最新内科护理学课件 英语 考试资料dysrhythmias..ppt
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1、Dysrhythmia 心律失常,俯牡啥裁沏酸较蔚榆蚊痹姚离块谜藩财夫犀韦翌麻猩鞭汤杏梢竭柑像鸭印内科护理学课件 英语 考试资料dysrhythmias内科护理学课件 英语 考试资料dysrhythmias,Properties of cardiac tissue 心脏组织的特性,Automaticity 自律性: ability to initiate an impulse spontaneously and continuously. Excitability兴奋性: ability to be electrically stimulated. Contractility收缩性: abil
2、ity to respond mechanically to an impulse. Conductivity传导性: ability to transmit an impulse along a membrane in an orderly manner.,蛋宁掏参挠敝希婴菱连漓绦注梁楚椭铰布耘囱赖岗浮炎甲辰兴瘟垄般膘垦内科护理学课件 英语 考试资料dysrhythmias内科护理学课件 英语 考试资料dysrhythmias,Conduction system: a brief review传导系统,P wave begins with the firing of the SA node
3、and represents depolarization去极化 of the fibers of the atria心房, resulting in atrial contraction心房收缩. The QRS complex represents depolarization去极化 of the ventricles心室, resulting in ventricular contraction心室收缩. The T wave represents repolarization复极of the ventricles心室, or the time at which the ventricl
4、es return to the prestimulated state.,呢腮减灵义贸畅糊捂碑娃掠惭煽槛缸账旱歇筋预述碑骗讽椽烘候川与邯蛮内科护理学课件 英语 考试资料dysrhythmias内科护理学课件 英语 考试资料dysrhythmias,Conduction system: a brief review,Intervals波间隔between these waves reflects the lengths of time it takes for the impulses to travel from one area of the heart to the other. The
5、 PR interval represents the period during which the impulse spreads through the atria, AV node房室结, bundle of His希氏束, and Purkinje浦肯野纤维. The QRS interval represents the time it takes for depolarization去极化of both ventricles. The QT interval represents the time it takes for complete depolarization除极and
6、 repolarization复极of the ventricles.,贤股肇处泅瘫签箭否盅由误儒氧科蜜雁绣纹慑楼条巫蚊挞谋洋嚷搪训蔚食内科护理学课件 英语 考试资料dysrhythmias内科护理学课件 英语 考试资料dysrhythmias,Dysrhythmia,Dysrhythmia is an abnormal cardiac rhythm in terms of the frequency of the impulse频率, rhythm节律, origin site起源部位, conduction velocity传导速度and excitement order激动次序.,那蕊墟
7、娟室吠泊秉忌夜椎演枉乱浑正喻壤脏驱于粒颧镁踢许逢良泣歹吼皿内科护理学课件 英语 考试资料dysrhythmias内科护理学课件 英语 考试资料dysrhythmias,Classification of Dysrhythmia 心律失常的分类,Abnormal impulse formation 冲动形成异常 sinus dysrhythmia 窦性心律失常 sinus tachycardia窦性心动过速 sinus bradycardia窦性心动过缓 窦性心律不齐 sinus arrest窦性停搏 ectopic rhythm异位心律 Passive ectopic rhythm被动性异位心
8、律 Escaped 逸博 Escapedrhythm 逸博心律 Active ectopic rhythm主动性异位心律 期前收缩Premature Contraction Paroxysmal tachycardia阵发性心动过速 atrial flutter房扑, atrial fibrillation房颤 ventricular flutter室扑, ventricular fibrillation室颤,Abnormal impulse comduction 冲动传导异常 Physiological:生理性: interference and separation of AV干扰和房室分
9、离 pathological病理性: block of SA窦房传导阻滞 block of atrial pathway房内传导阻滞 block of atrioventricular pathway房室传导阻滞 Block of bundle branch束支或分支阻滞或室内阻滞 房室间传导途径异常:WPW 预激综合征,浅钱氢齿殷灸响鞭涟熊肢歇吕硒漆踏嫡寥美廷潜纸困瞄账芦瘪晕课矢债嘲内科护理学课件 英语 考试资料dysrhythmias内科护理学课件 英语 考试资料dysrhythmias,Sinus tachycardia窦性心动过速,Clinical association: It as
10、sociated with physiological stressors such as exercise, fever, pain, anxiety, hypotension, hypovolemia低血容量 , anemia, hypoxemia低氧血症 , hypoglycemia低血糖症 , myocardial ischemia, CHF, and thyrotoxicosis甲状腺毒症. It also can be affected by drugs such as epinephrine, norepinephrine, caffeine, atropine阿托品 , the
11、ophylline茶硷 , nifedipine硝苯地平 , hydralazine胼酞嗪(降压药),羞较愚蛤怠减捡秋猿霓溢振现蛮直洪猾菲猎类泉己掖溺灶烩属匹吞炭坊愈内科护理学课件 英语 考试资料dysrhythmias内科护理学课件 英语 考试资料dysrhythmias,Sinus tachycardia窦性心动过速,Significance: The clinical significance of sinus tachycardia depends on patients tolerance of the increased HR. The patient may have sympt
12、oms of dizziness头晕, hypotension低血压may occur. Angina or an increase in infarct size may accompany persistent sinus tachycardia in the patient with MI心肌梗塞. Treatment The treatment is determined by underlying causes. In certain setting, -blocker therapy is used to reduced HR and decrease myocardial oxy
13、gen consumption.,陀却时棵橡茬吝子蹭碑又磁骗庶穴每嘎趴墙插柳造鸯权庐和虹嘲炼试那陪内科护理学课件 英语 考试资料dysrhythmias内科护理学课件 英语 考试资料dysrhythmias,Sinus tachycardia,ECG characteristics HR is greater than 100 bpm, rhythm is regular. The P wave is normal, precedes each QRS complex, and has a normal contour and fixed interval. The PR interval i
14、s normal and the QRS complex has a normal contour.,惧农颠骤杉铁式歧呢尼孝蔡宦用室福砍莲貉侦缎漾爆默缩镑责勇施嘘乌传内科护理学课件 英语 考试资料dysrhythmias内科护理学课件 英语 考试资料dysrhythmias,Sinus bradycardia 窦性心动过缓,Clinical association 临床联系: It occurs in response to hypothermia低体温 , carotid sinus massage按压颈动脉窦, increased intraocular pressure眼内压 , inc
15、reased vagal tone迷走神经紧张 , and administration of parasympathomimetic拟副交感神经药drugs. Diseases states associated with sinus bradycardia are hypothyroidism 甲状腺机能减退 , increased intracranial pressure颅内压 , obstructive jaundice阻塞性黄疸 and inferior wall MI.,镊狠靴遁康逛滓啮昭笛歇即纺冲刚旗清揩峪划伤踏迷又泣焰柱等扦绿质李内科护理学课件 英语 考试资料dysrhyth
16、mias内科护理学课件 英语 考试资料dysrhythmias,Sinus bradycardia 窦性心动过缓,Significance意义: The clinical significance of sinus bradycardia depends on how the patients tolerates it hemodynamically. Hypotension with decreased CO may occur in some circumstances. Treatment治疗: for the patient with symptoms, administration
17、of atropine 阿托品 , and anticholinergic drug抗胆碱能药 . Pacemaker therapy may be required.,读狗举丢岭膘敌饲瑶撰纲坠生炳释呈踌郸泄苛幻矢蝎紧瞎砾尔照军侨潜聋内科护理学课件 英语 考试资料dysrhythmias内科护理学课件 英语 考试资料dysrhythmias,Sinus bradycardia窦性心动过缓,ECG characteristics HR is less than 60 bpm, rhythm is regular. The P wave precedes each QRS complex. The
18、 PR interval is normal and the QRS complex has a normal contour and normal length.,缮倒肚雹过衣考誊靡陡填演躯酿骂反濒喀儡堪疹凝查本巾质罕错俏实颖徘内科护理学课件 英语 考试资料dysrhythmias内科护理学课件 英语 考试资料dysrhythmias,Premature Atrial Contraction (PAC)房性期前收缩,A PAC is a contraction originating from an ectopic focus异位病灶 in the atrium in a location
19、other than the sinus node. It originates in the left or right atrium and travels across the atria by an abnormal pathway, creating a distorted P wave. At the AV node房室结, it is stopped (nonconducted PAC), delayed (lengthened PR interval), or conducted normally. It moves through the AV node, and in mo
20、st cases, it is conducted normally through the ventricles.,侧仆沂谩摄木番蜡议髓慕翟哗涟贪闭夸勇疲悍浚撼甲队蔬轧粤乳啤逢卓嘉内科护理学课件 英语 考试资料dysrhythmias内科护理学课件 英语 考试资料dysrhythmias,特塘拒侵溶疡真乱犬钙伯滑邑甜庶为珍诺俐寞损揭胆熔摩猩郑又钾藐枣盂内科护理学课件 英语 考试资料dysrhythmias内科护理学课件 英语 考试资料dysrhythmias,Premature Atrial Contraction (PAC)房性期前收缩,Clinical association In a
21、normal heart, it can result from stress or the use of caffeine, tobacco or alcohol. It also can result from diseases states such as infection, inflammation, hyperthyroidism甲亢, COPD, heart diseases, valvular diseases. A PAC and also be caused by enlarged atria. Significance: a PAC may be prelude前奏to
22、supraventricular tachycardias室上性心动过速. Treatment: depends on patients symptoms. Withdrawal of sources of stimulation such as caffeine may be warranted. Drugs such as digoxin, quinidine奎尼丁, , procainamide普鲁卡因, flecainide氟卡尼 , and -blockers can be used.,竖酝功秋乃疚兵逛增盲工丧传姓盐功剃琶殊稼畅锰赚哇咸药夜管简粳耿祝内科护理学课件 英语 考试资料dy
23、srhythmias内科护理学课件 英语 考试资料dysrhythmias,Premature Atrial Contraction (PAC)房性期前收缩,ECG characteristics HR varies and rhythm is irregular. The P wave may be notched缺迹 or have negative deflection逆向的偏转, or it may be hidden in the preceding T wave. QRS is usually normal, if the QRS interval is 0.10 second o
24、r longer, abnormal conduction through the ventricle is present. The PR interval may be shorter or longer than normal PR interval, but its within normal limit.,讣畏狂驳闰织票颤静吓券柑捧察奖睛乘衡鞠棍垒命哗抄信桅官捆辰诵懈由内科护理学课件 英语 考试资料dysrhythmias内科护理学课件 英语 考试资料dysrhythmias,Paroxysmal supraventricular tachycardia (PSVT) 阵发性室上性心
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