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CVPR Exam I > 27. Introduction to the 12-lead ECG Interpretation > Flashcards

27. Introduction to the 12-lead ECG Interpretation Flashcards

1
Q

What does an ST elevation indicate?

A

an MI in progress (acute)

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2
Q

In ____, a large Q wave means an MI (necrosis, infarct).

A

lead III

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3
Q

How will a right bundle branch block (RBBB) look on V1?

A

widened QRS that is upright/positive

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3
Q

LVH will have highly positive R waves and a negative T wave in leads _____.

A

V4, V5, and V6

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4
Q

Lead II is a bipolar lead that is _____ in the L leg and _____ in the R arm.

A

positive; negative

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4
Q

In lead III, the Q wave should be _____ in a normal ECG.

A

very small if not absent

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4
Q

If an acute infarct shows up on leads V1 or V2, it’s located in the ____ of the heart.

A

anteroseptal wall

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5
Q

In lead III, a large Q wave means _____.

A

an MI (necrosis, infarct)

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5
Q

The site of an acute MI is where the ____ shows up on ECG.

A

ST elevation

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7
Q

Everything is _____ in aVr.

A

negative

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7
Q

Each mm of the read paper is equal to ____ mV.

A

1

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9
Q

Lead 1 is a bipolar lead that is _____ in the right arm and ____ in the left arm.

A

negative; positive

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10
Q

A very positive and wide QRS that may have bunny ears, and a large negative T wave on V6 indicates what?

A

a LBBB

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10
Q

_____ will have highly positive R waves and a negative T wave in leads V4, V5, and V6.

A

LVH

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11
Q

What is aVf?

A

the unipolar lead headed straight down the body

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12
Q

Lead III is a bipolar positive in the _____ and negative in the _____.

A

right leg; left arm

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13
Q

If an acute infarct shows up on leads _____, it’s located in the anterior wall of the heart.

A

V3 or V4

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14
Q

What is “large” for a Q wave? Where do you need to see it for it to be diagnostic?

A

greater than 25% of the R wave and 1 box wide; in 2 contiguous leads

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14
Q

If an acute infarct shows up on leads V3 or V4, it’s located in the ____ of the heart.

A

anterior wall

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15
Q

What does RA enlargement look like on lead II?

A

it has an early positive spike that’s taller than normal and dips slightly when the LA depolarizes

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16
Q

A widened QRS that is downwards/negative in V1 is indicative of?

A

a left bundle branch block (LBBB)

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17
Q

What does LA enlargement look like on lead II?

A

it has a late positive spike that’s taller than normal after growing slightly taller post RA-depolarization

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17
Q

If there are positive ST elevations in every lead but aVr, it’s not a bunch of MIs, it’s _____.

A

acute pericarditis

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18
Q

What lead should you check the P wave with?

A

lead II

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18
Q

Which are the L sided leads?

A

V4, 5, and 6

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18
Q

A _____ means the infarct is acute but a _____ means it is an old MI.

A

ST elevation; Q wave

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20
Q

What is aVL?

A

the unipolar lead on the L arm

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21
Q

Lead I is a bipolar lead that is negative in the _____ and positive in the ______.

A

right arm; left arm

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22
Q

How will a left bundle branch block (RBBB) look on V1?

A

a widened QRS that is downwards/negative

22
Q

Hemiblocks cause ______ without _____.

A

axis shifts; widening the QRS

24
Q

Which is the unipolar lead on the L arm?

A

aVL

25
Q

What is aVr?

A

the lead on the R arm

26
Q

What does a bundle branch block do to the ventricular depolarization?

A

whichever branch is blocked, that side of the heart has to wait for the depol to go all the way around the other side of the heart first, so there will be a delay of depol on the affected side

27
Q

If the P wave goes in the opposite direction of the R wave, this is abnormal and means ____ or ____.

A

hypertrophy; ischemia

28
Q

To remember R vs L BBB QRS direction: - when you drive a car, to turn RIGHT you flick the turn signal UPWARDS. To turn LEFT, you hit the turn signal DOWNWARDS.

A

for your learning pleasure only!

30
Q

Lead III is a bipolar lead that is _____ in the R leg and ______ in the left arm.

A

positive; negative

31
Q

If an acute infarct shows up on leads _____, it’s located in the anterolateral wall of the heart.

A

V5 or V6

32
Q

Hypertrophy causes increased mass which causes ____ on the ECG.

A

increased voltage

33
Q

LVH will have highly positive ____ waves and a negative ___ wave in leads V4, V5, and V6.

A

R; T

34
Q

Each large box = _____.

A

0.2 sec

36
Q

The PR interval starts at _____ and ends at _____.

A

the beginning of the p-wave; the beginning of the QRS

37
Q

LVH will have very high voltage R waves in the _____ leads.

A

left sided

38
Q

If an acute infarct shows up on leads V5 or V6, it’s located in the ____ of the heart.

A

anterolateral wall

39
Q

When will the QRS’s be opposite in lead I versus lead II on the same ECG?

A

in hemiblocks

40
Q

A widened QRS that is upright/positive in V1 is indicative of?

A

a right bundle branch block (RBBB)

41
Q

What pathology masks an infarct?

A

a LBBB

42
Q

If an acute infarct shows up on leads _____, it’s located in the inferior wall of the heart.

A

II, III, or aVf

44
Q

The QT interval starts at ______ and ends at ____.

A

the beginning of the QRS; the end of the T wave

46
Q

If you start at V1 and move towards V6, you are moving from the _____ to the _____.

A

R ventricle; apex of the heart

47
Q

V1 and V2 will show a very tall, narrow QRS in ____.

A

RVH

48
Q

Which is the unipolar lead on the R arm?

A

aVr

49
Q

In which leads will the R wave be very highly positive in RVH?

A

V1 and V2

50
Q

Each small box = ____.

A

0.04 sec

51
Q

In lead III, the ____ should be very small if not absent in a normal ECG.

A

Q wave

52
Q

If an acute infarct shows up on leads II, III, or aVf, it’s located in the ____ of the heart.

A

inferior wall

53
Q

If an acute infarct shows up on leads _____, it’s located in the anteroseptal wall of the heart.

A

V1 or V2

55
Q

In lead ___, the Q wave should be very small if not absent in a normal ECG.

A

III

57
Q

What is the standard for wide QRS (time and # of boxes)?

A

more than 0.12 sec or 3 small boxes

58
Q

On V6 in a LBBB, you will see _____.

A

a very positive and wide QRS that may have bunny ears, and a large negative T wave

59
Q

Everything is _____ in aVf.

A

positive

61
Q

Lead II is a bipolar lead that is positive in the _____ and negative in the _____.

A

left leg; right arm

62
Q

Normal, V5 and V6 should have ____ T waves with ____ S-T segments.

A

upright; flat

63
Q

In lead III, a large ____ means an MI (necrosis, infarct).

A

Q wave

64
Q

Which hemiblock is most common?

A

anterior

65
Q

If you start at lead ____ and move towards lead ____, you are moving from the R ventricle to the apex of the heart.

A

V1; V6

66
Q

If there are _____ in every lead but aVr, it’s not a bunch of MIs, it’s acute pericarditis.

A

positive ST elevations

67
Q

The PR interval should be less than _____.

A

0.2 seconds

68
Q

aVr look at which part of the heart?

A

the right side

69
Q

A LBBB can mask an _____.

A

infarct

70
Q

Which is the unipolar lead headed straight down the body?

A

aVf

CVPR Exam I (29 decks)

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