AV block or more
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what ECG findings are expected with Wenckebach/Mobitz 1 second degree atrioventricular block?
repeating pattern where p wave conduction progressively slows, followed by a missing QRS complex
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is a 2:1 AV block Mobitz 1 or 2?
- can be either:
- Mobitz 1 is a blockage above the AV node,
- Mobitz 2 is a blockage below the AV node
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how to determine if 2:1 AV block is Wenckebach or Mobitz 2
- If PR interval is lengthened but the QRS is normal, probably Wenckebach.
- If PR interval is normal, but the QRS is widened, probably Mobitz
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what ECG findings are expected with third degree atrioventricular block?
P waves and QRS complexes are both regular, but not synchronized
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what ECG findings are expected with right bundle branch block?
- wide QRS in a supraventricular rhythm,
- wide or "slurred" S waves in Leads I and V6
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what ECG findings are expected with left bundle branch block?
- Poor R wave in V1-3,
- Broad R wave in V5-6
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Parasystolic
Entrance block of automaticity focus: paces but cannot be overdrive-suppressed
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What is a common rhythm in COPD patients?
Multifocal atrial tachycardia
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Vagal maneuver can convert _____ to NSR
SVT
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By slowing AV node conduction, vagal maneuver can help diagnose which two heart conditions?
Atrial flutter and 2:1 AV block
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Bachmann’s bundle innervates what
the left atrium
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The QT interval is considered normal if...
At normal rate, it is less than half the width of the R to R interval
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Stokes-Adams Syndrome is due to...
Syncope due to low blood flow to the brain due to low pace rate of ventricular escape rhythm. Monitor airway.
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A too-tall T wave can mask what?
A P’ wave from a premature atrial beat.
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A ventricular focus can be triggered by what?
Low oxygen, low potassium, hypovolemia
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P’ wave indicates what?
Irregularity comes from atrial focus
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change in QRS complex indicates what?
Change in ventricular conduction
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Paroxysmal atrial tachycardia with 2:1 AV block indicates what?
Digitalis excess or toxicity
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Digitalis _______ the AV node
Inhibits
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PAT with block should be treated with what?
Digitalis antibodies or IV potassium
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paroxysmal tachycardia with widened QRS complexes indicates what?
Junctional origin: left ventricle is depolarized before the right ventricle
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“Supraventricular tachycardia” includes _____ and ________ and implies________
paroxysmal is implied. SVT can be used to indicate both paroxysmal atrial tachycardia and paroxysmal junctional tachycardia.
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Factors triggering ventricular irritability
- low O2,
- Low K+,
- MVP,
- myocarditis
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Names for ventricular tachycardia
- Paroxysmal ventricular tachycardia,
- PVT,
- VT,
- V-tach
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What EKG finding confirms the diagnosis of PVT?
- fusion beat: normal QRS complex blended with PVC-like complex, or
- capture beat: normal QRS among VT run
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differentiate wide QRS from SVT versus that from VT
- QRS > 0.14 sec: VT
- QRS < 0.14 sec: SVT
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Deep Q wave indicates what?
Necrosis
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inverted p wave indicates what
retrograde depolarization of atria
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inverted t wave indicates what?
ischemia
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A depressed ST segment indicates what?
Decreased coronary flow
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elevated ST segment indicates what?
Acute injury or pericarditis
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Wide QRS complex indicates what?
Aberrant ventricular contraction; possibly BBB
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Which leads are the inferior leads
II, III, AVF
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which leads are the lateral leads
I and AVL
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What ECG findings are expected with right axis deviation
Negative QRS complex in Lead I
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Sinus rhythm
- Constant p-p and R-R intervals
- p waves upright in I, II, AVF
- Narrow QRS
- P:QRS ratio 1:1
- P-R interval normal and constant
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QRS should be less than
3 boxes
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Junctional arrhythmiapwavewill be inverted in leads ...
I, II, AVF
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EKG findings expected in LVH
- R in V5/6 + S in V1 > 35 mm
- OR
- R> 13 mm in avL
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Expected ECG findings for RVH
RAD and R wave >7mm in V1
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Expected ekg findings for right atrial enlargement
p wave >2.5 mm in any lead
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Expected ECG findings for hyperkalemia
Bradycardia, flattening, and loss of p waves
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