ECG (2)

Question 1

What is the pathway of the conduction system in the heart?

Answer 1

SA node goes to the AV node

AV node goes to the bundle of his

Bundle of his goes to left and right bundle branch

Left and right bundle branch goes to purkinje fibers

Question 2

What is the P-wave?

Answer 2

Depolarization of the atrium (atrium contraction)

Question 3

What is the QRS complex?

Answer 3

Ventricular depolarization (ventricular contraction)

Question 4

What is the T-wave?

Answer 4

Ventricular repolarization

Question 5

What is the summary of what is happening during an ECG reading?

Answer 5

Understanding ECG part 1 slide 7

Question 6

How much blood does atrial contraction at the p-wave pump into the ventricles?

Answer 6

15-20% of stroke volume

Question 7

What does a 12 lead ECG help you read?

Answer 7

Past and present problems (not future)

Question 8

What are the steps to reading an ECG?

Answer 8

Look at P wave (rounded and upright)

Look at PR interval (no more than 5 small boxes)

Look at QRS complex (no more than 2 1/2 small boxes)

Look at R to R interval (equal distance between)

Look at rate (60-100 bpm)

Question 9

What is the difference between sinus bradycardia and regular bradycardia?

Answer 9

Sinus bradycardia has a p-wave present whereas regular bradycardia does not (under 60 bpm)

Question 10

What is treatment for a sinus pause?

Answer 10

Back up pacemaker

Question 11

How do you determine rate on an ECG?

Answer 11

Count number of big boxes between R to R and divide by 300

Count R’s between marks and multiply by 10

Question 12

What are the sinus rhythms that you can see on an ECG?

Answer 12

Normal sinus rhythm (NSR)

Sinus bradycardia

Sinus tachycardia

Sinus arrhythmia

Sinus pause

Question 13

Are premature atrial contractions dangerous?

Answer 13

No they are normal and benign

Question 14

What is a premature atrial contraction (PAC)?

Answer 14

Has a p wave and normal QRS (just comes early then returns back to normal)

Question 15

What is a premature nodal (junctional)?

Answer 15

No p wave, beat comes early, QRS is normal

Question 16

What is a premature ventricular contraction?

Answer 16

No p wave and QRS is wide and bizarre

Question 17

What are arrhythmias originating in the atria?

Answer 17

Premature atrial contractions

Atrial fibrillation

Atrial flutter

Question 18

What does atrial fibrillation look like on an ECG?

Answer 18

No p wave and no rhythm (< 100 bpm is controlled, > 100 bpm is uncontrolled)

Question 19

What does paroxysmal atrial tachycardia look like on an ECG?

Answer 19

Normal first and then transitions into no p wave with fast R to R

Question 20

What does atrial flutter look like on an ECG?

Answer 20

Multiple p waves

Question 21

What are arrhythmias originating in the AV node?

Answer 21

Premature junctional beats

Nodal rhythm

Nodal tachycardia

Question 22

What is the AV node?

Answer 22

Back up pacemaker for SA node

Question 23

How many PVCs is too many in one minute?

Answer 23

6 or more

Question 24

What are signs and symptoms of arrhythmias?

Answer 24

Palpitations

Dizziness

Shortness of breath

Heart racing

Question 25

What is the HISBED acronym?

Answer 25

Hypoxia

Ischemia

Sympathetic stimulation

Bradycardia

Electrolyte disturbance

Drugs

Question 26

What is the HISBED acronym used for?

Answer 26

Clinical problem solving with new arrhythmias

Question 27

What does a 1st degree AV block look like on an ECG?

Answer 27

P-R interval greater than 1 big box

Question 28

What does a type 1 2nd degree block (wenckebach) look like on an ECG?

Answer 28

Progressive lengthening of P-R interval

Question 29

What does a type 2 2nd degree block look like on an ECG?

Answer 29

Multiple p waves for one QRS

Question 30

What does a 3rd degree heart block look like on an ECG?

Answer 30

P waves and QRS firing unrelated

Question 31

What does a bundle branch block look like on an ECG?

Answer 31

Everything is normal but a notched QRS