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BSN > ECG > Flashcards

ECG Flashcards

1
Q

two types of cardiac cells

A

myocardial cells

specialized cells

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2
Q

Conductivity

A

ability to transmit impulses from one area of the heart to another

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3
Q

Excitability

A

(irritability) capability of the cell

to respond to a stimulus

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4
Q

Automaticity

A

capacity to initiate an impulse or stimulus

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5
Q

Rhythmicity

A

property of regularitiy of the intervals at which impulses are formed.

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6
Q

Refractoriness

A

Property of being unresponsive to an impulse

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7
Q

Sodium and potassium concentration in and around the cell

A

potassium is high inside the cell and sodium is high outside the cell

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8
Q

The inside of the cell is ____ when at rest or in the polarized state

A

the inside is negative compared to the outside

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9
Q

how the sodium moves into the cell

A

when the cells are stimulated the cell membrane changes its permeability and allows sodium to move rapidly into the cell making the inside + and the outside negative. this is called depolarization

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10
Q

depolarized is ____ inside the cell

A

positive

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11
Q

polarized is ____ inside the cell

A

negative

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12
Q

Refractory periods

A

absolute refractory Period (heart cant respond-during depolarization)

Relative refractory period (can only respond to a strong stimulus-repolarization is n progress.) (this is the T-wave)

Subnormal period (will respond to weaker stimulus- just before reoplarization is completed)

Nonrefractory period (heart is completely repolarized and ready to respond to a stimulus)

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13
Q

SA node rate

A

60-100

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14
Q

AV node rate

A

40-60

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15
Q

Purkinje Fibers rate

A

20-40

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16
Q

Bachmans bundle

A

pathway from RA to LA

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17
Q

what does the p wave represent

A

atrial depolarization

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18
Q

What does the QRS represent

A

ventricular depolarization

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19
Q

unipolar electrode records what

A

the electrical activity between the positive electrode and the center of the heart

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20
Q

a bipolar electrode records what

A

the electrical activity between the positive and negative terminal

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21
Q

which way is the impulse going in an upward deflection

A

toward the positive electrode

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22
Q

which way is the impulse going in a downward deflection

A

toward the negative electrode (from the positive in a bipolar electrode)

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23
Q

list the unipolar chest leads

A

V1, V2, V3, V4, V5, V6

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24
Q

List the bipolar leads

A

Lead I, Lead II, Lead III

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25
Q

List the unipolar leads

A

aVR, aVL, aVF

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26
Q

commonly used monitoring lead

A

MCL1 (modified chest lead) and Lead II

27
Q

Where are the electrodes in Lead II

A

+ over the apex of the heart (4-5ics MCL)

  • right side, MCL 2nd ics
28
Q

Where are the electrodes in Lead I

A

+ left upper MCL (2ics)

- R upper MCL (2ics)

29
Q

Were are the electrodes in Lead 3

A

+ Left lower

- Left upper

30
Q

Where are the electrodes in V1 MCL1

A

+ right lower

-left upper

31
Q

Voltage

A

measured on vertical axis

32
Q

Duration

A

measured on the horizontal axis by a
series of vertical lines; the interval between
vertical lines equals 0.04 second

33
Q

small box

A

0.04

34
Q

large box

A

0.20

35
Q

isoelectric

A

baseline- no electric activity

36
Q

An upright p wave means what

A

that it is coming from the SA node

37
Q

Normal PRI

A

0.12 - 0.20 seconds

38
Q

where is the PRI measured

A

from the start of the P wave to the start of the QRS

39
Q

What does the PRI represent?

A

atrial depolarization and delay through the AV node

40
Q

QRS complex duration

A

less than 0.12

41
Q

how to measure the QRS

A

from the beginning of the QRS (Q or R
wave, whichever is present) to the end of the S
wave

42
Q

J point

A

end of QRS and beginning of ST segment.

43
Q

what does the T wave represent

A

Ventricular repolarization (revcovery)

it is normally upright in Lead II

44
Q

What does a U wave indicate

A

Hypokalemia

45
Q

QT interval represents what

A

the time it takes for the ventricle to depolarize

and repolarize.

46
Q

Normal QT interval

A

usually 0.34-0.43

for a quick measure if its within 1/2 of the R-R its probably WNL

is based on heart rate. A QTc is corrected by the equation to a heartrate of 60 bpm

47
Q

A prolonged QT does what?

what is considered prolonged

A

increases the risk of lethal arrhythmias and sudden cardiac death

QTc >500ms

48
Q

Interpretation of ECG

A

is there a p for every QRS

is the PRI regular

QRS wide or narrow

what is the atrial rate, what is the ventricular rate

49
Q

calculating HR - big box method

A

300 / the number of big boxes between QRS complexes

50
Q

Calculating HR - small box method

A

1500 / # small boxes between QRSs

51
Q

another way to calculate HR

A

10 multiplied by the # of QRS in 6 seconds

52
Q

Most accurate way to check rate on irregular rhythms

A

count # of R waves for 1 minute.

53
Q

How do you measure the atrial rhythm?

How about Ventricular rhythm?

A

measuring P to P

Measuring R to R

54
Q

How to interpret the P wave

A 
is it present?
is it upright (in lead II)
is there a p for every qrs
do all the p waves look alike
are the Ps regular
do they occur where they should
55
Q

How to interpret the P-R interval?

A

what is the PRI duration
(short or prolonged)
are the durations consistent across the strip (progressively longer)
is there a pattern to the changing PRI

56
Q

How to interpret the QRS?

A

duration of the QRS?
do all of them look the same
does it bear a fixed relationship to the P

Nl < 0.12

57
Q

Premature v. Escape

A 
Premature = early
Escape = back up rhythm

(Escape rate is based on origin of the impulse)

58
Q

NODAL =

A

Junctional / escape

59
Q

Characteristics of junctional rhythm

A

PR interval - regular or absent since the P wave may be absent

P wave - pacemaker site is the junction so in lead II the p wave may be inverted before the QRS, buried in the QRS or inverted behind the QRS.

PRI (if there is a p wave) PRI will be 0.12 or less

60
Q

Normal junctional rate

A

40-60

61
Q

Accelerated junctional rate

A

61-100

62
Q

Clinical signs and symptoms of junctional escape rhythm

A

Slow regular pulse
Often a temporary Dysrhythmia
If rate dramatically decreases CO may drop

63
Q

Are junctional rhythms regular

A

Yes

64
Q

S & S of accelerated junctional rhythm

A

Usually benign

BSN (5 decks)

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