How does an atrial P wave differ3, 4, 5, 42from a sinus P wave?2.

What two basic

mechanisms can 1, 2, 11cause an atrial focus to take over pacemaking
responsibilities? 3. What is an ectopic focus?9, 10 4. Which atrial arrhythmia is
characterized 6, 7, 8by a pacemaker that shifts between the SA node and various
foci in the atria, sometimes even dropping down to the AV junction? 5. What is a
PAC (Premature Atrial 9, 10, 11, 12, 13, Complex)?14, 20, 21, 226. Is a PAC an
ectopic?9, 10, 11, 12, 13, 22ATRIAL RHYTHMSS E L F - T E S T 123C H A P T E R 5
ATRIAL RHYTHMS C h a p t e r5S E L F -T E S T
Atrial P wave may be hidden in the QRS, small or fibrillatory.

A stimulus that produces an unusual beat

Irritable focus within the atrium goes prematurely and produces one unusual beat

Irritability or escape

Wandering Pacemaker

Yes, because it originates outside of the SA node

QuestionsReferenced FramesAnswers C H A P T E R 5 www.bradybooks.com124 C h a p t e

r5S E L F -T E S T 7. If an ectopic is caused by irritability, 11, 14, 18, 22 will
it come earlier than expected or later than expected?8. Is Wandering Pacemaker a
single 6, 9 ectopic beat?9. What is the most characteristic 6 feature of Wandering
Pacemaker?10. What should the QRS measurement 5, 17, 19, 21, 42be for a PAC? 11.
What will the P wave look like on a 5, 16, 19, 20, 21, 42 PAC?12. If the P wave of
a PAC was not 18clearly visible, where might you consider looking for it? 13. Is
Atrial Tachycardia caused by one 22irritable focus or by many?14. What is the usual
rate range for 24, 25, 26 Atrial Tachycardia? 15. Does Atrial Tachycardia have a
26P wave in front of every QRS complex?16. What does the P wave look like in 5, 23,
26, 43 an Atrial Tachycardia?
Earlier because if the ectopic comes later than expected then it was caused by
escape mechanism.

no

The morphing p waves

Less than 0.12 seconds

flattened, notched, diphasic or peaked.

In the T wave of the preceding complex

one

150-250

Yes

Like the p waves present during PAC

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The AV node may block some of the impulses so

they aren't conducted to the ventricles.

Atrial flutter and atrial fibrillation.

250-350

If the impulses are being conducted in a regular pattern, the ventricular rhythm
would be regular. If the conduction is irregular, the ventricular rhythm would be
irregular.

Slower

spiky saw tooth shape

23. How would you describe the atrial 35, 36, 41 activity in Atrial Fibrillation?
24. What is the atrial rate in Atrial 36, 41Fibrillation?25. Is there a
relationship between atrial 36, 38, 41activity and ventricular activity in Atrial
Fibrillation?26. What is the ventricular rate for 36, 39, 41 Atrial Fibrillation?
27. What are the two most characteristic 36, 37, 41 features of Atrial
Fibrillation?C H A P T E R 5 www.bradybooks.com126 C h a p t e r5S E L F -T E S T
QuestionsReferenced FramesAnswers
A very irregular and uncontrolled fibrillatory wave

>350

Yes

At 100 bpm or less, it has controlled ventricular responses.

At over 100 bpm, it has rapid ventricular response.

No visible P waves and R-R interval is very irregular.