EKG I & II Flashcards

1
Q

Depolarization of the atria in response to SA node triggering is represented by the ____

A

P wave

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2
Q

Delay of the AV node to allow filling of the ventricles is represented by the ____

A

PR interval

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3
Q

Ventricular repolarization is represented by the ____

A

T wave

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4
Q

Depolarization of the ventricles is represented by the ____.
(time from AV node thru Purkinjie fibers)

A

QRS complex

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5
Q

____ is the beginning of ventricle repolarization, and should be flat

A

ST segment

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6
Q

P wave can be inverted in lead ___

A

aVR

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7
Q

What is the length of a normal P wave

A

< 0.12 seconds

or <3 boxes

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8
Q

A broad or notched P wave in leads II or V1 is a sign of ______

A

left atrial enlargement

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9
Q

Peaked P waves in leads II or V1 is a sign of ______

A

right atrial enlargement

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10
Q

An ectopic inverted P wave is a sign that the site of origin of contraction is from ___

A

lower atria or AV junction

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11
Q

An ectopic upright P wave is a sign that the site of origin of contraction is from ___

A

high in the atria

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12
Q

Normal duration of the PR interval is ___ seconds or ____ boxes.

A
< 0.20 seconds
1 large (5 small) boxes
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13
Q

Normal duration of the QRS complex is ____ seconds or ____ boxes.

A

< 0.12 seconds

< 3 small boxes

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14
Q

Q wave should be < __ boxes in amplitude and < __ box in duration

A

< 2 amplitude

< 1 duration

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15
Q

Abnormal (larger) Q waves indicate ____

A

prior or current MI

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16
Q

RSR’ indicates a ____

A

bundle branch block

17
Q

ST elevations in specific leads indicate ____, while diffuse ST elevations indicate ____.

A
  • MI

- pericarditis

18
Q

ST depressions indicate ____

A

myocardial ischemia

19
Q

Peaked T waves may suggest ____ or ____

A
  • MI

- hyperkalemia

20
Q

Inverted T waves may suggest ______

A
  • cardiac ischemia
  • LVH
  • hypokalemia
  • digitalis administration
21
Q

Normal QT interval should be ____ seconds

A

< 500ms (0.5 sec)

22
Q

QT interval shortening can be due to ____

A

hypercalcemia

23
Q

Prolonged or shortened QT intervals both increase risk of ____

A

ventricular tachycardia (Torsades)

24
Q

U waves are more common in ___

A

young athletes

25
Q

Large U waves can be due to

A
  • hyperkalemia
  • thyroid disease
  • medication effects
26
Q

What are the sets of numbers used in the triplicate method?

A

300-150-100 75-60-50

27
Q

What are the steps of interpreting an EKG?

A
  • Age
  • Rate
  • Axis
  • Rhythm
  • Evaluate following:
  • P wave, PR interval
  • Q wave depth, QT prolongation
  • R wave - progression, QRS width
  • ST - elevate/depression
  • T wave - peaked/inverted
28
Q

When determining axis, left thumb should be lead ___ and right thumb should be lead ___.

A

Lead I = left

aVF = right

29
Q

Which lead should you look at if both Lead I and aVF are negative?

A

Lead II

If (+), normal
If (-), LEFT axis

30
Q

When determining axis, 2 thumbs up means ____

A

normal axis

31
Q

When determining axis, left up and right down means

A

left axis deviation

32
Q

When determining axis, left down and right up means

A

right axis deviation

33
Q

What are some causes of LAD?

A

LVH, emphysema, hyperkalemia, Atrial septal defect, obesity

34
Q

What are some causes of RAD?

A

RVH, chronic lung disease, PE

- can be normal in kids and tall thin adults

35
Q

A wide QRS indicates that something is slowing the electrical current through the ventricles in the _____.

A

Purkinje fibers

36
Q

True or False: RVH is the most common hypertrophy

A

FALSE - LVH more common

37
Q

What is the criteria used to identify LVH?

A

R in V5 or V6 is >35 mm (>7 boxes)

S in V1 or V2 is >30 mm ( >6 boxes)

38
Q

What are the steps for evaluating for RVH?

A
  • evaluate for RAD first

- If RAD and R wave in V1 >7mm, then RVH