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J Cardio > ECGs > Flashcards

ECGs Flashcards

1
Q

how many wires are there to give a 12 lead ECG

where are they

A

10

3 limb leads (RA, LA, LL)
1 earthed wire
6 chest wires - V1-V6

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2
Q

what wires contribute to lead I

A

RA-LA

I = 1 L

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3
Q

what wires contribute to lead II

A

RA-LL

II = 2 L

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4
Q

what wires contribute to lead III

A

LA-LL

III = 3 L

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5
Q

where is the earthed wire

A

right leg

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6
Q

what wire does aVR come from

A

RA

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7
Q

what wire does aVL come from

A

LA

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8
Q

what wire does aVF come from

A

LL

F = foot

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9
Q

where is V1 on the chest

A

R sternal edge 4th intercostal space

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10
Q

where is V2 on the chest

A

L sternal edge 4th intercostal space

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11
Q

where is V3 on the chest

A

between V2 and V4

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12
Q

where is V4 on the chest

A

5th intercostal space, midclavicular line (apex beat)

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13
Q

where is V5 on the chest

A

anterior axillary line, same level as V4

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14
Q

where is V6 on the chest

A

mid axillary line, same level as V4 and V5

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15
Q

sinus arrythmia aetiology

sinus bc P wave followed by QRS

A

normal person with caffeine overdose/drugs etc

common in children

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16
Q

which lead is at the bottom of the ECG for you to read (figure out rate etc)

A

lead II

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17
Q

how long is one big square on ECG

A

0.2 seconds

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18
Q

how many small squares are in a big square on ECG

A

5

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19
Q

how long is one little square on ECG

A

0.04 seconds (0.2/5)

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20
Q

how to figure our rate if regular rhythm

A

300/number of large squares between QRSs

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21
Q

how to figure out rate if irregular rhythm

A

number of QRS in 30 boxes x10

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22
Q

what area of the heart does lead I represent

A

lateral

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23
Q

what area of the heart does lead II represent

A

inferior

bc connected to foot (LL) = inferior

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24
Q

what area of the heart does lead III represent

A

inferior

bc connected to foot (LL) = inferior

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25
Q

what area of the heart does lead aVL represent

A

lateral

bc most to left

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26
Q

what area of the heart does lead aVF represent

A

inferior

bc F = foot = inferior

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27
Q

what area of the heart does lead V5 represent

A

lateral

bc most to left

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28
Q

what area of the heart does lead V6 represent

A

lateral

bc most to left

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29
Q

normally, which lead is inverted

A

aVR

30
Q

what does P represent

A

atrial depolarisation

31
Q

what does QRS represent

A

ventricular depolarisation (and atrial repolarisation)

32
Q

what does T represent

A

ventricular repolarisation

33
Q

what does PR interval represent

A

AV node delay

34
Q

normal length of P wave

A

<0.12secs (3 small boxes)

35
Q

normal length of QRS

A

0.04-0.12secs (1-3 small boxes)

36
Q

normal length of PR interval

A

0.12-0.2secs (3-5 small boxes)

37
Q

steps to reading ECG (14)

A 
patient details
date and time of ECG
calibration of ECG paper
axis - normal?
activity present?
rhythm regular/irregular 
rate
P waves present
PR interval 
QRS after each P wave
QRS duration 
delta waves
ST elevation
T waves - tall?
38
Q

tall T waves

A

hyperkalaemia

39
Q

ST elevation

A

STEMI

40
Q

wide QRS

A

ventricular problem

eg ventricular tachycardia

41
Q

absent P waves

A

atrial problem

eg atrial flutter, atrial fibrillation

42
Q

sawtooth baseline

A

atrial flutter

43
Q

treatment of ventricular tachycardia

A

defib them

44
Q

P waves regular
QRS regular
P waves not followed by QRS (no correlation between the 2)

A

third degree heart block

45
Q

inferior MI lead changes

A

II, III, aVF

46
Q

anterior MI lead changes

A

V1-V6

47
Q

which artery is occluded in inferior MI

A

right coronary artery

48
Q

anterolateral MI lead changes

A

I, aVL, V1-V6

49
Q

which artery is occluded in anterior MI

A

left anterior descending

50
Q

posterior MI lead changes

A

V1-V3

ST depression!

51
Q

lateral MI lead changes

A

V5-V6, I, aVL

52
Q

high lateral MI changes

A

I, aVL

not V5-V6 bc theyre lower

53
Q

treatment of STEMI

A

primary PCI ASAP (<90mins)

thrombolysis >90mins

54
Q

prolonged PR

A

AV block

a type of heart block - need to figure which one

55
Q

which leads do you look at for axis deviation

A

I and aVF

56
Q

what is the axis deviation if;
I QRS positive
aVF QRS positive

A

no axis deviation

57
Q

what is the axis deviation if;
I QRS negative
aVF QRS positive

A

right axis deviation

58
Q

what is the axis deviation if;
I QRS positive
aVF QRS negative

A

left axis deviation

more common than right

59
Q

which artery is occluded in lateral MI

A

circumflex

60
Q

hr of sinus rhythm

A

60-100

61
Q

hr of sinus bradycardia

A

<60

62
Q

hr of sinus tachycardia

A

> 100

63
Q

ECG of sinus node block

A

missed P wave and QRS (together)

64
Q

how does supraventricular tachycardia differ from ventricular tachycardia

A

narrow QRS complex in supraventricular tachycardia

broad QRS complex in ventricular tachycardia

65
Q

loss of P waves
chaotic rhythm
QRS complexes present

A

atrial fibrillation

66
Q

prolonged PR interval

A

first degree heart block

67
Q

increasing PR interval until a QRS is dropped

A

second degree heart block type 1

68
Q

normal P waves but dropped QRS complex

A

second degree heart block type 2

69
Q

hr >100

broad QRS

A

ventricular tachycardia

70
Q

chaotic rhythm with no QRS = no heart rate detectable

A

ventricular fibrillation

J Cardio (4 decks)

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