ECG Flashcards

1
Q

ECG definition?

A

A body surface recording of a change in electrical potential, which is a PROJECTION of the net potential changes occurring in the heart

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2
Q

ventricular depolarization - first things to contract?

A

interventricular septum and papillary muscles

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3
Q

on read out yo get a peak going up and one going down. what does this mean?

A

The depolarizations were paced from different areas - multple PVCs = compromise in circulation in those areas

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4
Q

vertical axis=

A

voltage

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5
Q

horiz axis=

A

time

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6
Q

10 mm is how many mvolts?

A

1.0mV

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7
Q

How many horiz lines will you pass on a EC chart in 1sec?

A

25mm per second= 25 lines (boxes)

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8
Q

How long to travel across 5 boxes? Dark line to dark line?

A

0.2 seconds since each 1mm box=.04seconds

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9
Q

PR interval shouldnt be longer than?

A

0.2 seconds

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10
Q

P-wave

A
  • atrial depolarization
  • Phase 0 of atrial muscle cells
    range: 60msec to 110msec
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11
Q

P-R interval

A
  • time for atrial depolarization and passage through the A-V node (to begining of QRS or ventricular depolarization)
  • range: 120msec to 200msec
  • onset of atrial depol to onset of ventricular depol
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12
Q

P-R segment

A
  • passage of current through the A-V node

- base line!

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13
Q

QRS complex and components

A
  • ventricular depolarization
  • takes about 80 miliseconds (2 boxes) (30msec- 120msec)
  • positive deflection = R wave of QRS
  • negative deflection before R wave = Q-wave
  • negative deflection after R-wave = S-wave
  • Phase 0 of all ventricular muscle cells
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14
Q

S-T segment

A
  • about at isoelectric line - 0 mV

- between depolarization and repolarization (between Phase 0 and phase 3 = refractory period –> the plateau PHASE 2)

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15
Q

T-wave

A
  • repolarization - Phase 3 of all ventricular muscle cells
  • length varies
  • REPOL OF VENTRICLE
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16
Q

U-wave

A
  • repolarization of purkinje or papillary muscles

- not really seeing it

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17
Q

isoelectric line

A

base- 0 milivolts

18
Q

ATRIAL DEPOLARIZATION should be how long?

A

60-110msec

19
Q

What happens to time of atrial depolarization if the left atrium is enlarged?

A

longer than 120msec

-usually due to stenosis and mitral regurg

20
Q

QRS longer than #msec? ventricules should not take longer than how long to depolarize? what could be the problem?

A
  • 120msec or 0.12seconds
  • ectopic focus
  • right or left bundlebranch block
21
Q

S-T segment can indicate? (When the line is not flat at 0V)

A
  • acute ischemia of the ehart (its fixable bc its still alive)
  • shouldnt detect electrical activity at surface because during Phase 2 (ie STsegment) the voltage is at 0!)
  • So problem injured or ischemic - the damaged area is at a different voltage that another part which will show up on the ECG
  • ST-segment elevation from 0 = acute injury
  • STsegment depression from 0 = ischemia without injury (need to open the vessel)
22
Q

QT interval

A
  • begining of QRS to end of T-wave (onset of vent depol to end of ventricular repolarization)
  • varies with heartrate
  • commonly changes with Rx drugs
23
Q

what can cause U waves to get larger?

A
  • electrochemical conditions of the heart

ex) hypocalcemia

24
Q

If Pr interval is less than its min range - 120msec then this means/

A

-accessory pathway between atria and ventricules - bundle of kent

25
What lead analyzes the ECG in the frontal plane along a line that bisects the angle made by Lead I and Lead III?
-AVL lead
26
unipolar chest leads.
Chest Leads V1, V2, V3, V4, V5, V6 | Limb Leads: AVR, AVL, AVF
27
chest leads record acvtivity in what plane?
transverse - horizontal plane
28
Lead 1
bipolar electrode | -looking for difference between left arm and right arm
29
Lead 2
-recording Right arm to the left leg
30
Putting leads on:
L arm Lead 1+/Lead 3- R arm - L leg + R leg = GROUND
31
Lead 3
-recording Left leg to L arm
32
Whcih leads are bipolar?
Limb Leads 1,2,3
33
positive deflection means? Neg... etc
vector starts in the heart and points more to LEFT than to RIGHT then its + in LEAD I
34
vector that describes atrial depolarization points?
down and left - SHORT (compared to ventricular depol)
35
ventricular depolarization vector points?
down and left - LONG (compared to atrial depol)
36
which leads do you usually look at to analyze? why?
Lead 2 - SHOULD HAVE THE BIGGEST DEFLECTIONG
37
Junctional rhythms has what with respect to which lead?
inverted in lead II
38
shift ventricular vector to left-up
- LAD - left axis deviation - LVH (left ventricular hypertrophy) - toward 0 degrees - arterial hypertension
39
shift ventricular vector to right
- RAD - right axis deviation - right ventricular hypertrophy (pulmonary) - toward 180 degrees - hypertension - lung disease
40
Heart rate from ECG
- count boxes from start of Q of QRS. - 300 - 150 - 100 - 75 - 60 - 50 - 43
41
unipolar leads in transverse plane and their placement:
- V1 = fourth intercostal space, right sternal border - V2 = fourth intercostal space, left sternal border - V3 = midway between V2 & V4 on a line joining those two points - V4 = fifth interspace midclavicular line - V5 = anterior axillary line; on same level with V4 - V6 = midaxillary line; on same level with V4 and V5
42
PR interval longer than normal time range?
usually nothing pathophysiological