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EKG > 1 > Flashcards

1 Flashcards

1
Q

segment is a

A

line connected by two points

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2
Q

what is a normal PR interval

A

0.12-0.20 seconds; 3-5 small boxes

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3
Q

normal QRS

A

Normal: 0.08-0.12 seconds; 2-3 small boxes

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4
Q

” QT Interval normal

A

max: 0.45 seconds (11-12 boxes);

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5
Q

prolonged QT

A

over 12 boxes?

prolonged QT = @ risk for sudden death (hypokalemia, hypomagnesemia, hypocalcemia)

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6
Q

SA nodes bpm

A

60-100

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7
Q

Atrial muscle BPM

A

60-80

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8
Q

AV node BPM

A

40-60

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9
Q

placement of precordial leads

A

V1 4th intercostal space to right of atrium
V2 same as V1 but to the left
V3 directly between 2 and 4
V4 5th intercostal midclavicular
v5 to the left of V4 left anterior axillary line
V6 to the left of V5 midaxillary line

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10
Q

which precordial leads give us a view of the septum

A

V1 and V2

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11
Q

Which precordial leads give us a view of the anterior heart

A

V3 and V4

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12
Q

which anterior leads give us a view of the lateral heart

A

V5 and V6

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13
Q

What are the labels of the limb leads

A

I, II, II

aVR, aVF, aVL

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14
Q

where should a normal heart sit

A

between 0 and 90 degrees

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15
Q

what does isoelectric line refer to

A

if the mean depolarization path is directed at right angels (perpendicular) to any lead there will be a biphasic deflection and the isoelectric line can be drawn through this

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16
Q

1st area of ventricular muscle to be activated is is the inter-ventricular septum which is seen as what on a EKG

A

Q wave

negative

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17
Q

impulse travel at what speed through the AV node

A

slowly

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18
Q

impulse typically travels at what speed through the bundle of his

A

very quickly

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19
Q

where does impulse travel once thru the AV node

A

bundle of his–> BB>–> ventricualr muscle

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20
Q

what does the R wave represent

A

left and right ventricular muscle activation (endocardial first followed by epicardial)

big positive

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21
Q

s waves

A

a few small areas of ventricles are activated at a late stage and this is represented by the s wave

typically seen as negative

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22
Q

atrial depolarization is represented by the

A

p wave

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23
Q

intervals are

A

wave(s) and segments

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24
Q

order of signals starting with pacemaker cells in the SA

A 
sa
atrial syncytium
juntional fibers
atrioventricular node 
BB
PF
ventricular synctium
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25
Q

which atrium contracts first

A

the right

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26
Q

usually SA node stimulus appears as a

A

P wave

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27
Q

AV node signal is delayed by

A

.12 seconds

this is important because AV node blocks will prolong this signal

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28
Q

AV junction is made up of

A

AV node
bundle of his
R and L bb

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29
Q

SA node typically beats around

A

60-100

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30
Q

atria beats typically

A

40-60

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31
Q

ventricles bpm

A

20-40

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32
Q

atrial junction is typically seen with what bpm

A

60-80

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33
Q

1st degree normal AV block might be seen in what pt population

A

athletes

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34
Q

things that can change the conductions in a EKG

A

hair wheelchair bra pacemaker, bone, muscle movement, dried out electrodes, heavy breathing and sweating

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35
Q

V1 and V2 will tell you the

A

septum

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36
Q

V3 and V4 will tell you

A

the anterior

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37
Q

V5 and V6 will tell you

A

lateral

38
Q

V1 is lovated where

A

4th intercostal space to right of sternum

39
Q

V2 is located

A

4th intercostal space to left of sternum

40
Q

V3 placement

A

directly between V2 and V4

41
Q

v4 placement

A

5th intercostal space at midclavicular line

42
Q

v5

A

level with V4 at left anterior axillary line

43
Q

v6 location

A

level with v5 at left midaxillary line

44
Q

positive electrode will appear on a ekg

A

as a positive wave (mountain top)

45
Q

isoelectric line what is it?

A

is the straight line drawn across a depolarization path that is at a right angle ( or perpenducular ) to any lead

46
Q

1st area of ventricular muscle to be activated is the interventricular septum which activates L–> R and is represented as the

A

Q wave

47
Q

L& R ventricular muscle walls get activated after w/ the endocardial surface BEING activate before epicardial surface creating the

A

R wave

48
Q

a few small areas of ventricles are activated in the late stage known as the

A

S wave

49
Q

ventricular muscle repolarizes and is represented as a

A

T wave

50
Q

QRS complex represents

A

ventricular depolarization/ventricular contraction

51
Q

atrial depolarization is represented by

A

p wave

52
Q

U waves are usually detected in the presence of

A

Electrolyte imbalance

usually this U wave is merged with the T wave

53
Q

i small box is what amount of time

A

.04 seconds

54
Q

5 small boxes represent what amt of time

A

.2 seconds

55
Q

1 big box is

A

1 mv (10 small boxes)

56
Q

i small box is

A

.1 mv

57
Q

TELEMETRY

A

putting pt on EKG monitor and observing continuously

Long-term ekg

58
Q

two thumbs up method

A

looking at AVF and I to determine deviation

59
Q

if I and AVF are positive

A

heart is in normal placement

60
Q

if I is positive and AVF is negative

A

left axis deviation

61
Q

negative I and negative avf

A

indeterminate axis

62
Q

negative I and positive avf

A

right axis deviation

63
Q

depolarization is synonymous with

A

contraction

64
Q

QRS complex is representative of

A

ventricular depolarization

65
Q

ventricular repolorization is seen as the

A

T wav

66
Q

U wave

A

after potential of ventricular muscle and re-polarization of purkinje fibers

67
Q

why would se typically see a U wave

A

electrolyte imbalance.

68
Q
  1. Identify the differences between analog imaging and digital imaging and some of the advantages of digital over analog.
A

Digital imaging can be sent and viewed anywhere. It can also be manipulated without having to re-expose the patient

69
Q

Define PACS. Identify and recognize correct view box placement of films.

A

PACS = Picture Archiving and Communication Systems

Viewbox films are placed with the pts R on your L

Old → new
films are placed L → R

70
Q

b. Two things make an image more radiopaque:

A

Identify and recognize radiolucent and radiopaque.

i. Density
ii. Thickness

radiopaque is more white

radio lucent is less

71
Q

a. Pt must remain still
b. Magnification issues.

Objects are magnified when:

i. Beam is close to the pt
ii. Pt is far from cassette surface

c. Distortion issues.

ii. Example is “lordotic CXR” where pt is in bed, angled
1. This makes the base of the heart look larger
2. You can tell it’s lordotic if the clavicles are high
d. *Never judge cardiomegaly from a CXR unless it’s a perfect PA!!

A
  1. Identify those factors which must be considered by an x-ray technician before obtaining a plain film, including positioning of the patient, the cassette and the beam.
72
Q

i. Beam is close to the pt

ii. Pt is far from cassette surface

A

magnifications issues occur when

73
Q

Objects aren’t perpendicular when

A

objects are distorted in xray when

74
Q

where pt is in bed, angled

  1. This makes the base of the heart look larger
  2. You can tell it’s lordotic if the clavicles are high
A

“lordotic CXR

75
Q

a. Frontal (from the front, coronal), same as PA
b. PA (from behind, coronal)
c. Oblique (anything other than the cardinal planes
d. Cephalo-caudal (birds eye view) → AKA “axial”

A
  1. Identify and recognize frontal projection, lateral view, posteroanterior, anteroposterior and oblique views.
76
Q

CT and MRI both use the_______ to describe the views

A

CT and MRI both use the three cardinal planes to describe the views

77
Q

a. Contrast is bright white (e.g. barium)
b. Don’t use it if the thing you’re looking for is also high attenuation!
c. PO and IV contrast both are eliminated by the kidneys. (They will appear as high attenuation either way!)

A
  1. Recognize a CT scan with and without oral and/or IV contrast
78
Q

d. Contraindications ofr CT contrast

A

CI for contrast w/ d. Contraindications:

i. Allergy
ii. Renal insuff. (creatinine >1.5) → CT, Contrast, Creatinine!
iii. Current metformin (d/c 24 before and resume 48h after)

79
Q

iii. Current metformin (d/c 24 before and resume 48h after)

10. Recognize 3-D CT image reconstruction. Identify how this technique is useful in contrast to non-enhanced CT images.

A

a. Can give you a 3D orientation

b. Can subtract out stuff you don’t want to see (e.g. isolate renal vessels)

80
Q
  1. Identify those patients for whom MRI is not an option and identify why.
A

a. Unstable patients (can’t run a code until the machine powers down)
b. Pacemakers
c. Other ferrous metal implantations (titanium & stainless steel ok)

81
Q

when would you not want to use a xray (what are they not good at evaluating)

A

detail, precise location, solid organs, brain, or vasculature

82
Q

what imagining would you want to run for a pt coming in with a new seizure or changed mental status

A

CT

83
Q

when would you want a CT of the chest vs CXR

A

CT:lung tumor, effusion, infxn, PE, etc)

CXR: resp sx, chest pain, upper GI, trauma, procedures, fever)

84
Q

two tests for the detection of a metallic fb

A

XRAY and CT

85
Q

what imaging would you need for ligament or tendon injuries

A

MRI

Exceptional detail
Contrast not renal toxic
unless GFR <30
Safe in pregnancy

86
Q

what imaging would you do for a pt with a CVA

A

CT 1st followed by MRI

MRI is more subtle

87
Q

how do you describe an ULS

black
whiter
darker
casts shadow

A 
Anechoic 
  (black)
Hyperechoic 
 (whiter)
Hypoechoic  
 (darker)
Echogenic 
 (casts acoustic 
 shadow, Ca+2)
88
Q

Biliary tract stuff (stones, etc) would be evaluated best with what imagining

A

MRI

89
Q

V/Q scan (PEmbolus) is an example of what type of imaging

A

nuclear studies

90
Q

HIDA scan (gallbladder) is an example of what type of imaging

A

nuclear scan

91
Q

Vessels (DVTs) are evaluated best with what type of imagery

A

ULS

92
Q

low attenuation refers to

A

Low attenuation = less dense
Shades of grey to black

CT

EKG (7 decks)

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