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Cardiovascular System > ECG > Flashcards

ECG Flashcards

1
Q

What is Ohm’s law

A

Voltage= current X resistance

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2
Q

On as ECG what does a positive deflection show

A

The net current is travelling towards the lead

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3
Q

What does it mean if there is an isoelectric point on an ECG

A

The line would be flat showing no net current in direction of a lead

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4
Q

What does it mean if there is a negative deflection on an ECG

A

The next current flow is travelling away from the lead

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5
Q

What is an ECG

A

Electrocardiogram

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6
Q

What is an ECG used for

A

The record the electrical activity of the heart from different angles to identify and locate pathology via placing electrodes on the limps and chest of the patient

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7
Q

What does the P wave represent on a healthy individuals ECG

A

Atrial depolarisation

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8
Q

What does the PR interval represent in an ECG of a healthy individual

A

This interval begins at the beginning of the P wave and ends at the beginning of the Q wave and it represents the time taken for the electrical activity to move between the atria and the ventricles

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9
Q

What is the QRS complex

A

The ORS Complex is 3 closely related waves that show the depolarisation of the ventricles

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10
Q

What is the ST segment on the ECG

A

This segment start at the S wave and ends at the end of the T wave.
This is shown as an isoelectric line between the depolarisation and the re polarisation of the ventricles in the heart

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11
Q

What is the T wave on an ECG

A

The T wave show ventricular repolarisation and is shown as a small wave after the QRS complex

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12
Q

What is the QT interval on an ECG

A

This is begins at the beginning of the QRS complex and finishes at the T wave
This interval shows the depolarisation of the ventricles and then them repolarising

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13
Q

What is an ECG electrode

A

It is a conductive pad that attaches to the skin that records the electrical activity of the heart

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14
Q

What is an ECG lead

A

This is a lead that gives a graphical representation of the Hearts electrical activity which is calculated by data from several ECG electrodes

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15
Q

How many chest electrodes are there

A

6

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16
Q

What is the location of each chest electrodes on the chest wall

A

V1 is located on the 4th intercostal space at the right side of the sternal angle
V2 is located on the 4th intercostal space at the left side of the sternal angle
V3 is located midway between chest lead v2 and v4
V4 is located in the 5th intercostal space in the midclavicular line
V5 is located in the left anterior axillary line at the same horizontal level as v4
V6 is located in the left mid axillary line at the same horizontal level of v4 and v5

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17
Q

How many limb leads are there

A

4

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18
Q

Where are the limb leads located

A

Red lead is located on the right arm on the ulnar styloid process of the right arm
Yellow lead is located on the left arm on the ulnar styloid process of the left arm
Green lead is located on the left leg on the medial/lateral malleolus of the left leg
Black lead is located on the right leg on the medial/lateral malleolus of the right leg

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19
Q

What do each chest lead show

A

V1 shows a septal view of the heart
V2 shows a septal view of the heart
V3 shows a anterior view of the heart
V4 shows a anterior view of the heart
V5 shows a lateral view of the heart
V6 shows a lateral view of the heart

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20
Q

What does lead I show and how is it calculated

A

Lead I shows an inferior view of the heart and is calculated by analysing the right arm and left leg

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21
Q

What does lead II show and how is it calculated

A

Lead II shows an inferior view of the heart and is calculated by analysing the right arm and left leg electrode

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22
Q

What does lead III show and how is it calculated

A

Lead III shows an inferior view of the heart and is calculated by analysing the Left arm and left leg electrodes

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23
Q

What does the aVR lead show and how is it calculated

A

This lead shows a lateral view and is calculated by analysing the activity between Left arm and left leg compared with right arm

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24
Q

What does the aVL lead show and how is it calculated

A

This shows a lateral view of the heart and is calculated by analysing the activity between the right arm and left leg compared to the left arm

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25
Q

What does the aVF lead Show and how is it calculated

A

This lead shows the inferior view of the heart and is calculated by analysing the activity between the right arm and left arm compared to the left leg

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26
Q

What does a positive deflection on an ECG

A

A positive deflection shows that the electrical activity within the heart is travelling towards the lead

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27
Q

What does a negative deflection on an ECG show

A

A negative deflection shows that the electrical activity within the heart is travelling away from the lead =

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28
Q

What is each deflection on an ECG representing

A

Each deflection is a wave of the average electrical activity is traveling

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29
Q

What does the height of the deflection show

A

The height of the deflection represents the amount of electrical activity flowing in that direction

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30
Q

What is shown by the lead with the most positive deflection

A

The lead with the most positive deflection is the most aligned with the direction the hearts electrical activity is travelling

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31
Q

What does it mean if the R wave is greater than the S wave

A

It suggests the depolarisation is moving towards the lead

32
Q

What does it mean if the S wave is greater than the R wave

A

It would suggest that the depolarisation is moving away from the lead

33
Q

What does it mean if the S and R wave are of equal heights

A

It means that the depolarisation is travelling at 90 degrees to the lead

34
Q

Different leads represent different anatomical territories of the heart what does this allow

A

This allows for pathology to be localised to a particular region of the heart

35
Q

Which leads show an inferior view of the heart

A

Leads II, III and aVF

36
Q

Which leads show a lateral view of the heart

A

Leads I, aVL, aVR, V5, V6

37
Q

Which leads show an anterior view of the heart

A

Leads V3 and V4

38
Q

Which leads show a septal view of the heart

A

Leads V1 and V2

39
Q

If an ECG shows an ST elevation which leads would be affected and what would it suggest

A

Leads to V3 and V4 which could suggest an anterior myocardial infarction

40
Q

Where does electrical activity start in the heart

A

At the sinoatrial node

41
Q

From the sinoatrial node where does the electrical activity spread to

A

The atrioventricular node

42
Q

From the atrioventricular node where does the electrical activity spread to

A

Spreads down the bundle of HIS and into the purkinje fibres

43
Q

What does the electrical activity in the purkinje fibres cause

A

The ventricular contraction

44
Q

What is a normal cardiac axis in a healthy individual

A

Lies between -30 degrees and +90 degrees

45
Q

In a normal cardiac axis in a healthy individual in which leads is overall electrical activity seen

A

In leads I, II and III

46
Q

In a normal cardiac axis of a healthy individual which leads has the most positive deflection

A

Lead II

47
Q

In a normal cardiac axis of a healthy individual which lead shows the most negative deflection and why

A

The aVR lead because it has a viewpoint of the heart from the opposite direction

48
Q

What causes right axis deviation

A

The direction of depolarisation is been distorted to the right between +90 and +180 degrees

49
Q

What is the most common cause of right axis deviation and how does it occur

A

Right ventricular hypertrophy.
This occurs when there is extra right ventricular tissue resulting in a stronger electrical signal been generated by the right side of the heart this causes the deflection in lead I to become negative and the deflection on lead aVF and IIII to become more positive

50
Q

What is right ventricular hypertrophy most commonly associated with

A

Pulmonary hypertension but can be seen in very tall people

51
Q

What causes left axis deviation

A

Left axis deviation is caused by the direction of depolarisation being distorted to the left between -30 and -90 degrees

52
Q

How is left axis deviation showing in relation to the lead

A

The deflection of lead III becomes more negative

53
Q

When should left axis deviation be considered significant

A

Left axis deviation should only be considered significant if the deflection of lead II becomes negative

54
Q

What can cause left axis deviation

A

Conduction abnormalities

55
Q

What are the boundaries of a
Normal
Tachycardia
Bradycardia
Heart rates

A

Normal is 60-100 bpm
Tachycardia is over 100 bpm
Bradycardia is under 60 bpm

56
Q

How do you calculate a heart rate from an ECG of a regular heart rhythm

A

Count the number of large squares present in the PR Interval and then divide 300 by the number counted which gives you the heart rate

57
Q

How do you calculate heart rate from an ECG id the patient has an irregular heart rhythm

A

Count the number of complexes on the rhythm strip and multiple by 6

58
Q

There are 2 types of irregular heart rhythm… what are they

A

Regularly irregular
Irregularly irregular

59
Q

What is meant when a patient has a regular irregular heart rhythm

A

The patients hear rhythm has a recurrent pattern of irregularity

60
Q

What is meant if a patient has a irregularly irregular heart rhythm

A

This patients heart rhythm is completely disorganised

61
Q

If P waves are present what should they be followed by

A

QRS Complex with a normal duration, direction and shape

62
Q

What happens if P waves are absent with an irregular heart rhythm

A

Atrial fibrillation

63
Q

How lon should the PR interval last for

A

Between 120-200m/s (3-5 small squares)

64
Q

If there is a prolonged PR interval what does this mean

A

There would be atrioventricular delay which could cause AV block

65
Q

How many types of heart block is there

A

4

66
Q

What are the 4 types of heart block

A

First degree heart block
Second degree heart block type 1
Second degree heart block type 2
Third degree heart block

67
Q

What are the characteristics of first degree heart block

A

Fixed PR interval longer than 200 m/s (longer than 5 small squares)

68
Q

What are the characteristics of second degree heart block type 1

A

Progressive prolongation of the PR interval until the atrial impulse is no longer conducted and the QRS complex is dropped. AV condition resumes with the new beat and the sequence repeats

69
Q

What are the characteristics of seconds degree heart block type 2

A

Consistent PR interval duration with the QRS complex intermittently dropped due to a condition failure, this follows a repeating pattern at every 3rd or 4th P waves

70
Q

What is 3rd degree heart block also known as

A

Complete heart block

71
Q

What does complete heart block mean

A

There is non electrical communication between the atria and the ventricles which results in a complete failure of conduction

72
Q

How would compete heart block be represented on an ECG trace

A

There would be a presence of both P waves and QRS Complexes but they have no association with each other due to the atria and ventricles functioning independently

73
Q

What does it mean if in 3rd degree heart block the QRS complex lasts for less than 0.12s in duration

A

The signal originated above the bifurcation of the bundle of HIS

74
Q

WHAT DOES IT MEAN IF THE QRS Complex lasts longer that 0.12s in 3rd degree heart block

A

The signal originates fro below the bifurcation of the bundle of HIS

75
Q

What does it mean if a patient has a shortened PR interval

A

The P wave originated from somewhere closer to the AV node so the conduction takes less time

Or

The atrial impulse is getting to the ventricle by a faster shortcut instead of conducting slowly across the atrial wall, this is known as an accessory pathway associated with the delta wave

Cardiovascular System (12 decks)

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