5- Intro To 12 Leads Flashcards

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1
Q

2 types of leads

A

Hexaxial (Limb)

Precordial (Chest)

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2
Q

Locations for the precordial leads

A
V1- 4th ICS R of sternum
V2- 4th ICS L of sternum
V3- Between V2 and V4
V4- 5th ICS mid clavicular
V5- Between V4 and V6
V6- 5th ICS mid-axillary
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3
Q

Name the charges of RA, LA, LL and the polarity of them all

A

RA -
LA -,+
LL +

Bipolar polarity

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4
Q

Name the charges of AVR, AVL, AVF and the polarity of them all

A

AVR +
AVL +
AVF -

Unipolar polarity, augmented voltage

Augmented vectors R, L, F

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5
Q

What is the polarity of the precordial leads

A

Unipolar

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6
Q

What does each lead look at

A

1 - Lateral
2 - Inferior
3 - Inferior

AVR - None
AVL - Lateral
AVF - Inferior

V1 - Septal
V2 - Septal
V3 - Anterior
V4 - Anterior
V5 - Lateral
V6- Lateral
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7
Q

6 step process of reading a 12 lead

A
  1. Calibration
  2. Determine the rhythm
  3. QRS assessment
  4. Hypertrophy
  5. Axis deviation
  6. Ischemia/Infarction
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8
Q

What to look for with calibration

A

The box is 10 tall and 5 wide

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9
Q

What to look for with the QRS

A

R wave progression

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10
Q

What is proper progression of the R wave from V1-V6

A
V1- Down
V2- Down
V3- Biphasic
V4- Biphasic
V5- Up
V6- Up
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11
Q

6 causes of poor R wave progression

A
LBBB (very late)
LAFB
Certain WPW’s (early)
RVH
LVH
Anterior MI (old MI)
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12
Q

How to determine axis deviation and the 4 kinds

A

I and AVF

Normal I up AVF up
Left I up AVF down
Right I down AVF up
Extreme right I down AVF down

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13
Q

7 causes of L Axis Deviation

A
  • Normal in obese, old, or pregnant patients
  • Emphysema
  • LVH
  • LAFB
  • Inferior MI
  • LBBB
  • VTach
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14
Q

5 causes of R Axis Deviation

A
  • Emphysema
  • RVH
  • LPFB
  • RBBB
  • VTah
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15
Q

2 causes of Extreme R Axis Deviation

A
  • Bifasicular heart block

- VTach

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16
Q

How to confirm a bundle branch block (2)

A
  • Wide QRS or “rabbit ears”

- V1 up or down from jpoint

17
Q

The cause of LBBB

A

MI, new onset LBBB = MI

18
Q

Causes of RBBB (5)

A
  • Anteroseptal MI
  • Pulmonary embolism
  • CHF
  • HTN
  • Myocarditis/Pericarditis
19
Q

Characteristics of a Left Anterior Fascicular block (3)

A
  • LAD
  • Q wave in I, R wave in III
  • Common to have RBBB
20
Q

Characteristics of a Left Posterior Fascicular block (2)

A
  • RAD

- R wave in I, Q wave in III

21
Q

Signs of RAE (2) and 3 causes

A
  • Teepee shaped PWave
  • V1 biphasic wave

Causes
-COPD, PE, Pulmonic HTN

22
Q

Signs of LAE and 2 causes

A

-Wide or notched/double humped PWave

Causes

  • HTN
  • LVHF
23
Q

Signs of RVH

A
  • Rs pattern
  • RAE
  • RAD

-Not RVH if:
RBBB, Posterior MI

24
Q

Signs of LVH

A

V1 or V2 - deflection

Plus

V5 or V6 + deflection