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SS- Cardio > EKG > Flashcards

EKG Flashcards

1
Q

normal axis

A

I: up
aVF: up

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2
Q

left axis deviation

A

I: up
aVF: down

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3
Q

right axis deviation

A

I: down
aVF: up

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4
Q

extreme right axis deviation

A

I: down
aVF: down

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5
Q

Heart rate from EKG

A

300/ big boxes

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6
Q

duration of small box

A

40 msec

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7
Q

duration of big box

A

200 msec

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8
Q

inferior leads

A

II, III, aVF
right coronary artery
appearance: normal
(II: no S wave)

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9
Q

septal leads

A

V1, V2
left anterior descending artery
appearance: small P wave; upside down
(V2: upright T wave)

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10
Q

anterior leads

A

V3, V4
left anterior descending artery
appearance: small P wave, tall QRS and T
(V3: upside down QRS)

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11
Q

lateral leads

A

I, aVL, V5, V6
circumflex artery
appearance: small P waves

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12
Q

What is unique about lead aVR?

A

no Q wave

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13
Q

P wave

A

atrial depolarization/ contraction

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14
Q

QRS complex

A

ventricular depolarization/ contraction
atrial repolarization
less than 120ms

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15
Q

T wave

A

ventricular repolarization

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16
Q

QT interval

A

less than 1/2 R-R interval
beginning of Q to end of T wave
less than 440ms
ventricular depol and repol

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17
Q

ST segment

A

end of S wave to beginning of T wave

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18
Q

PR interval

A

beginning of P wave to R wave

less than 200ms

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19
Q

PR segment

A

end of P wave to beginning of Q wave

AV node conduction to Bundle of His

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20
Q

intraventricular conduction delay (IVCD)

A

widened QRS with no other abnormalities

21
Q

RBBB

A

widened QRS with rabbit ears on V1 or V2 (big split)

22
Q

LBBB

A

widened QRS with rabbit ears on lead V5 or V6

considered a STEMI if new

23
Q

ventricular origin of beat

A

no P wave before widened QRS

24
Q

ischemia

A

ST segment depression (2mm or 2 small boxes)

T wave inversion

25
Q

injury

A 
ST elevation (2mm or 2 small boxes)
T wave hypertrophy (tombstone)
26
Q

infarction

A

significant Q waves (at least 1/3 size of QRS)

27
Q

STEMI

A

ST segment elevation

severe if there is a giant Q wave

28
Q

Wolf-Parkinson-White syndrome

A

short PR interval
direct pathway from SA node to ventricles: high HR
due to re-entry

29
Q

What does a prolonged QT interval put a patient at risk for?

A

ventricular tachyarrhythmias

ex: torsades de pointe and v. fib

30
Q

type 1 AV block

A

prolonged PR interval

31
Q

type 3 AV block (complete heart block)

A

P waves and QRS complexes are not related to each other

Tx: pacemaker

32
Q

type 2 AV block: Mobitz type I

A

increasing length of PR intervals leading to a dropped QRS

going going gone

33
Q

type 2 AV block: Mobitz type II

A

normal PR interval leading to a dropped beat

risk for type 3 AV block

34
Q

type 3 AV block (complete heart block)

A

P waves and QRS complexes are not related to each other

35
Q

ventricular hypertrophy

A

increase voltage, can have inverted T wave (increases CAD risk)
delayed depolarization/repolarization

36
Q

pericarditis

A

diffuse ST elevation in all leads

37
Q

altered automaticity

A

myocyte fires that is not stimulated by SA node

can alter slope of depolarization: phase 4 pushed to threshold

38
Q

triggered automaticity

A

AP “triggers” a 2nd AP immediately after it

delayed after-depolarization

39
Q

Re-entry

A

unidirectional block in normally contiguous pathway(ex: from fibrosis or MI = now noncontiguous)
impulse takes a slower alternative pathway: moves anterograde and retrograde (normal pathway has had time to repolarize enough to trigger)
retrograde pathway sets up loop leading to ventricular tachycardia
HR: >140 and sustained

40
Q

junctional rhythm

A

no P waves, constant firing of atria
seen in digitalis intoxication
due to enhanced automaticity

41
Q

multifocal atrial tachycardia

A

constant firing from multiple sites in the atria: lots of EKG morphologies
see in emphysema due to high CO levels
due to enhanced automaticity

42
Q

V-tach

A

due to organized re-entry
Tx: DC cardioconversion then maintain with Class I (slow conduction and increse refractory period) or III (prolong repol. and increase effective refractory period)

43
Q

SVT

A

due to re-entry

44
Q

arrhythmias due to enhanced automaticity

A

sinus tachycardia
atrial premature beat
ventricular premature beat

45
Q

What might make a latent pacemaker prone to acceleration?

A 
beta stimulation
hypokalemia
fiber stretch
hypoxemia
acidosis
injury
46
Q

arrhythmias due to abnormal “triggered” automaticity

A

early after depolarization: interrupts phase 3 (can trigger long QT (torsades))
delayed after depolarization: interrupts phase 4 (occur as a result of Ca overload (digitalis))

47
Q

ventricular bigeminy

A

due to digitalis (Ca overload)

exacerbated by: catecholamines, hypokalemia

48
Q

torsades de pointes

A

polymorphic ventricular tachycardia triggered by EAD
occurs in QT prolongation (phase 2 and 3)
see in K channel blockers
exacerbated by: low HR, hypokalemia
re-entry

49
Q

arrhythmias due to re-entry

A

atrium: a. fib/flutter
AV node: PSVT
ventricle: ventricular tachycardia/fibrillation
Drugs treat by interrupting re-entry: change conduction velocity, refractory period, convert unidirectional block to complete block

SS- Cardio (16 decks)

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