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Y2 CARDIORESP > ECG > Flashcards

ECG Flashcards

1
Q

what do ECGs allow us to identify?

A

conductional abnormalities, structural abnormalities, perfusion abnormalities

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2
Q

What is happening if the deflection from the isoelectric line is in a downward direction?

A

theres a charge travelling towards the negative electrode (anode)

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3
Q

what is happening if the deflection from the isoelectric line is in an upward direction?

A

the wave of excitation is moving toward the cathode (positive electrode)

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4
Q

What is happening if there is no deflection from the isoelectric line?

A

no net change in voltage, the vectors are perpendicular to lead

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5
Q

What happens during the P wave of an ECG?

A

atrial excitation phase, the electrical signal stimulates the contraction of the atria (atrial systole)

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6
Q

What happens during the QRS complex of an ECG?

A

contraction of ventricles, electrical signal stimulating ventricular contraction (ventricular systole)

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7
Q

What happens during the T wave of an ECG?

A

repolarisation of the ventricles, electrical signal that signifies the relaxation of ventricles

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8
Q

What are the six cardiac vectors?

A

SAN, AVN, bundle of his, bundle branches, purkinje fibres 1, purkinje fibres 2,

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9
Q

What is the SAN vector?

A

Shows Autorythmic myocytes and atrial depolarisation

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10
Q

What is the AVN vector?

A

Shows AVN depolarisation, isoelectric ECG, slows signal transduction , is protective and important for mechanics of heart

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11
Q

What is the Bundle of His vector?

A

Is insulated and has rapid conduction

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12
Q

What is the bundle branches vector?

A

Shows septal depolarisation, start of QRS complex

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13
Q

What is the Purkinje fibres 1 vector?

A

Shows ventricular depolarisation, is the R wave

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14
Q

What is the Purkinje fibres 2 vector?

A

Shows late ventricular depolarisation, is the S wave

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15
Q

What is the fully repolarised vector?

A

Comes after QRS complex, is isoelectric

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16
Q

What is the repolarisation vector?

A

The T wave

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17
Q

How are leads arranged in an ECG?

A

Rule of L’s:
Lead 1 = right arm to Left arm
Lead 2 = right arm to Left Leg
Lead 3 = Left arm to Left Leg

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18
Q

How is each lead read in an ECG?

A

Drawn as a triangle, read from left to right, and top to bottom, 1st electrode in each pair is the anode

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19
Q

What is the chest electrode arrangement?

A

V1 = right sternal border, 4th intercostal space
V2= left sternal border, 4th intercostal space
V3 = Halfway between V2 and V4
V4 = mid-clavicular line, 5th intercostal space
V5 = Anterior axillary line at level of V4
V6 = Mid-axillary line, level of V4

20
Q

What are the 8 things we can calculate from an ECG?

A

R-R interval, P wave duration, P-R interval, QRS duration, QT interval, T wave duration, HR, QRS axis

21
Q

Each small square on an ECG represents how long?

A

0.04 seconds (big square = 0.2 seconds)

22
Q

What do we need to be able to calculate the cardiac axis?

A

2 perpendicular leads

23
Q

Which leads are perpendicular to each other?

A

aVF perpendicular to lead 1. aVL perpendicular to lead 2, aVR perpendicular to lead 3

24
Q

What checks are made before an ECG report is conducted?

A

Is it the correct recording, review the signal quality and leads, verify the voltage and paper speed, review the patient background if available

25
Q

Outline the steps of the ECG reporting procedure

A

1.Rate and rythmn
2. P wave and PR interval: duration, are all P waves followed by R
3. QRS duration: how long signal taking to get through myocardium
4. QRS axis
5. ST segment
6. QT interval
7. T wave
Double check findings

26
Q

What is seen on the ECG of someone with Sinus rythmn?

A

Each P wave followed by a QRS wave. Rate is regular (even R-R intervals) and normal (60-90bpm)

27
Q

What is seen on the ECG of someone with sinus bradycardia

A

Each P wave followed by QRS. Rate is regular and slow (<60bpm)

28
Q

What is seen on the ECG of someone with sinus tachycardia?

A

Each P wave followed by QRS. Rate is regular and fast (>100bpm)

29
Q

What is seen on the ECG of someone with sinus arrhythmia?

A

Each P wave followed by QRS. Rate is irregular (variable R-R intervals) and normal-ish (65-105bpm). R-R interval varies with breathing cycle

30
Q

Why does the R-R interval of a patient with sinus arrhythmia vary with the breathing cycle?

A

Turns up or down PNS which slows down HR

31
Q

What is seen on the ECG of someone with atrial fibrillation?

A

An oscillating baseline as atria contracting asynchronously. Rhythm can be irregular and rate may be slow.

32
Q

The turbulent flow pattern seen on the ECG of a patient with atrial fibrillation increases the risk of what?

A

Blood clots

33
Q

What is seen on the ECG of someone with atrial flutter?

A

Regular sawtooth pattern baseline. Atrial to ventricular beats at 2:1 ratio, 3:1 ratio or higher. Sawtooth not always visible in all leads

34
Q

What is seen on the ECG of someone with first degree heart block?

A

Prolonged PR segment caused by slower AV conduction. Regular rhythm

35
Q

What is seen on the ECG of someone with second degree heart block - Mobitz 1?

A

Gradual prolongation of the PR interval until beat skipped. Most P-waves followed by QRS but some are not. Is ‘regularly irregular’ (caused by a diseased AV node

36
Q

What is seen on the ECG of someone with second degree heart block - Mobitz 2?

A

P-waves are regular but only some are followed by QRS complexes, no P-R prolongation.

37
Q

What is seen on the ECG of someone with third degree heart block?

A

P-waves are regular, QRS are regular but no relationship between them, P waves can be hidden within bigger vectors

38
Q

What is seen on the ECG of someone with ventricular tachycardia?

A

P-waves are hidden, rate is regular and fast

39
Q

Ventricular tachycardia puts the patient at high risk of what?

A

Deteriorating into fibrillation (cardiac arrest)

40
Q

What is seen on the ECG of someone with ventricular fibrillation?

A

Irregular heart rate and speed of 250bpm and above, heart unable to generate output

41
Q

What two cardiac abnormalities show a shockable rythmn?

A

Ventricular tachycardia and ventricular arrhythmia

42
Q

What is seen on the ECG of a patient with ST elevation?

A

P waves visible and always followed by a QRS, rythmn is regular and rate is normal, ST segment elevated

43
Q

What causes the upwards movement associated with an ST elevation on an ECG?

A

Infarction

44
Q

What is seen on the ECG of someone with ST depression?

A

P waves visible and always followed by QRS. Rythmn is regular and rate is normal, ST segment is depressed below isoelectric line

45
Q

What causes ST depression?

A

Ischaemia

Y2 CARDIORESP (15 decks)

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