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year 3 OSCE > ECG > Flashcards

ECG Flashcards

1
Q

What is sinus bradycardia ?

A

<60BPM

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2
Q

What is sinus tachycardia?

A

> 100BPM

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3
Q

What part of ECG shows atrial depolarisation?

A

P wave

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4
Q

What part of the ECG shows ventricle depolarisation?

A

QRS compelx

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5
Q

What are the four limb ECG and where are they on the body?

A

Red (AVR) on the right arm
Yellow (AVL) on the left arm
Green (AVF) on the right leg
Black is neutral on right leg

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6
Q

What creates lead 1?

A

AVR to AVL

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7
Q

What creates lead 2?

A

AVR to AVF

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8
Q

What creates lead 3?

A

aVL to AVF

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9
Q

What are the chest electrode placement positions?

A

1 – 4th Intercostal Space, Rt. Sternal Edge.

V2 – 4th Intercostal Space, Lt. Sternal Edge.

V3 – Midway between V2 & V4.

V4 - 5th Intercostal Space, Mid Clavicular.

V5 – Midway between V4 & V6.

V6 – 5th Intercostal space, Mid Axillary.

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10
Q

What are leads 2,3 and AVF looking at?

A

Inferior view of the heart

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11
Q

What are V1 and V2 looking at?

A

Septal view of the heart

Anterior

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12
Q

What are V3 and V4 looking at?

A

anterior wall

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13
Q

What are lead 1 and AVL looking at?

A

Superior lateral view of the heart

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14
Q

What are V5 and V6 looking at?

A

Inferior lateral view of the heart

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15
Q

What do you initially comment on when looking at ECG?

A

Patient name and DOB
Date of ECG and indication
Quality of ECG and if its 12 lead
Scale

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16
Q

What is the system that should be used when looking ECG?

A 
Rate ?
Rhythm ?
P wave ?
PR interval ? (AV conduction time).
QRS Complex interval ?
QT interval ? (Ventricular contraction time).
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17
Q

What does one small box horizontally represent?

A

0.04s

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18
Q

What does one large box horizontally represent?

A

0.20s

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19
Q

What does one large box vertically represent?

A

0.5mv

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20
Q

When looking at rhythm strip what are you trying to identify?

A

Clear P wave
QRS regular or irregular
Is the QRS narrow or broad

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21
Q

What is the normal length of a P wave?

A

0.11s just less than 3 small squares

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22
Q

What does absent P wave indicate?

A

AF or nodal rhythm

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23
Q

What is the PR interval?

A

P wave to start of QRS complex

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24
Q

What is normal size of PR interval?

A

0.12-0.2

3-5 small squares

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25
Q

What does a short PR interval indicate?

A

Wolff Parkinson syndrome –> abnormal fast heart rate or it can be normal

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26
Q

What does long Pr interval indicate?

A

AV block –>1st 2nd or 3rd degree

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27
Q

What is normal ORS size?

A

3 small squares

0.12s

28
Q

What does ST depression indicate?

A

NStemi

Ischaemia

29
Q

What does ST elevation indicate?

A

Stemi

Infarction

30
Q

What does a peaked T wave indicate?

A

Hyperkalaemia or normal for young man

31
Q

What does a inverted/biphasic T wave indicate?

A

Previous infarct/ ischaemia
Hypokalaemia
Bundle branch block
Wolf Parkinson White syndrome

32
Q

What does a small T wave indicate?

A

Hypokalaemia

33
Q

What are the characteristics of atrial fibrillation ECG?

A

Irregular Baseline.
Unable to distinguish P waves.
Irregular and narrow QRS complexes.
Normal T Waves.

34
Q

What are the characteristics of atrial flutter in a ECG?

A

Difficult to distinguish P and T waves.
Narrow QRS.
No flat baseline between P waves.
Giving a saw toothed appearance

35
Q

What are the characteristics of ventricle fibrillation in a ECG?

A

No P Waves.
A rhythm of ventricular origin with rapid, bizarre and wide QRS ( ventricle when wide QRS)
No identifiable T wave

36
Q

Can you see the P wave and QRS complex in ventricular fibrillation?

A

No

37
Q

What are the characteristics of asytole?

A

Rhythm - Flat absence of all ventricular activity.
Rate - 0 Beats per minute.
P Wave – None.
No QRS Complexes

38
Q

What is a pulseless electrical activity?

A 
Ventricular Activity.
Still electrical activity but pump not working 
IE. QRS complexes.
No Major Circulation.
PATIENT HAS NO PULSE.
Non shockable but correctable
Normal Sinus Rhythm – Pulseless.
39
Q

What are the 4 H’s and 4 T’s reversible causes of cardiac arrest?

A

Hypovolemia
Hypoxia
Hyper/hypokalemia
Hypothermia

Tablets/toxins cocaine overdose 
Cardiac Tamponade
Thrombosis 
Trauma
Tension pneumothorax
40
Q

What is the treatment for PEA?

A

Adrenaline and CPR

Not shockable

41
Q

Is asystole shockable?

A

Yes

42
Q

What is the PR interval a indication of?

A

It represents the time taken for electrical activity to move between the atria and ventricles.
Atrial contraction time

43
Q

What is the QT interval a indication of?

A

Ventricle contraction time

It represents the time taken for the ventricles to depolarise and then repolarise.

44
Q

In normal cardic axis what is the most positive and negative?

A

Lead 2 most positive

AvR most negative

45
Q

what causes right axis deviation?

A

Right ventricle hypertrophy

Great electrical current from the right side of the heart

46
Q

What affect does right axis deviation have on the ECG?

A

Lead 1 negative and AVL negative

Lead 3 and AvF more positive

47
Q

In who can right axis deviation on a ECG be normal?

A

Very tall patients

48
Q

What is the cause of left axis deviation?

A

Conduction defect

49
Q

What is the ECG change of left axis deviation?

A

Lead 3 negative and AvF negative

Lead 1 and AvL are positive

50
Q

When is Left axis deviation significant?

A

When lead 2 is also negative

51
Q

What does a increase PR interval indicate?

A

Heart block

52
Q

What can a reduce PR interaval indicate?

A

Wolf parkinson white syndrome

53
Q

What would a QRS shorter than 0.12 seconds (3 small squares) indicate?

A

The complex is supraventricular in origion

54
Q

What would a QRS greater than 0.12 seconds (3 small squares) indicate?

A

The complex is ventricle in origin

55
Q

What is the structure of the QRS in ventricle tachycardia and what does this indicate?

A

Regular Bizarre wide QRS which indicate origin in ventricle

56
Q

What is the cause of ventricular tachycardia?

A

Direct damage to the myocardium secondary to MI or cardiomyopathy

57
Q

What is the treatment for ventricular tachycardia?

A

Pace maker or defibrillator

Stable patient= give 300 mg Iv of amiodarone in first hour then 900mg IV/24hrs

58
Q

What is the immediate treatment of VF (cardiac arrest)

A

Defibrillation

59
Q

What is the rate rhythm and character of VF?

A 
Rate = >300
Rhythm= irregular
Character = No P, QRS complex
60
Q

What do you need to do immediately for patient who is asystole?

A

CPR

61
Q

Are AvL and AVf facing each other or away each other in left axis deviation?

A

Facing away from other

62
Q

Are AvL and AVf facing each other or away each other in right axis deviation?

A

Facing towards each other

63
Q

Describe the Pr interval in 1st degree heart block

A

fixed prolonged PR interval (>200 ms)

64
Q

Describe second degree heart block type 1?

A

If the PR interval slowly increases then there is a dropped QRS complex

65
Q

Describe second degree heart block type 2?

A

If the PR interval is fixed but there are dropped beats, t

66
Q

Describe third degree heart block?

A

If the P waves and QRS complexes are completely unrelated

year 3 OSCE (14 decks)

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