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telemetry med surg exam 3 questions and answers A+ score assured 2024/2025
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telemetry med surg exam 3 questions and answers A+ score assured 2024/2025
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telemetrymed
surg
exam
3
sinus
node
The
intrinsic
pacemaker.
Cell
membrane
"leakiness"
causes
spontaneous
depolarization
at
a
rate
of
60-100
times
a
minute.
AV
node
Acts
like
a
resistor
to
slow
the
impulse
allowing
time
for
the
atria
to
completely
contract
before
initiating
ventricular
contraction.
Back
up
pacemaker
if
SA
fails,
pacing
at
a
rate
of
40-60
times
a
minute.
Previous
Play
Next
Rewind
10
seconds
Move
forward
10
seconds
Unmute
0:03
/
0:15
Full
screen
Brainpower
Read
More
Bundle
of
his
"Cable"
that
passes
through
the
fibrous
sheath
separating
atria
from
ventricles.
Divides
into
the
bundle
branches.
Bundle
branches
"Wires"
that
run
down
the
septum
and
into
the
ventricles.
There
are
two
left
bundle
branches
and
one
right.
Purkinje
Terminal
fibers
branches
from
the
bundles,
distributing
the
impulse
throughout
the
ventricles.
Intranodal
pathways "Wiring"
that
allows
rapid
impulse
movement
around
the
atria
to
coordinate
simultaneous
atria
contraction
Impulse
vectors
SA
node
Atria
AV
node
The
depolarization
wave
in
the
ventricles
also
travel
in
specific
directions
forming
vectors.
Because
the
left
ventricle
has
a
bigger
muscle
mass,
the
wave
of
depolarization
(starts
in
mid
septum)
is
greater
than
the
right
and
is
represented
as
a
bigger
vector.
which
ventricle
has
bigger
muscle
mass
left
ventricle
degree
of
perpendicular
If
the
current
is
running
at
an
angle
to
the
field,
the
angulation
is
seen
as
so
much
positive
and
so
much
negative
depending
on
how
parallel
and
perpendicular
the
current
vector
is
to
the
field.
The
degree
of
perpendicular
can
also
be
seen
as
a
decrease
in
amplitude
only.
leads
PQRST
P
wave
ATRIAL
DEPOLARIZATION
Normal:
small,
round,
positive
in
lead
II
amplitude
0.5-2.5
mm,
0.10
seconds
or
less
p
wave
amplitude
and
time
0.5-2.5
mm
0.10
s abnormally
shaped
P
wave
indicates
damaged
atria
(enlarged
makes
p
wave
look
like
an
"m")
or
an
impulse
origin
outside
of
the
SA
node
(ectopic)
notching
in
P
wave
indicates
atrial
enlargement
(p
mitrale)
PR
interval
normal
length
0.12-.20s
PR
interval
Start:
beginning
of
P
End:
beginning
of
QRS
atrial
depolarization
and
pause
before
QRS
(AV
node
delay)
current
traveling
quickly
down
the
His
and
purkinjes
shortened
PRI
bypass
pathway
or
the
impulse
origin
was
ectopic
and
close
to
the
AV
node
long
PRI
delays
at
the
AV
or
His
QRS
complex
normal
length
and
characteristics
0.06-0.12
s
BEGIN:
first
deflection
END:
flattening
before
the
t
(j
point)
The
"classic"
QRS
complex
is
composed
of
three
distinct
waves:
Q
wave-the
negative
deflection
following
the
PRI.
R
wave-tall
positively
deflected
wave
in
lead
II.
S
wave-negative
deflection
following
the
R
wave.
abnormal
QRS
wide,
longer
than
0.12
s
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