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Cardiovascular System > ECG > Flashcards

ECG Flashcards

1
Q

What do leads refer to in an ECG

A

the view of the heart

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2
Q

Define cardiac vectors

A

reflect the magnitude and direction of electrical events in the heart, measured by electrocardiography

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3
Q

What does an isoelectric line suggest

A

Mo net change in voltage i.e. the vectors are perpendicular to the lead

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4
Q

What denotes the duration of an event in an ECG

A

width of deflection

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5
Q

What are upward deflections toward in an ECG

A

Cathode (+)

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6
Q

What are downward deflections toward in an ECG

A

Anode (-)

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7
Q

What does steepness of a line denote in an ECG

A

velocity of action potential

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8
Q

What occurs at P in an ECG

A

atrial depolarisation and contraction

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9
Q

What occurs through QRS in an ECG

A

ventricular depolarisation and contraction (+atrial depolarisation)

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10
Q

What occurs at T in an ECG

A

Ventricular repolarisation and relaxation

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11
Q

What occurs at Q in an ECG

A

Septal depolarisation in the bundle branches

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12
Q

What occurs at R in an ECG

A

Ventricular depolarisation in the Purkinje fibres

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13
Q

What occurs at S in an ECG

A

Late ventricular depolarisation in the Purkinje fibres

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14
Q

Which electrodes does lead I read from

A

right arm to left arm

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15
Q

Which electrodes does lead II read from

A

Left leg to right arm

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16
Q

Which electrodes does lead III read from

A

left arm to left leg

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17
Q

What is used to enhance conduction on the limb electrodes

A

Conductive gel

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18
Q

What planes are the leads visual representations of

A

Coronal and horizontal plane

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19
Q

Which leads have a fixed anode

A

Lead I, II, III

20
Q

Which leads have a viral anode

A

aVR, aVL, aVF, V1-V6

21
Q

Which lead is usually isoelectric

A

avL as it is viewed from bottom right to top left

22
Q

Where are the chest leads placed

A 
V1 - right 4th intercostal
V2 - left 4th intercostal
V3 - halfway V2 V4
V4 - 5th intercostal space mid-clavicular line
V5 - V4 at the Anterior axillary line
V6 - V4 at the mid-axillary line
23
Q

Which lead is commonly used

A

Lead II

24
Q

What does each big square represent in most ECGs

A

1mV

25
Q

What may ECGs interpretation vary for the same person

A

Interpretation can be subjective and dependent on skill, experience and knowledge

26
Q

What can an ECG help to recognise

A

Conduction abnormalities
Structural abnormalities
Perfusion abnormalities

27
Q

What is the order of approach to evaluation of ECG

A
  1. Rate and rhythm (R-R)
  2. P-wave and PR interval
  3. QRS duration
  4. QRS axis
  5. ST segment (height)
  6. QT interval T wave
28
Q

What must be taken into account before reading an ECG

A

Is it the correct one?
review the signal and quality of the leads
Verify voltage and paper speed
Review patient background

29
Q

Describe the ECG for sinus rhythm

A

P wave followed by QRS

Rate is regular (even R-R) and normal (~80bpm)

30
Q

Describe the ECG for sinus bradycardia

A

P wave followed by QRS
Rate is regular (Even R-R) and slow (~56bpm)
May be healthy, on medication, or vagal stimulated

31
Q

Describe the ECG for sinus tachycardia

A

P wave followed by QRS
Rate is regular (even R-R) and fast (~110bpm)
Often a physiological response

32
Q

Describe the ECG for sinus arrhythmia

A

P wave followed by a QRS wave
Rate is irregular (variable R-R) and normal (65-100 bpm)
R-R interval varies with breathing

33
Q

Describe the ECG for atrial fibrillation

A

Oscillating baseline
Rhythm irregular and slow rate
Turbulent flow increases clot risk
Atria contract asynchronously

34
Q

Describe the ECG for atrial flutter

A

Regular saw-tooth pattern in II, III , aVF

Atrial to ventricular beats at 2:1 ratio or greater

35
Q

Describe the ECG for First degree heart block

A

Prolonged PR segment (slow AV conduction)

Regular rhythm and 1:! ratio of P waves to QRS

36
Q

Describe the ECG for second degree heart block (Mobitz I)

A

Gradual prolongation of the PR interval until a beat is skipped
Most P followed by QRS
Regularly irregular
Disease in AV node

37
Q

Describe the ECG for second degree heart block (Mobitz II)

A

Regular P waves, only some followed by QRS
No P-R prolongation
Regularly irregular

38
Q

Describe the ECG for third degree heartblock

A

Regular P waves, QRS regular, no relationship

P waves can be hidden by bigger vectors

39
Q

Describe the ECG for ventricular tachycardia

A

Rate is regular and fast
P waves hidden
High risk of deterioration into fibrillation/ cardiac arrest

40
Q

Describe the ECG for ventricular fibrillation

A

Irregular and fast (>250bpm)
Cardiac arrest
Unable to generate output - no filling

41
Q

Describe the ECG for ST elevation

A

P waves visible and followed by QRS
Rhythm is regular and rate is normal (85bpm)
ST segment elevated >2mm above isoelectric line
Caused by infarction

42
Q

Describe the ECG for ST depression

A

P waves are visible and followed by QRS
Rhythm is regular and normal
ST segment is depressed >2mm below the isoelectric line
Caused by ischaemia

43
Q

What is the time represented by each small square

A

0.04s (100ms)

44
Q

What are the clinical features and management for atrial fibrillation

A

Dizziness and confusion
Chest pain, palpitations and dyspnoea

Anti-arrythmia medication or beta blockers
Anticoagulants?

45
Q

What is someone with left axis deviation likely to have

A 
Left ventricular hypertrophy
Left bundle branch block (LBBB)
Hyperkalemia
Inferior myocardial infarction
Conditions that elevate the diaphragm such as pregnancy, ascites, abdominal tumors, and also in patients with COPD
46
Q

What is someone with right axis deviation likely to have

A

Right bundle branch block
Right ventricular hypertrophy
Lateral wall myocardial infarction

Cardiovascular System (13 decks)

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