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12 Lead > 12 Lead > Flashcards

12 Lead Flashcards

1
Q

Right axis deviation can indicate what five conditions?

A

1) Posterior hemiblock
2) Right ventricular hypertrophy
3) Cor pulmonal or right heart failure
4) Pulmonary embolism
5) Arrhythmias

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2
Q

What two arteries supply the posterior hemifascicle?

A

Right coronary and the circumflex

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4
Q

What vessel supplies blood to the anterior hemifascicle?

A

Left anterior descending (LAD)

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5
Q

A left anterior hemiblock causes what kind of axis deviation?

A

Pathologic left axis

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6
Q

What can an extreme right axis deviation indicate?

A

A rhythm ventricular in origin

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7
Q

Right axis deviation indicates what kind of block?

A

Left posterior hemiblock

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9
Q

Describe the positive/negative deflection of leads I, II, and III with normal axis deviation and the angle associated.

A

I - positive
II - positive
III - positive
0 to 90

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10
Q

Describe the positive/negative deflection of leads I, II, and III with pathologic left axis deviation and the angle associated.

A

I - positive
II - negative
III - negative
-40 to -90

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11
Q

Describe the positive/negative deflection of leads I, II, and III with physiological left axis deviation and the angle associated.

A

I - positive
II - positive or isoelectric
III - negative
0 to -40

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12
Q

Describe the positive/negative deflection of leads I, II, and III with right axis deviation and the angle associated.

A

I - negative
II - any
III - positive
90 to 180

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13
Q

An axis deviation of 0 to 90 indicates what type of deviation?

A

Normal

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14
Q

An axis deviation of 0 to -40 indicates what type of deviation?

A

Physiological left

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15
Q

An axis deviation of -40 to -90 indicates what type of deviation?

A

Pathological left

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16
Q

An axis deviation of 90 to 180 indicates what type of deviation?

A

Right

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17
Q

An axis deviation of >180 indicates what type of deviation?

A

Extreme right

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18
Q

Describe the positive/negative deflection of leads I, II, and III with extreme right axis deviation and the angle associated.

A

I - negative
II - negative
III - negative
>180

19
Q

What is the main characteristic of a bundle branch block?

A

A QRS complex of at least 0.12 seconds or more.

36

20
Q

What are the three fascicles?

A

Right bundle branch
Left anterior hemifascicle
Left posterior hemifascicle

36

21
Q

What lead is used to diagnosed BBBs using the “turn signal criteria”?

22
Q

Are BBB’s permanent, temporary, or either?

23
Q

In the setting of an acute MI a BBB usually indicates what two problems?

A

1) Extensive coronary artery occlusion
2) Anterior wall damage

39

24
Q

Pts with occlusion to what coronary artery producing an anterior wall MI frequently develop complete heart blocks and sometimes V-fib?

A

Left anterior descending

39

25
Q

Why should lidocaine , procainamide, amiodarone, and morphine be used with caution when a bifascicular block exists?

A

That may result in a drug-induced complete heart block

39

26
Q

A QRS complex >170ms usually means an ejection fraction of ___%?

27
Q

Cardiac output = ____ X ____

A

Heart rate
Stroke Volume

40

28
Q

Stroke volume is comprised of what three components?

A

Preload
Afterload
Contractile force

40

29
Q

Ejection fraction is one measure of what?

A

Left ventricular effectiveness

40

30
Q

What is normal ejection fraction?

31
Q

What type of medication should be used with caution if Pt has a QRS wider than 170ms?

Why?

A

Vasodilators

Afterload is most likely a result of vasoconstriction compensating for other conditions.

40

32
Q

What is a bifascicular block?

A

A RBBB combined with a hemiblock or a LBBB

46
or

A blockage of 2 of the 3 pathways to contract the ventricles.

49

33
Q

What is a hemiblock?

A

A block of one of the two fascicles of the left bundle branch

33

34
Q

What are the six severe degrees of heart block?

A
  • 2nd degree type II
  • 3rd degree CHB
  • Bifascicular block
  • 1st degree + hemiblock
  • 1st degree + BBB
  • “block” said or implied twice during initial observation.

49

35
Q

When should vasodilators be used with extreme caution?

A

When the QRS is >170ms

40

36
Q

Until proven differently, wide complex bradycardia should be diagnosed as what?

A

Hyperkalemia

Dr. Edminster
February 2018 Medic Meeting

37
Q

What four things result in a wide QRS?

A
  • Bundle Branch Block
  • Ventricular Beats
  • Hyperkalemia
  • Tricyclics

Dr. Edminster
February 2018 Medic Meeting

38
Q

What does a downward sloping PR interval indicate?

A

Pericarditis

Dr. Edminster
February 2018 Medic Meeting

12 Lead (2 decks)

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