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Boards > EKG > Flashcards

EKG Flashcards

1
Q

Normal QTc Interval

A

Normal when less than half of R-to-R interval at normal rates

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2
Q

each small square represents (time)

A

0.04 sec

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3
Q

each large square represents (time)

A

0.2 sec

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4
Q

lead I

A

horizontal

L arm electrode is positive

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5
Q

lead II

A

from R arm to L foot

L foot electrode is positive

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6
Q

lead III

A

from L arm to L foot

L foot electrode is positive

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7
Q

AVF lead

A

negative on arms
positive on L foot
vector is 90 degrees down

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8
Q

AVR lead

A

negative on L arm and L foot
positive on R arm
vector is 210 degrees to the R (or -160)

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9
Q

AVL lead

A

negative on R arm and L foot
positive on L arm
vector is -30 degrees to the L

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10
Q

“lateral” leads

A

I and AVL

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11
Q

“inferior” leads

A

II, III, and AVF

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12
Q

The center of the “wheel” made by the chest leads is

A

the AV node

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13
Q

which chest lead describes a straight line directly from the front to the back of the patient

A

V2

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14
Q

chest leads oriented over the R heart

A

V1 and V2

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15
Q

chest leads oriented over the L heart

A

V5 and V6

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16
Q

chest leads oriented over the interventricular septum

A

V3 and V4

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17
Q

sinus rhythm

A

60-100

18
Q

sinus bradycardia

A

<60

19
Q

sinus tachycardia

A

> 100

20
Q

atrial automatic foci rate

A

60-80

21
Q

AV junctional foci rate

A

40-60

proximal end has no foci

22
Q

ventricular foci rate

A

20-40

23
Q

u wave

A

final phase of Purkinje repolarization

24
Q

wandering pacemaker

A 
irregular rhythm
P' wave shape varies
atrial rate less than 100 
irregular ventricular rhythm
can accelerate into tachycardia and becomes Multifocal Atrial Tachycardia
25
Q

irregular rhythm seen in very ill COPD patients

A

Multifocal atrial tachycardia

26
Q

multifocal atrial tachycardia

A 
irregular rhythm
P' wave shape varies
atrial rate exceeds 100
irregular ventricular rhythm
seen in very ill COPD and digitalis tox
27
Q

Atrial fibrillation

A

irregular rhythm
continuous chaotic atrial spikes - no P waves
irregular ventricular rhythm

28
Q

Atrial and junctional foci become irritable because of

A

adrenaline
increased sympathetic stimulation
presence of caffeine, amphetamines, cocaine, or other B1 receptor stimulants
excess digitalis, some toxins, occasionally ethanol
thyperthyroidism
stretch
and to some extent, low oxygen

29
Q

ventricular focus can be made irritable by

A 
Low oxygen
low potassium
MVP
Stretch
Myocarditis
30
Q

number of PVC’s that is pathological

A

6 or more in one minute

31
Q

ventricular parasystole

A

produced by a ventricular automaticity focus that suffers from entrance block but it not irritable
paces at its inherent rate
the ventricular complexes it generates poke through the dominant sinus rhythm

32
Q

a run of VT that last longer than 30 seconds

A

“sustained” VT

33
Q

Mitral Valve Prolapse (Barlow syndrome)

A

causes PVC’s including runs of VT and multifocal PVC’s
considered a benign condition
mitral valve is floppy and billows into the LA during systole
valves pull and stretch the papillary muscles irritating ventricular automaticity foci

34
Q

tachy-arrhythmia

A 
150-250 = paroxysmal tachycardia
250-350 = flutter
350-450 = fibrillation
35
Q

paroxysmal means

A

sudden

36
Q

PAT with AV Block

A

rapid rate, spiked P’ waves
2:1 ratio of P’:QRS
Suspect digitalis excess or tox

37
Q

capture beat or fusion beat

A

During VT, a sinus-paced depolarization stimulus from the atria finds the entire ventricular conduction system receptive to depolarization and produces a normal-appearing QRS(capture beat)
atrial depolarization find a receptive AV Node, but ventricular depolarization only proceeds so far before it meets ventricular depolarization progressing from the ventricular focus and normal QRS blends with PVC-like complex(fusion beat)

38
Q

causes of Torsades

A

low potassium
medications that block potassium channels
congenital abnormalities (long AT syndrome)
***things that lengthen the QT segment

39
Q

atrial flutter

A

250-350/min

can have rapid QRS response

40
Q

ventricular flutter

A

250-350/min
rapid series of smooth sine-waves of similar amplitude
often deteriorates into V fib

41
Q

fibrillation

A

multiple foci discharging rapidly
350-450/min
a fib - ventricular response is irregular

42
Q

Wolff-Parkinson-White

A

abnormal, accessory AV conduction pathway = bundle of Kent causes ventricular pre-excitation = delta wave
delta wave creates the illusion of a “shortened” PR interval and “lengthened” QRS
Can develop paroxysmal tachycardia

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