Med Testing-Guest Lectures
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Placement of 3-lead EKG is:
_____ over R and ____ over ____.
White over R and smoke (black) over fire (red)
____ _____: iatrogenic condition of the heart; P and T waves overlap; very quick
_____: can reset AV node and turns off conduction of heart for a few seconds to normalize.
____ ____: no defined P or T wave; QRS complex equal distances apart (shark teeth)
___ ____: non-equal QRS, no defined P or T's; can be faint, cool/clammy with palpitations
___ ____ ____: abnormal, random QRS complexes among normal complexes. Bad news if trigeminy or bigeminy of these occur. Precursor for ______ _____.
Premature Ventricular Complexes
____ ______: wide QRS complexes; may be alive and feel ok, but take BP and get to ER if found. If unconscious, complete CPR and use ____
- Ventricular Tachycardia
___ ____: very random electrical signal in heart; no CO and patient is most likely unconscious. AED and CPR must be used.
______: no signal of the heart at all! Check ____ and ____ before you signify death has occurred. Shocking the heart is not possible during this stage.
- leads and electrodes
Heart Block: ____ ____: far apart P's
Heart Blocks: ____ ____: multiple P's before QRS complex (further away)
Heart Blocks: ____ ____: random P's and QRS complexes; no CO-very serious
ST segment elevation indicates: _______
ST segment depression indicates: _______
________: takes over the activity of the SA node; creates _____ spike with no P wave
______: blood viscosity; Normal range: ___ - ____
Elevated troponin indicates heart muscle distress or _____.
_____: used for diabetes testing
Complete Blood Count (CBC):
- 3.6-11.2 K/cmm
or just know the ones for CMI...
BMP: _____ _____ _____
-includes sodium, potassium, chloride, CO2, Urea, Creatinine, Glucose and Calcium
basic metabolic panel
...know the values if you want...
Normal HgA1C: ____-____ %
>____% equals risk for vision loss, nerve damage, heart disease...
____ ____: marker for MI
-total value for markers less than ____ U/L
Negative Troponin levels: ____ - ____
Intermediate Troponin levels: ____ - _____
Positive Troponin levels: _____ - _____
- >/= .3ng/ml
HGB norms for male and female?
____: don't get up
____: don't exercise
Hematocrit for males and females?
____: don't exercise
____: light ex
____: add resistance
Typical goal for blood viscosity (_ _ _) post joint replacement is ___ -____.
Goal for post heart valve transplant: ___ -___
Generally, PT is deferred if _ _ _ is above ___.
NCV (___ ___ ____) use electrical stim up to ____ mA; objective study.
CMAP: ___ ____ ____ ___; combo of all muscular motor APs
- nerve conduction velocity
- Compound motor action potential
_______: invasive procedure and uses needle to penetrate skin to listen to conduction; subjective; does not use electrical stim
____ _____: nerve cell and all the muscle fibers innervated by that nerve cell.
What part of the nerve has the most tensile strength?
- Motor Unit
- perineurium (around fasciles)
______: decrease in chemical in axon, but still alive
_____: axon dies and ____ degeneration occurs
- axonotemesis; Wallerian
NCS performed at ___ to ____ days can help differentiate between ______ and ______.
If ____ occurs, EMG will become abnormal with ____ ____.
EMG/NCS should not be ordered until __-___ days after onset of symptoms for isolated acute ______ ("Saturday Night Palsy")
- 7-10 days
- neuropraxia and axonotomesis
axonotemesis; denervation potentials
____ _____: occurs when there is disconnect between the distal nerve endings and the muscle fibers; seen at rest.
Pathology can come from "sick" nerve (__) or "sick" muscle (___)
- Denervation potentials
- neuropathy, myopathy
EMG/NCS can be good for ruling out diagnosis in nonspecific ____/____ patients.
____ and _____ pain syndrome will not have EMG/NCS abnormalities.
- fibromyalgia/myofascial pain syndrome
Peak time for eval of radiculopathy is _____ weeks after onset of symptoms.
_____/____ are not contraindicated for NCV
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