Chapter 4- ECG

Question 1

***Hexaxial (Limb) Leads look into what plane?

______Triangle, include leads ____ , ___ and _____These leads are

Answer 1

look in frontal plane)
– Einthoven’s triangle – Leads I, II, III
Bipolar pos and neg poles

Question 2

*****aVR, aVL, aVF
• Unipolar
What does the letter stands for?

Answer 2

• aV = “augmented voltage”
• R = Right arm
• L = Left arm
• F = Foot

Question 3

**Precordial Leads look into what plane? what are the leads?

Answer 3

look in transverse plane – v1 through v6

Question 4

***Lead II

Answer 4

Conduction system pointing toward lead II

Question 5

** I, aVL: lateral

Answer 5

Lateral

Question 6

** II, III, aVF:

Answer 6

inferior

Question 7

** aVR:

Answer 7

superiomedial

Question 8

What are the precordial leads

Answer 8

V1-V6

Question 9

**Anterol septal looks at

Answer 9

V1, V2

Question 10

*****Antero apical

Answer 10

V3, V4

Question 11

*****Anterolateral

Answer 11

I, aVL, V5, V6

Question 12

*****Interior

Answer 12

II, III, aVF

Question 13

**Anteroseptal wall infarct include

Answer 13

V1-V4

Question 14

*****Lateral wall infarct include

Answer 14

I, avL, V5, V6

Question 15

*****Inferior wall Infarct include

Answer 15

II, III

Question 16

QRS axis should be between _____to ______

Answer 16

-30 to +90, represents average direction of ventricular depolarization in frontal plane based on leads I and II

Question 17

________represents abnormality

Answer 17

Deviation

Question 18

• **Right axis deviation

* **Left axis deviation

Answer 18

> +90 degrees

Question 19

***Causes of left axis deviation (ILLeftANL)

Answer 19

Inferior wall MI
Left anterior fascicular block
LVH

Question 20

**Causes of Right axis deviation (RAleftPo)

Answer 20

RVH
Acute R heart strain
Left posterior fascicular block

Question 21

**How to determine MEAN QRS AXIS ? The more perpendicular the axis is to a lead,

Answer 21

**the more isoelectric the QRS complex will be

Question 22

P wave abnormalities (ATRIAL ENLARGEMENT)

Answer 22

Best seen in Lead II & V1

Question 23

P wave abnormalities
*****Lead II views which axis ? what plane

ATRIAL ENLARGEMENT in _____leads what plane?

Answer 23

RA depol. almost immediately followed by LA
depol. Both superimposed.

Perpendicular axis
FRONTAL
V1
Transverse

Question 24

STEP to find Axis deviation

Answer 24

1. FIND ISOMETRIC LEAD

2. FIND LEADS PERPENDICULAR TO ISOMETRIC LEAD

Question 25

***Best to look for atrial abnormalities

Answer 25

Lead II and V1

Question 26

***Ventricular abnormalities best seen in ___and ____

Answer 26

V1 and V6

Question 27

** Right Ventricular Hypertrophy

Answer 27

RIGHT AXIS DEVIATION
Wide R in V1
Deep S in V6

Question 28

*****LEFT Ventricular hypertrophy

Answer 28

LEFT AXIS DEVIATION

Right axis deviation
Deep S in V1
Tall R in V6

Question 29

***BBB best seen in ____and ______ .

Answer 29

V1 and V6

Question 30

**RBBB in ______ you will see ____ “______”

Answer 30

V1; RSR’; RABBIT EARS

V6 prominent S with late R depolarization

Question 31

***LBBB in ______ you will see ______

Answer 31

V1; prominent S

V6 notched R (similar to rabbit ear)

Question 32

***ST elevation is

Answer 32

First sign of MI

STEMI (ST elevation myocardial infarction

Question 33

****Pathologic Q waves
Develop where?
They are \_\_\_\_\_
Occur in \_\_\_\_\_\_
Do NOT INDICATE \_\_\_\_\_

Answer 33

In leads overlying infarcted tissue
Permanent evidence of MI
Groups of leads
When injury occurred, could be acute or years ago

Question 34

***Explain pathological Q waves

Answer 34

Dead infarcted tissue under lead has no electrical activity and act as a window for lead to see opposite side of the heart depolarizing away from lead causing downward deflecting pathological Q wave