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assessment > EKG > Flashcards

EKG Flashcards

1
Q

heart depolarizes from

A

base to apex

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2
Q

myocytes go from

A

internally negative to internally positive

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3
Q

lead I goes from

A

NEGATIVE electrode on RUE to POSITIVE electrode on LUE -> lateral wall of heart, supplied by circumflex

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4
Q

lead II goes from

A

NEGATIVE electrode on RUE to POSITIVE electrode on LLL -> inferior wall of heart, area supplied by RCA.

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5
Q

lead III goes from

A

NEGATIVE electrode on LUE to POSITIVE electrode on LLL - view of the inferior wall of heart, supplied by RCA

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6
Q

standard limb leads are bipolar and have

A

both positive and negative electrodes. L1, L2, L3

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7
Q

Standard limb leads =

A

L1, L2, L3

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8
Q

augmented limb leads =

A

aVR, aVL, and aVF augmented because voltage must be amplified by EKG machine

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9
Q

Augmented limb leads are

A

unipolar. Meaning they have one positive pole and a reference point in the opposite side of the heart but use the same electrode placement as standard limb leads.

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10
Q

aVR =

A

right arm is positive. RUE is positive, LUE and LLL are channeled together to form a negative reference point. -> ugly step child.

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11
Q

aVL =

A

Left arm is positive. LUE is positive, RUE and LLL are channeled together for form a negative reference point. ->> View of the LATERAL wall areas supplied by circumflex (lead I)

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12
Q

aVF

A

Foot is positive (Left foot?) LLL is positive, RUE and LUE are channeled together fo form a negative reference point. View of the INFERIOR wall of heart supplied by RCA (lead II and lead III)

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13
Q

Precordial leads look at the

A

anterior and lateral surfaces of the heart

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14
Q

V1 looks at

A

right atrium, V1 = positive, looks at septal wall and area supplied by LAD

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15
Q

V2 looks at

A

AV node V2 = positive, looks at septal wall and area supplied by LAD

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16
Q

V3 and v4

A

look at ventricular septum. Anterior wall of heart, supplied by LAD

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17
Q

V5 and V6

A

lateral surface of left ventricle. lateral wall of heart and areas suppled by circumflex. also look at lead I, lead aVL

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18
Q

Anterior Wall MI

A

V1, V2, V3, V4 ->LCA

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19
Q

Lateral Wall MI

A

Lead V5, V6, lead I, aVL -> Circumflex

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20
Q

Inferior wall MI:

A

Lead II, Lead III, aVF -> RCA

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21
Q

5 lead EKG =

A

three standard limb leads (RUE, LUE, LLL) adds a RLL -> any of the six limb leads can now be viewed adds chest lead -> can be moved to any of precordial V positions to obtain all six precordial views

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22
Q

positive deflection on the EKG occurs when vector of depolarization

A

Travels toward a positive electrode.

Ex. Lead I -> Negative RUE to POSITIVE LUE

Ex. Lead II -> Negative RUE to POSITIVE LLL

Ex. Lead III -> Negative LUE to POSITIVE LLL

23
Q

Negative deflection on the EKG occurs when vector of depolarization travels

A

away from a positive electrode

Ex. aVR,

24
Q

Heart Repolarizes from

A
  • apex to base
  • epicardium to endocardium
  • myocytes go from internally positive to internally negative
25
Q

PR internval =

A

PR internval =

0.12 to 0.2 seconds

26
Q

QRS complex =

A

QRS complex =

<0.12 seconds

27
Q

PR interval represents

A

delay of electrical impulse at the AV node to allow for atrial contraction.

28
Q

QRS represents

A

ventricular depolarization, if duration if increased consider: WPW, LVH, BBB

29
Q

Q wave

A
  • may or may not be abnormal
  • Consider abnormal and possible MI when amplitude is 1/3 of R wave
    • or duration is >0.04 seconds / depth >1 mm
30
Q

T wave represents

A

ventricular repolarization

31
Q

Normal j point is at

A

isoeletric line

32
Q

Prolonged QT can lead to

A

torsades de pont.

33
Q

Normal QT =

A

Normal QT =

  • men = <0.45
  • women = <0.47
34
Q

QT internval represents

A

the amount of time it takes for ventricular depolarization and repolarization

35
Q

RBBB signs

A
  1. QRS > 120 ms
  2. Rabbit ears in V1, V2, V3
  3. Slurred S waves in lead I, aVL, and V5, V6 [lateral leads]
36
Q

LBBB signs

A

ST segments and T waves

  1. ST elevation and upright T waves with negative QRS
  2. ST depression and T wave inversion with positive QRS
37
Q

To look for axis deviation, look at

A

lead I and aVF

38
Q

Left Axis Deviation =

A

leaving each other.

R waves of lead I and aVF are going away from each other

39
Q

Right Axis Deviation

A

Reaching for each other

R wave in lead I and AVF are reaching for each other

40
Q

Causes of right access deviation =

A

Conditions that make the right side of the heart work harder

  1. COPD
  2. Acute bronchospasm
  3. Cor pulmonale
  4. pulmonary HTN
  5. PE
41
Q

Causes of Left Axis Deviation

A

Causes of Left Axis Deviation

Conditions that make the left side of the heart work harder or hypertrophy.

  1. Chronic HTN
  2. LBBB
  3. Aortic Stenosis
  4. Aortic Insufficiency
  5. Mitral Regurgitation
42
Q
A
43
Q

Right Ventricular Hypertrophy =

A

Large R wave in V1 and gets progressvively smaller in V2, V3, V4

44
Q

Left Ventricular Hypertrophy =

A

Large S wave in V1 and larger R wave in V5.

Depth of S in V1 plus the height of R in V5 is greater than 35 mm -> LVH

45
Q

normal R wave size progression

A

V4/V5 has a taller R wave than others. Progressively gets larger from V1.

Right Ventricular Hypertrophy -> V1 is largest R wave and ges progressively smaller.

46
Q

ischemia on EKG =

A

T wave inversion or ST segment depression

47
Q

Injury on EKG =

A

ST segment elevation (>1mm)

48
Q

Septal Ischemia appears in

A

V1, V2

49
Q

Infarction (old MI) =

A

Q waves which are > 1 small box or 1/3 the size of QRS

50
Q

Anterior Ischemia appears in

A

V3, V4

51
Q

Inferior Ischemia =

A

Lead II, Lead III, aVF

52
Q

Lateral Ischemia appears in

A

In Lead I, avL, V5, V6

53
Q

Mobitz I vs Mobitz II

A

Mobitz I:

  • progressively longer PR until impulse is dropped
  • Longer, longer, longer, drop -> winkebach

Mobitz II:

  • PR is prolonged but constant, with an occasional dropped beat.
  • more dangerous bc its more likely to be r/t to structural changes of heart

assessment (5 decks)

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