EKG and Cardiovascular Testing

Question 1

What is the ratio of applied leads to recorded leads on a standard EkG machine?

Answer 1

10:12. A standard EKG machine records 12 leads. For a standard EKG machine, the ratio of applied leads to recorded leads is 10:12.

Question 2

A provider requests a rhythm strip in addition to regular EKG tracing. Which lead provides the clearest recording of the heart rhythm?

Answer 2

Lead II provides the clearest recording of the heart rhythm and is the standard lead used for a rhythm strip.

Question 3

What is the standard speed of the recording for EKG?

Answer 3

The assistant should identify that the standard speed for an EKG recording is 25 mm/sec.

Question 4

An MA notices a widened QRS complex on the EKG. What is a possible caused of the artifact?

Answer 4

An abnormally widened QRS complex should alert the assistant to a ventricular dysrhythmia, such as premature ventricular contraction (PVC). A PVC is caused by an early contraction of the ventricles, which produces a widened QRS complex artifact.

Question 5

What is true of limb leads and electrodes?

Answer 5

Placed on fleshy areas of the skin, limb leads are bipolar, V1 through V6 are precordial leads that are unipolar. Limb leads are bipolar.The right leg lead wire serves as the ground and helps to avoid artifacts in the EKG recording.

Question 6

What is sinus bradycardia?

Answer 6

A heart rate of less than 60/min is considered bradycardia. This patient’s cardiac waves are all within the expected reference range, so this is a sinus bradycardia.

Question 7

What is sinus tachycardia?

Answer 7

Sinus tachycardia is indicated by a heart rate of greater than 100/min.

Question 8

What is atrial fibrillation?

Answer 8

Atrial fibrillation is an irregular heart rate that does not present as an expected P wave, QRS complex, and T wave configuration on the patient’s EKG tracing.

Question 9

What is ventricular fibrillation?

Answer 9

Ventricular fibrillation is a state of cardiac dysfunction in which the heart is ineffective in pumping blood and does not provide a consistent heart rhythm. Therefore, it would not present as an expected P wave, QRS complex, and T wave configuration on the patient’s EKG tracing.

Question 10

What is it called when the EKG is at a state of cellular rest that is represented by a flatline on the EKG strip?

Answer 10

Polarization/ It is the resting state of the myocardial wall, resulting in a flatline or pause on the EKG pattern. This is a normal phase of the EKG cycle and represents a state of cellular rest with a positively charged outside and negatively charged inside.

Question 11

What does lead 1 record on an ekg?

Answer 11

Records impulses between left and right arms.

Question 12

What does lead two record on an ekg?

Answer 12

Records impulses between the right arm and the left arm

Question 13

What does the P wave represent?

Answer 13

Atrial depolarization or contraction.

Question 14

What does the QRS wave represent

Answer 14

Represents ventricular depolarization or contraction. Atrial repolarization is not visible but incurs during this phase

Question 15

What does the T wave represent?

Answer 15

The T wave comes after the QRS complex and indicates or represent ventricular repolarization or relaxation

Question 16

What does the U wave represent

Answer 16

Not always visible for represents a repolarization of the bundle of purkinje fibers.

Question 17

What is the P-R interval

Answer 17

Represents the time it takes from the beginning of atrial depolarization to the beginning of ventricular depolarization

Question 18

What is the QT interval

Answer 18

Represents the time it takes from the beginning of ventricular depolarization to the end of ventricular repolarization

Question 19

What is the ST segment

Answer 19

Represents a time from the end of ventricular depolarization to the beginning of ventricular repolarization

Question 20

What is the universal standardization for an EKG machine

Answer 20

10 mm high and 5 mm wide.

Question 21

Should the p wave be positively or negatively deflecting?

Answer 21

Positively deflecting. (an upward curvature of waves in an EKG tracing)

in this case its negatively deflected (downward), a junctional dysrhythmia is occurring. Picture of negative deflection included.

Question 22

Which leads are “bipolar” and what does that mean?

Answer 22

Leads I, II, and II are bipolar (recording of electrical current involving both positive and negative pole), and record impulses that travel from a negative to positive pole at specific positions in the heart.

Question 23

What does Lead I does?

Answer 23

Lead I records impulses between the left and right arms.

Question 24

What does Lead II does?

Answer 24

Lead II records impulses between the right arm and left leg

Question 25

What does Lead III does?

Answer 25

Lead III records impulses between the left arm and left leg

Question 26

Which leads are “unipolar” and what does that mean?

Answer 26

Leads AVL, AVR, and AVF are unipolar (recording from one location or one pole), but due to poor illustration of the waveforms, the waveforms must be augmented (a unipolar recording that requires assisting in magnifying the tracing by drawing from other poles) and therefore get assistance from two poles to enhance the tracing

Question 27

What does Lead AVL does?

Answer 27

in AVL, the left leg and right arm assist with the left arm tracing

Question 28

What does Lead AVR does?

Answer 28

in AVR, the left arm and left leg assist with the right arm tracing

Question 29

What does Lead AVF does?

Answer 29

in AVF, the right and left arms assist with the left leg tracing

Question 30

What is the six precordial leads? And what does precordial mean?

Answer 30

The six precordial leads are called leads V1, V2, V3, V4, V5 and V6. It means located on the chest In front of the heart

Question 31

Wave meaning?

Answer 31

A positive or negative deflection from baseline that indicates a specific electrical event. The waves on an ECG include the P wave, Q wave, R wave, S wave, T wave and U wave.

Question 32

Interval meaning?

Answer 32

The time between two specific EKG events. The intervals commonly measured on an ECG include the PR interval, QRS interval (also called QRS duration), QT interval and RR interval.

Question 33

Segment meaning?

Answer 33

The length between two specific points on an ECG that are supposed to be at the baseline amplitude (not negative or positive). The segments on an ECG include the PR segment, ST segment and TP segment.

Question 34

Complex meaning?

Answer 34

The combination of multiple waves grouped together. The only main complex on an ECG is the QRS complex.

Question 35

Points meaning?

Answer 35

There is only one point on an ECG termed the J point, which is where the QRS complex ends and the ST segment begins.

Question 36

What is the QRS complex?

Answer 36

The QRS complex consists of a Q wave, R wave and S wave and represents ventricular depolarization.

Question 37

What is the Chest lead placement of the precordial?

Answer 37

V1: right side of the sternum at the fourth intercostal space
V2: left side of the sternum, directly across V1 at the fourth intercostal space
V4: left side of the chest, fifth intercostal space, midclavicular line
V3: left side of the chest, midway between V2 and V4 (V4 is placed before VS because of this)
V5: left side of the chest, fifth intercostal space, anterior axillary line
V6: Left side of the chest, fifth intercostal space, midaxillary line

Question 38

What is Sinus Arrest?

Answer 38

Sinus arrest is a cessation of sinus node activity for a short period. Although sinus arrest commonly is described as a pause in the sinus rhythm that lasts for more than two normal R-R intervals, this can also be seen with severe sinus arrhythmia.

Question 39

What is Atrial flutter?

Answer 39

In atrial flutter, the heart’s upper chambers (atria) beat too quickly. This causes the heart to beat in a fast, but usually regular, rhythm.

Atrial flutter is a type of heart rhythm disorder (arrhythmia) caused by problems in the heart’s electrical system.

Atrial flutter is similar to atrial fibrillation, a common disorder that causes the heart to beat in irregular patterns. People with atrial flutter have a heart rhythm that’s more organized and less chaotic than that of atrial fibrillation.

Question 40

What is Asystole?

Answer 40

Asystole is when your heart’s electrical system fails, causing your heart to stop pumping. This is also known as “flat-line” or “flat-lining” because it causes your heart’s electrical activity to look like a flat line on an electrocardiogram.

Question 41

What does junctional dysrhythmia mean?

Answer 41

It means that the typical impulse pathway from the sinoatrial node (SA) to atrioventricular (AV) node is not occurring. The initial impulse is originating in the AV junction, AV node, or from some ectopic source.

Question 42

Ventricular arrhythmia

Answer 42

Ventricular arrhythmias are wide complex rhythms that may be regular or irregular. These may be normal rate, bradycardic, or tachycardic, and may occur as single beats or sustained. One should suspect this if the QRS appears wide and bizarre. The provider should be notified as it could be premature ventricular contractions (PVCs)