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Cardiopulmonary > ECG > Flashcards

ECG Flashcards

1
Q

P-R Interval

.12-.20 seconds, 3-5 small boxes

A

The time from the beginning of atrial activation to the beginning of ventricular activation Measured from the point where the P wave leaves the baseline to the beginning of the QRS complex.

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3
Q

P Wave

A

Atrial depolarization and the spread of electrical impulses throughout the L and R atria

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4
Q

This precedes each QRS complex

A

P wave

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5
Q

Why is a waveform representing atrial repolatization not seen on the ECG

A

It is buried in the QRS complex

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6
Q

QRS Complex

A

Spread of the electrical impulse through the ventricles= ventricular depolarization, triggering contraction of the ventricles

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7
Q

Why is the QRS complex bigger then the P wave?

A

QRS is significantly larger than the P wave b/c depolarization of the vents involves a considerably greater muscle mass

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8
Q

T wave

A

Ventricular Repolarization, the absolute refractory period is still present during the beginning of the T wave, the normal T wave is slightly asymmetric, return of K inward and Na outward (change in polarization of the cell)

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9
Q

What is an interval

A

It includes the waveform and the segment

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10
Q

Time in between small squares (1mm) on the ECG paper

A

.04 sec

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11
Q

Time in between each large square (5mm) on the ECG paper

A

.2 sec

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12
Q

15 boxes = how many seconds

A

3 seconds

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13
Q

Normal time and box count for PR interval

A

.12-.2 seconds or 3-5 little boxes

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14
Q

Normal time and box count for QRS Complex

A

.06-.10 seconds or 1.5-2.5 little boxes

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15
Q

ST segment

A

Slight pause after QRS complex, between QRS and T wave, normally flat segment of isoelectic line

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16
Q

QT interval

A

Measure from the beginning of the Q wave to the end of the T wave. Normally about .32-.40 seconds or 8-10 little boxes

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17
Q

What is abnormal deviation of the ST segment

A

.5mm from baseline

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18
Q

Longer the QT interval the increased risk for what?

A

arrhythmia

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19
Q

What is the one abnormal factor about sinus bradycardia?

A

HR is less than 60 beats/min

20
Q

Pain, fear, exercise, artificial stimulants (caffeine, nicotine, amphetamines), CHF, infection, anemia, hemorrhage, MI and hyperthyroidism are all causes for what?

A

Sinus Tachycardia

21
Q

What is the difference between sinus arrhythmia and sinus block/pause?

A

-Sinus arrhythmia has a HR of 40-100, there is an irregular rhythm due to the R-R interval varying throughout-Sinus pause/block has a HR 60-100 but the R-R is regular except for occasional pauses (usually see 1 pause in a 6 second segment)

22
Q

Delay or interruption in impulse conduction occurs within the AV node, bundle of His or Purkinje system the resulting dysrhythmia is called…

A

AV block

23
Q

PR interval reflects what?

A

depolarization of the R and L atria (p wave) and the spread of the impulse through the AV node, bundle of his, R and L bundle branches and the Prukinje fibers

24
Q

What is key when determining the type of AV block?

A

PR interval

25
Q

Impulses from the SA node to the ventricle are delayed (not blocked), usually occurs at the AV node…what degree of block is this?

A

First Degree PR Interval > .20 seconds (>3-5 little boxes)

26
Q

The site of block in 2nd degree AV block type 1 is typically where?

A

At the AV node (above the bundle of his)

27
Q

The site of block in the 2nd degree AV type 2 is typically where?

A

The bundle of His or the bundle branches (below the AV node)

28
Q

3rd degree block there is what type of block?

A

Complete block in conduction of impulses between the atria and ventricles. The site may be at the AV node, but more commonly at the bundle of His or bundle branches

29
Q

All components of the ECG tracing are usually w/in normal limits with the exception of the PR interval..what degree block is this?

A

1st Degree AV Block, because all electrical impulses travel normally from the SA node though the atria but there is a delay in impulse conduction, usually at the level of the AV node

30
Q

What should you do if a 1st degree block is found?

A

Usually nothing, more than likely the block is asymptomatic. However, if sx can lead to higher degrees of AV block.

31
Q

When some but not all atrial impulses are blocked from reaching the ventricles because the SA node is generating impulses in a normal manner each P wave will occur at a regular interval across the strip but not every P wave will be followed by QRS–atria a depol normally but not every impulse is conducted to vents

A

Second Degree AC Block

32
Q

In what block do the PR interval get longer and longer until you see a P wave with lack of a QRS complex?

A

Second Degree AV block Type 1 (Wenckebach)

33
Q

What blocks are the RR interval irregular

A

Second Degree AV block type 1 and 2

34
Q

In this AV block the QRS complexes are wider then normal, not every P wave is followed by a QRS complex (see multiple P waves w/o QRS) and PR interval is usually within normal limits. May also see ST segment elevation.

A

2nd degree Type 2 (Mobitz II)*Remember, in Type 1 the QRS complexes are more narrow than usual b/c block is occurs at the level of the AV node and the PR intervals increase in length

35
Q

Second degree blocks are types of incomplete blocks because the AV junction conducts at least some impulses to the ventricles. In third degree AV blocks what happens to the impulses?

A

Impulses generated by the SA node are blocked before reaching the ventricles so no P waves are conducted. The atria and ventricles beat independently of each other. This is a COMPLETE block. A secondary pacemaker (either junction or ventricular) stimulates the ventricles; therefore, the QRS may be narrow or wide, depending on location of the escape pacemaker and the condition of the intraventriular conduction system.

36
Q

Where can a complete block occur? (3rd degree)

A

AV node, bundle of His, bundle branches

37
Q

What is the heart’s least efficient pacemaker?

A

Ventricles–if they function as the heart’s pacemaker the rate is usually 20-40 beats/min. This happens if SA node fails to discharge, SA node impulses are blocked, rate of discharge from SA is slower then vents, irritable site in either vent produces an early beat or rapid rhythm

38
Q

If an area of either ventricle becomes ischemic or injured, it can become irritable. This affects the manner in which impulses are conducted. When an ectopic site within vent assumes responsibility for pacing the heart, electrical impulse bypasses the normal intraventricualr conduction pathway. This results in stimulation of the ventricles at slightly different times. As a result, ventricular beats and rhythms usually have QRS complexes that are abnormally shaped and longer than normal.

A

Sorry….just a note.

39
Q

On a strip you see wide QRS w/o P wave, and T wave in the opposite direction of the QRS complex. What is this?

A

Premature Ventricular Complexes

40
Q

What do you call a PVC every other beat?

A

Bigeminy

41
Q

What do you call a PVC every third beat?

A

Trigeminy

42
Q

What do you call PVCs that are all identical?

A

Unifocal

43
Q

What if no two PVC appear similar in configuration?

A

Multifocal

44
Q

When you have a strip where the QRS complex varies in shape/amplitude beat to beat, looks as if the QRS is twisting around the isoelectric line

A

Torsade De Pointes

45
Q

3 PVC’s is what?

A

Ventricular Tachycardia *When 3 PVC’s occur in a row at a rate greater than 100 beats/min (No P waves, QRS is wide and bizarre)

Cardiopulmonary (7 decks)

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