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NPTE Prep > ECG > Flashcards

ECG Flashcards

1
Q

Right arm electrode location

A
  • infraclavicular fossa medial to the right deltoid muscle
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2
Q

Left arm electrode location

A
  • infraclavicular fossa medial to left deltoid muscle
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3
Q

left leg electrode location

A
  • left side of the abdomen below the rib cage
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4
Q

right leg electrode location

A
  • right side of the abdomen (ground electrode)
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5
Q

V1 location

A
  • 4th intercostal space at right sternal border
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6
Q

V2 location

A
  • 4th intercostal space at left sternal border
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7
Q

V3 location

A
  • midway between V1 and V2
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8
Q

V4 location

A
  • 5th intercostal space at left midclavicular line
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9
Q

V5 location

A
  • left anterior axillary line at V4 level
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10
Q

V6 location

A
  • left midaxillary line at V4 and V5 levels
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11
Q

lead 1

A

+ left arm

- right arm

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12
Q

lead 2

A

+ left leg

- right arm

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13
Q

lead 3

A

+ left leg

- left arm

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14
Q

aVR

A

+ right arm

- left arm and left leg

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15
Q

aVL

A

+ left arm

- right arm and left leg

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16
Q

aVF

A

+ left leg

- right arm and left arm

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17
Q

P wave

A
  • atrial depolarization
18
Q

PR interval

A
  • time for atrial depolarization and conduction from SA nod to AV node
  • normal time is .12-.20 seconds
19
Q

QRS complex

A
  • ventricular depolarization and atrial repolarization

- normal ranges from .06-.10 seconds

20
Q

QT interval

A
  • time for ventricular depolarization and repolarization

- normal ranges from .20-.40 seconds depending on heart rate

21
Q

ST segment

A
  • isoelectric period following QRS when the ventricles are depolarized
22
Q

T wave

A
  • ventricular repolarization
23
Q

normal sinus rhythm

A
  • atrial depolarization begins in the SA node and spreads normally throughout the electrical conduction system with heart rate between 60 and 100 beats/minute
24
Q

sinus bradycardia

A
  • sinus rhythm of less than 60 bpm
25
Q

sinus tachycardia

A
  • sinus rhythm with a heartrate of more than 100 bpm
26
Q

sinus arrhythmia

A
  • sinus rhythm but with quickening and slowing of impulse formation in the SA node resulting in a slight, beat to beat variation of rate
27
Q

sinus arrest

A
  • a sinus rhythm except with intermittent failure of either SA node impulse formation or AV node conduction that results in the occasional complete absence or P or QRS wave
28
Q

premature atrial contraction (PAC)

A
  • occur when an ectopic focus in the atrium initiates an impulse before the SA node
  • P wave is premature with abnormal configuration
  • common and generally benign, may progress to atrial flutter, tachycardia, or fibrillation
  • may occur with a normal heart or any type of heart disease
29
Q

atrial flutter

A
  • ectopic, very rapid atrial tachycardia
  • atrial rate of 250-350 bpm, ventricular rate dependent upon AV node conduction
  • saw-tooth shaped P waves
  • occurs with valvular disease, ischemic heart disease, cardiomyopathy, hypertension, acute MI, chronic obstructive lung disease, and PE
  • signs include palpitations, lightheadedness, and angina due to rapid rate
  • stagnation of blood may predispose to thrombi in the atria
30
Q

atrial fibrillation

A
  • a common arrhythmia where the atria are depolarized between 350 and 600 times/min
  • ECG shows irregular undulations of ECG baseline without P waves
  • occurs in healthy hears and in patients with coronary artery disease, hypertension, and valvular disease
  • symptoms may include palpitations, fatigue, dyspnea, lightheadedness, syncope, and chest pain
  • stagnation of blood may predispose to thrombi in the atria
31
Q

1st degree AV block

A
  • PR interval is longer than .2 seconds, but relatively constant from beat to beat
  • no symptoms
  • PR interval may be prolonged for many reasons including medication that suppress AV conduction
32
Q

2nd degree AV block

A
  • AV conduction disturbance in which impulses between the atria and ventricles fail intermittently
  • two major types: mobitz type 1 block (wenckebach block) and mobitz type 2 block
  • Mobitz 1: progressive prolongation of PR interval until one impulse is not conducted (benign)
  • Mobitz 2: consecutive PR intervals are the same and normal followed by nonconduction of one or more impulses. If HR is slow, cardiac output will decrease with the blocked impulse. 2nd degree may progress to 3rd degree
33
Q

3rd degree AV block

A
  • all impulses are blocked at the AV node and none are transmitted to the ventricles
  • the atria and ventricles are paced independently; atrial rate>ventricular rate
  • considered a medical emergency requiring a pacemaker
  • if the ventricular rate is too slow, the cardiac output drops and the patient may faint
  • common causes include degenerative changes of conduction systems, digitalis, heart surgery, and acute MI
34
Q

premature ventricular complex (PVC)

A
  • premature depolarization in the ventricles due to an ectopic focus
  • unifocal PVCs arise from the same ectopic focus and have the same configuration
  • the P wave is usually absent and the QRS complex has a wide and aberrant shape
  • Bigeminy- normal sinus impulse is followed by PVC
  • Trigeminy- PVC occurs after every two normal sinus impulses
  • a common arrhythmia that occurs in healthy and diseased hearts
  • patient may be asymptomatic or have palpitations
  • common causes include anxiety, caffeine, stress, smoking, and all forms of heart disease
35
Q

ventricular tachycardia

A
  • 3 or more consecutive PVCs at a ventricular rate of >150 bpm
  • P waves are absent and QRS complex is wide and aberrant
  • V-tach longer than 30 secs is a life-threatening arrhythmia and requires immediate medical intervention
  • patients are not able to maintain an adequate blood pressure and eventually become hypotensive
  • v-tach may degenerate into ventricular fibrillation causing cardiac arrest
  • common causes include MI, cardiomyopathy, and valvular disease
36
Q

ventricular fibrillation

A
  • ventricles do not beat in a coordinated fashion, but fibrillate or quiver asynchronously and ineffectively
  • no cardiac output, patient becomes unconsciousness
  • ECG shoes fibrillatory waves with an irregular pattern that is either coarse or fine
  • a lethal tachyarrhythmia requires defibrillation
  • medication to support the circulation and intravenous antiarrhythmic agents
  • common causes include heart disease, MI, and cocaine
37
Q

ST segment depression

A
  • sign of MI
  • a sign of supendocardial ischemia
  • the segment is evaluated relative to isoelectric baseline at .08 seconds after the J pint (junction between end of QRS and beginning of ST segment
  • deviations from the isoelectric baseline are expressed as ST segment depression of 1mm or 2mm etc
38
Q

ST segment elevation

A
  • earliest sign of acute transmural infarction
  • can also indicate a benign early repolarization pattern in a normal heart
  • deviations form isoelectric baseline are expressed as ST elevation of 1 mm. 2 mm etc
39
Q

Q wave

A
  • a characteristic marker of infarction, signifies the loss of positive electrical voltages due to necrosis
  • a significant or abnormal Q wave is longer than .04 msec and larger than 1/3 the amplitude of the R wave
40
Q

T wave inversion

A
  • occurs hours or days after an MI as the result of a delay in repolarization produced by an injury
  • may also occur with right and left bundle branch blocks, after a CVA and as a normal T wave pattern in children and some adults
41
Q

how to analyze ECG rhythm

A

page 429

NPTE Prep (74 decks)

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