So not Basic
What is the normal Pacemaker of the heart
SA Node
Chamber with largest Myocardium
Left Ventricle
Single Spike that may or may not produce a P wave
Atrial Paced Rhythm
What are ectopic beats?
A beat fired anywhere outside the SA node.
What is the intrinsic rate for the BOH?
20-40BPM
What is a normal PRI, QRS and (Bonus - QT) measurement?
PRI - 0.12 - 0.20
QRS - 0.04 -0.11
QT - 0.36 - 0.44
In what chamber are the SA and AV nodes housed?
Right Atrium
2 Spikes present 1 which may or may not produce a P wave and 1 that produces a wider than normal QRS Complex
Dual Chamber Paced Rhythm
What is Multifocal? When is it used?
Multiple sites in the Ventricles firing, giving different shaped QRS Complex's.
PVCs or VCs
What is the relationship of P wave to QRS complex in 3rd Degree Heart Block?
There is no relationship, they are completely Independent of each other.
What is the main difference between Junctional Rhythm's and Ventricular Rhythm's when the P wave is hidden?
The width of the QRS
What valves control the flow of blood from the atrium to the ventricles?
Atrio-Ventricular Valves
Tricuspid Valve
Bicuspid (Mitral) Valve
Pacemaker fires and Impulse, but heart muscle does not respond
Failure to Capture
(Spike followed by nothing)
What would you call and early ectopic P wave that is not followed by a QRS?
Blocked PAC
What is the difference between an Aberrant PAC and a PVC?
Early Ectopic P wave followed by Early Wide QRS with APAC - will not map out, will be early
Mapping Sinus P waves, Early Wide QRS with a PVC - QRS will be early, but P wave will map out with sinus P waves
How many different P waves can Junctional Beats have? What are they?
3 (Inverted, Hidden, Retrograde)
What conduction pathway does a normal impulse take (all locations)?
SA node, (extra: Internodal pathways), AV node, BOH, Bundle Branches, Purkinjie Fibers
Pacemaker Sensing feature is disrupted causing it to incorrectly sense the patients intrinsic rhythm
Failure to Sense
Daily Double:
Name and explain both Failures
What are the characteristics of PSVT?
Rapid, Regular, No P
Daily Double:
What do you do if you think you have PSVT, but now it gets irregular?
When you hear, Long, Drop, Short.. what do you think of? Why do you get the Longer beats?
2nd Degree AVB, Type 1 (Mobitz Type 1)
With every beat it gets progressively harder to pass through the AV node, until it does not make it through at all.
Define the PR interval
The time it take the electrical impulse to travel from the SA node through the AV node.
Which valves allow 1 way blood flow from the Ventricles to the Arteries.
Semi-Lunar
Aortic and Pulmonic
Name 3 instances where a patient may need a pacemaker implanted
1. Periods of Asystole
2. Advanced Heart Blocks (2D2, 3D, AHB)
3. Symptomatic Brady
4. Sick Sinus Syndrome
5. Av node ablation
6. Constant Pauses
If you see... No P Wave, Wide Crazy QRS and it is Irregular.. What rhythm am I?
Atrial Fibrillation with IVCD
How does de-oxegenated Blood from the Coronary Arteries drain back into the heart?
The Coronary Sinus - Located in the Right Atrium