EKG Flashcards
Big boxes on an EKG account for how many seconds?
0.20 seconds
Small boxes on EKG account for how many seconds?
0.04 Seconds
A single lead can show?
Rate and regularity of rhythm and time to conduct an impulse
P wave is indicative of?
Atrial depolarization
QRS complex is indicative of?
Ventricles depolarizing
T wave is indicitive of?
Ventricles repolarizing
PR interval lasts how many seconds?
0.12-0.20 seconds
QRS interval lasts how many seconds?
0.04-0.12 seconds
QT interval lasts how many seconds?
0.33-0.42 seconds
Q wave is the first?
Negative deflection
Absolute refractory is?
Before downslope of T wave and is not capable of being affected by inside or outside forces
Upright P waves indicate?
Rhythm is coming from atria
Inverted P wave indicates rhythm originates in?
AV node or AV junction
No P wave indicates rhythm is originating in?
AV node and located in QRS which is narrow
How do Junctional rhythms appear on the EKG?
Inverted P wave before QRS
Absent P wave
Inverted P wave after QRS
The rythm containing no P wave and wide QRS originates in?
Purkinje system or ventricles
Six second method counting can be used with which rhythms?
Regular or irregular
The RR interval is used how?
Counting big boxes between R waves divide into 300
Which counting methods are only used with regular rhythms?
RR interval and triplicate method
What is the only Irregularly Irregular rhythm?
AFIB
More P waves than QRS occurs with which rhythms?
AV HEART BLOCKS
Define sinus bradycardia
Sinus rhythm with rate less than 60
When is a rhythm classified as a symptomatic bradycardic?
BP less than 90, decreased mental status, pulmonary edema
What are 2 times atropine is stopped?
Heart rate is greater than 60 and atropine is maxed out at 3 mg
Which sinus rhythm is irregular with normal P wave, QRS, T waves?
Sinus Arrhythmia
Which rhythm contains normal sinus with period of flatline?
Sinus Arrest
Sinus tach is classified as a sinus rhythm with a rate greater than?
100bpm
Premature atrial contractions usually occur where?
On previous T wave
A rhythm with varying P waves and a rate 45-100 is considered to be called a ?
Wandering Pacemaker
How does Atrial Flutter appear?
Sawtooth
F waves are seen in which rhythm?
Atrial Flutter
Which rhythm, atrial flutter or atrial fibrillation is regular?
Atrial flutter
AFIB is only treated if the rate is greater than?
180
If P waves are all upright but look different, the rhythm is originating from?
Different sites in the atria
If P waves are upright and the QRS is wide, the rhythm is originating from?
Atria
If P waves are inverted, the rhythm is originating from?
AV junction
If P waves are not present and the QRS is narrow, the rhythm is originating from the?
AV junction
If P waves are not present, and the QRS is wide, the rhythm is originating from?
The ventricles
The PR interval will determine if what exists?
AV block
If the PR interval is less than 0.20 seconds, a block?
Does not exist
If the PR interval is greater than 0.20 seconds, a block?
Does exist
If the QRS is wide, with no P waves present, the rhythm is originating in?
The Ventricles
Normal rates for junctional rhythm?
40-60
What is the pacemaker for junctional rhythms?
AV junction
The ST segment is used for determining?
Damage to heart muscle
An elevated ST segment is usually indicative of?
Current infacrt
If T wave is inverted, this may indicate?
previous or current ischemia
What is the regularly irregular rhythm?
Bigeminal PVC
What occurs during a R on T phenomenon?
Heart is trying to contract during resting period
When are PVCs classified as malignant PVCs?
More than 6 per minute, PVCs with chest pain, multifocal PVCs, Couplets, Runs of VTACH, R on T phenomenon, Bradycardia and hemodynamically unstable
What are the concerns (in order) with treating PVCs?
Rate
Rhythm
BP
3 or more PVCs in a row is called?
Run of VTACH
What is the normal rate for an idioventricular rhythm?
15-40
Torsades is caused by?
Prolonged QT, post surgery, low magnesium
What is the dug of choice for torsades?
2GM magnesium sulfate in 100cc bag over 6-10 minutes
More course Vfib =?
Less down time
What leads are included in the inferior grouping of a 12-lead?
II, III, aVF
What leads are included in the anterior grouping on 12-lead?
V3, V4
Which leads are included in the lateral grouping on a 12 lead?
1, aVL, V5, v6
Where should V1 lead be placed?
4th intercostal space, right sternal border
Where should the V2 lead be placed?
Left sternal border
T wave inversion indicates?
Ischemia
ST elevation indicates?
Injury
ST elevation is measured starting at the?
J point
ST depression indicates?
Ischemia
What does ST depression (alone in anterior leads) indicate?
A posterior MI
Pathological Q waves indicate?
Infarction
A q wave must be how wide to indicate infarct?
1 small box
Which leads are considered septal leads?
V1 and V2
If inferior portion of the heart is in MI, which artery are involved?
Right coronary artery
If anterior portion of the heart is in MI, which artery is involved?
Left ascending
If inferior lead injury is noted what should be done?
V4R
How is a V4R conducted?
Moving V4 to the right side
Remove V1 and V2 leads
In einthovens triangle, the direction from the negative to the positive electrode is the?
Leads axis
Which leads help view the left ventricle and septum?
Precordial leads
Where is the positive electrode in lead 2 usually placed?
Apex of the heart on the chest wall
Where is the negative electrode in lead II placed?
Below right clavicle
A prolonged PRI indicates a delay in which node?
AV
How does ischemia appear on an ECG?
ST segment depression or an inverted T wave
Which leads view the anterior surface of the heart?
Leads V1-V4
Which leads can view the inferior portion of the heart?
II, III, aVF
Explain enhanced automaticity.
This condition results when ectopic foci automatically depolarize and produce ectopic beats
How is Pericarditis represented on an EKG?
ST elevation in all or nearly all leads with concave shaped T waves
Which leads are included in augmented leads?
I, II, II, AVR, AVF, AVL
Lead 1 looks at which part of the heart?
Lateral
