ECG and Common Arrhythmias

Question 1

12 lead ECG (# of electrodes and leads)

Answer 1

10 electrodes
12 leads

Question 2

what does the PR interval mean

Answer 2

atrial depolarization

Question 3

what does the PR segment mean

Answer 3

atrial contraction

Question 4

normal PR interval (ms)

Answer 4

< 200ms

Question 5

QRS complex normal (ms)

Answer 5

<100ms

Question 6

5 step method to determining arrhythmias

Answer 6

1. HR: normal 50-100 bpm
2. Rhythm: ir/regular
3. P waves: uniform? one per QRS
4. PR interval: normal <200ms
5. QRS complex: normal <100ms

Healthy Routines Promote Physical Quality

Question 7

if we note an arrhythmia while scanning a _______ image should be taken

Answer 7

still

Question 8

when taking doppler measurements on a patient with an arrhythmia, you should take an average of _____ beats

Answer 8

3-5

Question 9

NSR

Answer 9

normal sinus rhythm
impulse travels through a normal conduction pathway through the heart at a normal rate

Question 10

Sinus bradycardia numbers

Answer 10

<50bpm

Question 11

sinus tachycardia numbers

Answer 11

> 100bpm

Question 12

sinus arrhythmias (2)

Answer 12

Sinus bradycardia
sinus tachycardia

Question 13

two types of heart blocks

Answer 13

bundle branch blocks
Av blocks

Question 14

AV block types (3)

Answer 14

1. 1st degree
2. 2nd degree (type I, type II)
3. 3rd degreee

Question 15

what is a bundle branch block (what, result, changes ECG)

Answer 15

refers to a signal slowing up or being blocked at either the right or left bundle branch= impulse cant go further and has to be stimulated by other ventricle = wider QRS complex (>120ms)

Question 16

RBBB (what, appearance)

Answer 16

right branch bundle block

rabbit ear appearance

Question 17

LBBB (what, appearance)

Answer 17

left branch bundle branch

wide QRS with broad notched R wave

Question 18

what is an AV block

Answer 18

a disturbance in the conduction at the AV node level

Question 19

1st degree AV block

Answer 19

prolonged PR interval (>200ms)
one P wave before QRS

Question 20

2nd degree AV block Mobitz I (what, AKA)

Answer 20

AKA Wenckebach

gradually lengthening PR interval until there is a dropped QRS complex

Question 21

2nd degree AVB Mobitz II

Answer 21

normal PR interval
has a P wave with no QRS following (signal blocked after atria contract=no ventricular contraction)

Question 22

if the R is far from the P then you have a _____ (AVB)

Answer 22

1st degree

Question 22

3rd degree AVB (what, AKA, results in)

Answer 22

AKA AV dissociation

no association between P waves and QRS complexes
(ventricles making own beating rate)

results in pacemaker

Question 23

longer, longer, longer drop then you have a ______ (AVB)

Answer 23

Wenckebach (2nd degree Mobitz I)

Question 24

if some Ps don't get through then you have a _____ (AVB)

Answer 24

Mobitz II

Question 25

if Ps and Qs don't agree then you have a ______ (AVB)

Answer 25

3rd degree

Question 26

3 types of atrial arrhythmias

Answer 26

premature atrial contractions atrial flutter atrial fibrillation

Question 27

PAC (stands for,what, result of)

Answer 27

premature atrial contractions when atrial muscle tissue produces its own impulse leading to atrial contraction followed by ventricular contraction (early beat then compensatory pause) result of too many catecholamines (stress, hormones, caffeine)

Question 28

atrial flutter (what, AV reacts by, ECG)

Answer 28

abnormal atrial pacemakers set firing rate very high, up tp 300bpm AV node cant handle, only lets some impulse through many atrial beats for every ventricular signal (saw tooth)

Question 29

atrial fibrillation (what, associated with, ECG)

Answer 29

atria quiver rather than contract many ectopic atrial electrical signals competing to pace the heart = irregular rhythm associated with: atrial enlargement, patients lose atrial kick (30% of filling) no detectable p waves, smaller waves than A-flutter, irregular R-R intervals)

Question 30

3 types of ventricular arrhythmias

Answer 30

premature ventricular contractions ventricular tachycardia ventricular fibrillation

Question 31

PVC (stands for, what/ECG, causes)

Answer 31

premature ventricular contractions QRS early= no P wave before and usually higher voltage/compensatory pause causes: catecholamines, blocked artery causing zone of ischemia

Question 32

when do PVCs become a significant finding

Answer 32

when there are multiples (2/3/4... in a row)

Question 33

Multifocal PVCs

Answer 33

impulses originate from more than one site within the ventricles (12-lead finding)

Question 34

VT

Answer 34

ventricular tachycardia rapid but coordinated, re-entry loop through ventricles only= no P wave can be due to MI sustained VT= medical emergency

Question 35

VF

Answer 35

ventricular fibrillation rapid, incoordinate motion, ventricles quiver (not beat) extremely emergent situation

Question 36

SVT (stand for, 3 identifying factors)

Answer 36

supraventricular tachycardia HR > 150bpm P waves hidden narrow QRS complex

Question 37

ST segment depression indicates

Answer 37

myocardial ischemia (not emergent)

Question 38

ST segment elevation indicates

Answer 38

MI (or recently had one)

Question 39

we compare the level of the ST segment with the ____

Answer 39

PR segment

Question 40

difference between PAC and PVC on ECG

Answer 40

PAC has p wave with early beat and compensatory pause PVC has no p wave with early beat and compensatory pause and usually has higher voltage on that beat