Term
| Ischemia is a _____ blood supply to an area of tissue, resulting in tissue _____ |
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Definition
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Term
| Injury is a degree of tissue ______ that is severe enough to cause ______ to cells. Cells may/may not survive is perfusion is rapidly achieved. |
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Definition
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Term
| Infarction is a degree of tissue ______ severe enough to cause reversible/irreversible ______ to cells. Reperfusion is/is not beneficial in this case. |
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Definition
| hypoxia, irreversible, damage, is not |
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Term
| An MI is a _______ or ______ development within the _____ as a result of minimal/severe deprivation of blood supply. |
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Definition
| gangrenous, necrotic, myocardium, severe |
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Term
| The evolution of an infarction is a result of 3 stages. Stage I is ______, Stage II is ______ and Stage III is ______ |
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Definition
| Injury, Infarction, Resolution |
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Term
| _____ manifests within minutes to hours after the onset of ischemia and will persist until the cells either ____ or are ______. |
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Definition
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Term
| Manifestations of myocardial death occur within ___ to ____ hours. Infarcted cells turn into ______ tissue and are/are not excitable. |
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Definition
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Term
| Necrotic tissue acts as a ____ conductor of action potentials generated from the viable ______ wall of the heart. |
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Definition
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Term
| In an anterior infarction noted in ____ and ____ leads, the main vector will shift and point towards the _____ wall of the heart. |
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Definition
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Term
| Stage III is AKA ______ and occurs over ____ to ____ as the damaged tissue is replaced by _____ tissue. |
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Definition
| Resolution, weeks, months, scar |
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Term
| In general, a pt may have a ____ hour time frame to reperfuse before necrosis sets in. |
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Definition
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Term
| The "classic triad" of a transmural MI is:_____, ______ and ______. |
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Definition
| ST elevation, pathological Q waves and T wave inversion |
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Term
| What is the only immediate indicator of occlusion? |
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Definition
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Term
| T/F you need all 3 indicators in the triad to have an MI. |
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Definition
| False, may or may not have Q waves, ST elevation or T wave changes. |
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Term
| ST elevation signifies injury to tissue (significant hypoxia), and is most common during ____ and ____ of anesthesia. |
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Definition
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Term
| ST elevation signifies a change in depolarization/repolarization. |
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Definition
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Term
| Pathological Q waves occur ____ to ____ after an infarction or may never occur. These types of Q waves signify a change in depolarization/repolarization. |
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Definition
| hours, days, depolarization |
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Term
| T wave inversion signifies a change in depolarization/repolarization and occurs _____ to ____ hours after an infarction. In other words, T wave changes occur early/late in the infarction process. |
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Definition
| depolarization, 6-24, late |
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Term
| Anterior MI: The _____ coronary artery supplies this region. |
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Definition
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Term
| Indicative leads in an anterior MI |
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Definition
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Term
| Reciprocal leads for ant MI |
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Definition
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Term
| Coronary artery blockage corresponding to an inferior MI |
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Definition
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Term
| Indicative leads for an inferior MI |
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Definition
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Term
| Reciprocal leads for an inferior MI |
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Definition
| anterior (V1-V4), Lateral (V5-V6) |
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Term
| Coronary artery blockage corresponding to a lateral MI. |
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Definition
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Term
| Indicative leads for a lateral MI |
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Definition
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Term
| Reciprocal leads for a lateral MI. |
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Definition
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Term
| Coronary artery blockage corresponding to a posterior MI |
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Definition
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Term
| Indicative leads for a posterior MI |
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Definition
| V1 and V2 have tall R waves and depressed ST segment. We do not have direct indicative leads for a posterior MI, so we look for reciprocal changes. |
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Term
| Reciprocal leads for a posterior MI |
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Definition
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Term
| ST elevation denotes myocardial ______. |
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Definition
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Term
| Pathological Q waves denote myocardial _______ |
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Definition
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Term
| T wave inversion denotes myocardial _______ |
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Definition
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Term
| T/F some people normally have some ST elevation. |
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Definition
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Term
| T/F It is common to have small Q waves in the inferior (II, III, aVF) and lateral (I, aVL, V5-V6) leads. |
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Definition
| True, but note, they are small Q waves, not pathological. |
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Term
| Pathological Q waves are ___ in duration and are ____ the height of the R wave |
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Definition
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Term
| T waves invert as the ST segment begins to ______, and occurs early/later in the MI process. |
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Definition
| return to baseline, later |
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Term
| T/F with an inferior MI, it is appropriate to look at the precordial leads as indicative leads. |
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Definition
| False, with an inferior MI, you will see indicative changes in II, III, and aVF |
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Term
| A lateral infarction corresponds to the _____ coronary artery. |
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Definition
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Term
| A septal infarction corresponds to a blockage in the _____ coronary artery and is indicated in _____ and _____ leads. |
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Definition
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Term
| With an inferior MI, you will probably see pathological Q waves in the inferior leads because the vectors are moving toward/away the area of infarction. |
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Definition
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Term
| Electrical impulses do/do not flow through the area of injury. |
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Definition
| Do. This denotes the ST changes. |
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Term
| With a transmural MI, there is more damage to the epicardial/endocardial surface. |
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Definition
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Term
| T/F you will see Q waves over leads other than the areas of infarction. |
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Definition
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Term
| The following four conditions may also have associated ST elevation, related to CAD: Recent_____, Old _____ (aneurism), chronic ________, and _______ angina. These may all induce a sub-epicardial/endocardial MI. |
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Definition
| MI, MI, coronary insufficiency, Prinzmetal's, subendocardial |
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Term
| The following 8 conditions can lead to ST elevation that is not related to CAD: ____carditis, ______carditis, metabolic _______, intoxication, infectious diseases, endocrine D/O, acute ventricular overload AKA _________, _______ heart disease. These can all lead to a sub-epicardial/endocardial MI. |
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Definition
| myo, peri, abnormalities, pulmonary embolism, congenital, subepicardial |
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Term
| T/F The current of injury tends to resolve over time. |
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Definition
| T. The ST segment normally returns to baseline. |
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Term
| A good/poor prognosis is associated with 2nd and 3rd degree HB s/p Ant MI. |
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Definition
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Term
| Usually, like to see changes in _____ contiguous leads to denote infarction. |
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Definition
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Term
| An inferior MI is caused by occlusion of the ______, and can cause RV/LV infarction, as well as R/L axis deviation. Complications include heart blocks and brady/tachyarryhthmias. |
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Definition
| RCA, RV, Left axis deviation, brady. The AVN is supplied by the RCA. |
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Term
| If you see an EKG with a pathological Q wave and T wave inversion, how old is it? |
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Definition
| Unable to determine...long enough for the ST segment to try to correct itself, but it may take hours to days. |
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Term
| An anterior MI is caused by occlusion of the _____. It includes possible damage to the ____ and ____ resulting in _____ problems. |
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Definition
| LAD, septum, bundle branches, conduction |
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Term
| A lateral MI is caused by occlusion of the _____. There is a possible R/L axis deviation associated with this condition. |
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Definition
| Left circumflex, right axis deviation. The left side is no longer conducting impulses, so these impulses are shifted to the right. |
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Term
| A posterior MI can be caused by occlusion of either _____ or _____ and is associated with reciprocal changes in ____ and ____. |
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Definition
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Term
| What does an acute posterior MI look like? |
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Definition
| ST depression in V1 and V2, tall R wave in V1-V2 or possibly V3. |
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Term
| What does an old posterior MI look like? |
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Definition
| Tall R waves in V1-V2, without ST changes |
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