EKG Flashcards

1
Q

what is the primary pacemaker for the heart?

A

the SA node

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2
Q

2 body systems that control heart rate

A

PNS / SNS

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3
Q

what happens during atrial depolarization?

A

cells become more negative – atrium contracts –> filling of ventricles

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4
Q

Sa node fires- what part of ekg?

A

p wave

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5
Q

ventricles fillings a lil more = what part of ekg?

A

PR segment

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6
Q

______ _______ slow down the electrical impulses on their way to ventricles (why do i care?)

A

transitional cells
◦ This delay allows atrial contraction and ventricular filling
–> represented by PR segment

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7
Q

what is the PR interval composed of? (2 parts)

A

p wave and PR segment

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8
Q

how long should the PR interval be?

A

0.2 - 0.10 seconds

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9
Q

what part of EKG represents ventriclular depolarization (contraction)?

A

QRS complex

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10
Q

can the ventricles start an impulse?

A

yes! they contain nodal cells which can cause the ventricles to start an impulse but its not what we want - es muy mal

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11
Q

which part of the EKG represents ventricular repolarization?

A

T wave

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12
Q

which part of the EKG represents early ventricular repolarization?

A

ST segment

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13
Q

how many pictures of the heart does a 12 lead show us? how many electrodes are there?

A

◦ 12 lead system has 10 electrodes but shows us 12 pictures

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14
Q

how often do we change the electrodes?

A

q24 hours

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15
Q

the top 2 leads are placed where?

A

on the out portion of the 2nd intercostal

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16
Q

what does a positive deflection look like on an ekg?

A

line rises up

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17
Q

what does a negative reflection look like on an ekg?

A

dip down

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18
Q

what is it called when a line moves straight across an EKG?

A

isoelectric

19
Q

tiny little box. = _____ seconds

20
Q

1 big box. = ______ seconds

21
Q

5 big boxes = ______ seconds

A

1.0 seconds

22
Q

30 big boxes = _______ seconds

23
Q

how can we calculate the heart rate on an ekg?

A

count the # of QRS complexes in 6 seconds (30 big boxes) and multiply by 10 = Heart Rate

24
Q

what should the PR segment look like?

A

isoelectric

25
which parts of QRS complex are sometimes not visible?
Q and S
26
will R be a positive or negative defelction?
positive
27
What is happening during the QRS complex?
= ventricular depolarization = ventricular contraction = squeezing blood out
28
what should the ST segment look like on a normal EKG?
isoelectric
29
what should the T wave look like? what does T wave represent?
• SHOULD be positive, round and symmetrical = Ventricular repolarization
30
______ wave Represents slow repolarization of Purkinje fibers in ventricles
U ---> its not normal!
31
what does the QT interval represent?
=time it takes for ventricular depolarization and repolarization to occur (contract and rest)
32
normal range for QT interval?
0.36-0.44 seconds
33
this is an emergency that can happen with a prolonged QT interval and it looks like a party streamer
Torsades de Pointe
34
causes of artifact on EKG
• Check your patient before you panic… ASSESS • Interference on the monitor • Movement • Old electrodes --> change the electrodes everyday • Poor contact of electrodes • Faulty equipment
35
8 basic steps of EKG analysis
1.Determine HR 2.Determine Rhythm 3.Analyze P waves 4.Measure PR Interval 5.Measure QRS Duration 6.Examine ST Segment 7.Assess T wave 8.Measure QT interval
36
Step 1 of ekg interpretation - heart rate- how do we do it?
◦ 6-second strip (30 big boxes) rule- count the QRS complexes and multiply X 10
37
step 2 ekg interpretation- how do we determine the heart rhythm?
◦ Is it regular? Irregular? ◦ March out the beats... P –P interval (first), R-R interval (peak)
38
step 3 ekg interpretation - how do we analyze the p waves?
◦ Regular occurrence and shape? ◦ 1:1 ratio with QRS? - for every p wave there should be a QRS complex ◦ Do they all look similar to one another?
39
step 4 eky interpreation - how do we measure the PR interval?
◦ Place caliper points at beginning of P wave and end of PR segment ◦ Count blocks (# of blocks X 0.04) --> Should be 0.12-0.20 seconds ◦ Are they constant? > 0.20? (taking heart longer time to contract atria) < 0.12?
40
step 5 ekg interpretation- how do we measure the QRS duration? what is normal?
◦ Place caliper points at beginning of QRS and at end of QRS ◦ Count blocks (# of blocks X 0.04) Should be between 0.04 and 0.10 seconds ◦ Are they constant? More than 0.10? Less than .04?
41
step 6 ekg interpretation - what are we looking for in the ST segment?
◦ Is it isoelectric? (good) Is it elevated? Is it depressed? (is it elevated or depressed= > one small block (1 mm = 1 lil box), two or more leads?)
42
step 7 ekg interpretation- what are we looking for in the T wave?
◦ is it rounded and fairly symmetrical? (first bump after isoelectric ST)
43
step 8 of ekg interpretation - how do we measure the QT interval?
◦ Place Caliper points at beginning of QRS complex and end of T wave ◦ Count small boxes and multiply by 0.04 ◦ Can compare to R-R interval and divide by 2 for normal (or 0.36-0.44) ‣ should be < 1/2 of r-r interval
44
step 9 ekg interpretation =
shake your head and say thank god i'm done looking at that