Download presentation
Presentation is loading. Please wait.
1
Heart Conduction System
February 27-March 1
2
Bell work What is the heart doing in systole? (contract or relax?) What is the heart doing in diastole? (contract or relax?) What heart valves close when you hear the first heart sound? The “lub” in lub dub. What heart valves close when you hear the second heart sound, the “dub” in lub dub?
3
Standard Create an infographic to identify gross heart anatomy and physiology and related cardiac conduction and circulatory pathways.
4
Objective Know the parts of the conduction system
Understand why we look at an EKG
5
The Heart: Conduction System
The heart pumps blood through the body This is accomplished by contraction and relaxation of the cardiac muscle tissue in the myocardium layer.
6
Conduction System Continued….
Cardiac conduction system: The electrical conduction system controls the heart rate This system creates the electrical impulses and sends them throughout the heart. These impulses make the heart contract and pump blood.
7
CARDIAC CYCLE Creates Heart sounds Heard through stethoscope
“LUB-DUB” sound 1st sound, AKA S1 – longest and loudest (closure of atrioventricular (AV) valves) Atrioventricular is Tricuspid and Mitral What would Right AV valve be? What would Left AV valve be?
8
2nd sound – closure of aortic and pulmonary valves (AKA Semilunar Valves)
If valves do not close properly – you will hear an extra sound called a heart murmur
9
THE CARDIAC CYCLE SYSTOLE – CARDIAC CONTRACTION THE BLOOD IS FORCED OUT OF THE HEART TO THE LUNGS FOR OXYGENATION AND TO THE BODY FOR CIRCULATION (CONTRACTION) DIASTOLE – CARDIAC RELAXATION THE BLOOD IS RETURNED TO THE HEART FROM THE LUNGS AND THE BODY (RELAXATION) What is this measuring?
10
1 - Sinoatrial node (SA node)
2 - Atrioventricular node (AV node) 3 – Bundle of His 4 - Right & Left Bundle Branches which lead to Purkinje Fibers
11
Components of the Conduction System
Sinoatrial Node (Part I): located in back wall of the right atrium near the entrance of vena cava initiates impulses times per minute without any nerve stimulation from brain establishes basic rhythm of the heartbeat called the pacemaker of the heart impulses move through atria causing the two atria to contract. at the same time, impulses reach the second part of the conduction system
12
Septum
13
Components of the Conduction System Continued ….
Atrioventricular Node (Part II): located in the bottom of the right atrium near the septum Called Gatekeeper. cells in the AV node conduct impulses more slowly, so there is a delay as impulses travel through the node this allows time for atria to finish contraction before ventricles begin contracting
14
Atrioventricular Bundle
A.K.A. “Bundle of His” From the AV node, impulses travel through to the right and left bundle branches These branches extend to the right and left sides of the septum and bottom of the heart.
15
Atrioventricular Bundle Continued….
These branch a lot to form the Purkinje fibers that transmit the impulses to the myocardium (muscle tissue) The bundle of His, bundle branches and Purkinje fibers transmit quickly and cause both ventricles to contract at the same time Like a “phone tree”
16
Atrioventricular Bundle Continued….
As the ventricles contract, blood is forced out through the semilunar valves into the pulmonary trunk and the aorta. After the ventricles complete their contraction phase, they relax and the SA node initiates another impulse to start another cardiac cycle.
18
THE CONDUCTION SYSTEM SINO-ATRIAL (SA) NODE ATRIAL IMPULSES
ATRIO-VENTRICULAR (AV) NODE BUNDLE OF HIS BUNDLE BRANCHES PURKINJE FIBERS
19
Conduction system shown on EKG
EKG means Electrocardiogram. AKA ECG
20
Normal Sinus Rhythm
22
USES OF AN EKG TO DIAGNOSE FOR MONITORING IN DEFIBRILLATORS
23
INDICATIONS FOR AN EKG FUNCTION OF HEART
ELECTRICAL PROBLEMS CHANGES IN THE HEART ROUTINE PRE-OP PART OF A COMPLETE Physical exam AFTER AGE 40 EVALUATION OF CARDIAC CONDITIONS STAT – USUALLY IN AN EMERGENCY
24
EKG PREPARATION PHYSICIAN’S ORDER PATIENT’S WEIGHT AND HEIGHT
PATIENT’S DATA LOCATION, DATE, AND TIME PATIENT’S AGE, SEX AND CARDIAC MEDS PATIENT’S WEIGHT AND HEIGHT ANY SPECIAL CONDITION OR POSITION OF PATIENT DURING PROCEDURE
25
WHAT THE EKG WILL SHOW HEART RATE RHYTHM SIGNS OF CARDIAC ENLARGEMENT
HEART DISEASE MYOCARDITIS SIGNS OF HEART INJURY (MI) ELECTROLYTE ABNORMALITY PULMONARY EMBOLISM DRUG TOXICITY
26
EKG BASICS 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
27
PATIENT PREPARATION REMOVE CLOTHING FROM THE WAIST UP
REMOVE JEWELRY THAT MAY INTERFERE PROVIDE DRAPE FOR PRIVACY CLEAN SKIN WITH ALCOHOL APPLY LEADS TO NON-HAIRY AREA SHAVE AREA ONLY IF NECESSARY
28
APPLYING ELECTRODES COMPLETE EKG CONSISTS OF 12 LEADS
LIMB LEADS ARE APPLIED TO ARMS AND LEGS CHEST LEADS ARE APPLIED TO THE CHEST
29
CHEST LEADS 12 Leads V4 – 5TH INTERCOSTAL SPACE AT MID-CLAVICULAR LINE
V5 – SAME LEVEL AS 4 AT LT ANT. AXILLARY LINE V6 – SAME LEVEL AS 4 AT LT MIDAXILLARY LINE V1 – 4TH INTERCOSTAL SPACE RT OF STERNUM V2 – 4TH INTERCOSTAL SPACE LT OF STERNUM V3 – MIDWAY BETWEEN V2 & V4
30
LIMB LEADS RA - FLESHY OUTER AREA OF UPPER RIGHT ARM
LA – FLESHY OUTER AREA OF UPPER LEFT ARM RL – FLESHY PART OF LOWER RIGHT LEG LL – FLESHY PART OF LOWER LEFT LEG
31
THREE LEAD TRACING RA- RIGHT OF STERNUM (white)
LA – LEFT OF STERNUM (black) LL LEFT LOWER RIB AREA (red) Can have 5 lead tracing – see all leads
32
Practice Go Outside, use sidewalk chalk and draw heart, blood flow and conduction Take Heart Hand-out outside
33
Day 2
34
Bell work 1. How do you prepare a patient for an EKG? 2. Name three items an EKG could show 3. Put the following terms in order of correct cardiac conduction: Bundle of HIS SA Node Purkinje Fibers L/R Bundle Branches AV Node
35
Standard Create an infographic to identify gross heart anatomy and physiology and related cardiac conduction and circulatory pathways.
36
Objective Understand Repolarization and Depolarization as it relates to the PQRST wave Identify arrhythmias
37
EKG
39
Polarization Depolarization and Repolarization 1. Cardiac cells at rest are considered polarized, meaning no electrical activity takes place 2. The cell membrane of the cardiac muscle cell separates different concentrations of ions, such as sodium, potassium, and calcium. This is called the resting potential.
40
Polarization 3. Electrical impulses are generated by automaticity of specialized cardiac cells 4. Once an electrical cell generates an electrical impulse, this electrical impulse causes the ions to cross the cell membrane and causes the action potential, also called depolarization 5. The movement of ions across the cell membrane through sodium, potassium and calcium channels, is the drive that causes contraction of the cardiac cells/muscle
41
Polarization 6. Depolarization with corresponding contraction of myocardial muscle moves as a wave through the heart 7. Repolarization is the return of the ions to their previous resting state, which corresponds with relaxation of the myocardial muscle
42
Polarization 8. Depolarization and repolarization are electrical activities which cause muscular activity 9. The action potential curve shows the electrical changes in the myocardial cell during the depolarization – repolarization cycle 10. This electrical activity is what is detected on ECG, not the muscular activity.
43
EKG COMPONENTS 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
44
How To Read EKG EKG paper is a grid where time is measured along the horizontal axis. Each small square is 1 mm in length and represents 0.04 seconds. Each larger square is 5 mm in length and represents 0.2 seconds In order to correctly identify heart rhythms, you will need to print off 6 second strips
45
How to Read EKG Can determine HR from EKG strip
Each strip is 6 seconds To determine HR: Count R waves and multiply by 10
46
EKG Analysis – 8 steps Rhythm – Regular or Irregular Heart Rate
Is there a P Wave? Is there a PR – interval? Is there a QRS? Is there a T wave? Is there a Q-T interval Is there an ST segment
47
REGULAR HEART RHYTHMS NORMAL SINUS RHYTHM (NSR) SINUS TACHYCARDIA
between 60 – 100 BPM, regular rhythm SINUS TACHYCARDIA > 100 BPM, regular rhythm SINUS BRADYCARDIA < 60 BPM, regular rhythm
48
Normal Sinus Rhythm 60 – 100 Beats per minute
49
Sinus Tachycardia A fast heart rhythm with a rate of more than 100 beats per minute.
50
Sinus Bradycardia A slow heart rhythm with a rate below 60 beats per minute.
51
Arrhythmias Abnormal heart rhythms that can be mild to life threatening. Atrial Junctional Ventricular Heart Blocks
52
Irregular Rhythm
53
Arrhythmias ATRIAL PREMATURE ATRIAL CONTRACTION (PAC) ATRIAL FLUTTER
ATRIAL FIBRILLATION (A-FIB) VENTRICULAR PREMATURE VENTRICULAR CONTRACTION (PVC) VENTRICULAR TACHYCARDIA (V-TACH) VENTRICULAR FIBRILLATION (V-FIB) SUPRAVENTRICULAR TACHYCARDIA (SVT) ASYSTOLE
54
PAC Premature atrial contraction (PAC)
Can occur in anyone but usually goes unnoticed. Most common forms of arrhythmias. the premature discharge of an electrical impulse in the atrium, causing a premature contraction. A PAC is premature, because the it occurs earlier than the next regular beat should have occurred.
56
Atrial Flutter the electrical signal travels along a pathway within the right atrium. It moves in an organized circular motion, or "circuit," causing the atria to beat faster than the ventricles of your heart.
57
Atrial Fibrillation Many impulses begin and spread through the atria, competing for a chance to travel through the AV node. The resulting rhythm is disorganized, rapid and irregular. Because the impulses are traveling through the atria in a disorderly fashion, there is a loss of coordinated atrial contraction.
58
Premature Ventricular Contraction (PVC)
Early, extra heartbeats that originate in the ventricles. Most of the time, PVCs don’t cause any symptoms or require treatment. This type of arrhythmia is common and can be related to stress, too much caffeine or nicotine, or exercise. They can be also be caused by heart disease or electrolyte imbalance.
59
Ventricular Tachycardia
A rapid heartbeat that originates in the ventricles. The rapid rhythm keeps the heart from adequately filling with blood, and less blood is able to pump through the body. V-tach can be serious, especially in people with heart disease.
60
Ventricular Fibrillation
An erratic, disorganized firing of impulses from the ventricles. The ventricles quiver and cannot generate an effective contraction, which results in a lack of blood being delivered to the body. This is a medical emergency that must be treated with cardiopulmonary resuscitation (CPR) and defibrillation (delivery of an energy shock to the heart muscle to restore a normal rhythm) as soon as possible.
61
Superventricular Tachycardia SVT
Supraventricular tachycardia (SVT) is a cardiac arrhythmia characterized by very rapid or erratic beating. HR above 150 heart racing/palpitations, dizziness or light-headedness, chest pain, breathlessness
62
Asystole Asystole is defined as a cardiac arrest rhythm in which there is no discernible electrical activity on the ECG monitor.
63
Artifact
64
Telemetry Strip Practice
65
Exit Ticket What is happening during repolarization?
What is happening during depolarization? On the PQRST, when are the atria depolarizing? On the PQRST, when are the ventricles depolarizing?
66
Bell Work In the PQRST Wave – Describe when the atrial and ventricles are contracting/depolarizing What is abnormal rhythm called?
67
New Seating Chart Find your numbered desk: Sugey:10 Kelton: 15
Lou: Madi G: 8 Rebecca: 7 Josie: 17 Mary Mack: Hannah: 11 Katlyn: 1 Daegan: 18 Madison C: Chrissy: 14 Kennedy: Caleb: 13 Abby: Allison: 22 Matt: Jaylie: 5 Anna: Taha: 20 Harley: 6 Jon: 16 Elsayed: 9 Meagan: 4
68
Standards 27) Create an infographic to identify gross heart anatomy and physiology and related cardiac conduction and circulatory pathways. 28) Assess lead placements and correlate their relationship to the conduction system through the use of a diagram or model. 29) Analyze the P,Q,R,S,T complex and its correlation to the cardiac cycle. Chart a mock representation of these waves on an electrocardiogram. 30) Analyze rhythm strips and/or 12 lead EKGs and differentiate between critical and non-critical cardiac rhythms using student created algorithms.
69
Objective Identify arrhythmias Understand General Symptoms, Causes, Treatments
70
Main Symptoms of Arrhythmias
A fluttering in your chest A racing heartbeat (tachycardia) A slow heartbeat (bradycardia) Chest pain Shortness of breath Lightheadedness or dizziness Sweating Fainting (syncope) or near fainting
71
Main Causes of Arrhythmias
alcohol abuse diabetes drug abuse excessive coffee consumption heart disease like congestive heart failure hypertension (high blood pressure) hyperthyroidism (an overactive thyroid gland) mental stress scarring of the heart, often the result of a heart attack smoking some dietary supplements some herbal treatments some medications structural changes of the heart
72
Main Treatments Cardioversion Defibrillate
Both mean Shock! Cardioversion done more in a controlled environment. Patient have a pulse Antiarrhythmic Drugs (IV or PO)
73
Causes of Arrhythmias PAC and PVC: caffeine, alcohol, stress, fatigue or poor sleep. medication that lists irregular heartbeat as a side effects PVC: Antihistamines and decongestants Symptoms: Heart palpitations Treatment: Benign, no treatment usually needed.
74
Atrial Flutter Decreased blood flow to the heart (ischemia) due to coronary heart disease, atherosclerosis, or a blood clot. High blood pressure (hypertension) Disease of the heart muscle Treatment: Cardioversion, antiarrhythmic drugs.
75
Atrial Fibrillation General fatigue. Rapid and irregular heartbeat. Fluttering or “thumping” in the chest. Dizziness. Shortness of breath and anxiety. Weakness. Faintness or confusion. Treatment: Cardioversion (electrical current to heart) and antiarrhythmic drugs
76
Ventricular Fibrillation
Early signs: chest pain, dizzy, rapid heart beat, SOB, LOC Treat: CPR and defibrillation (delivery of an energy shock to the heart muscle to restore a normal rhythm) as soon as possible
77
Ventricular Tachycardia
Symptoms: dizziness, lightheadedness, palpitations or even loss of consciousness. Causes: Lack of oxygen to the heart due to tissue damage from heart disease Abnormal electrical pathways in the heart present at birth (congenital heart conditions, including long QT syndrome) Structural heart disease (cardiomyopathy) Medication side effects An inflammatory disease affecting skin or other tissues (sarcoidosis) Abuse of recreational drugs, such as cocaine Imbalance of electrolytes, mineral-related substances necessary for conducting electrical impulses Treatments: cardioversion (shock)
78
SVT A fluttering in your chest Rapid heartbeat (palpitations)
Shortness of breath Lightheadedness or dizziness Sweating A pounding sensation in the neck Fainting (syncope) or near fainting Treat: Vagal maneuvers, lay down, coughing
79
EKG Lab After Lunch – Meet in Media Center Lab
Choose Partners (2 per group)
80
Bell Work 3-2-18 What is happening during the P wave?
What is happening during the QRS? What is happening during the T wave? Why would a patient have a cardiac Arrhythmia? If a patient has a heart rate over 150 but her rhythm is regular. The patient is sweating, C/O palpitations and feels like might pass out? What rhythm might this be?
81
Work it out Finish EKG Lab on Phones (turn in box)
Start Cardiac Career Research Make chart in notebook. Can do on copy paper and paste in notebook. Use color to brighten up!
82
Career Duties Education Requirements Certification Licensures Cardiovascular Technologist Diagnostic Vascular Technologist Electrocardiogram Technician Telemetry Technician Cardiac Sonographers
Similar presentations
© 2025 SlidePlayer.com. Inc.
All rights reserved.