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B2. Cardiovascular System > A First Look at the ECG > Flashcards

A First Look at the ECG Flashcards

1
Q

In what plane do standard limb leads look a events?

A

Vertical (coronal)

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2
Q

What are the 3 standard limb leads?

A

SLL I (left arm to right arm)

SLL II (left leg to right arm)

SLL III (left leg to left arm)

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3
Q

Where does SLL I go from and to?

A

Left arm to right arm

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4
Q

What SLL goes from left arm to right arm?

A

SLL I

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5
Q

Where does SLL II go from and to?

A

Left leg to right arm

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6
Q

What SLL goes from left leg to right arm?

A

SLL II

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7
Q

Where does SLL III go from and to?

A

Left leg to left arm

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8
Q

What SLL goes from left leg to right arm?

A

SLL II

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9
Q

What does SLL stand up for?

A

Standard limb lead

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10
Q

What are the basic principles of standard limb leads?

A

Fast events, such as depolarisation and repolarisation of the action potential are transmitted well

Slow events, such as the plateua of the action potential, are not transmitted well

A wave of approaching depolarisation causes an upward-going blip

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11
Q

How are fast events picked up by SLL?

A

Transmitted well

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12
Q

What are examples of fast events picked up well by SLL?

A

Depolarisation and repolarisation of the action potential

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13
Q

What is an example of a slow event not picked up well by SLL?

A

Plateau of the action potential

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14
Q

What does a wave of approaching depolarisation cause?

A

Upward-going blip

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15
Q

What does each lead of the SLL record?

A

Difference in potential between the two body parts

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16
Q

Where does the main wave of depolarisation travel?

A

Down the ventricles and through the body fluids towards the electrodes

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17
Q

What happens as the wave of depolarisation passes the electrode?

A

Creates a positive potential relative to the other electrode

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18
Q

What can the depolarisation wave be compared to?

A

Wave of water

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19
Q

What happens if a wave of depolarisation travels towards the left arm?

A

Positive potential relative to the other node

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20
Q

What happens if a wave of depolarisation travels away from the left arm?

A

Negative potential compared to other node

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21
Q

What happens if a wave of repolarisation travels towards the left arm?

A

Negative potential compared to other node

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22
Q

What happens if a wave of repolarisation travels away from left arm?

A

Positive potential compared to other node

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23
Q

What does the P wave of an ECG represent?

A

Atrial depolarisation

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24
Q

What does the QRS complex of an ECG represent?

A

Ventricular depolarisation

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25
What does the T wave of an ECG represent?
Ventricular repolarisation
26
What does the flat line between the P wave and Q on an ECG represent?
Plateau of atrial repolarisation
27
What does the flat line between S and the T wave on an ECG represent?
Plateau after ventricular depolarisation
28
What does the plateau of atrial and ventricular repolarisation show a flat line on the ECG?
Slow even so is not detected well
29
What is the PR interval?
Time from atrial depolarisation to ventricular depolarisation
30
What is the time from atrial depolarisation and ventricular depolarisation called?
PR interval
31
What is the PR interval due to?
Transmission through AV node
32
What is the time of the PR interval normally?
0.12-0.2s
33
What is the QRS interval?
Time for the whole of the ventricle to depolarise
34
What is the time for the whole of the ventricle to depolarise called?
QRS interval
35
What is the normal time of the QRS interval?
0.08s
36
What is the QT interval?
Time spent while ventricles are depolarising
37
What is the time spend while ventricles are depolarising called?
QT interval
38
What is the normal time of the QT interval?
0.42s at 60bpm
39
What does the QT interval vary with?
Heartrate
40
What cannot be seen on the ECG?
Atrial repolarisation
41
Why can atrial repolarisation not be seen on the ECG?
Coincides with ventricular depolarisation which involves much more tissue depolarising faster so swamps any signal
42
Why is the QRS complex so complicated?
Different parts of the ventricle depolarising at different times in different directions
43
Why is the T wave positve?
Action potential is no longer in endocardial cells but in epicardial cells so the wave runs in the opposite direction to the wave of depolarisation
44
In which SLL is the R wave biggest?
SLL II
45
Why is the R wave biggest in SLL II?
The main vector of depolarision is in line with the axis of recording from the left leg with respect to the right arm
46
What are the steps of the QRS complex?
1) Interventricular septum depolarises from left to right 2) The bulk of ventricle depolarises from endocardial to epicardial surface 3) Upper part of the interventricular septum depolarises
47
What causes the Q wave?
Interventricular septum depolarises from left to right
48
What causes the R wave?
The bulk of the ventricle depolarises from the endocardial to epicardial surface
49
What causes the S wave?
Upper part of the interventricular septum depolarises
50
What other limbs leads can be used other than SLL?
Augmented limb leads
51
What do augmented limb leads give combined with standard limb leads?
3 additional perspectives on the events of the heart
52
What are augmented limb leads?
Recordings from one limb lead with respect to the 2 others combined
53
What are recordings from one limb lead with respect to the other 2 combined called?
Augmented limb leads
54
When is the ECG negative?
When depolarisation is travelling away from the electrode When repolarisation is travelling towards the electrode
55
When is the ECG positive?
When depolarisation is travelling towards the electrode When repolarisation is travelling away from the electrode
56
What plane do precordial (chest) leads get information in?
Horizontal (transverse) plane
57
What leads get information in the horizontal (transverse) plane?
Precordial (chest leads)
58
How many electrodes are used in precordial (chest) leads?
6 (V1 to V6)
59
How does the wave change from V1 to V6?
Negative blips at V1 going to positive blip at V6, changing somewhere around V3 or V4
60
Which chest electrode has the greatest positive blip?
V5
61
Which chest electrode has the greatest negative blip?
V1
62
How many perspectives does using all available leads allow?
6 angles in the coronal plane 6 angles in the transverse plane
63
What is the advantage of looking at the heart from 12 perspectives?
Changes in the spread of depolarisation will affect the ECG in a predictable manner
64
What does I, II and III along the left show?
Standard limb leads (SLL)
65
What does aVR, aVL and aVF in the middle-left show?
Augmented limb leads
66
What does V1 to V6 at the right show?
Precardial (chest) leads
67
What does II at the bottom show?
Rhythm strip
68
What is the limb lead between between the right arm and the middle of SLL III called?
aVR
69
What is the limb lead between the left arm and SLL II called?
aVL
70
What is the limb lead between the left foot and SLL I called?
aVF
71
What is aVR between?
Right arm and SLL III
72
What is aVL between?
Left arm and SLL II
73
What is aVF between?
Left leg and SLL I
74
What is the rhythm strip?
Continuous recording from SLL II
75
What is a continuous recording from SLL II called?
Rhythm strip
76
What does the rhythm strip allow you to work out?
Heart rate
77
What speed does the ECG paper run at?
25m/s
78
How large is the calibrating pulse of the ECG?
0.2s (1 large square, 5mm)
79
What does 1 large square on an ECG represent?
0.2s
80
How is the heart rate worked out from the rhythm strip?
Measure the R-R interval and work out how many occur in 60s Or count the R waves in 30 larger squares (this is 6s) and multiple by 10
81
What is the normal heart rate?
60-100bpm
82
What is considered to be bradycardia?
\<60bpm
83
What is considered to be tachycardia?
\>100bpm
84
What is bradycardia?
Abnormally slow heart rate
85
What is abnormally slow heart rate called?
Bradycardia
86
What is tachycardia?
Abnormally fast heart rate
87
What is abnormally fast heart rate called?
Tachycardia
88
What does the rhythm strip tell you?
Is each QRS complex preceded by a P wave Is the PR interval too short or too long Is the QRS complex too wide Is the QT complex too long
89
When is the PR interval too short?
\<0.12s
90
When is the PR interval too long?
\>0.2s
91
When is the QRS complex too wide?
\>0.12s
92
When is the QT complex too long?
\>0.42s at 60bpm
93
What is myocardial infarction?
Blood flow decreases or stops to a part of the heart, causing damage to the heart muscle (heart attack)
94
What is it called when blood flow decreases or stops to a part of the heart?
Myocardial infarction
95
What are the 2 kinds of myocardial infarction?
STEMI NSTEMI
96
What is STEMI?
ST elevated myocardial infarction
97
What is NSTEMI?
Non-ST elevated myocardial infarction
98
Which of STEMI and NSTEMI is worse?
STEMI

B2. Cardiovascular System (41 decks)

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