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S&F III: Exam 1 > EKG > Flashcards

EKG Flashcards

1
Q

Where is the current EKGs measure?

A

ECM

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2
Q

Cardiac Dipole

A

in the ventricle, there is a zone of + resting and a zone of - excitation

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3
Q

which way does a vector point

A

towards the positive side

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4
Q

Mean electrical vector

A

the sum of the indiv. instant. vectors; ECG records this

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5
Q

V1

A

4th ICS, 2 cm right of sternum

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6
Q

V2

A

4th ICS, 2 cm left of sternum

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7
Q

V4

A

5th ICS, left midclavicular

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8
Q

V5

A

5th ICS, left anterior axillary line

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9
Q

V6

A

left midaxillary line

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10
Q

What is the oddball lead?

A

aVR (all negative)

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11
Q

bipolar limb leads

A

I, II, III

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12
Q

what is Einthoven’s triangle?

A

Leads I, II, III

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13
Q

aVR

A

-150*

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14
Q

aVF

A

+90*

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15
Q

aVL

A

-30*

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16
Q

I

A

0*

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17
Q

II

A

+60*

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18
Q

III

A

+120*

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19
Q

axis of lead

A

the direction from - to + of a lead

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20
Q

Mean QRS axis

A

average direction of MEV during ventricular depolarization

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21
Q

where should you look at for quick axis diagnosis?

A

Leads I and AVF

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22
Q

normal axis

A

+90 to 0/-30* (both positive)

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23
Q

left axis deviation

A

0/-30* to -90* (I positive, AVF negative)

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24
Q

extreme right axis deviation

A

-90* to 180* (both negative)

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25
Q

right axis deviation

A

+90 to 180 (I negative, AVF positive)

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26
Q

dimensions of EKG

A

small (1x1 mm); lg (5x5 mm)

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27
Q

horizontal reading

A

time–> small (0.04 sec); lg (0.2 secs)

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28
Q

vertical reading

A

voltage–> sm (0.1 mV); lg (0.5 mV)

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29
Q

P-wave

A

atrial depolarization

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30
Q

What leads show a normal + P wave?

A

I, II***, AVL, AVF, V5, V6

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31
Q

What leads show a normal - P wave?

A

aVR

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32
Q

What leads show a normal BIP P wave?

A

III, V1

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33
Q

What leads show a normal variable P wave?

A

V2, V3, V4

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34
Q

Which leads show a normal septal Q wave?

A

I, AVL, V5, V6***

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35
Q

What leads show a normal R wave?

A

I, II, III, AVL, AVF, V5***, V6

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36
Q

What is the J point?

A

origin of ST segment at end of QRS

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37
Q

What leads show a normal S wave?

A

AVR, V1, V2

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38
Q

What leads show a normal transition QRS wave?

A

V3, V4

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39
Q

What leads show a normal - T wave?

A

AVR

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40
Q

What leads show a normal + T wave?

A

III, AVL, AFV, V2-V6

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41
Q

What leads show a normal BIP/- T wave?

A

V1, V2

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42
Q

What leads show no T wave?

A

I, II

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43
Q

How long is PR Interval?

A

0.12-0.20 sec

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44
Q

How long is QRS Interval?

A

<= 0.10 sec

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45
Q

How long is QT Interval?

A

0.35 sec

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46
Q

How long is corrected QT interval?

A

<= 0.44 sec

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47
Q

anterior apical leads

A

V3, V4

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48
Q

hi left lateral leads

A

I, aVL

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49
Q

lo left lateral leads

A

V5, V6

50
Q

inferior leads

A

II, III, aVF

51
Q

anterior septal leads

A

V1, V2

52
Q

Q wave

A

1st deflection is down (sm=n, lg=infarct)

53
Q

R wave

A

1st deflection is up

54
Q

R’ wave

A

second up deflection

55
Q

S wave

A

1st down deflection after up deflection

56
Q

QS

A

1 down deflection w/o R present

57
Q

+

A

current towards electrode

58
Q

-

A

current away from electrode

59
Q

biphasic

A

perpendicular to electrode

60
Q

T wave

A

repolarization of cells

61
Q

T wave changes

A

sensitive to electrolytes, ischemia, & drugs

62
Q

U wave

A

follows T wave, represents repol of Purkinje

63
Q

Heart Rate Method 1

A

60/R-R interval (rhythm strip X6)

64
Q

HR Method 2

A

300-150-100-75-60-50

wherever 2nd QRS falls is HR

65
Q

HR Method 3

A

count # in 3 sec interval, mult. by 20

*irregular HR

66
Q

What is PR interval?

A

onset of P wave to onset of QRS

67
Q

What is QRS interval

A

from beg. to end of complex

68
Q

What is QT interval

A

from beginning of Q to end of T

69
Q

What is corrected QT interval

A

QT/sqrt(R-R)

70
Q

When does Lt Axis Dev. occur?

A

inferior wall MI
LAFB
LVT (occ.)

71
Q

When does Rt Axis Dev. occur?

A

RV Hypertrophy
Acute Right Heart Strain (PE)
LPFB

72
Q

Rt Atrial Enlargement

A

Inc. P-wave + amplitude in Lead II

Pulmonary etiology

73
Q

Lt Atrial Enlargement

A

Inc P wave - amp and duration in V1

mitral etiology

74
Q

Which side does the QRS axis deviate to in VH?

A

hypertrophied side

75
Q

Which leads do you spot VH in?

A

I, AVF

76
Q

Which leads do you spot AE?

A

II, V1

77
Q

Rt VH

A

R>S in lead I; Right Axis Deviation

etiology pulmonary & congenital

78
Q

Lt VH

A

Lt Axis Deviation;
S in V1 plus R in V5/V6 => 35 mm
OR R in aVL >11 mm OR R in I >15 mm

etiology HTN, valvular disease

79
Q

Main difference between AE and VH

A

duration change in AE (Lt)

axis shift in VH

80
Q

Bundle branch blocks

A

myocyte-myocyte spread of conduction; QRS WIDENS

81
Q

RBBB

A

widened QRS; RSR’ in V1

prom. S in lead V6

82
Q

LBBB

A

widened QRS
absent R, prominent S in V1
absent Q, broad R in V6

83
Q

Where does left anterior fascicle run

A

ant., superior, lat portion of LV

84
Q

where does left posterior fascicle run

A

post., inferior, med. LV

85
Q

why don’t hemiblocks have widened QRS

A

purkinje fibers bridge gaps

86
Q

LAFB

A

left axis deviation

Q in I and wide/deep S in III

87
Q

LPFB

A

right axis deviation

deep S in I and Q in III

88
Q

posterior MI

A

Inc R in V1&2 with NO Axis Dev.

RCA affected

89
Q

inferior MI

A

Q wave in II, III, AVF

RCA

90
Q

anteroseptal MI

A

Q V1-V2

LAD

91
Q

Anterioapical MI

A

Q V3,V4

LAD

92
Q

Extensive Anterior MI

A

Q V1-V6

LCA

93
Q

Anterolateral MI

A

Q V5-V6, I, aVL

CFX

94
Q

Transient Myocardial Ischemia

A

T wave inversion in V2-V6 (negative)

95
Q

Acute ST segment Elev MI

A

elevated over infarct,
deep over opposite side
ionic leak

96
Q

Acute Non-ST segment Elev MI

A

acute POC thrombus

ST depression over infarct

97
Q

Sinus Bradycardia

A

normal EKG with HR <60 bpm
ischemia, cardiomyopathy, meds, metabolic promblems

athletes

98
Q

Sick Sinus Syndrome

A

intermittent SB
dizziness, syncope, confusion
common in pts with AFib

99
Q

Escape Rhythms

A

No P Waves

Junctional and Ventricular

100
Q

Junctional escape rhythm

A

arise from AV node/bundle of His
normal QRS complex
rate 40 to 60 bpm

101
Q

Ventricular Escape Rhythm

A

depolarized past His

WIDENED QRS, 30-40 bpm

102
Q

1* AV Block

A

increased PR interval (>0.2 sec)

103
Q

2* AV Block

A

P waves with no QRS

104
Q

Type I 2* AV block

A

progressive Inc. in PR Interval until QRS skipped and then restarts
benign

105
Q

Type II 2* AV block

A

severe blockage of bundle of His/Purkinje

sudden loss of QRS (widened when present)

106
Q

3* AV block

A

“complete heart block*
no relation btwn P & QRS
if @ AV, normal QRS with 40-60
if @ His, wide QRS and dec. rate

107
Q

3* AV Block @ His

A

wide QRS and dec. rate

108
Q

3* AV block @ AV

A

normal QRS with 40-60

109
Q

Sinus tachycardia

A

100-180 bpm, normal EKG otherwise

110
Q

Atrial Premature Beats (APB)

A

not related to SA! P-wave abnormal. early

111
Q

Atrial Flutter

A

100-350 bpm

2 A:1 V

112
Q

atrial fibrillation

A

A 350-600 bpm/ V 140-160

no p-waves

113
Q

Paroxysmal Supraventricular Tachycardia

A

sudden onset/termination with rate of 140-250 bpm

114
Q

AVNRT

A

most common in adults

NO P-wave, normal QRS

115
Q

orthodromic AVRT

A

no change in wave or widened QRS

Retrograde P waves visible

116
Q

antidromic AVRT

A

widened QRS

117
Q

ventricular pre-excitation syndrome

“wolff-parkinson-white”

A

decreased PRT interval (<0.12 secs)

slurred, widened QRS

118
Q

VPB

A

widened QRS, inverted T

119
Q

VT

A

series of =>3 VPBS

100-200 bpm

120
Q

Torsades de Pointe

A

(VT)

polymorphic, early afterdepol

121
Q

VFib

A

morbidity increased, cessation of cardiac output

S&F III: Exam 1 (17 decks)

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