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Cardiovascular > ECG > Flashcards

ECG Flashcards

1
Q

what are upward deflections?

A

depolarisation moving towards leads

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2
Q

what are downward deflections?

A

depolarisation moving away from leads

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3
Q

how do you get lead I?

A

left arm positive - right arm negative

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4
Q

how do you get lead II?

A

left leg positive - right arm negative

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5
Q

how do you get lead III?

A

left leg positive - left arm positive

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6
Q

what does V1-2 show?

A

right ventricle electrical activity

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7
Q

what does V3-4 show?

A

septum and anterior wall of left ventricle electrical activity

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8
Q

what does V5-6 show?

A

anterior and lateral walls of left ventricle electrical activity

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9
Q

what are the factors to remember while recording an ECG?

A
  • Standard settings of machine (amplitude normally 10mm/mV), (speed – 25mm/s)
  • Accurate placing of leads
  • Electrode contact with skin – no oily moisturisers, clean and dry etc
  • Patient relaxed – no tensing (other electrical signal interference)
  • Slightly abrase skin – helps get ride of dead cells – better for conduction
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10
Q

what do you generally look for within an abnormal ECG?

A
  • Wave height
  • Wave duration
  • Curves – straight/ gradual/ steep
  • No rogue notches
  • Normal order
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11
Q

what does the P wave show?

A

depolarisation of the atria - right side first

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12
Q

how is the P wave unique in comparison to the others?

A

its quite wide - goes across the atria

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13
Q

how long is the P wave duration?

A

0.12s

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14
Q

what is the PR interval in terms of electrical activity?

A

time for conduction from SAN through to AVN, bundle of His, Purkinje fibres
onset of atrial depolarisation to ventricular depolarisation

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15
Q

what is the duration of the PR interval?

A

0.12-0.3s

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16
Q

what does a shorter PR interval show?

A

either depolarisation occurred near AVN (hence no pause) or abnormally fast conduction from atria

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17
Q

what is the QRS complex showing?

A

ventricular depolarisation
septum depolarises left to right

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18
Q

what is the normal duration of QRS complex?

A

<120ms

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19
Q

where can Q waves be seen on the ECG leads?

A

leads facing left - I, II, AVL, V5, V6

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20
Q

what is the ST segement?

A

end of ventricular depolarisation to beginning of repolarisation

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21
Q

where does the ST segment usually lie?

A

on baseline on isoelectric point

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22
Q

what does the QT interval show?

A

total time for depolarisation and repolarisation of ventricles

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23
Q

what is the U wave?

A

small deflection after t wave
barely seen
potentially repolarisation of papillary muscles

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24
Q

what is the repolarisation of ventricles on the ECG?

A

T waves

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25
Q

what is prolonged QT interval a risk of?

A

pointes de tourades

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26
Q

which leads show QRS?

A

AVL, AVF, leads I, II, III

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27
Q

what is cQT used for?

A

more accurate and helps see ventricular tachycardia

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28
Q

what is the equation for cQT?

A

cQT= (QT (ms)/ √RR(s))

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29
Q

what do pathological Q waves suggest?

A

previous mild infarction

30
Q

what is the RR interval?

A

between two R peaks

31
Q

what is the RR interval useful for?

A

determining heart rate
* Hr= 300/RR
* Hr= (how many QRS in 30 big squares) x 10

32
Q

on standard ECG, how many seconds is a big square?

A

0.2s or 200ms

33
Q

on a standard setting ecg what is a little square in ms?

A

40ms

34
Q

on a standard ecg what are 5 big squares worth in seconds?

A

1s

35
Q

which leads show left lateral surface?

A

leads I, II and AVL

36
Q

which leads show inferior surface?

A

leads II, III, AVf

37
Q

which leads show right atrium?

A

AVR

38
Q

what does V1-6 leads show?

A

chest leads - heart from horizontal plane from front to left side

39
Q

what is the cardiac axis?

A

average direction of spread of depolarisation wave through ventricles as seen from the front

40
Q

what is the normal heart axis?

A

-30 degrees to 90 degrees

41
Q

what angle is left axis deviation?

A

<-30

42
Q

what angle is right axis deviation?

A

> 90

43
Q

what are the causes of left axis pathophysiology?

A
  • Left ventricular hypertrophy (increase cell growth)
  • Left bundle branch block
  • Left anterior fasicular block
  • Inferior MI
  • Ventricular pacing
  • Wollf-parkinson white – heart beats abnormally fast for a period time
    Conduction abnormalities
44
Q

what is seen on the ECG with left axis deviation?

A

QRS becomes negative in lead III

45
Q

what are the causes of right axis deviation?

A
  • Right ventricular hypertrophy
  • Acute RV strain (PE)
  • Lateral MI
  • Chronic lung disease
  • Dextrocardia (heart on right side not left)
  • Variant of normal – children / thin adults
46
Q

where is V1 placed?

A

4th intercostal space to the right sternal edge

47
Q

where is v2?

A

4th intercostal space to the left

48
Q

where is V3?

A

midway between V2 and v4

49
Q

where is V4 placed?

A

5th intercostal space in midclavicular line

50
Q

where is V5?

A

left axillary line at same horizontal level as v4

51
Q

where is v6 placed?

A

left mid-axillary line at same horizontal line as V4 and V5

52
Q

what colour electrode is RA negative?

A

red

53
Q

what colour is left arm positive?

A

yellow

54
Q

what colour is left leg (positive)

A

green

55
Q

what colour is right leg (neutral)

A

black

56
Q

where is overall direction of electrical activity in terms of leads?

A

leads I, II, III - positive deflection

57
Q

which lead ha the most positive deflection and most closely aligned to the overall direction of the electrical spread?

A

lead II

58
Q

what is the most significant cause of left axis deviation?

A

conduction abnormalities

59
Q

what is the most common cause of right deviation?

A

right ventricular hypertrophy

60
Q

what would indicate IE on an ECG?

A

prolonging PR (first degree heart block), p mitrale, dysthymia

61
Q

what is P mitrale on ECG?

A

left atrial enlargement producing bifid p waves

62
Q

what area does LCA cover?

A

anterolateral

63
Q

what are the anterolateral leads (LCA)?

A

I, aVL, V3-6

64
Q

what area of the heart is covered by LAD?

A

anterior

65
Q

what leads show anterior part of the heart (LAD)?

A

V1-4

66
Q

what area does the circumflex serve?

A

lateral

67
Q

what are the lateral leads? (circumflex)

A

I, aVL, V5-6

68
Q

what does the RCA serve?

A

inferior heart

69
Q

what leads show RCA? (inferior)

A

I, II, aVF

70
Q
A

Cardiovascular (14 decks)

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