THE CARDIOVASCULAR SYSTEM ANATOMY AND PHYSIOLOGY LAYERS OF

THE CARDIOVASCULAR SYSTEM ANATOMY AND PHYSIOLOGY

LAYERS OF THE HEART n PERICARDIUM n MYOCARDIUM n ENDOCARDIUM

RIGHT SIDE OF THE HEART n n n SUPERIOR VENA CAVA INFERIOR VENA CAVA RIGHT ATRIUM TRICUSPID VALVE RIGHT VENTRICLE PULMONARY SEMILUNAR VALVE n n RIGHT PULMONARY ARTERIES LEFT PULMONARY ARTERIES RIGHT AND LEFT LUNGS DEOXYGENATED BLOOD

LEFT SIDE OF THE HEART n n RIGHT PULMONARY VEINS LEFT ATRIUM BICUSPID (MITRAL) VALVE n n RIGHT VENTRICLE AORTIC SEMILUNAR VALVE AORTA OXYGENATED BLOOD

CORONARY ARTERIES n SUPPLY THE MYOCARDIUM WITH OXYGENATED BLOOD n BLOCKAGE OR INFARCT OF ONE OF THESE ARTERIES CAUSES A MYOCARDIAL INFARCTION (MI)

THE CARDIAC CYCLE n n SYSTOLE – CARDIAC CONTRACTION THE BLOOD IS FORCED OUT OF THE HEART TO THE LUNGS FOR OXYGENATION AND TO THE BODY FOR CIRCULATION DIASTOLE – CARDIAC RELAXATION THE BLOOD IS RETURNED TO THE HEART FROM THE LUNGS AND THE BODY

THE CONDUCTION SYSTEM n n n SINO-ATRIAL (SA) NODE ATRIAL IMPULSES ATRIO-VENTRICULAR (AV) NODE BUNDLE OF HIS BUNDLE BRANCHES PURKINJE FIBERS

EKG COMPONENTS n n P WAVE – INDICATES ATRIAL DEPOLARIZATION CAUSING ATRIAL CONTRACTION QRS COMPLEX – INDICATES VENTRICULAR DEPOLARIZATION CAUSING VENTRICULAR CONTRACTION ST SEGMENT – INDICATES MYOCARDIAL DAMAGE T WAVE – INDICATES VENTRICULAR REPOLARIZATION CAUSING VENTRICULAR RELAXATION

EKG BASICS n n ELECTRODES – SENSORS PLACED ON THE PATIENT TO PICK UP ELECTRICAL ACTIVITY LCD DISPLAY – LIQUID CRYSTAL DIODE AREA FOR PATIENT DATA ENTRY ECG/EKG – RECORDING OF ELECTRICAL ACTIVITY ONTO GRID PAPER LEADS – WIRES ATTACHED TO ELECTRODES

CARDIAC DIAGNOSTICS n BLOOD ENZYME TESTS n WAVEFORM MEASUREMENTS n IMAGING TECHNIQUES

WHAT THE EKG WILL SHOW n n n HEART RATE RHYTHM SIGNS OF CARDIAC ENLARGEMENT HEART DISEASE MYOCARDITIS n n SIGNS OF HEART INJURY (MI) ELECTROLYTE ABNORMALITY PULMONARY EMBOLISM DRUG TOXICITY

USES OF AN EKG n TO DIAGNOSE n FOR MONITORING n IN DEFIBRILLATORS

INDICATIONS FOR AN EKG n n FUNCTION OF HEART ELECTRICAL PROBLEMS CHANGES IN THE HEART ROUTINE PRE-OP n n n PART OF A COMPLETE P. E. AFTER AGE 40 EVALUATION OF CARDIAC CONDITIONS STAT – USUALLY IN AN EMERGENCY

EKG PREPARATION n n n PHYSICIAN’S ORDER CALIBRATION PATIENT’S DATA LOCATION, DATE, AND TIME PATIENT’S AGE, SEX AND CARDIAC MEDS n n PATIENT’S WEIGHT AND HEIGHT ANY SPECIAL CONDITION OR POSITION OF PATIENT DURING PROCEDURE

PATIENT PREPARATION n n n REMOVE CLOTHING FROM THE WAIST UP REMOVE JEWELRY THAT MAY INTERFERE PROVIDE DRAPE FOR PRIVACY n n n CLEAN SKIN WITH ALCOHOL APPLY LEADS TO NON-HAIRY AREA SHAVE AREA ONLY IF NECESSARY

APPLYING ELECTRODES n n n COMPLETE EKG CONSISTS OF 12 LEADS LIMB LEADS ARE APPLIED TO ARMS AND LEGS CHEST LEADS ARE APPLIED TO THE CHEST

LIMB LEADS n n RA - FLESHY OUTER AREA OF UPPER RIGHT ARM LA – FLESHY OUTER AREA OF UPPER LEFT ARM n RL – FLESHY PART OF LOWER RIGHT LEG n LL – FLESHY PART OF LOWER LEFT LEG

CHEST LEADS n n n V 1 – 4 TH INTERCOSTAL SPACE RT OF STERNUM V 2 – 4 TH INTERCOSTAL SPACE LT OF STERNUM V 3 – MIDWAY BETWEEN V 2 & V 4 n n n V 4 – 5 TH INTERCOSTAL SPACE AT MID-CLAVICULAR LINE V 5 – SAME LEVEL AS 4 AT LT ANT. AXILLARY LINE V 6 – SAME LEVEL AS 4 AT LT MIDAXILLARY LINE

THREE LEAD TRACING n RA- RIGHT OF STERNUM n LA – LEFT OF STERNUM n LL LEFT LOWER RIB AREA

HEART RHYTHMS n n NORMAL SINUS RHYTHM (NSR) SINUS TACHYCARDIA SINUS BRADYCARDIA ATRIAL TACHYCARDIA (A-TACH)

HEART RHYTHMS n n PREMATURE ATRIAL CONTRACTION (PAC) ATRIAL FLUTTER ATRIAL FIBRILLATION (A-FIB) PREMATURE VENTRICULAR CONTRACTION (PVC) n n DANGEROUS PVCs VENTRICULAR TACHYCARDIA (VTACH) VENTRICULAR FIBRILLATION (VFIB) ASYSTOLE

CARDIAC DISEASES n CORONARY ARTERY DISEASE (CAD) n ANGINA PECTORIS n MYOCARDIAL INFARCTION (MI)

VALVE DISORDERS n RHEUMATIC HEART DISEASE n STENOSIS n INSUFFICIENCY (PROLAPSE)

MUSCLE DISORDERS n CARDIOMYOPATHY n CONGESTIVE HEART FAILURE (CHF)

CARDIAC TREATMENTS n MEDICATIONS n n ANGIOPLASTY n n CORONARY ARTERY BYPASS GRAFT (CABG) HEART TRANSPLANT VALVE REPLACEMENT

CARDIAC HC WORKERS n n CARDIOLOGIST CARDIAC SURGEON CARDIAC INTENSIVE CARE NURSE CARDIAC CATHERTERIZATION NURSE n n n EKG TECHNICIAN ECHO TECHNICIAN CARDIAC BIOMEDICAL EQUIPMENT TECHNICIAN