Cardi - ECG Flashcards
Intrinsic rate of SA node
60-100bpm
Intrinsic rate of AV node
40-60bpm
Intrinsic rate of Ventricular Cells node
20-45bpm
SA node is located at the upper portion of the RA _____ to the site where the SVC drainis into the RA
a. lateral
b. medial
A
ECG wave form corresponding to atiral depolarization
p wave
ECG wave form corresponding to ventricular depolarization
QRS complex
A left bundle branch block is manifested in the ECG as
wide QRS
The ST-T-U complex correspond to
repolarization
The junction between the end of the QRS complex and the beginning of the ST segment
J point
Conditions in which atrial repolarization can becom aparent in the ECG
acute pericarditis
atrial infarction
Standard speed of ECG
25mm/s
location of V1
4th ICS right parasternal border
location of V2
4th ICS left parasternal border
location V3
midway between V2 and V4
location of V4
5th ICS left midclavicular line
location V5
5th ICS, L AAL
location V6
5th ICS L MAL
precordial lead at 5th ICS left midclavicular line
V4
precordial lead at 4th ICS right parasternal border
V1
precordial lead at 5th ICS L anterior axillary line
V5
precordial lead at 4th ICS L parasternal border
V2
Location of V6
5th ICS L mid axillary line
precordial leads: Anterior wall of the heart
V3V4
precordial leads: Lateral wall of the heart
V5-V6
The vector of lead I is going to the _____
a. left arm
b. right arm
c. foot
A
The vector of lead II is going
a. left foot
b. right foot
c. left arm
A
The vector of lead III is going
a. left foot
b. right foot
c. left arm
B
The vector of aVR is towards
a. Right arm
b. Left arm
c. floor
A
The vector of aVL is towards
a. Right arm
b. Left arm
c. floor
B
The vector of aVF is towards
a. Right arm
b. Left arm
c. floor
C
formed from the two arms and left leg. 2 apices of the upper part of the triangle represent the points at which the two arms connect electrically with the fluids around the heart. Lower apex is the point at which the left leg connect with th fluids
Einthoven’s triangle
The lead most commonly used during cardiac monitoring
lead II
lead I, II and II are
a. Unipolar leads
b. Bipolar leads
B
lead aVR, aVL, aVF are
a. Unipolar leads
b. Bipolar leads
A
Bipolar lead corresponding to left lateral wall of the heart
Lead I
Bipolar lead/s corresponding to inferior wall of the heart
Lead II, III
Unipolar lead/s that reflect right side of the heart
aVR
Affected wall when there’s ST segment elevation at
II, III, aVF
Inferior
Affected wall when there’s ST segment elevation at
V2, V3, V4
Anterior wallV2, V3, V4
Affected wall when there’s ST segment elevation at
V1, V2
Septum
Affected wall when there’s ST segment elevation at
V4, V5, V6
Lateral wall
Affected wall when there’s ST segment elevation at
I, aVL
High Lateral
Suspected artery with anterior wall MI
LAD
Suspected artery with lateral wall MI
left circumflex artery
Suspected artery with Right ventricular wall MI
right coronary artery
V1, V3R and V4R ST elevation
a. RIght atrial ischemia
b. Right ventricular ischemia
c. Inferior wall MI
d. Inferomedial wall MI
B
Normal duration of p wave
0.06-0.11s
Best lead to look at the atrium
Lead II
R atrial enlargement in ECG is peaked p wave with amplitude
> =2.5
what do you call peaked p waves on ECG
p pulmunale
what do you call left atrial enlargement on ECG
p mitrale
biphasic p wave in V1 with a broad negative component of a broad, often notched p wave in one or more limb leads
left atrial hypertrophy
Left atrial hypertrophy on lead V1
inverted p wave
most common condition causing notched p wave on Lead II or inverted p wave at Lead V1
mitral stenosis secondary to RHD
Normal duration of QRS complex
0.10-0.12s
The first negative deflection
Q wave
ECG finding: Rabbit Ear appearance at V1
RBBB
S in V1 + R in V5 or V6 whichever is larger or equal to 35mm
R in aVL >=11mm
The Sokolow-Lyon Index
The Sokolow-Lyon Index signifies what chamber abnormality
LVH
S in V3 + R in aVL = _____ in men to qualify for Cornell voltate criteria
> 28 mm
S in V3 + R in aVL = _____ in women to qualify for Cornell voltate criteria
> 20 mm
\What does the ST segment measure?
time between actual ventricular depolarization and repolarization
ST elevation is normal if it does not exceed
1 small square
What does T wave correspond to?
repolarization of the ventricles
T wave should not be more than __mm in amplitude in standard leads and __mm in precordial leads
5mm standard leads
10mm precordial leads
ECG findings in hypokalemia (<2.5mEq/L)
Prominent U wave
Diphasic T wave
Depressed ST segment
Normal duration of PR interval in terms of # of small squares
3-5
QRS should be ___ small squares
<3
What is the normal corrected QT interval for women
<0.46
What is the normal corrected QT interval for men
<0.45
saw tooth pattern of the p wave is seen in
Atrial flutter
Prominent ECG finding in First degree AV block
prolonged PR interval
p wave amplitude should not be more than __mm
2.5mm
p wave is usually positive in which limb leads?
all limb leads, EXCEPT aVR, variable in V1
Interpretation of inverted P wave
a. impulses may be originating at varying sites
b. wandering pacemaker
c. SA node is not the pacemaker
d. left atrial dilatation
C
normal duration of PR interval
0.12-0.20s
Prolonged PR interval EXCEPT
a. first degree AV block
b. cardiac glycoside
c. Junctional dysrhythmia
d. NOTA
C
normal duration of qrs complex
0.06-0.09s
Widened QRS EXCEPT
a. atrial tachycardia
b. bundle branch block
c. PVC
d. VT
e. Idioventricular rhythm
A
part of ECG that represent early phase of ventricular repolarization
ST segment
T/F ST segment elevation 1mm above isoelectric point is normal
T; >1mm above or below isoelectric point abnormal
T wave is usually positive EXCEPT in
a. aVR
b. AVF
c. II
d. AOTA
A; could also be negative in III, V1, V2
MI
a. peaked T waves
b. inverted T waves
c. biphasic T wave
B
Hyperkalemia
a. peaked T waves
b. inverted T waves
c. biphasic T wave
A
Prolonged QT interval
a. hypocalcemia
b. hypercalcemia
A
Part of ECG representing His-Purkinje system
U wave
Left axis deviation value
-30 to -90deg
Right axis deviation value
+90 to 180deg
Normal axis
-30 to +90 deg
Extreme exis
-90 to 180
normal sinus rhythm:
cycle length do not vary by ___%
10%
Left anterior fascicular block
a. left axis deviation
b. QRS duration<120msec
c. rS in II, III, aVF
d. qR in I and aVL
e. AOTA
E
Left posterior fascicular block axis deviation:\_\_\_\_\_ rS pattern in \_\_ and \_\_\_ qR in \_\_\_\_\_ QRS duration:\_\_\_\_
RAD
I and avL
inferior leads
<120msec
broad, notched R in V5-V6 and usually I and aVL
a. LBBB
b. RBBB
A
deep S waves in v5-v6
a. LBBB
b. RBBB
B
QRS duration in LBBB or RBBB
> =120msec
ST elevation
a. ischemia
b. injury
B
peaked T waves, ST elevation, significant Q waves
a. Ischemia
b. Injury
c. Infarction
C
Criteria for significant ST elevation
1mm in at least 2 limb leads
2mm in at least 2 chest leads
Definition of pathologic Qwave
> 25% of R wave amplitude and 0.04s duration
inverted T waves, St depression
a. Ischemia
b. Infarction
A
Septal MI
V1
V2
Anterior MI
V3
V4
Inferior MI
II, II aVF
Lateral
I, AvL
Anterolateral
V5, V6
Definition of Ischemia based on T wave
T wave inversion of at least 1mm in two contiguous leads
Peaked T waves
a. hypokalemia
b. hyperkalemia
B
Shortened QT interval
a. hypokalemia
b. hyperkalemia
c. hypercalcemia
d. hypocalcemia
C
Prolonged QT interval
a. hypercalcemia
b. hypocalcemia
c. digitalis toxicity
d. hyperkalemia
B
T/F U wave as tall as T wave is significant
T
Prolonged PR interval >0.2s
a. 1st degree AV block
b. Wenkebach
c. Mobitz Type I
d. Mobitz Type II
A
Progressive prolongation of the PR interval until there is a dropped beat a. 1st degree AV block b. Mobitz Type I c. Wenkebach d. A and B E. B and C
E
Mobitz Type II 2nd degree AV block
a. regular P waves
b. dropped beat
c. PR interval does not change
d. AOTA
D
QRS <0.12s
a. normal qrs
b. narrow qrs
c. wide qrs
B
150-250 bpm
a. sinus tachycardia
b. SVT
c. Afib
d. VT
B
Narrow QRS EXCEPT
a. SVT
b. VT
A
Describe QRS of VT
Narrow
narrow qrs tachycardia, 150-250 bpm, no p waves
SVT
atrial firing in atrial fibrillation ___-___bpm
350-600/min
Atrial rate of atrial flutter
250-350/min
At least how many consecutive pVCs in ventricular tachycardia?
at least 3
5 types of ventricular tachcardia
nonsustained sustained monomorphic polymorphic torsades de pointes
