A WebQuest for Physician Assistant Students

Designed by
Diane Visich, PA-C

visic1d@cmich.edu

Introduction

Understanding cardiac physiology is important for understanding cardiovascular examination components, including knowledge of EKG and heart sounds. This Web Quest lesson will review cardiac physiology, and will introduce cardiovascular exam skills, heart sounds, and basic EKG interpretation.

The Task

After completing this lesson, the student will be able to

• Describe cardiac anatomy and physiology

• Understand basic EKG interpretation

• Recognize most common arrhythmias

• Recognize normal and commonly heard abnormal heart sounds

• Be prepared to demonstrate a focused cardiovascular examination

The Process

Students will visit assigned sites describing cardiac anatomy including heart chambers, valves, and major coronary arteries. Please review the structure and function of the heart including:

• Myocardium

• Heart chambers

• Four heart valves

• Major coronary arteries.

Through these sights you will develop an understanding of the movement of blood flow through the heart and valves, so as to be able to understand common pathological conditions including cardiomyopathy, valve disease, coronary artery disease, and congestive heart failure.

http://www.texasheartinstitute.org/HIC/Anatomy/conduct.cfm

YouTube - Heart Anatomy

http://www.jasonmlynch.com/uploads/Cardiac_Anatomy.ppt

Electrical conduction pathways of the heart will be demonstrated through the following links. Student should develop an understanding of the normal electrical conduction pathway through the heart, and abnormal pathways resulting in common arrythmias.

http://www.alaskaems.usanethosting.com/EMSER/Cardiaca&pKorn1.ppt

After obtaining the previous background information, the groundwork for understanding EKG and arrhythmias will have been accomplished, and students will explore the websites associated with basic EKG and arrhythmia interpretation. Be familiar with common arrhythmias including:

• atrial fibrillation and flutter

• PVCs and PACs

• tachycardias (supraventricular and ventricular)

• First, second and third degree heart blocks heart blocks

• Ventricular fibrillation and asystole

• Patterns of ischemia, injury and infarction.

http://images.raph14.multiply.multiplycontent.com/attachment/0/S4kaaAooCj0AAB-oeUc1/CARDIAC CONDUCTION SYSTEM.ppt?nmid=320607826

http://jsgreen.tamu.edu/639 2 Arrythmias.ppt

This will lead to a website demonstration of a focused cardiovascular examination. Focus on developing effective communication with the patient and the performance of an organized and thorough cardiovascular examination.

https://www.youtube.com/watch?v=SFrsv6U-0KU

https://www.youtube.com/watch?v=dp5m2tXHDmA

Finally students will explore common heart sounds. These will include common murmurs such as aortic stenosis and regurgitation, mitral valve murmurs, pericarditis, bruits and thrills, to name the most common.

http://www.blaufuss.org/tutorial/indexTut.html

http://www.med.ucla.edu/wilkes/intro.html

Conclusion

The purpose of this WebQuest is to prepare students for their practical examination covering cardiovascular examination skills, which will take place near the end of next semester. This WebQuest will provide resources for self study, frequent practice and review for the practical. Although this Webquest is not a graded assignment, the practical will include graded sections on heart murmurs, EKG interpretation, and cardiovascular examination skills, all of which are included in this WebQuest. Good luck with your practice, and with your final practical, and ultimately the Boards!