Transcript Electrocardiography abd Pulmonary Function Testing

PowerPoint® to accompany
Medical Assisting
Chapter52
Second Edition
Ramutkowski  Booth  Pugh  Thompson  Whicker
Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.
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Electrocardiography and
Pulmonary Function Testing
Objectives
52-1 Describe the anatomy and physiology of the
heart.
52-2 Explain the conduction system of the heart.
52-3 Describe the basic patterns of an
electrocardiogram (ECG.)
52-4 Identify the components of an
electrocardiograph and what each does.
52-5 Explain how to position the limb and precordial
electrodes correctly.
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Electrocardiography and
Pulmonary Function Testing
Objectives (cont.)
52-6 Describe in detail how to obtain an ECG.
52-7 Identify the various types of artifacts and
potential equipment problems and how to
correct them.
52-8 Discuss how the ECG is interpreted.
52-9 Define exercise electrocardiography.
52-10 Explain the procedure of Holter monitoring.
52-11 Describe the anatomy and physiology of the
lung.
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Electrocardiography and
Pulmonary Function Testing
Objectives (cont.)
52-12 Describe various types of spirometers.
52-13 Describe the procedures of performing
spirometry.
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Introduction
 It is not uncommon
for patient to have
cardiovascular or
respiratory
problems.
 You may be responsible
for performing,
screening, and/or
diagnostic testing in the
physician’s office.
You will learn how to correctly perform testing on
the cardiac and respiratory systems.
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Electrocardiography and
Pulmonary Function Testing
Your role will be to
perform:


Electrocardiography –
graphic recordings of the
electrical impulses of the
heart
Pulmonary function tests –
measure and evaluate a
patient’s lung capacity and
volume
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Anatomy of the Heart
 Muscular pump that
circulates blood
throughout the body
 Carries oxygen and
nutrients to tissues
and removes waste
products
 Pumping action begins
in the muscle tissue of
the heart
(myocardium)
 Double pump
 Right side
 Left side
A description of the anatomy and physiology of the heart
will help you better understand electrocardiography.
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Anatomy of the Heart


Right side receives blood
from the body and pumps
blood to the lungs where
carbon dioxide is exchanged
for oxygen.
Oxygenated blood flows
into the left side of the heart
and is pumped into the aorta
and to all parts of the body.
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Heart Valves and Vessels
Tricuspid Valve
Aorta
Bicuspid Valve
Vena Cava
Aortic Valve
Pulmonary Artery
Pulmonary Valve
Pulmonary Veins
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Using the on-screen pen draw a line from the label to its location.
Physiology of the Heart




Two pumps – divided into separate chambers
that work as a single unit.
Contraction of the atria (systole) followed by
the contraction of the ventricles moves the
blood.
Diastole – follows systole by a relaxation
phase.
The sequence of systole and diastole is a
complete heartbeat (cardiac cycle) and lasts
about 0.8 second.
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Conduction System
of the Heart


Cardiac cycle is
controlled by
specialized tissues in
the heart wall that
transmit electrical
impulses.
These impulses cause
the heart to contract.




Sinoatrial (SA) node
pacemaker of the
heart – right atrium.
Atrioventricular
(AV) node – bottom
of right atrium.
Bundle of His
Purkinje fibers
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Conduction System
Bundle of His
SA Node
Bundle
Branches
AV Node
Purkinje
Fibers
Using the on-screen pen draw a line from the label to its location.
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Conduction and
Electrocardiography


Transmission,
magnitude, and
duration of the
various electrical
impulses of the heart
Electrocardiograph –
machine that
measures and
displays impulses of
the heart
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Basic Pattern of the
Electrocardiogram
 Peaks and valleys called waves are labeled P,
Q,R,S,T,U. Each letter represents part of the
pattern.
Basic Pattern of ECG
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Types of Electrocardiographs
 Standard
machine – 12 lead
that records 12
different views at
once
 Single channel –
one lead and
records only one
view
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Lead Placement
 Limb leads – six leads, three are
standard, three are augmented leads
 Bipolar leads monitor two limbs
 Augmented leads monitor one limb and
a point midway between two other
limbs (unipolor)
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Lead Placement
 Precordial
leads – six
leads
(unipolar)
 Placed across
the chest
Precordial Leads
Placement
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Obtaining an ECG
Prepare the room and equipment




Quiet, protected from interruptions
All other electrical equipments off
Sturdy and comfortable exam table
Ensure equipment is working properly
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Obtaining an ECG (cont.)
Preparing the patient




Introduce yourself
Explain the procedure
Answer any questions
Complete ECG
procedure accurately
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Troubleshooting


You must recognize artifacts and identify sources of
interferences.
Caused by improper techniques, poor conduction,
outside interference, or improper handling.
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Troubleshooting (cont.)



Wandering baselinecauses somatic
interference or
mechanical problem
Flat line – loose or
disconnected wire
Extraneous marks –
careless handling
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Interpreting the ECG
You will not be responsible for interpreting an ECG
Sometimes knowing how they are interpreted will allow
you to recognize a problem that requires immediate
attention.




Heart rhythm
Heart rate
Intervals and segments
Wave changes
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Exercise Electrocardiography
 Stress tests - assesses the heart’s conduction
system during exercise when the demand for
oxygen increases.
 Measures the patient’s
responses to workload.
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Holter Monitoring
 Electrocardiography device that includes a
small cassette recorder worn around a
patient’s waist or shoulder strap to record the
heart’s electrical activity.
 Patient is to do normal daily activities and
keep a written log of activities and of stress
or symptoms experienced.
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Apply Your Knowledge
Where is the atrioventricular node
located?
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Apply Your Knowledge -Answer
Where is the atrioventricular node
located?
The atrioventricular (AV) node is located at the
bottom of right atrium
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Anatomy of the Respiratory
System
 Composed of nose, pharynx, larynx, trachea,
two bronchi, and the lungs
 The alveoli is where exchange of gases
between the air and the blood (external
respiration) occurs
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Physiology of the Respiratory
System
External respiration :
 Ventilation – movement of air in and out of
the lungs
Diffusion:
 Passive process wherein oxygen and carbon
dioxide cross the capillary and alveolar
membranes and enters the capillaries or
alveoli
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Physiology of the Respiratory
System (cont.)
Perfusion (internal respiratory) –
 Exchange of oxygen in the blood for carbon
dioxide in the cells of the body tissue and
organs
Perfusion, diffusion, and ventilation occur
simultaneously
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Pulmonary Function Testing
Evaluates lung volume
and capacity.
Used to evaluate
shortness of breath.
Help detect and classify
pulmonary disorders.
 Asthma
 Cystic fibrosis
 COPD
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Spirometry
Spirometer – Measures air taken in
by and expelled by the lungs.
Forced vital capacity (FVC) –
greatest volume of air that can be
expelled when a person performs
rapid, forced expiration.
Types of spirometers:
 Computerized
 Mechanical
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Performing Spirometry
Patient preparation:




Inform the patient about conditions that
could affect the test accuracy.
Explain that he/she will wear a nose clip.
Be sure patient forms a tight seal around the
mouthpiece with his/her lips.
Position the patient – chin slightly elevated
and neck slightly extended.
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Performing Spirometry (cont.)
Performing the maneuver:




Urge patient to blow hard and to continue
blowing until you tell them to stop.
Obtain three acceptable maneuvers.
Observe the patient for signs of breathing
difficulty.
Notify physician immediately if symptoms
occur.
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Apply Your Knowledge
What does FVC abbreviate?
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Apply Your Knowledge -Answer
What does FVC abbreviate?
Forced vital capacity (FVC) – greatest volume of
air that can be expelled when a person
performs rapid, forced expiration.
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Summary
Medical Assistant
Electrocardiography and pulmonary function
testing play a vital role in diagnosis and treatment of
cardiac and pulmonary disease.
You need to know the basics of the conduction
system of the heart, components of the ECG, and the
correct techniques to get a spirometry reading.
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End of Chapter
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