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Clin Med-Cardio pt 1 > EKG book..basics cont. > Flashcards

EKG book..basics cont. Flashcards

1
Q

A wave of depolarization moving toward a positive electrode causes a ________ deflection

A

Positive

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2
Q

A wave of depolarization moving away from a positive electrode causes a _______ deflection

A

Negative

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3
Q

The final inscription of a depolarizing wave moving perpendicularly to a positive electrode

A

Biphasic wave

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4
Q

A wave of repolarization moving towards a positive electrode causes a _______ deflection

A

Negative

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5
Q

A wave of repolarization moving away from a positive electrode causes a _______ deflection

A

Positive

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6
Q

The limb leads view the heart in which plane?

A

Frontal (vertical) plane

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7
Q

Leads II, III and aVF are _____ leads

A

inferior

*they most effectively view the inferior surface of the heart

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8
Q

The _______ surface of the heart is the anatomic term for the bottom of the heart, the portion that rests on the diaphragm

A

inferior

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9
Q

Placed on 4th intercostal space to the R of the sternum

A

V1

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10
Q

Placed in the 4th intercostal space to the L of the sternum

A

V2

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11
Q

Placed in-between V2 and V4

A

V3

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12
Q

Placed in the 5th intercostal space in the midclaviular line

A

V4

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13
Q

Placed between V4 and V6

A

V5

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14
Q

Placed in the 5th intercostal space in the midaxillary line

A

V6

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15
Q

Under normal circumstances, which lead as inverted waves?

A

aVR

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16
Q

V1 may or may not have..

A

R wave

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17
Q

By the time you get to ___, you should have an R wave

A

V2

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18
Q

R wave progression…

A

R wave gets bigger from V1–>V3

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19
Q

Lead II is almost the same of the average direction of depolarization of the entire heart..resulting in…

A

Tallest R amplitude

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20
Q

“transition lead” of QRS complex..when the complex is transitioning from being mostly negative to being mostly positive. At this phase, it is biphasic bc this lead is perpendicular

A

V3

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21
Q

Depolarization is what kind of process

A

Passive

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22
Q

Unlike depolarization, which is largely passive, repolarization requires a great deal of..

A

Cellular energy

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23
Q

T wave can have a lot of..

A

Variability

*when you see QRS predominately upward, the T wave will also be downward usually

24
Q

Measures beginning of depolarization (QRS) to the end of repolarization (end of T wave)

A

QT interval

25
Q

Prolonged QT interval

A

V tach
V fib

**life threatening!!!!

26
Q

QT interval varies depending on..

A

Heart rate!

Fast HR= shorter QT
Slow HR= longer QT

(must look at chart w gender and HR to determine what QT duration is normal)

27
Q

Defines a cardiac cycle..from beginning of depolarization to the end of repolarization

A

R to R interval

28
Q

Normally QT interval takes up about ___% of corresponding R to R interval

A

40%

if under 50%, we consider normal QT interval

29
Q

V1-V4 are _____ leads

A

Precordial/Anterior

30
Q

V5, V6, Lead I, aVL are…

A

Left lateral leads

31
Q

II, III, aVF are..

A

Inferior leads

32
Q

Hypertrophy refers to an increase in..

A

Muscle mass

the wall of a hypertrophied ventricle are THICK and POWERFUL

33
Q

Most hypertrophy is caused by..

A

Pressure overload!

34
Q

When the heart is forced to pump blood against an increased resistance, as in patients with systemic hypertension or aortic stenosis..what happens?

A

Hypertrophy!

35
Q

_______ refers to dilation of a particular chamber

A

Enlargement

36
Q

An enlarged ventricle can hold more blood, this is typically caused by…

A

Volume overload

37
Q

The chamber dilates to accommodate an increased amount of blood

A

Enlargement

38
Q

Where will atrial enlargement be seen on an EKG?

A

P wave

39
Q

Where will ventricular hypertrophy be seen on an EKG?

A

QRS complex

40
Q

Hypertrophied myocardium demands more blood supply but it has reduced density of capillaries and therefor is more susceptible to..

A

Ischemia

41
Q

The chamber can take longer to depolarize..the EKG wave may therefore increase in duration

A

Hypertrophied or enlarged chamber

42
Q

The chamber can generate more current and thus a larger voltage. The wave may therefore increase in amplitude

A

Hypertrophied or enlarged chamber

43
Q

A larger percentage of the total electrical current can move through the expanded chamber. The mean electrical vector, or what we call the electrical axis, of the EKG wave may therefore shift

A

Hypertrophied or enlarged chamber

44
Q

3 things that can change on the EKG in a hypertrophied or enlarged chamber..

A
  1. Increase duration
  2. Increase amplitude
  3. Shift in electrical axis
45
Q

The direction of the mean vector

A

Electrical axis

46
Q

The normal QRS axis lies between which degrees?

A

0 and 90 degrees

47
Q

We can quickly determine whether the QRS axis on any EKG is normal by looking only at leads….

A

I and aVF

48
Q

If the QRS complex is predominately positive in leads I and aVF, then the QRS axis is…

A

Normal!

49
Q

If the QRS complex in either lead I or lead aVF is not predominately positive, then the QRS axis is…

A

Not normal! (bc it must not lie between 0 and 90 degrees)

50
Q

If the axis lies between 90 and 180 degrees, it is a…

A

Right axis deviation

51
Q

If the axis lies between 90 and 180 degrees, what will leads aVF and I look like?

A

QRS complex will be positive in aVF

QRS complex will be negative in lead I

52
Q

If the axis lies between 0 and -90 degrees, it is a..

A

Left axis deviation

53
Q

If the axis lies between 0 and -90 degrees, what will leads aVF and lead I look like?

A

QRS complex will be positive in lead I

QRS complex will be negative in aVF

54
Q

In rare instances, the axis becomes totally disoriented and lies between -90 and +180, this is called..

A

Extreme right axis deviation

leads in both aVF and I will be negative

55
Q

Sustained and severe hypertension can cause L ventricle to work too hard for too long and it hypertrophies. How does this change affect the axis?

A

Left axis deviation

the mean electrical vector is drawn even further leftward because the electrical dominance of the L ventricle over the R ventricle increases even more

56
Q

Patients with _______ _______ may have:

  1. downsloping ST segment depression
  2. T wave inversion
A

Ventricular hypertrophy

Clin Med-Cardio pt 1 (10 decks)

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