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Cardiopulmonary > EKG > Flashcards

EKG Flashcards

1
Q

what is an EKG?

A

electrical pictures of heart from diff angles, assess HR, rhythm, ischemia/infarction, other structural tissues

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2
Q

what are the components of an EKG?

A

isoelectric line, P wave, PR interval, QRS complex, J point, ST segment, T wave, QT interval

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3
Q

what is the isoelectric line?

A

baseline when no electrical activity occurs

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4
Q

what is the P wave?

A

atrial depolarization

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5
Q

what is the PR interval?

A

0.12-0.2 seconds between P wave and beginning of QRS complex

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6
Q

what is the QRS comples?

A

ventricular depolarization

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7
Q

what is the J poiint?

A

beginning of ST segment

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8
Q

what is the ST segment?

A

should be flat, time between the end of QRS complex and end of T wave

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9
Q

what is the T wave

A

ventricular repolarization

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10
Q

what is the QT interval

A

<0.44-0.46 seconds, time from beginning of QRS complex to end of T wave

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11
Q

what are the 5 lead EKGs

A

I, II, III, aVR, aVL, aVF

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12
Q

what lead is commonly used in a single lead rhythm strip?

A

lead II

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13
Q

how long are the heart rate strips and how is that calculated?

A

6 seconds, 1 small box is 0.04 seconds, 1 large box is 0.20 seconds, 5 large boxes is 1 second

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14
Q

how do you calculate HR on a strip?

A

count the QRS complexes and multiply by 10

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15
Q

what does the lead V1 and V2 capture for a chest lead?

A

R ventricle / interventricular septum

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16
Q

what does the lead V3 and V4 capture for a chest lead?

A

septum / anterior wall

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17
Q

what does the lead V5 and V6 capture for a chest lead?

A

lateral wall

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18
Q

what leads have the inferior view?

A

II, III aVF

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19
Q

what leads have the lateral view?

A

I, aVL, aVR, V5, V6

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20
Q

what leads have the anterior view?

A

V3, V4

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21
Q

what leads have the septal view?

A

V1, V2

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22
Q

what is a normal length for the QRS complex?

A

1.5 - 3 small boxes (0.06 - 0.12 seconds)

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23
Q

what is a normal length for the PR interval?

A

3 - 5 small boxes (0.12 - 0.20 seconds)

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24
Q

what are abnormal EKGs for atrial arrhythmias?

A

atrial flutter, atrial fibrillation, premature atrial contraction, SVT

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25
Q

how does an atrial flutter present on an EKG?

A

quick short P waves, saw tooth pattern, either 2:1 or 4:1 QRS variable

26
Q

how does an atrial fibrillation present on an EKG?

A

no discernable P waves, continuous rapid firing within atria, decreases CO up to 20%

27
Q

how does a premature atrial contraction present on an EKG?

A

early abnormal looking P wave followed by normal QRS, or may have absent P wave with esrly but normal QRS, pause before sinus rhythm resets.

28
Q

how does supraventricular tachycardia present on an EKG?

A

narrow QRS, looks like sinus tachycardia but lacks clearly defined P wave

29
Q

what are abnormal EKGs for nodal / junction arrhythmias?

A

heart blocks (1-3° block), bundle branch blocks

30
Q

how does a 1° heart block present on an EKG?

A

delay between SA and AV node = prolonged PR interval, consistent in every cycle, regular rhythm. each pause is exactly the same.

31
Q

how does a type 1 (wenckebach or mobitz 1) 2° heart block present on an EKG?

A

lengthened PR interval, time increases between P wave and QRS until eventually there is no QRS

32
Q

how does a type II or mobitz II 2° heart block present on an EKG?

A

normal until sudden drop of QRS, may have 2-4 P waves for every QRS. 3 P waves in between QRS

33
Q

what’s the poem for type one 2° heart block?

A

longer longer longer drop then you have a wenckebach

34
Q

why does a Mobitz II compromise CO more?

A

because there are so many less ventricular contractions

35
Q

What is the partner poem to remember the types of heart blocks?

A

1st degree: partner comes home late every night, but the same amount of late each night 2nd degree Type 1: partner comes home later, and later, and later and then one night they don’t come home and then come home the next day 2nd degree Type II: coming home on time until one night they don’t 3rd degree: partner and you in same house but you don’t talk to each other at all

36
Q

how does a 3° or complete heart block present on an EKG?

A

regular P waves but no relationship between P wave and QRS, abnormal QRS complexes

37
Q

what is the other heart block poem?

A

If the R is far from P, you have a first degree. Longer, longer, longer, drop! then you have a Wenkebach. If some Ps don’t get through, you have a Mobitz II. If Ps and Qs don’t agree, then you have a third degree.

38
Q

how do bundle branch blocks present on an EKG?

A

“rabbit ears” of QRS complex (2 distinct R waves), wide QRS, normal rate/rhythm

39
Q

what are abnormal EKGs for ventricular arrhythmias?

A

PVC, ventricular tachycardia, ventricular fibrillation, Asystole

40
Q

How does a Premature Ventricular Contraction (PVC) present on an EKG?

A

wide, irregular QRS complexes without associated P wave, ventriciles depolarize before SA node fires as stimulus for contraction arises within ventricles

41
Q

what are the different types of PVCs?

A

unifocal, multifocal, couplet, triplet, bigeminy, trigeminy, quadrageminy

42
Q

what is a unifocal PVC?

A

all PVCs look the same

43
Q

what is a multifocal PVC?

A

all PVCs look different

44
Q

what is a couplet PVC?

A

2 PVCs in a row

45
Q

what is a triplet PVC?

A

3 PVCs in a row

46
Q

what is a bigeminy PVC?

A

every other beat is a PVC

47
Q

what is a trigeminy PVC?

A

every 3rd beat is a PVC

48
Q

what is a quadrageminy PVC?

A

every 4th beat is a PVC

49
Q

how does ventricular tachycardia present on an EKG?

A

non-discernable P waves, multiple wide bizarre QRS complexes in a row (4 or more PVCs in a row = v tach)

50
Q

how does ventricular fibrillation present on an EKG?

A

*lethal! most frequently encountered arrhythmia w/ out of hospital cardiac arrest. cardiac twitching - no discernable P waves or QRS complexes

51
Q

how does asystole present on an EKG?

A

straight line, no rate, may see some isolated P waves, 4-5% survival rate

52
Q

what are abnormal EKGs for ST segment arrhythmias?

A

myocardial ischemia, myocardial infarction, other

53
Q

how does ST depression present on an EKG?

A

seen with NSTEMI, can be present @ rest, associated w/ elevated troponins – ST segment is below isoelectric line

54
Q

how does a T wave inversion present on an EKG?

A

T wave below isoelectric line, sensitive indicator of changes in repolarization of ventricles, seen after resolution of ST depression

55
Q

how does a ST elevation present on an EKG?

A

high above isoelectric line, diagnostic for acute infarction. this associated w/ acute onset of chest pain = cardiac emergency

56
Q

how does a pacemaker present on an EKG?

A

regular paced spikes on EKG, positioned before P wave (atrial pacing), before QRS complex (ventricle pacing), or both

57
Q

how do you manage arrhythmias?

A

pace makers - electronic pulse generator that creates artifical action potential to control arrhythmia.

58
Q

what are cardioversion pacemakers for?

A

treatment of tachyarrhythmias unresponsive to medicine, electrical shock delivered on R wave

59
Q

what are defibrillation pacemakers for?

A

manages uncontrolled life threathening arrhythmias, allows for intrinsic conduction

60
Q

what are implantable cardioverter-defibrillator (ICD) pacemakers for?

A

cardioverts arrhythmias, defibrilaltes patient who is experiencing a life threatening arrhythmia

Cardiopulmonary (9 decks)

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