ECG Lecture Flashcards by Michael bebbington

What is the double membrane sac that surrounds the heart?

PeriCardium

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Name the 3 parts of the pericardium

1- Fibrous
2- Serous - Parietal & visceral
3- Pericardial cavity

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What are the 3 layers of the heart

1- Endo Cardium
2- Myo Cardium
3- Epi Cardium

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Flow of the blood through the heart

1- Right Atrium
2- Tricuspid valve
3- Right Ventricle
4- Pulmonary Valve
5- Pulmonary artery
6- Pulmonary vein
7- Left Atrium
8 - Mittral (bicuspid) valve
9- Left Ventricle
10 - Aortic Valve

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2 types of cardiac muscles

1- Cardiomyocytes

2- Cardiac pacemaker cells

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Electrical conduction of the heart

1- SA Node
2- Bachmann's bundle
3- AV Node
4- Bundle of His
5- Right &amp; left Bundle Branch
6 - Purkinje Fibres

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Intrinsic heart rate of SA node

60-100

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Intrinsic rate of AV node

40-60

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Intrinsic rate of Purkinje Fibres

30-40

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What deflection will occur with current heading towards an electrode?

Positive/upwards

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What deflection will occur with current heading away from an electrode?

Negative/downwards

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Location of limb leads

AVr- Right wrist
AVl - Left Wrist
AVf - Left ankle
Neutral - Right ankle

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Lead 1 direction & description

Towards AVL creating a second high lateral lead

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Lead II Direction and description

Towards AVf form Avr creating a 2nd inferior lead

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Lead III direction and description

Towards AVF from AVl creating a 3rd inferior lead

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What is the Cardiac Axis

Major direction of the overall electrical activity of the heart

What would show a normal cardiac axis

positive on leads I and AVF

What would show a LAD cardiac axis

positive lead I but negative on AVf

What would show RAD

Negative lead I but positive on AVf

What would show Extreme Axis Deviation

Negative both

What does V1 and V2 look at

Right ventricle

What does V3 and V4 look at

Septum and the anterior wall of the left ventricle

What does V5 and V6 look at

Anterior and lateral walls of the left ventricle

What does the P wave represent

Atrial depolarisation

What does the Q wave represent

Septal depolarisation

What does the R wave represent

Ventricular Depolarisation

What does the S wave represent

depolarisation of purkinje fibres

What does the t wave represent

Ventricular repolarisation

normal PR interval

0.12-0.2s (3-5 squares)

Normal QRS interval

<0.06-0.1s (1.5-2.5 squares)

Normal QT interval

Rate dependent so corrected by machine. QTc 0.36-0.44s

ECG paper speed

25mm/s

Time of horizontal displacement

1 small = 0.04s | 1 Large = 0.2s

Vertical Displacement

1 small = 0.1mV | 1 large = 1mV

Subject Preparation

1- All clients to be offered a chaperone 2- Explain the procedure and gain full informed and written consent for EECG. 3- Explain that you are non-diagnostic 4- Disrobe from waist up (bra kept on) 5- If hairy chest, must be shaved with consent 6- if electrodes don't stick use piece of abrasive paper to clear skin

Poor skin contact: what and what does is cause

1- Chest hair, Wet skin, dry/old electrodes | 2- Wandering baseline

Movement Artefact

small high frequent waves

Electrical Artefact

Dense waves