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Fall 2024 > EKG Exam 1 > Flashcards

EKG Exam 1 Flashcards

1
Q

What is the rate of different foci according to their origination in the heart?

A

SA - 60-100
Atrium - 60-80
AV Junction - 40-60
Ventricle - 20-40

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2
Q

What is it called when there is still electrical activity flowing through the heart but no mechanical activity?

A

PEA: pulseless electrical activity

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3
Q

Deficiencies in what ions can affect how hard the heart pumps?

A

Potassium, sodium, and calcium

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4
Q

What is the route of the electrical pathway

A

SA node to AV node to bundle of his to bundle branches (left and right) to purkinje

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5
Q

Where is SA node located

A

Right atrium near opening of SVC

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6
Q

Where is AV node located

A

Base of interatrial septum and extends into ventricular septum

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7
Q

Where is the bundle of his located

A

Distal to AV node and before the bundle branches

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8
Q

Where are the right and left bundle branches located

A

Intraventricular septum; carry impulses down the septum to both ventricles

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9
Q

Where do the purkinje fibers carry the impulse?

A

Up the ventricular walls, inside out; endocardium to myocardium to epicardium

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10
Q

Where is the issue if the QRS is wide?

A

Below the AV node; in the ventricle

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11
Q

What can a 12 lead EKG identify that a rhythm strip can’t?

A

Electrical axis
Bundle branch blocks
Chamber enlargement/hypertrophy
Myocardial ischemia/infarction
Long/short QT syndrome
Pulmonary embolism
Pericarditis/cardiac tamponade

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12
Q

In a normal EKG, I is _____ and III is _____

A

Positive; negative

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13
Q

What leads are the P wave best seen in?

A

II and V1

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14
Q

How long is the normal PR interval?

A

0.12-.20 seconds (3-5 blocks)

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15
Q

What does the PR interval signify?

A

Beginning of atrial fibrillation to the beginning of ventricular depolarization

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16
Q

What does a prolonged PR interval represent?

A

First degree AV block

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17
Q

What are the 2 criteria for a pathological Q wave

A

Wider than 1 small block or >1/3 as deep as R wave is high

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18
Q

How wide should a QRS wave be?

A

No more than 3 boxes (0.12 seconds)

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19
Q

What does a wide QRS mean?

A

Electrical activity is not conducting through the system and is instead traveling from myocyte to myocyte

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20
Q

What do ST elevations demonstrate

A

Myocarditis, pericarditis, LBBB, electrolyte abnormalities

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21
Q

What do ST segment depressions signify?

A

Myocardial ischemia, hypokalemia, digitalis effect

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22
Q

What are the septal leads

A

V1 and V2

23
Q

What are the anterior leads

A

V3 and V4

24
Q

What are the lateral leads

A

V5 and V6

25
Q

RA is

A

Both -

26
Q

LA is

A

+ and -

27
Q

LL is

A

Both +

28
Q

I connects

A

RA to LA (- to +)

29
Q

II connects

A

LA to LL (- to +)

30
Q

III connects

A

RA to LL (- to +)

31
Q

Normal QRS axis is

A

-30 to +90 (or just 0-+90?)

32
Q

Lead 1 positive + aVF positive

A

Normal axis

33
Q

Lead 1 positive + lead aVF negative

A

Possible left axis deviation (0 to -90)

34
Q

Lead 1 negative + Lead aVF positive

A

Right axis deviation (+90 to 180)

35
Q

Lead 1 negative + aVF negative

A

Extreme Axis deviation (-90 to 180)

36
Q

Right axis deviation (90-180) causes

A

LPFB
RVH
RBBB
WPW
Ventricular rhythm
Dextrocardia
Normal variant

37
Q

Pathological left Axis Deviation (-30 to -90)

A

LAFB
LBBB
WPW
LVH
Hyperkalemia
Q-waves, MI
Pregnancy

38
Q

Which leads look at the chest from the horizontal axis?

A

Precordial leads
V1-V6

39
Q

Which leads look at the heart from the frontal axis?

A

Limb leads
aVR, aVL, aVF, I, II, III

40
Q

Potential etiologies of AV heart blocks

A

Insult to AV node
MI
Digitalis toxicity
Hypoxemia

41
Q

Treatment for first degree AV block

A

Usually none but depends on the severity

42
Q

Treatment for Wenckebach

A

None unless symptomatic; if symptomatic consider pacemaker

43
Q

Symptoms of Mobitz II

A

Light-headedness, dizziness, syncope, chest pain, regularly irregular heartbeat, may have bradycardia, hypo perfusion may cause hypotension

44
Q

How is Mobitz II treated

A

Pacemaker

45
Q

What are temporary pacemakers more

A

Sustain a patient’s heart rate in emergency situations

46
Q

What is a transvenous pacemaker

A

An electrode is threaded through a vein and into the right atrium, right ventricle, or both

47
Q

What is a transcutaneous pacemaker

A

Electrical current through patients chest with 2 large pads anterior/posterior; stimulates ventricular contraction

48
Q

Are are the two parts of a permanent pacemaker

A

Generator: controls rate/strength of electrical impulse
Lead wires: relay electrical impulse to myocardium

49
Q

How does a demand pacemaker work

A

Pacemaker fires when rate falls below 75/min; is suppressed by NSR

50
Q

Indications for pacing

A
  1. Bradycardia
  2. Complete heart block
  3. Second degree Type II heart block
  4. Sick sinus syndrome
51
Q

What ekg findings indicate ventricular pacing

A

A spike followed by QRS complex
Wide QRS
LBBB pattern (bc pacing typically occurs in right ventricle)
May or may not have P wave

52
Q

What is Marriott’s “approximation approach” to ventricular rate

A

300-150-100
75-60-50

53
Q

What are some causes of LBBB

A

Aortic stenosis
Dilated cardiomyopathy
Acute MI
Primary dz of conduction system
Lyme disease
Side effects of trauma/surgeries

Fall 2024 (34 decks)

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