Diagnostics EKG Quiz 1

Question 1

Resting heart electrical charge

Answer 1

-70

Question 2

What is the (+) electrode

Answer 2

The “looker”

Question 3

3 types of cardiac cells

Answer 3

Pacemaker cells: electrical power (sinus node)

Electrical conduction cells: wiring of heart

Myocardial cells: Machinery of heart

Question 4

How long does it take to get from SA node to AV node

Answer 4

.04 sec

Question 5

How long is pause at AV node

Answer 5

.1 sec

Question 6

How long does it take for current to cross ventricles

Answer 6

.06 sec

Question 7

Electrical current route of heart

Answer 7

SA 
Atrium
AV
Bundle of His
Splits left and right

Left bundle Branch
Purkinje fibers

Right bundle branch
splits again into posterior/anterior fascicle

Question 8

Sinus node rate

Answer 8

60-100

Question 9

AV node rate

Answer 9

40-60

Question 10

Bundle of his rate

Answer 10

40-60

Question 11

Ventricles / purkinje fibers rate

Answer 11

30-45

Question 12

Interval times

PR interval

Answer 12

0.12 - 0.20

Avg. = 0.18

Question 13

Interval times

QRS duration

Answer 13

0.06 to 0.12

Avg. = 0.08

Question 14

Interval times

QT interval

Answer 14

0.40 to 0.43 (less than half of R-R interval)

Avg. = 0.40

Question 15

Interval times

ST interval

Answer 15

Avg. = 0.32

Question 16

Segment times

ST Segment

Answer 16

0.08

Question 17

Avg. HR

Answer 17

60-100

Question 18

P wave time

Answer 18

0. 04-0.12

2. 5mm

Question 19

What is PR interval

Answer 19

Conduction pause of AV node

Question 20

What does P wave represent

Answer 20

Atrial depolarization

Question 21

What does QRS represent

Answer 21

Ventricular depolarization

Question 22

What does T wave represent

Answer 22

Ventricular repolarization

Question 23

Where is the Atrial repolarization on ECG

Answer 23

hidden in QRS

Question 24

Difference between intervals and segments

Answer 24

Intervals include Wave

Segments do not

Question 25

What does the flat line on the ecg represent

Answer 25

no electrical activity

Question 26

Lead I direction

Answer 26

Left to right

Question 27

Lead II direction

Answer 27

inferior to right

Question 28

Lead III Direction

Answer 28

Inferior to left

Question 29

AVF Direction

Answer 29

Inferior to heart

Question 30

AVL Direction

Answer 30

Left to Heart

Question 31

AVR Direction

Answer 31

Right to heart

Question 32

What orientation are precordial leads

Answer 32

anterior

Question 33

What are the inferior leads

Answer 33

II (+60) III (+120) AVF (+90)

Question 34

What are the Lateral leads

Answer 34

I (+0) AVL (-30) V5 V6

Question 35

What are the right sided leads

Answer 35

AVR (-150) | V1

Question 36

What are the anterior leads

Answer 36

V3 | V4

Question 37

What are the septal leads

Answer 37

V3 | V4

Question 38

What is a normal axis

Answer 38

0 - 90 degrees (positive)

Question 39

If there is a deviation, where is the problem

Answer 39

on the deviation side.

Question 40

What are deviation leads

Answer 40

I | AVF

Question 41

Causes of left axis deviation

Answer 41

Cause must be on left ie. Left ventricular hypertrophy Systemic hypertension Aortic stenosis

Question 42

Causes of right axis deviation

Answer 42

Cause must be on right ie. Right ventricular hypertrophy Pulmonary artery hypertension Uncorrected congenital heart disease

Question 43

RVH ECG findings

Answer 43

Right axis deviation R wave larger than S wave in V1 S wave larger than R wave in V6

Question 44

LVH ECG findings

Answer 44

R wave in V5 or V6 plus the S wave in V1 or V2 Exceeds 35mm R wave in V5 exceeds 26mm R wave in V6 exceeds 20mm R wave in V6 exceeds R wave in V5

Question 45

LVH ecg in limb leads

Answer 45

Any of these R wave in lead AVL exceeds 11mm R wave in lead AVF exceeds 20mm R wave in lead I exceeds 13mm R wave in lead I plus S wave in lead II exceeds 25mm

Question 46

Amplitude on ECG strip

Answer 46

2 large squares = 1 mV One small square = 0.1 mV One large square = 0.5 mV

Question 47

Time on ECG Strip

Answer 47

5 large squares = 1 sec one small square = 0.04 sec One large square = 0.2 sec

Question 48

Ways to assess rate on ecg

Answer 48

6 second strip, count complexes, mult by 10 Large squares = 300,150,100,75,60,50,43,38 count small boxes between complexes, divide by 1500

Question 49

ECG Analysis

Answer 49

Rate ``` Rhythm Are p waves present Are qrs narrow or wide (< or > 0.12) Is there a P for every QRS is the rhythm regular or irregular ``` Axis Hypertrophy intervals infarction

Question 50

Rhythm (Reg/irr)

Answer 50

regular irregular regular irregular irregular irregular

Question 51

Ectopic

Answer 51

originates elsewhere

Question 52

R-R Interval

Answer 52

0.6 - 1.0

Question 53

5 types of arrhythmias

Answer 53

``` Sinus Ectopic reentrant conduction blocks preexcitation syndromes ```

Question 54

Sinus arrhythmias

Answer 54

Sinus Brady Sinus Tach Sinus arrhythmia Sinus arrest, asystole, escape beat

Question 55

Ectopic rhythms

Answer 55

Sinus node 60 - 100 Atrial pacemakers 60-75 AV node / junction / bundle of His 40-60 if 60-100 its accelerated junction If > 100 its junctional tachycardia Ventricles (bundle Branch, purkinje fiber) 30-45 Vent escape beats 30-45 Accelerated idioventricular rhythm 45-100 Ventricular tachycardia >100

Question 56

Junctional rhythms and p waves

Answer 56

no p wave in junctional rhythm

Question 57

A Fib

Answer 57

No p waves atria is fibrillating

Question 58

A flutter

Answer 58

saw tooth | lots of P waves

Question 59

Carotid massage

Answer 59

Fool carotid baroreceptors into thinking blood pressure is rising Vagal input decreases sinus node rate, slows conduction through AV node can terminate AVNRT can increase block rate of flutter to see waves more clearly not diagnostic can terminate AT

Question 60

Vagal maneuvers

Answer 60

Valsalva, squatting can raise blood pressure and stimulate vagal input to heart Decreases SA node rate Slows conduction through AV node