Basic EKG and Rhythm Interpretation Symposia - The CRUDEM FoundationThe CRUDEM Foundation
Basic EKG and Rhythm Interpretation Symposia presented in Milot, Haiti at Hôpital Sacré Coeur.
CRUDEM’s Education Committee (a subcommittee of the Board of Directors) sponsors one-week medical symposia on specific medical topics, i.e. diabetes, infectious disease. The classes are held at Hôpital Sacré Coeur and doctors and nurses come from all over Haiti to attend.
Basic EKG and Rhythm Interpretation Symposia - The CRUDEM FoundationThe CRUDEM Foundation
Basic EKG and Rhythm Interpretation Symposia presented in Milot, Haiti at Hôpital Sacré Coeur.
CRUDEM’s Education Committee (a subcommittee of the Board of Directors) sponsors one-week medical symposia on specific medical topics, i.e. diabetes, infectious disease. The classes are held at Hôpital Sacré Coeur and doctors and nurses come from all over Haiti to attend.
An electrocardiogram (ECG or EKG) records the electrical signal from your heart to check for different heart conditions. Electrodes are placed on your chest to record your heart's electrical signals, which cause your heart to beat. The signals are shown as waves on an attached computer monitor or printer
Medical records means and includes the record pertaining to the admission, diagnosis, treatment, investigation, daily progress, operations, consultations
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
2. ORIENTATION OF
THE 12-LEAD ECG
Types of Leads
1.Bipolar limb
leads
2.Augmented limb
leads
3.“Unipolar” (+)
chest leads
3. 1. Bipolar limb leads (frontal
plane)
(RA = right arm; LA = left arm, LL = left
leg)
- Lead I: RA (- pole) to LA (+ pole) (Right -to- Left
direction)
-Lead II: RA (-) to LL (+) (mostly Superior -to- Inferior
direction)
-Lead III: LA (-) to LL (+) (mostly Superior -to-
Inferior
direction)
4. 1. Bipolar limb leads (frontal
plane)
(RA = right arm; LA = left arm, LL = left
leg)
5. 2. Augmented limb leads (frontal plane)
(RA = right arm; LA = left arm, LL = left leg)
Homeobook.com
-Lead aVR: RA (+) to [LA & LL] (-) (mostly
Rightward direction)
-Lead aVL: LA (+) to [RA & LL] (-) (mostly
Leftward direction)
-Lead aVF: LL (+) to [RA & LA] (-) (Inferior
direction)
6. 2. Augmented limb leads (frontal plane)
(RA = right arm; LAHo
=meo
lb
eook
f.c
tom
arm, LL = left
10. CHEST LEAD PLACEMENT
Precordial lead placement V1: 4th
intercostal space (IS)
adjacent to right sternal border
V2: 4th IS adjacent to left sternal
border
V3: Halfway between V2 and V4
V4: 5th IS, midclavicular line V5:
horizontal to V4; anterior axillary
line
V6: horizontal to V4-5; midaxillary
line
(Note: in women, the precordial
leads should be placed on the breast
surface not under the breast to
insure proper lead placement)
15. P -
WAVE
P wave: sequential depolarization of
the right and left atria
16. P -
WAVE•The impulse is originating at the SA node
•It spreads over the atria in an usual
direction.
•There is no defect of conduction.
•The strength of conduction, mass of atrial
musculature, nutritions are normal.
•Duration 0.12 sec(3 small squares)
•Amplitude 0.25 mv(2.5 small square)
•Upright in all leads except VR
•Inverted – dextro cardia
17. P – WAVE
MORPHOLOGY
The P wave in general should not be more than 1 box wide or 1
box tall. If it exceeds these, it generally means that either or
both atria is enlarged (hypertrophied). The best lead to look at
the P wave is V1. In lead V1, the following characteristics
indicate pathology:
•Positive deflection greater than 1 box wide or 1 box in height
--> right atrial hypertrophy
•If P wave is inverted SA node fails to initiate the impulse.
•If P wave is absent in atrial fibrillation – nodal rhythm, sino
atrial block and hyperkalaemia
•If P wave is hidden – in rapid tachycardia
19. Negative deflection which preceeds R wave
•Caused by the activity of septum.
•Small negative wave & often inconspicious detection.
•Absent in infants suffering from congenital patency
of the septum.
•Prominent Q wave indicates old infarction.
•Q wave in lead III and aVR should be ignore
•Abnormal Q wave- MI, ischemia, bundle branch
block, left ventricular hypertrophy
•A Q wave is significant if it is greater than 1 box
wide or greater than 1/3 the amplitude of the QRS
complex.
Q –
WAVE
20. Negative deflection which preceeds R wave
•Caused by the activity of septum.
•Small negative wave & often inconspicious detection.
•Absent in infants suffering from congenital patency
of the septum.
•Prominent Q wave indicates old infarction.
•Q wave in lead III and aVR should be ignore
•Abnormal Q wave- MI, ischemia, bundle branch
block, left ventricular hypertrophy
•A Q wave is significant if it is greater than 1 box
wide or greater than 1/3 the amplitude of the QRS
complex.
Q – WAVE MORPHOLOGY
21. R –
WAVE
R - waves indicate the changing direction of the
electrical stimulus as it passes through the
heart's conduction system.
22. R –
WAVER is most constant & conspicuous wave having the
tallest amplitude.
•First positive deflection during ventricular
depolarisation.
•Follows immediately upon Q wave.
•In abnormal conditions of ventricles, the shape, size,
duration of R & S altered.
•R wave in aVL must not be > 13mm
•R wave in aVF must not be > 20mm
•Minimum voltage: Atleast one R wave should be >
8mm
•Maximum voltage : The tallest R should not be > 27mm
23. S –
WAVE
S wave represents depolarization in the Purkinje
fibres.
24. S is next downward deflection to R.
•In lead I, R is mainly caused by right ventricle and S due
to left ventricle.
•In lead III, it is just reverse.
•For instance, in bundle branch heart block their
duration is prolonged beyond 0.1sec. & their relative
amplitude varies.
•Deepest S wave shouldnot be > 30mm
•Sum of tallest R wave and deepest S wave should not be
> 40mm
•Abnormal R and S wave suggest ventricular
hypertrophy, posterior MI, WPW syndrome,
dextrocardia+
S –
WAVE
25. •Steady progression from V1 to V6. (R wave).
•At V1 it is predominantly downwards.(S wave)
•From V2 to V6 it progresses to upwards.
•Duration: should be 0.08 - 0.10 sec (2 - 2.5 boxes).
LOW VOLTAGE:
•QRS complex < 5 small square in most of the leads:
pericardial effusion, myxoedema, emphysema, obesity,
HIGH VOLTAGE:
•Ventricular hypertrophy
•Abnormal QRS suggest: incomplete budle branch block
and WPW syndrome
QRS - MORPHOLOGY
27. T –
WAVE
Represents: ventricular repolarization.
•Always upright in leads I and II
•Always inverted in aVR
•Lead V1 normally upright (may be inverted in
20%)
•Lead V2 normally upright( may be inverted in
5
%)
•If upright in V1 and inverted in V2 : abnormal
•Must be upright in leads V3 and V6
28. T – WAVE MORPHOLOGY
T wave Morphology
*Abnormal T wave in shape, size, direction, duration,
reaction to exercise in leads I & II are of great prognostic
significance – myocardial damage with cardiac hypoxia.
*Ischemia: when T waves are in an opposite direction
(inverted), it may indicate that ischemia is present,
especially when it occurs in a pattern as previously
described for ST segment changes.
*Hyperkalemia: associated with tall peaked T waves, flat P
waves, and wide QRS complexes
*Hypokalemia: associated with flat T waves, U waves, U
waves taller than T waves
29. U –
WAVE
The U wave occurs when the ECG machine picks up
repolarisation of the Purkinje fibres.
electrolyte imbalances (potassium) but, again, this is
not very common.
30. This upright wave, when present, follows
the T wave. What it represents is not
certain.
U Wave Morphology
•The presence of U waves may indicate
hypokalemia.
U –
WAVE
31. This is the junction between the QRS complex
and the ST segment.
J – Point
32. •Sinus rhythm PP- RR are equal.
•They are used to calculate the heart
rate.
•PP is atrial rate& RR is the
ventricular rate.
CALCULATION
•Y = 1500/X beats/min.
•X = PP or RR interval.
P-P & R-R
INTERVAL
33. Measures from the beginning of P wave to the
beginning of QRS complex. It represents the total
amount of time required for depolarization of atria
( p wave) as well as the time required for the impulse
to travel slowly through the AV junction, through the
bundle branches, & just upto the point of QRS.
•Normally 0.13 to 0.16 sec.should not exceed 0.2 sec.
P-R
INTERVAL
34. NORMAL
INTERVAL
P-R interval = 0.12 - 0.20 sec (3 - 5 small squares)
QRS width = 0.08 - 0.12 sec (2 - 3 small squares)
Q-T interval 0.35 - 0.43 sec
* The PR interval should really be referred to as the PQ
interval; however it is commonly refeH
ro
rm
eeo
dboo
ak.
scom
the PR
97. Implantable Cardioverter
Defibrillator
Implantable cardioverter defibrillator
Most of this 12-lead recording is polymorphic ventricular tachycardia but, in
the rhythm strip, the large deflection (arrowed) is the defibrillator
discharging.
Following the defibrillation a dual chamber pacemaker can be seen.
OK so I cheated a little with this one as the odds of catching this on a 12-
lead ECG recording are very slim indeed. This is a reconstructed 12-lead
recording from an electrophysiology study testing the device after
placement.
A 36 year old lady with recurrent blackouts.
