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CVS Physiology > ECG > Flashcards

ECG Flashcards

1
Q

What waves are seen on an ECG?

A

P QRS T

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2
Q

What is the complex seen on an ECG?

A

QRS complex

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3
Q

Why cant you see atrial repolarisation on an ECG?

A

Atrial repolarisation happens at the same time as ventricular depolarisation. Ventricular depolarisation involves much more tissue depolarising much faster so it swamps any signal from atrial repolarisation

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4
Q

What happens at the Q of the QRS complex?

A

The interventricular septum depolarises from L to R

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5
Q

What happens at the R of the QRS complex?

A

The bulk of the ventricle depolarises from the endocardial to the epicardial surface

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6
Q

What happens at the S of the QRS complex?

A

Upper part of the interventricular septum depolarises

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7
Q

What is the left leg in relation to?

A

Right arm

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8
Q

Which direction does a wave of repolarisation go in?

A

AWAY from the electrode

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9
Q

What direction does a wave of depolarisation go in?

A

TOWARDS the electrode

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10
Q

Why is the R wave bigger in the SLL II than in the SLL I or SLL III?

A

Because the main vector of depolarisation is in line with the axis of recording from t he left leg with the respect to the right arm

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11
Q

What is the P wave caused by?

A

Atrial depolarisation

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12
Q

What is the QRS complex caused by?

A

Ventricular depolarisation

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13
Q

What is the T wave caused by?

A

Ventricular repolarisation

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14
Q

Why is the T wave positive?

A

The AP is longer in the endocardial cells than in the epicardial cells, so the wave of repolarisation runs in the opposite direction to the wave of depolarisation i.e. a wave of repolarisation moving away from the recording electrode produces another positive going blip

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15
Q

What is the PR interval?

A

Time from atrial depolarisation to ventricular depolarisation

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16
Q

What is the PR interval mainly due to?

A

Transmission through the AV node

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17
Q

What is the QRS interval?

A

Time for the whole of the ventricle to depolarise

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18
Q

Normal time of QRS interval

A

0.08 seconds

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19
Q

What is the QT interval?

A

Time spent while the ventricles are depolarised

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20
Q

What does the QT interval vary with?

A

HR

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21
Q

Normal QT interval

A

0.42 seconds at 60 bpm

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22
Q

What does a wave of depolarisation cause on an ECG?

A

Upward going blip

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23
Q

Are fast events or slow events transmitted better?

A

Fast

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24
Q

How to work out the HR from an ECG?

A
  1. Measure R-R interval and work out how many in 60 seconds

2. Count how many R waves in 30 large squares (6 seconds) and multiple by 10

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25
Q

Normal HR

A

60 - 100

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26
Q

Name for < 60 bpm

A

Bradycardia

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27
Q

Name for > 100 bpm

A

Tachycardia

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28
Q

What else would you look at on an ECG?

A

HR
Is each QRS complex preceded by a P wave?
Is the PR interval too short (<0.12 sec) or too long (>0.2s)
Is the QRS complex too wide (>0.12 sec)
Is the QT interval too long (>0.42 s at 60bpm)?

29
Q

What does STEMI stand for?

A

ST elevated myocardial infarction

30
Q

What does NSTEMI stand for?

A

Non elevated myocardial infarction

31
Q

Which of STEMI or NSTEMI is worse?

A

STEMI

32
Q

What are the limb leads?

A 
aVR
aVF
aVL
SLL III
SLL II
SLL I
33
Q

Does AVF give a positive or a negative blip?

A

Positive

34
Q

Does AVR give a positive or a negative blip?

A

Negative

35
Q

Which precordium leads flip over?

A

V3/V4

36
Q

What plane do the limb leads look at?

A

Frontal plane

37
Q

What plane do the precordial leads look at?

A

Transverse plane

38
Q

What is a downward QR wave?

A

1st deflection

39
Q

What is a downward sR wave?

A

Subsequent deflection

40
Q

What does more voltage on the ECG indicate?

A

The more the muscle

41
Q

Max QRS width

A

3 little boxes

42
Q

What interval is very difficult to determine on the ECG due to all of the influencing variables?

A

QT interval

43
Q

What does prolonged P-R interval indicate?`

A

1st degree heart block

44
Q

Which Mobitz type of type II heart block is more pathological?

A

Mobitz type II

45
Q

What determines the atrial rate?

A

Between the P waves

46
Q

Causes of atrial dissociation

A

Complete heart block
VT
Pacemaker

47
Q

Does VT have to be >100bpm?

A

No, can be whatever speed it determines

48
Q

What type of BBB is always abnormal?

A

LBBB

49
Q

Signs on ECG of LBBB

A

V1 downward

V6 upright and notched

50
Q

Is RBBB always abnormal?

A

Can be a variant of normal

51
Q

Signs on ECG of RBBB

A

V1 smaller R waves and larger R prime

V6 slurred S wave

52
Q

How much of the myocardium does the left main stem artery cover?

A

2/3rds

53
Q

Causes of ST depression

A

Occlusion
Severe hypotension
Severe anaemia

54
Q

Why does troponin rise and fall in ischaemia?

A

Due to the dynamic features and nature of ischaemia

55
Q

Is P : QRS relationship is 1;1, what does this mean?

A

Sinus rhythm

56
Q

What wall of the heart is not looked at on the ECG? What can be looked at and where to try and identify this?

A

Posterior wall

Can look like ST depression on the anterior leads

57
Q

What artery supplies the sinus node?

A

Right coronary artery

58
Q

VF vs VT on ECG

A

VF - big amplitude, not same shape or frequency

VT - same waveform

59
Q

Does adenosine treat atrial tachycardia and why?

A

No - as does not needing the AV node

60
Q

What is used to treat SVT?

A

Cardioversion

61
Q

What kind of treatment is SVT?

A

An umbrella term

62
Q

Examples of Cardioversion

A

Valsalva
Carotid sinus massage
Adenosine

63
Q

Features of adenosine

A

Blocks AV node
Half life 10 seconds
Patients feel like they will die
Cannulas placed as proximal as possible

64
Q

What is given after adenosine?

A

Saline

65
Q

Treatment of VT

A

Anaesthetist put patient to sleep - then Defibrillator
If comes back
- amiodarone

66
Q

What are little bumps on ECG usually? What do they usually confirm?

A

P waves

Confirms VT due to more ventricular activity

67
Q

Is there atrial activity in AF?

A

Yes, but all fluttered/fibrillating

68
Q

What do irregular QRS complexes represent?

A

AV nodal function in AF

CVS Physiology (12 decks)

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