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Samenvatting Hartritmes en ECG-leer toets 3 BAZ
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Samenvatting van Hartritmes en ECG-leer 3e toets BAZ.
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Hartritmes en ECG-leerInhoudsopgave
Hartritmes en ECG-leer ..................................................................................................................................................... 1
ECG-leer ........................................................................................................................................................................ 4
Afleidingen: ............................................................................................................................................................... 4
Aflezen ECG-blad ........................................................................................................................................................... 4
Elektrodes ................................................................................................................................................................. 4
Borstafleidingen ........................................................................................................................................................ 4
Onderwand ............................................................................................................................................................... 5
Lateraal...................................................................................................................................................................... 5
Septum ...................................................................................................................................................................... 5
Voorwand .................................................................................................................................................................. 5
Deflecties....................................................................................................................................................................... 6
P-top .......................................................................................................................................................................... 6
Pta-segment .............................................................................................................................................................. 6
Q/Q-golf .................................................................................................................................................................... 6
R/R-top ...................................................................................................................................................................... 6
S/S-top....................................................................................................................................................................... 6
R accent (R`) .............................................................................................................................................................. 6
S accent (S`) ............................................................................................................................................................... 6
ST-segment ................................................................................................................................................................ 6
Junction/ J-punt ........................................................................................................................................................ 6
T-top .......................................................................................................................................................................... 7
U-golf......................................................................................................................................................................... 7
Basisritme...................................................................................................................................................................... 8
Sinusritme ................................................................................................................................................................. 8
Ectopie........................................................................................................................................................................... 9
Premature extrasystole ................................................................................................................................................. 9
Prematuur atriaal complex (PAC) .............................................................................................................................. 9
Prematuur junction complex (PJC) ............................................................................................................................ 9
Prematuur ventriculair complex (PVC) ...................................................................................................................... 9
Re-entry....................................................................................................................................................................... 10
AV-nodale re-entrytachycardie (AVNRT) ................................................................................................................. 10
SA-blok ........................................................................................................................................................................ 11
Sinusarrest................................................................................................................................................................... 11
Atriaal ritme ................................................................................................................................................................ 12
Atriaal tachycardie ...................................................................................................................................................... 12
,Supraventriculaire tachycardie (SVT) .......................................................................................................................... 12
Atriumfibrilleren.......................................................................................................................................................... 13
Behandeling ............................................................................................................................................................ 13
Atriumflutter ............................................................................................................................................................... 13
Junction ritmes............................................................................................................................................................ 15
Junction ritme ......................................................................................................................................................... 15
Geaccelereerd junction ritme ................................................................................................................................. 15
Junction tachycardie................................................................................................................................................ 15
AV-nodale re-entry tachycardie (AVNRT) ................................................................................................................ 15
Ventriculaire ritmes..................................................................................................................................................... 16
Idioventriculair ritme .............................................................................................................................................. 16
Accelerated idioventriculair ritme (AIVR) ............................................................................................................... 16
Ventrikeltachycardie (VT) ........................................................................................................................................ 16
Torsade de Pointes .................................................................................................................................................. 17
Ventrikel fibrilleren (VF) .......................................................................................................................................... 17
AV-blokken .................................................................................................................................................................. 18
1e graads AV-blok .................................................................................................................................................... 18
2e graads AV-blok type 1 Wenckebach .................................................................................................................... 18
2e graads AV-blok type 2 Mobitz ............................................................................................................................. 18
3e graads AV-blok .................................................................................................................................................... 18
3 mogelijke optisch voor het escape ritme: ............................................................................................................ 19
Pacemakers ................................................................................................................................................................. 20
AAI ........................................................................................................................................................................... 20
VVI ........................................................................................................................................................................... 20
DDD ......................................................................................................................................................................... 20
ICD ........................................................................................................................................................................... 21
Hartas .......................................................................................................................................................................... 22
Intermediaire hartas ............................................................................................................................................... 22
Linker hartas ............................................................................................................................................................ 22
Rechter hartas ......................................................................................................................................................... 22
Extreme hartas ........................................................................................................................................................ 22
Bepalen hartas ........................................................................................................................................................ 22
Ischemie en infarct ...................................................................................................................................................... 24
Ischemie .................................................................................................................................................................. 24
Infarct ...................................................................................................................................................................... 24
Infarctlokalisatie .......................................................................................................................................................... 26
Stroming op het ECG ............................................................................................................................................... 26
Waar kijk je naar?.................................................................................................................................................... 26
Bundeltakblok en hemiblok ........................................................................................................................................ 29
, Linker bundeltakblok ............................................................................................................................................... 29
Rechter bundeltakblok ............................................................................................................................................ 30
Hypertrofie .................................................................................................................................................................. 31
LVH = linkerventrikelhypertrofie ............................................................................................................................. 31
RVH = rechterventrikelhypertrofie .......................................................................................................................... 32
Pericarditis................................................................................................................................................................... 33
ECG kenmerken ....................................................................................................................................................... 33
Stadia....................................................................................................................................................................... 34
, ECG-leer
Ecg is een weergaven van de elektrische geleiding in het hart.
Er lopen elektrische geledingsbanen voor de geleiding
maar ook spieren kunnen geleiden, dit gaat dan wel langzamer.
Elektrische stroom → Verplaatsing van positieve lading.
Met de ECG meten we de potentiaal van de elektrische activiteit. (= spanning tussen de + en de - pol).
Afleidingen:
Je kijkt vanuit verschillende kanten naar het hart.
Je spreekt over het frontale en horizontale vlak.
- Frontale vlak = extremiteiten afleidingen.
- Horizontale vlak = precoridale afleidingen/
borstafleidingen.
Afleiding 1
Kijkrichting zie je al 0 ⁰C
Afleiding 2
Kijkrichting zie je al 60 ⁰C
Afleiding 3
Kijkrichting zie je al 120 ⁰C
Door 2 ledenmaten als 1
pool te zien en de derde als
de andere pool zijn er nog
3 afleidingen.
De 2 samengevoegde ledenmaten vormen de minpol en de derde de pluspool.
- a = augmented (versterkt)
- V = Vector (richting van de spanning, mooi
woord voor geleiding).
- F/R/L = plaats van de pluspool
Driehoek van Einthoven
Aflezen ECG-blad
Elektrodes
- Rood = re-arm
- Geel = li-arm
- Groen = li-been
- Zwart = re-been = referentie -elektrode, voegt niks toe aan het ECG.
Borstafleidingen
- V1 (rood): 4e intercostale ruimte rechts naast het borstbeen.
- V2 (geel): 4e intercostale ruimte links naast het borstbeen.
- V3 (groen): precies tussen V2 en V4.
- V4 (bruin): 5e intercostale ruimte mid claviculair.
- V5 (zwart): tussen V4 en V6
- V6 (paars): 5e intercostale ruimte mid axillair.
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