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BRS - Year 2 > 🫀🫁Cardio & Resp🫀🫁 - Electrocardiography & Rhythm Disorders > Flashcards

🫀🫁Cardio & Resp🫀🫁 - Electrocardiography & Rhythm Disorders Flashcards

1
Q

What can an ECG be used to diagnose?

A

Conduction abnormalities
Structural abnormalities
Perfusion abnormalities

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2
Q

Why are ECGs so popular?

A

Relatively cheap and easy to undertake
Reproducible between people and centres
Quick turnaround on results/report

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3
Q

What is a cardiac vector?

A
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4
Q

What causes a deflection on an ECG?

A

A deflection on an ECG is generated by the movement of electrical currents through the heart’s muscle tissue
If this is towards the positive electrode, upwards deflection
If this is towards the negative electrode, this will be downwards
If it is towards neither, then it will be isoelectric (may be picked up by another lead however)
This is why an ECG has so many leads, to capture electrical impulses moving in all directions

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5
Q

What are the signals in the cardiac cycle?

A
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6
Q

Where in the heart is the electrical impulse pictured here?

A

Sinoatrial node (SAN)
Autorhythmic myocytes
Atrial depolarisation

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7
Q

Where in the heart is the electrical impulse pictured here?

A

Atrioventricular node (AVN)
AVN depolarisation
Isoelectric ECG
Slow signal transduction
Protective

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8
Q

Where in the heart is the electrical impulse pictured here?

A

Bundle of His
Rapid conduction
Insulated

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9
Q

Where in the heart is the electrical impulse pictured here?

A

Bundle branches
Septal depolarisation

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10
Q

Where in the heart is the electrical impulse pictured here?

A

Purkinje fibres (1)
Ventricular depolarisation

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11
Q

Where in the heart is the electrical impulse pictured here?

A

Purkinje fibres (2)
Late ventricular depolarisation

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12
Q

Where in the heart is the electrical impulse pictured here?

A

Fully depolarised ventricles
Isoelectric ECG

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13
Q

Where in the heart is the electrical impulse pictured here?

A

Repolarisation
Ventricular repolarisation

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14
Q

Where is lead 1 placed?

A

Right arm to left arm
(negative to positive)

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15
Q

Where is lead 2 placed?

A

Right arm to left leg
(negative to positive)

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16
Q

Where is lead 3 placed?

A

Left arm to left leg
(negative to positive)

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17
Q

Where is V1 placed?

A
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18
Q

Where is V2 placed?

A
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19
Q

Where is V3 placed?

A
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20
Q

Where is V4 placed?

A
21
Q

Where is V5 placed?

A
22
Q

Where is V6 placed?

A
23
Q

What is the most commonly used single lead?

A

Lead 2

24
Q

Summarise the 12 lead ECG (unsure of how much is needed to be memorised/recalled)

A
25
Q

What are all the major timings on an ECG?

A
26
Q

What are the augmented limb leads?

A

aVR
aVL
aVF

27
Q

Where is the aVL positioned?

A

1/2 Lead 2 (RA to LL) to left arm
(negative to positive)

28
Q

Where is the aVR positioned?

A

1/2 lead 3 (LA to LL) to right arm
(negative to positive)

29
Q

Where is the aVF positioned?

A

1/2 lead 1 (RA to LA) to left leg
(negative to positive)

30
Q

What angle on the cardiac axis does each lead correspond to?

A

Lead I: 0° (horizontal, looking at the heart from the left side)
Lead II: +60° (looking from the lower-left diagonal, towards the left ventricle)
Lead III: +120° (lower-right diagonal, looking at the right ventricle)
aVR: -150° (rightward, opposite the normal flow of electrical impulses)
aVL: -30° (upper-left, between the left and right sides)
aVF: +90° (vertical, looking up from the feet)

31
Q

How is the cardiac axis angle of an impulse calculated?

A
32
Q

What are the steps of the ECG reporting procedure?

A
33
Q

What is a sinus rhythm?

A

Normal hearth rhythm
Each P-wave is followed by a QRS wave (1:1)
Rate is regular (even R-R intervals) and normal (83 bpm in this example)

34
Q

What is sinus bradycardia?

A

Each P-wave is followed by a QRS wave (1:1)
Rate is regular (even R-R intervals) and slow (e.g. 56 bpm)
Can be healthy, caused by medication or vagal stimulation

35
Q

What is sinus tachycardia?

A

Each P-wave is followed by a QRS wave (1:1)
Rate is regular (even R-R intervals) and fast (e.g. 107 bpm)
Often a physiological response (i.e. secondary)

36
Q

What is sinus arrythmia?

A

Each P-wave is followed by a QRS wave (1:1)
Rate is irregular (variable R-R intervals) and usually normal (65-100bpm)
R-R interval varies with breathing cycle

37
Q

Give an example of how sinus arrhythmia may appear on an ECG

A
38
Q

What is atrial fibrillation?

A

Oscillating baseline - atria contracting asynchronously
Rhythm can be irregular and rate my be slow
Turbulent flow pattern increases clot risk
Atria not essential for cardiac cycle - patient wont present with acute heart failure

39
Q

What is atrial flutter?

A

Regular saw-tooth pattern in baseline (II, III, aVF)
Atrial to ventricular beats at a 2:1, 3:1 or higher ratio
Saw tooth not always visible in all leads

40
Q

What is first degree heart block?

A

Prolonged PR segment/interval caused by slower AV conduction
Regular rhythm - 1:1 ratio of P-waves to QRS complexes
Most benign heart block, but a progressive disease of ageing

41
Q

What is second degree heart block (Mobitz I)?

A

Gradual prolongation of the PR interval until beat skipped
Most P-waves followed by QRS; but some P-waves are not
Regularly irregular: caused by a diseased AV node
Also called Wenckebach

42
Q

What is second degree heart block (Mobitz II)?

A

P-waves are regular, but only some are followed by QRS
No P-R prolongation
Regularly irregular: successes to failures (e.g. 2:1) or random
Can rapidly deteriorate into third degree heart block

43
Q

What is third degree heart block?

A

Complete heart block
P-waves are regular, QRS are regular, but no relationship
P waves can be hidden within bigger vectors (such as a QRS complex)
A truly non-sinus rhythm – back-up pacemaker in action

44
Q

What is ventricular tachycardia?

A

P-waves hidden – dissociated atrial rhythm
Rate is regular and fast (100-200 bpm)
At high risk of deteriorating into fibrillation (cardiac arrest)
Shockable rhythm – defibrillators widely available

45
Q

What is ventricular fibrillation?

A

Cardiac arrest
Heart rate irregular and 250+bpm
Heart unable to generate an output
Shockable rhythm - defibrillators widely available

46
Q

What is ST elevation?

A

P waves visible and always followed by QRS (1:1)
Rhythm is regular and rate is normal (85 bpm)
ST-segment is elevated >2mm above the isoelectric line
Caused by infarction (tissue death caused by hypoperfusion)

47
Q

What is ST depression?

A

P waves visible and always followed by QRS
Rhythm is regular and rate is normal (95 bpm)
ST-segment is depressed >2mm below the isoelectric line
Caused by myocardial ischaemia (coronary insufficiency)

48
Q

What is the difference between ischaemia and infarction?

A

Ischaemia is reduced blood flow, resulting in oxygen deprivation and cell injury
Infarction is cell death due to prolonged ischaemia

BRS - Year 2 (46 decks)

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