ECG (until Post exam protocol) Flashcards
Dr. Luigi Galvani is the ___________________
one who first noted that electrical current could be recorded from skeletal muscles or dissected muscles in 1786
Who recorded the first electrogram with a mercucy capillary electrometer?
Augustus D. Waller at St. Mary’s Hospital in London in 1887
When was a improved electrometer and correction formula developed?
1895
Enumerate Williem Einthoven’s contributions
- Developed improved electrometer and formula developed (labeled the corrected derived deflections PQRS and T
- first source using the term Elektrokardiogram (EKG)
- publishes the first electrocardiogram on a string galvanometer
What year was improved electrometer developed?
1895
When was first article using EKG used?
1900
When was published the first electrocardiogram on a string galvanometer?
1902
This measures the hearts’s electrical activity
Electrocardiography
What are the CVDs evaluated using ECG/EKG?
Abnormal heart rhythm (arrhythmias)
Myocardial ischemia/infarction
Chamber enlargement
Electrolyte abnormalities
This records electrical signals of the body esp the heart
ECG/EKG
TRUE OR FALSE:
ECG does induce electricity in measuring signals of the heart
FALSE
it does not induce electricity, it only measures the SIGNALS
TRUE OR FALSE:
ECG/EKG his is unsafe but effective
FALSE
It Quick, safe , common, and painless test can quickly detect for heart problems and monitor heart
What is the electrical impulse or wave seen?
Heartbeat = it squeezes pump blood from heart
What is the small electro-patches made of?
Silver-Silver Chloride
Where does the electro-patches placed on the patient?
Arms, Chest, Legs
What is the condition when there is poor blood flow in the heart muscles that is seen from the heart rhythm?
Ischemia
What are examples of electrolytes measured?
Sodium, potassium, chloride
TRUE OR FALSE:
Conditions such as endocarditis, heart attack and cardiac catheterization can be determined through ECG
TRUE
TRUE OR FALSE:
ECG/EKG is performed before and after treatment of patient
TRUE
This is the method of comparing previous and current results
Delta Check
What is the most important to be checked in ECG?
Different waves (cause to squeeze and pump of heart)
Which chambers produces the P wave?
Upper left and right atria
What comes after P wave?
Flat line
Which chambers produces QRS Complex?
right and left ventricles of the bottom chambers
Which wave represents the electrical recovery or return for resting state of ventricles?
T wave
What is the purpose of ECG?
- detects heart’s electrical rhythm and produces TRACING
What is the term defined as consists of representations of several waves that recur w/ each heartbeat?
Tracing
TRUE OR FALSE:
Wave pattern should have consistent shape.
TRUE
What is the indication if there is inconsistent or do not appear standards waves?
Heart disease
What is the itsura of a tracing?
Squiggly line
What is the ECG called when performed before surgery?
Pre-operative screening ECG
This is defined as sequence of events taking place in the heart from the beginning of one heartbeat to the beginning of next heartbeat?
Cardiac Cycle
Which initiates an impulse of a heartbeat?
SA Node
This is the event of depolarization, repolarization of the atria and ventricle
Electrical Events
This is the contraction or relaxation of atria and ventricles
Mechanical events
Define ECG tracing
electrodes will be attached or positioned to upper and lower extremities, chest wall because they will act as sensors and will pick up electronic potentials = seen in tracing = assess potential and activity
What is the direction of conduction of impulses of SA node to AV Node?
DOWN, LEFT
What is the direction of conduction of impulses of AV Node to bundle branch left and right?
DOWN, LEFT
What is the direction of conduction of impulses of left bundle branch to right bundle branch?
RIGHT
What is the direction of conduction of impulses of bundle branch to purkinje fiber?
DOWN
What is the direction of conduction of impulses of purkinje fibers to base of heart?
LEFT
What is the structure called were electrical impulses will go from SA node to AV node?
Internodal Tracts
Which internodal tract is responsible for the distribution of impulses to the left atrium?
Anterior tract of Bachman
Which internodal tract is responsible to connect the SA and AV node?
Middle Tract of Wencjebach
What does posterior tract of thorel responsible for?
It distributes impulses to the right atrium to AV node
From the AV node, where will impulses go?
Bundle of His/Av bundle
What is the cause of AV nodal delay?
happens in bundle of His = caused by small diameter and few gap junction of bundle of his fibers
from the Bundle of His, it will go to the ________________________
left (stimulated first) and right bundle branch
Enumerate the flow if electrical impulses
SA node -> AV node -> bundle of his -> Left and right bundle branch -> purkinje fibers -> base of heart
this is located in the right atrium near the entrance superior vena cava
SA Node
This is considered as the natural pacemaker of the heart
SA node
This initiates all heartbeat and determine heart rate
SA Node
This is located on the other side of the right atrium near the AV Valve
AV node
It serves as the electrical gateway to the ventricles. It is called ______________________
AV node
Why is there a delay in the passage of electrical impulses to the ventricles
To ensure that atria have rejected all the blood to the ventricles before it contracts
These conduct the impulses toward apex of the heart
Bundle of His or AV bundle
Which represents P wave?
When the atria are full of blood = SA node fires, electrical signals spread throughout atria = cause them to depolarize (atrial depolarization)
This represents the time signals travel from SA to AV node
PQ segment
What is the function of QRS complex?
marks the firing of AV node and represents ventricular depolarization
Q wave corresponds to ___________________
the depolarization of the interventricular septum
This is produced by depolarization of the main mass of ventricles (apical depolarization)
R wave
This represents the last phase of ventricular depolarization at the BASE OF THE HEART (depolarization of base of ventricle)
S wave
ST segment functions to ____________________
reflects the plateau in myocardial action potential
This wave represents ventricular repolarization immediately before ventricular relaxation or ventricular diastole and corresponds to phase 3 of repolarization
T wave
Where are the electrodes attached on the Patient?
right arm, Left arm, Left leg, chest
Which leg is not included to be attached with electrodes and why?
Right leg is not included because we use ground electrode
Grounded electrode is responsible for
removing other electrical potential aside from other ones from heart remove possible electrical potential
How many leads are required?
12
How many leads are required to check for arrythmia
3
This is a processor board found on data acquisition system
Analogue front end module
What does digital ecg data acquisition system do?
acquire data from body
What are the types of ECG?
Resting, exercise/stress, holter monitor
Which type of ECG requires 24hrs to monitor Patient’s heart?
Holter
The holter monitor is used when patient ______________________
always complain of palpitations and episodes of syncope
Where are cables of electrodes attached to patient during resting ECG tracing?
Chest and NOT on extremities
TRUE OR FALSE
Resting ECG appears normal but complains of chest pain requires exercise/stress ECG tracing
TRUE
may be indivative of heart disease (CAD, pulmonary embolism, ischemia)
What are the leads of bipolar limb leads?
Lead 1 – right arm and left arm (+)
Lead 2 – right arm and left leg (+)
Lead 3 – left arm and left leg (+)
This ECG lead is also known as Einthoven’s Triangle
Bipolar Limb Leads
What is the Einthoven’s equation
lead 2 = lead 1 + lead 3
What are the leads of Unipolar Limb lead?
Lead aVR - towards right arm
Lead aVL - towards left arm
Lead aVF - towards left foot
This lead under unipolar limb leads – always present mostly as a negative deflected waves
aVR
This ECG lead’s landmark is the Angle of Louis at the sternum
Chest leads
This ECG lead represent and records potential transmitted of the horizontal plane of the heart
Chest lead
Which position of chest leads is attached at the 4th intercoastal space, left parasternal border?
V1
Which position of chest leads is attached at the 4th intercoastal space, right parasternal border
V2
Which position of chest leads is attached between V2 and V4?
V3
Which position of chest leads is attached at the 5th intercoastal space, left midclavicular line (below nipple)?
V4
Which position of chest leads is attached at the left anterior axillary line (same level as V4)
V5
Where is V6 located?
same level as V4 and V5 but located at the mid axillary line
Where is Lead V4R located?
same level as V4 but located on the right
Where is Lead V3R located?
between V1 and V4R
This chest lead responsible for the right side of the heart particularly the right ventricle
V1
V3 and V4 is responsible for which chambers of the heart?
Anterior left ventricle
V5 and V6 is responsible for which chambers of the heart?
lateral left ventricle
V7 and V8 detects abnormality in __________________
myocardium of posterior side of heart
V7 is located in
same level of V5 and V6 but posterior axillary line
V8 is located in
left mid scapular line of the 5th intercostal space
ST segment starts at ___________
end of S to the beginning of T
This segment represents phase 2 of ventricular repolazrization
ST segment
This starts at the end of S wave and end of T wave
ST interval
This measures the whole period of latent repolarization
ST interval
WHat is U wave?
uncommon wave that is believed to be due to the slow repolarization of papillary muscles
What phase is the QRS wave represent?
Phase 0
What phase is the U wave represent?
Phase 1
Heart rate should be ________beats/minute
60-100
What is the interval called for P and R wave?
PR Interval - 0.12-0.20secs
How is ventricular rate can be checked?
by the number of small and big squares between 2 R waves
This is a neutral/straight line that is the basis for + and - waves
Isoelectric line
What are the two forms of waves?
Positive (P, R, T) and negative (Q and S) waves
This is the movement of ions across the cell membrane causes the inside of cell to become + = expects contraction
Depolarization
This is – movement of ions across the cell membrance causes the inside to become - which causes relaxation
Repolarization
What is the direction of a depolarization towards + electrode?
upward
What is the direction of a depolarization away from + electrode?
downward
What is the direction of a repolarization towards + electrode?
downward
What is the direction of a repolarization away from + electrode?
upward
Which muscle is first to depolarize and first to repolarize?
Atrial Muscle
Which muscle is first to depolarize and last to repolarize?
Ventricular muscle
How many hours should a patient abstain from smoking and caffeine?
6-10hrs before the test
TRUE OR FALSE
Drinking cold water before the test can cause changes in electrical patterns
TRUE
TRUE OR FALSE:
Fasting is required before the test
FALSE
TRUE OR FALSE:
All clothing must be not worn to not interfere with the test
FALSE
TRUE OR FALSE:
Jewelry should be removed to not interfere with test
TRUE
TRUE OR FALSE:
All patients must NOT take medications before the test
FALSE
How long does ECG testing lasts?
10mins (usually)
TRUE OR FALSE:
Special after care is required to follow
FALSE
What are the information included in the reading of ECG?
Name, age, date, standardization
TRUE OR FALSE:
If patient develops rashes after ECG, this is a serious effect and should seek medical attention IMMEDIATELY
FALSE
