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Assessment Exam 1 > Advanced EKG > Flashcards

Advanced EKG Flashcards

1
Q

ST elevation in leads II, III, aVF

A

Inferior MI; RCA

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2
Q

Reciprocal leads of II, III, AVF

A

I, aVL

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3
Q

ST elevation in leads V1, V2

A

Septal MI; LAD

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4
Q

Reciprocal of V1, V2

A

Posterior wall

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5
Q

ST elevation in leads V3, V4

A

Anterior MI; LAD

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6
Q

Reciprocal of V3, V4

A

II, III, aVF

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7
Q

ST elevation in V5, V6, I, aVL

A

Lateral MI; circumflex

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8
Q

Reciprocal of V5, V6, I, aVL

A

II, III, aVF

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9
Q

ST elevation in V8, V9 R>S in V1

A

Posterior MI; RCA

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10
Q

Reciprocal of V8, V9

A

ST depression in V1-4

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11
Q

ST elevation in V4R

A

Right ventricle infact

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12
Q

I

A

Inferior leads II, III, aVF

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13
Q

S

A

Septal leads V1, V2

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14
Q

A

A

Anterior leads V3, V4

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15
Q

L

A

Lateral leads V5, V6, I, aVL

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16
Q

Wher is the negative electrode in lead I?

A

Under the right clavicle

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17
Q

Where is the negative electrode in lead II?

A

Under the right clavicle

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18
Q

Where is the negative electrode in lead III?

A

Under the left clavicle

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19
Q

What lead is the standard monitoring lead?

A

Lead II

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20
Q

Where do the leads of a 12-lead EKG go

A

V1 on the 4th intercostal space to the right of the sternum, V2 on the 4th ICS to the left of the sternum, V3 in between V2 and V4, V4 on the 5th intercostal space mid-clavicular line, V5 anterior axillary line 5th ICS, and V6 5th ICS mid-axillary line

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21
Q

The precordial leads

A

Are the leads placed on the torso

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22
Q

RSR prime

A

The second time the complex goes above the isoelectric line; indicates a conduction abnormality

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23
Q

Where might you most commonly see an RSR prime?

A

RBBB in V1

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24
Q

What does the J point tell us?

A

It is the point of reference for determining BBBs and measuring ST elevation

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25
How would we determine a rapid axis?
Run leads I, II, and III
26
Normal axis
0-90 degrees
27
Physiologic LAD
0 to -40 degrees
28
Pathologic LAD
-40 to -90 degrees
29
Extreme RAD
No man's land
30
RAD
90-180 degrees
31
Who commonly has physiologic LAD?
Athletes and obese people
32
RAD is always
Indicative of pathology
33
How do we determine a BBB?
QRS must be wider than 0.12s and look in V1
34
Which is worse, LBBB or RBBB?
LBBB, because two of the three fascicles are blocked
35
When presenting with a RBBB and _____ put pads on the patient
A hemiblock; suspect occlusion of the LAD CA
36
A LBBB has which axis deviation?
Left or right depending on degree of blcok
37
Hemiblocks differ from BBBs in that
They can have narrow complexes
38
What drugs are contraindicated in bifasicular blocks?
Procainamide and lidocaine
39
The RCA supplies blood to what parts of the heart?
SA and AV node, inferior wall, posterior wall, right ventricle, and posterior fascicle of the LBB
40
People with RCA occlusion/MIs may present with
Abdominal pain/ N/V
41
The LAD supplies blood to what parts of the heart?
The anterior wall fo the LV, septal wall, BoH, and bundle brances
42
What is a common symptom of RCA occlusion?
Bradycardia
43
What do we worry about with LAD occlusion
Myocardial rupture
44
The circumflex artery supplies blood to what parts of the heart?
Lateral LV wall, SA and AV nodes, and posterior wall of LV
45
Chest pain on exertion indicates what percentage of occlusion?
70-85%
46
Chest pain at rest indicates what percentage of occlusion?
90%
47
Chest pain without relief from nitro indicates what percentage of occlusion?
100%
48
Absolute contraindications to anti-thrombolytic therapy
Sx within past three weeks, recent ICH, ischemic strokes, active bleeds, head trauma
49
Relative contraindications to anti-thrombolytic therapy
Age greater than 75, pregnancy
50
Three I's of infarction
Ischemia, Injury, ST depression, Infarction
51
Define ischemia
Transient reduction in blood flow to the myocardium
52
Ischemia will show up in a 12-lead by
Inverted T waves in 2 or more related leads
53
Injury will show up in a 12-lead by
ST elevation in 2 or more related leads; most important thing to look for
54
ST depression shows up in a 12-lead by
Reciprocal leads from ST elevation
55
ST depression can indicate
Subendocardial injury; drug or electrolyte issue; ischemia
56
What two things commonly cause ST depression?
Hypokalemia and dig
57
Infarction shows up on a 12-lead by
Pathologic Q waves - > .04s wide or 1/3 depth of R wave height; when seen with ST elevation
58
Infarction indicates
Death or necrosis of tissue
59
Why don't the septal leads have reciprocal leads?
No leads for posterior wall
60
Avoid what in an inferior MI?
Nitro; manage with fluids instead
61
Most common MI?
Inferior
62
Cardiac S/S of inferior MI
Bradycardia and HPN; 1st degree heart block or Mobitz I block; N/V
63
50% of patients with inferior MIs also have
Posterior and right ventricular involvement
64
What is the most lethal MI?
Anterior MI
65
What arrhythmias may suddenly develop with an anterior MI
Complete heart block, VF, Vtach
66
Anterior wall MIs also can extend to
The septum and lateral parts of the hear
67
Don't give ______ to patients with an anterior MI
Fluids
68
LBBB is considered a _________? Because?
Non diagnostic EKG; because the late repolarization of the LV distorts the ST elevation
69
Do not give ________ or ________ to a suspected dissecting thoracic aortic aneurysm?
Heparin or NTG
70
Dissecting thoracic aortic aneurysms do not
Have reciprocal changes in leads showing ST elevation
71
Pericarditis causes
ST elevation in at least 6 leads
72
Pericarditis might give itself away when
The patient leans forward to relieve the pain
73
Pericarditis will not
Have reciprocal lead changes

Assessment Exam 1 (5 decks)

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