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Cardiology > ECG > Flashcards

ECG Flashcards

1
Q

What does ECG stand for?

A

Electrocardiogram

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2
Q

What is an ECG?

A

Recording of electrical activity around the heart from body surface

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3
Q

What does an ECG check? (7)

A
  • Heart rhythm
  • Electrical activity
  • Heart rate
  • Myocardium thickness
  • Size and position of heat chambers
  • Conduction system integrity
  • Drug effects on heart
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4
Q

How does an ECG create measurements?

A

Sensors attached to the skin detect electrical signals produced by the heart each time it beats

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5
Q

What two parts of a depolarisation wave does an ECG measure? (2)

A
  • Amplitude

- Direction

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6
Q

What is an ECG representative of?

A

Electrical events of the cardiac cycle

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7
Q

How are the electrical events of the cardiac cycle represented on the ECG cycle?

A

Characteristic waveform recorded graphically against time

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8
Q

What are the 3 lead systems in a 12 lead ECG? (3)

A
  • Limb leads
  • Precordial/chest leads
  • Augmented limb leads
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9
Q

What are the limb leads in an ECG? (3)

A
  • Lead I
  • Lead II
  • Lead III
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10
Q

What are the chest/percordial leads? (6)

A
  • VI
  • V2
  • V3
  • V4
  • V5
  • V6
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11
Q

What are the augmented limb leads? (3)

A
  • avL
  • avF
  • avR
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12
Q

What is a lead in an ECG? (2)

A
  • Potential difference of electrical activity between two electrodes
    (Virtual)
  • Shows heart electrical activity from particular angle
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13
Q

What 3 limbs are used in an ECG? (3)

A
  • Right arm
  • Left arm
  • Left leg
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14
Q

What colour is a right arm electrode typically?

A

Red

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15
Q

What colour is a left arm electrode typically?

A

Yellow

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16
Q

What colour is a left leg electrode typically?

A

Black

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17
Q

What limbs is lead I made up of? And which one is the positive/negative electrode?

A
  • Left arm (positive)

- Right arm (negative)

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18
Q

What do the limb leads represent on an ECG?

A

Potential difference between 2 limbs at a time

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19
Q

Are limb leads bipolar/unipolar?

A

Bipolar

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20
Q

What does a bipolar lead mean?

A

Electrodes registering voltage between 2 electrodes

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21
Q

What does a unipolar lead mean? (2)

A
  • Activity in heart directed towards/below electrode

- Potential difference between heart activity (positive recording electrode) and indifferent negative electrode

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22
Q

What is the purpose of the lead connected to the right leg?

A

Reference electrode for recording purposes to complete electric circuit
Plays no role in ECG itself

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23
Q

What is the purpose of the limb ECG leads?

A

Gives information on general heart activity and direction

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24
Q

What is the purpose of the chest ECG leads?

A

Gives information on activity relative to area within the heart myocardium

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25
Q

What limbs is lead II made up of? And which one is the positive/negative electrode?

A
  • Right arm (negative)

- Left leg (positive)

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26
Q

What limbs is lead III made up of? And which one is the positive/negative electrode?

A
  • Left arm (negative)

- Left leg (positive)

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27
Q

What triangle do the 3 limb leads form?

A

Equilateral eithoven’s triangle

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28
Q

What lead is usually used to form the rhythm strip?

A

Lead II

29
Q

Why is lead II used to form the rhythm strip?

A

P waves clearest here

30
Q

What is a positive deflection?

A

Depolarisation towards the positive electrode, above isolectric line

31
Q

What is a negative deflection?

A

Depolarisation away the positive electrode, below isoelectric line

32
Q

What is the purpose of the augmented chest leads?

A

Give additional means of info to identify directionality of waveform propagation across the heart

33
Q

Where is lead V1 placed?

A

Right hand side of sternum

34
Q

Where is lead V2 placed?

A

Left hand side of sternum

35
Q

Where is lead V3 placed?

A

3

36
Q

Where is lead V4 placed?

A

4

37
Q

Where is lead V5 placed?

A

5

38
Q

Where is lead V6 placed?

A

6

39
Q

What indicates the direction of electricity in the heart?

A

Towards the lead with the most positive deflection

40
Q

What is seen on an ECG when depolarisation is going towards a lead?

A

Positive deflection

R wave bigger than S (and Q) wave

41
Q

What is seen on an ECG when electricity is going away from a lead?

A

Negative deflection

R wave smaller than S (and Q) wave

42
Q

What is normal cardiac axis? (2)

A
  • Between -30degrees and +90degrees
43
Q

What lead sees the most positive deflection in normal cardiac axis and why?

A

Lead II as this is at 5 oclock

44
Q

Draw the normal cardiac axis diagram

A

See notes

45
Q

Why direction does depolarisation normally happen in and why?

A

11 oclock to 5oclock

Apex is at that angle

46
Q

What lead sees the most negative deflection in normal cardiac axis and why?

A

aVR - opposite direction to lead II

47
Q

What deflections are seen in which leads in normal cardiac axis? (3)

A
  • Positive lead I
  • Positive avF
  • Lead II most positive compared to I and III
48
Q

What deflections are seen in which leads in right axis deviation?

A
  • Negative lead I

- Positive avF

49
Q

What deflections are seen in which leads in left axis deviation?

A
  • Positive lead I
  • Negative avF
  • Extreme: positive lead II
50
Q

Give examples of conditions with right axis deviation

A
  • Dextracardia (depolarisa

Right ventricular hypertrophy

51
Q

What causes left axis deviation?

A

Conduction defects and not by increased mass of the left ventricle.

52
Q

What height/amplitude is shown by a small square on an ECG? mm and mv

A

0.1mv=1mm

53
Q

What height/amplitude is shown by a large square on an ECG? mm and mv

A

0.5mv=5mm

54
Q

What time is shown by a small square on an ECG?

A

0.04 seconds

55
Q

What time is shown by a large square on an ECG?

A

0.2 seconds

56
Q

What is a normal value for PR interval? Seconds + squares

A

120 (0.12)-200ms (0.2secs)

3-5 small sqs

57
Q

What is a normal value for QRS interval/width? Seconds + squares

A

80-120ms (0.12secs)

3 small sqs

58
Q

What is a normal value for QT interval?

A

360-440ms

59
Q

What is QTc?

A

QT interval corrected for rate

= QT/R-R interval

60
Q

How is heart rate calculated using squares?

A

300 /Large squares R-R interval

61
Q

What is the normal level of variation in rhythm?

A

Less than 10% R-R interval

62
Q

Normal bpm?

A

60-100

63
Q

Calculating rate from an ECG if irregular rhythm?

A

Number of complexes on rhythm strip by 6

64
Q

How long is each rhythm strip?

A

10 seconds

65
Q

Order of reading ECG?

A
  • Patient details
  • ECG date and time
  • HR
  • Heart rhythm
  • Cardiac axis
  • P waves (present, each followed by QRS, duration, direction, shape)
  • P-R interval (heart block)
  • QRS (Width/height)
  • ST segment
  • T waves (height? Inverted?)
66
Q

How to check heart rhythm (2)

A
  • Mark out consecutive R-R intervals on a piece of paper

- Move them along the rhythm strip to check if the subsequent intervals are the same

67
Q

Normal QRS/T wave height? (2)

A
  • 5mm limb leads

- 10mm chest lead

68
Q

What is checked for in P waves?

A
  • Present
  • Each followed by QRS
  • Duration
  • Direction
  • Shape
69
Q

Normal P wave duration?

A

120-200ms

Cardiology (18 decks)

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