Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

TxWes Spring '25: Health assessment > Basic & Adv EKG Exam 1 > Flashcards

Basic & Adv EKG Exam 1 Flashcards

1
Q

In what leads should a p-wave be positive?

A

I, II, aVF, V4-V6

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What should the duration of a p-wave be?

A

< 0.12 seconds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What should the duration of a PR interval be?

A

0.1 - 0.2 seconds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What should the duration of a QRS complex be?

A

< 0.12 seconds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Elevation/depression of an ST segment by __ mm is clinically relevant

A

1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

T-waves should be positive in which leads?

A

I, II, V3-V6

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What does Paroxysmal mean?

A

Intermittent

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Ventricular ectopy is usually indicative of what?

A

K⁺ imbalances

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What effects do halothane/enflurane have in regards to arrhythmias?

A

Halothane & enflurane sensitize the myocardium (increase sensitivity to arrhythmias)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What arrhythmia in infants can result from sevoflurane?

A

Bradycardia (via oculo-cardiac reflex?)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What can desflurane cause during induction?

A

Prolonged QT (>0.35 seconds)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What two adverse events can occur from local anesthetic injection into the vasculature?

A

Severe bradycardia
Asystole

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

How would excessive intravascular lidocaine be treated?

A

Lipid rescue

Administer IV lipid emulsion to sequester lidocaine from plasma, reducing its toxic effects.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the exhaustive list of conditions that can result in perioperative dysrhythmias?

A

General anesthetics
Local anesthetics
Abnormal ABG or electrolytes
Endotracheal intubation (most common)
Autonomic reflexes
CVP cannulation
Surgical stimulation of heart/lungs
Location of surgery (eyes)
Hypoxemia
Cardiac Ischemia
Catecholamine excess

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What anatomic structure (discussed in class) causes dysrhythmias when stimulated during cardiac surgeries?

A

Pulmonary arteries

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What example was given of a surgical location where stimulation results in dysrhythmias?

A

Eyes (due to oculo-cardiac reflexes)
Heart/lungs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Where does lead V1 go? V2?

A

V1 - 4th ICS, right of sternum
V2 - 4th ICS, left of sternum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Where does lead V3 go?

A

V3 - between V2 and V4

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Where do leads V4, V5, and V6 go?

A

5th ICS, left of sternum
(mid-clavicular, anterior axillary, and mid-axillary)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What wave is the first negative deflection after the p-wave on any lead?

A

Q-wave
vector points toward right arm initially, signals beginning of ventricular contraction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What wave is the first positive deflection after a p-wave?

A

R-wave
Peak of ventricular systole

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Describe an s-wave.

A

Negative deflection below baseline after an R wave
Represents movement of axis toward last remaining ventricular cell to depolarize (top of left ventricle)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

1 small box on an EKG strip equals _____?

A

0.04s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

1 large box on an EKG strip equals ______?

A

0.2s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What mV is denoted by a small box on an EKG strip?

A

0.1mV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What mV is denoted by a large box on an EKG strip?

A

0.5mV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

One full EKG strip is how many seconds? What is half a strip?

A

Full strip: 6 secs
Half strip: 3 secs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

If healthy, both the QRS complex and T-wave should be ______ deflections in leads I, II, & III.

A

positive.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What is the mean electrical axis of the heart?

A

59°

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

A clockwise shift (>59 degrees) of the mean electrical axis shift of the heart is indicative of what?

A

Right-axis deviation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

A counterclockwise shift (<59 degrees) of the mean electrical axis shift of the heart is indicative of what?

A

Left-axis deviation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Regarding Lead I, where is the negative terminal connected? How about the positive terminal?

A

Negative terminal = Right arm
Positive terminal = Left arm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Regarding Lead II, where is the negative terminal connected? How about the positive terminal?

A

Negative terminal = Right arm
Positive terminal = Left leg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Regarding Lead III, where is the negative terminal connected? How about the positive terminal?

A

Negative terminal = Left arm
Positive terminal = Left leg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What angle is viewed utilizing aVF?

A

90°

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

What angle is viewed utilizing aVL?

A

-30°

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

What angle is viewed utilizing aVR?

A

-150°

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Which lead can be used as the determinant of posterior vs anterior injury?

A

V2
Positive deflection: posterior injury
Negative deflection: anterior injury

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

In which precordial lead does the QRS complex have the most magnitude?

A

V4

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

What are the positive & negative terminals for lead aVR?

A

Negative = left arm + left leg (+30°)
Positive = right arm (-150°)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

What are the positive & negative terminals for lead aVF?

A

Negative = left arm + right arm
Positive = left leg

42
Q

What are the positive & negative terminals for lead aVL?

A

Negative = left leg + right arm
Positive = left arm

43
Q

What cardiac EKG lead is the least useful in practice but most unique in its position?

44
Q

What is the axis of Lead I?

45
Q

What is the axis of Lead III?

46
Q

What is the axis of Lead II?

47
Q

What degree change would characterize an extreme axis deviation?

A

-90° to 180°

48
Q

What would the mV of this QRS complex be?

A

+1.5mV
(1 big box = 0.5mV)

49
Q

Determine the mV of leads I & III and subsequently the degree & axis of deviation noted by these strips.

A

Lead I ≈ -2.5mV
Lead III ≈ +1.75mV
Deviation ≈ inbetween +180° & +120° ≈ 170° due to greater Lead I magnitude. Significant right axis deviation

50
Q

What is the diagnosis for this EKG?

A

Left axis deviation in Lead I & Lead III
Possible LEFT ventricular hypertrophy (left ventricle depolarizes later than the right ventricle)
more tissue = longer depolarization

51
Q

What is the diagnosis of this EKG?

A

Right axis deviation in Lead I & Lead III
Possible RIGHT ventricular hypertrophy

52
Q

What is the diagnosis for this EKG?

A

Left axis deviation in Lead I & Lead III
Left bundle branch block

53
Q

A positive current of injury noted on V2 would be indicative of what?

A

Posterior MI
abnormal depolarizing tissue posteriorly moving towards V2

54
Q

A negative current of injury noted on V2 would be indicative of what?

A

Anterior MI
abnormal depolarizing tissue anteriorly moving away from V2

55
Q

What axis would be expected with a negative QS deflection in leads I and II and a positive R deflection in Lead III?

A

Right Axis Deviation

56
Q

What axis would be expected with a negative QS deflection in leads II and III and a positive R deflection in Lead I?

A

Left Axis Deviation

57
Q

A positive V1 QRS with negative QRS in leads I, II, and III would the resulting axis be?

A

Extreme Axis Deviation

58
Q

What block would you expect to present with a right axis deviation 90 to 180 degrees?

A

Posterior Hemiblock
Right axis deviation is always pathological
small R in lead I, small Q in lead III

59
Q

What block would you expect to present with a left axis deviation that is -40 to -90 degrees?

A

Anterior Hemiblock
this is a pathological left axis
small Q in lead I, small R in lead III

60
Q

What is physiologic left axis deviation?

A

Left axis deviation that is 0 to -40 degrees
normal variant especially in obese or athletic people

61
Q

What is an MCL1 lead? How is it placed?

A

Modified V1 lead

Negative on left arm, positive in 4th ICS right of sternum.

62
Q

What would leads I, II, and III look like with normal axis?

63
Q

What is the most common cause of right ventricular hypertrophy?

A

Lung disease, pulmonary embolus, and pulmonary valve disease.

64
Q

Bundle Branch Block diagnosis is dependent on ______. Hemiblock diagnosis is based on _______________.

A

time
axis deviation

65
Q

What pertinent anatomical features of the heart are fed via the RCA?

A

Inferior & posterior LV wall
Right ventricle
SA & AV node
Posterior fascicle of LBB

66
Q

What pertinent anatomical features of the heart are fed via the LAD?

A

Anterior wall of LV
Septal wall
Bundle of His & BB

67
Q

What severe outcome should you worry about with septal infarct?

A

Septal rupture

68
Q

What pertinent anatomical features of the heart are fed via the circumflex artery?

A

Lateral wall of LV
*SA & AV nodes (?)
Posterior wall of LV

69
Q

Why is morphine now avoided in MI’s?

A

Morphine causes histamine release.

70
Q

What percentage occlusion would be assumed with chest pain on exertion?

A

70 - 85% occlusion

71
Q

What percentage occlusion would be assumed with chest pain at rest?

A

90% occlusion

72
Q

What percentage occlusion would be assumed with chest pain unrelieved by nitroglycerin?

A

100% occlusion

73
Q

What should be administered before nitroglycerin with an acute right-sided MI?

A

fluid bolus

74
Q

Are EKGs better in regards to sensitivity or specificity?

A

Specificity
(If MI is shown on EKG then its likely an MI) but sensitivity is 50% for EKGs so a negative EKG result doesn’t rule out MI)

75
Q

What sign would indicate ischemia?

A

Symmetrical inverted T-waves in two or more related leads.

76
Q

What sign would indicate an injury pattern?

A

ST segment elevation of more than 1mm in two or more related leads.

77
Q

What sign would indicate infarction?

A

Pathologic Q waves ( >40ms wide or ⅓ the depth of r-wave height) coupled with ST elevation.

78
Q

Which leads indicate a true lateral MI? Which would indicate a high lateral?

A

True lateral = V5 & V6
High lateral = I, aVL

79
Q

What is the most commonly seen MI? What is commonly seen with this type of MI? Do you use nitrates?

A

Inferior
Bradycardia, hypotension, 1st degree or Mobitz 1 blocks, and nausea.
Caution with nitrates due to RV’s being preload dependent w/ inferior MI’s

80
Q

What is the most lethal MI? What dysrhythmias are commonly seen with this type of MI? Do you use nitrates?

A

Anterior Wall (LAD)
CHB and VF/Vtach
Yes to nitrates.

81
Q

What would cause one to prepare defibrillation pads for a patient undergoing an anterior MI? (other than vfib/vtach)

A

Presence of BBB or hemiblock whilst undergoing an anterior MI

82
Q

What condition presents with ST elevation on all leads? How is it diagnosed?

A

Pericarditis
Patient feels better when they lean forward and there won’t be reciprocal ST depression. Diagnosed via fever, WBCs, hx of IVDU, etc.

83
Q

What condition looks like myocardial infarction on an EKG but can be fatal if thrombolytics are administered?

A

Dissecting thoracic aorta aneurysm.

84
Q

What four conditions mimic myocardial infarction in their EKG presentation?

A

LBBB
LV hypertrophy
Pericarditis
Thoracic aortic dissection

85
Q

What is the intrinsic rate of the SA node?

A

110 bpm w/out SANS or PANS stimulation

86
Q

What is the intrinsic rate of the AV node?

87
Q

What is the intrinsic rate of the bundle branches?

88
Q

What is the intrinsic rate of the Purkinje system?

89
Q

What is the name of the nerve that branches off the SA node to innervate the left atrium?

A

Bachmann’s bundle (interatrial bundle)

90
Q

When does atrial repolarization occur?

A

During QRS interval
Cannot be seen because it occurs during ventricular depolarization

91
Q

What is Einthoven’s formula?

A

Lead I + Lead III = Lead II

92
Q

What is SALI? What leads are associated?

A

S: V1, V2 (SEPTAL)
A: V3, V4 (ANTERIOR)
L: V5, V6, aVL, I (LATERAL)
I: II, II, and aVR (INFERIOR)

93
Q

Hyperkalemia EKG changes are (3)

A
  1. Wide and low P wave
  2. Wide QRS
  3. Tall T waves
94
Q

Hypokalemia EKG changes? (3)

A
  1. ST depression
  2. Flat or negative T wave
  3. U-waves
95
Q

Hypercalcemia EKG changes (2)

A

broad, tall peaking T waves
Severe: extremely wide QRS, disappearance of P wave, tall peaking T waves

96
Q

Hypocalcemia EKG changes?

A
  1. Narrow QRS
  2. Flattened T waves Severe
  3. Prolonged QT interval
  4. U-wave
  5. Prolonged ST and ST depression
97
Q

What are the 3 I’s of infarction?

A
  1. Ischemia (inverted T waves >2 leads)
  2. Injury pattern (ST elevation > 1mm in >2 leads)
  3. Infarction (pathologic Q waves)
98
Q

What is reciprocal change on an EKG? What do we see?

A

ST changes that appear in leads that are opposite (reciprocal) to the leads where the primary changes are observed.
We see ST depression or inversion/flattening

99
Q

Where do we see reciprocal changes for ST elevations in: Leads V3, V4, V5, V6, aVL, and I? (anterior and lateral MI)

A

Leads II, III, and aVF
(inferior leads)

100
Q

Where do we see reciprocal changes for ST elevations in II, III, and aVF?
(Inferior MI)

A

I and aVL
(Lateral leads)

TxWes Spring '25: Health assessment (10 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions