12 Lead EKG Flashcards by I S

normal PR interval

0.12-0.20 (< 1 big box)

How well did you know this?

Not at all

Perfectly

normal QRS interval

< 0.12 (3 small boxes)

How well did you know this?

Not at all

Perfectly

sinus rhythm

How well did you know this?

Not at all

Perfectly

sinus rhythm rate

60-100 bpm

How well did you know this?

Not at all

Perfectly

Sinus Rhythm with First Degree Block

How well did you know this?

Not at all

Perfectly

what is the PR interval in Sinus Rhythm with First Degree Block

PR > 0.20 sec

How well did you know this?

Not at all

Perfectly

Sinus Rhythm with First Degree Block represents

a slowing of conduction through the AV node

How well did you know this?

Not at all

Perfectly

Sinus Rhythm with Second Degree AV Block - Mobitz type I (Wenckebach)

How well did you know this?

Not at all

Perfectly

features of Sinus Rhythm with Second Degree AV Block - Mobitz type I (Wenckebach)

increasing PR interval with dropped QRS

P-P interval constant

usually not symptomatic

How well did you know this?

Not at all

Perfectly

Sinus Rhythm with Second Degree AV Block - Mobitz type II

How well did you know this?

Not at all

Perfectly

Sinus Rhythm with Second Degree AV Block - Mobitz type II characteristics

PR intervals constant but > .20 seconds

unconducted P waves

usually symptomatic

How well did you know this?

Not at all

Perfectly

third-degree AV block represents

a complete disassociation between the atria and the ventricles

How well did you know this?

Not at all

Perfectly

third degree AV block

How well did you know this?

Not at all

Perfectly

P waves and QRS waves have nothing to do with each other

third degree AV block

How well did you know this?

Not at all

Perfectly

is 3rd degree AV block usually symptomatic

yes; go get the external pacer

How well did you know this?

Not at all

Perfectly

third degree AV block

How well did you know this?

Not at all

Perfectly

third degree AV block

How well did you know this?

Not at all

Perfectly

third degree AV block

How well did you know this?

Not at all

Perfectly

where does QRS originate from in junctional rhythm

AV node

How well did you know this?

Not at all

Perfectly

QRS rate in junctional rhythm

40-60 bpm

How well did you know this?

Not at all

Perfectly

are there P waves in junctional rhythm

may or may not be present

How well did you know this?

Not at all

Perfectly

junctional rhythm

How well did you know this?

Not at all

Perfectly

junctional rhythm

How well did you know this?

Not at all

Perfectly

accelerated junctional rhythm

How well did you know this?

Not at all

Perfectly

where does an accelerated junctional rhythm originate

AV node

accelerated junctional rhythm rate

greater than 60

accelerated junctional rhythm P waves

NONE

atrial fibrillation

atrial fibrillation P wave

can't find the P wave

atrial fibrillation rhythm

irregular

atrial fibrillation QRS

normally still within normal limits

uncontrolled atrial fibrillation

> 100 bpm

saw tooth pattern

atrial flutter

atrial flutter P waves?

present

most common atrial flutter conduction

2:1

atrial flutter QRS

usually WNL width parameters

almost always occurs in diseased heart

atrial flutter

supraventricular tachycardia

usually regular between 140-220 bpm

SVT

where are impulses generated during SVT

above the AV node

ventricular tachycardia

rate between 100-220 bpm

ventricular tachycardia

wide and bizarre looking morphology

ventricular tachycardia

usually symptomatic but not always

ventricular tachycardia

may progress to v-fib

ventricular tachycardia

ventricular fibrillation

no QRS observable

ventricular fibrillation

chaotic electrical activity

ventricular fibrillation

failure of primary pacemaker

idioventricular rhythm

rate usually less than 40 bpm

idioventricular rhythm

The ventricles “last ditch” attempt to maintain cardiac output

idioventricular rhythm

inferior leads

II, III, aVf

lateral leads

I, aVL, V5, V6

anterior leads

V3, V4

septal leads

V1, V2

bipolar leads

I, II, III

unipolar leads

aVL, aVR, aVF

axis deviation look at leads

I and aVF

(Axis Deviation) up up

normal

(Axis deviation) up down

left

down up

right

down down

extreme right

bundle branch blocks look to leads

I, V1, V6

bundle branch block QRS

wide QRS

right bundle branch block configuration

R, S, R1 configuration in V1

left bundle branch block What do we see in V1?

Large wide R, S pattern in V1

lead I positive deflection and wide

left bundle branch block

Usually “bunny ears” in V6

left bundle branch block

if not bunny ears, a notched QRS somewhere in V leads

left bundle branch block

ischemia EKG

ST depressions and T wave inversions in consecutive leads

acute injury/ infarction EKG

ST elevations, peaked T waves , or T wave inversions in consecutive leads

anterior wall supplied by

LAD

lateral wall is supplied by

LAD or obtuse marginal

changes seen in I, avL, V5, V6

LAD or obtuse marginal

inferior wall supplied by

RCA

seen in Leads II, III, avF

inferior wall supplied by RCA

posterior wall supplied by

PDA | posterior descending artery NOT patent ductus arteriosus

depression in V1 and V2

posterior wall

Acute injury patternST Elevations

when are Q waves significant

if more than 1/3 of the total height of the QRS wider than 0.03 sec

Big R wave in V5 or V6 plus Big S wave in V1

Left Ventricle Enlargement

rsR’ in V1 and S waves in V5/V6 Right “Strain” Pattern - T wave inversion in the right-sided leads

Right Ventricle Enlargement

monomorphic ventricular tachycardia

second-degree AV block type I

third-degree AV block

unstable SVT

torsades de pointes

ondansetron can cause

prolonged QT

which leads do you look at for axis deviation

Leads I and aVF

leads II or V5

best to detect ischemia or infarction

lead II

arrhythmias and inferior wall ischemia

lead V5

anterior/lateral wall ischemia

Signs of Left Bundle Branch Block

V1: large, wide R S pattern I: + deflection, wide QRS V6: bunny ears V leads: notched QRS

Signs of RV enlargement

V1: R S R’ V5 & 6: S wave Right “strain pattern”: inverted T in V leads (Do not confuse with RBBB which has R S R1 in V1)