Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

CV II > EKG Interpretation Unrein Lecture > Flashcards

EKG Interpretation Unrein Lecture Flashcards

1
Q

The Basics •Every time

A

–Rate –Rhythm –Axis –Hypertrophy –Infarction –Wave interval and segment abnormalities

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Tracings •Waves -Summation Vectors

A

–P, Q, R, S, T, U

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Tracings •Segments

A

–ST

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Tracings •Intervals

A
  • PR - QRS - QT
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

PR interval

A

less than 0.2 seconds (one big –five little boxes)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

QRS interval

A

less than 0.12 seconds (three little boxes)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

QT interval

A

0.44 seconds Bazett’s formula

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Rate

A

–300, 150, 100, 75, 60, 50 –Six second strip -Multiply by 10 –Normal, Bradycardia, Tachycardia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

QRS Sequence of Ventricular Depolarization

A

Depolarization starts at the ventricular septum (Q wave) and the endocardial surfaces. Average current flows from the base of the heart to the apex (R wave). At the end of depolarization, the current reverses, flows toward the outer walls of the ventricles near the base (S wave).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Atrial Rhythm simplified

A

•Up right P waves, narrow QRS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Junctional Rhythm simplified

A

•Absent or inverted P waves, narrow QRS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Ventricular Rhythm simplified

A

•No p waves •Wide QRS complexes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Repetitive Sequence Rhythm simplified

A

•Bigeminal, Trigeminal, Quadrigeminal –A series-pattern of ectopic depolarizations, either atrial or ventricular in origin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Physiology that affects Rhythm

A

–Sympathetic •adrenergic –Parasympathetic •Cholinergic –Depolarization/repolarization •Automaticity –Escape beats »Refractory periods –Premature »Irritable focus »Reentry –Injury/scaring

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Supraventricular Rhythms

A

–Sinus/Atrial –Junctional –Wolf-Parkinson-White (WPW)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

–Sinus/Atrial Rhythm Overview

A

•Sinus arrhythmia •Wandering pacemaker, multifocal atrial tachycardia (MAT) •Paroxysmal atrial tachycardia (PAT) •Artial flutter –Singular atrial focus–reentry mechanism •Artial fib –Lack of any organized atrial activity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Junctional Rhythm Overview

A

•Paroxysmal junctional tachycardia (PJT) •AV nodal reentry

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Wolf-Parkinson-White (WPW) Rhythm overview

A

•Accessory conduction pathway (bundle of Kent) •Delta waves •Often has the appearance of an IWMI, this determination must be interpreted carefully •Shortened PR interval

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Wandering Pacemaker

A

Irregular Rhythm P’ wave shape varies atrial rate less than 100 irregular ventricular rhythm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Atrial Bigeminy

A

normal sinus beat followed by an abnormal beat

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

atrial flutter

A

sawtooth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

atrial fibrillation

A

no p waves, qrs coming in at no pattern

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Junctional Rhythm notes

A

no p waves, so not atrial origin

if qrs is truly widended and not from a supraventricular origin, the upper limit is 3 boxes

inverted p waves, conduction is retrograde from junctino up to atria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Wolf-Parkinson-White (WPW) notes

A

p wave runs into qrs to make delta wave

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

First Degree AV Blocks

A

•Prolonged PR interval -> 0.2 seconds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Second Degree AV block overview

A

Variable penetration of AV conductions –lone P waves without a QRS conduction following

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Type I second degree AV block

A

(conduction abnormality in the AV node and heavy parasympathetic influence)

–Wenckebach

–Progressively prolonged PR intervals with a subsequent dropped beat and lone P wave –usually a fixed ratio/pattern

–Vagal maneuvers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

type II second degree AV block

A

–Mobitz

–Failure of AV conduction in a fixed ratio/pattern, the PR interval is not gradually increasing in length

–Widened QRS

multiple p waves to each qrs?

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Third Degree AV block

A

–Complete Atrial and Ventricular dissociation –both are being independently paced

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

wenckeback is a…

A

Regularly Irregular pattern

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Ventricular Dysrhytmias

A

Wide QRS complex tachycardia

greater than .12

usually less than 40

Ventricular tachycardia

Torsades De Pointes

Vetricullar Fibrillation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Ventricular Dysrhythmias

Wide QRS complex tachycardia

A

–Supraventricular vs. ventricular

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Ventricular Dysrhythmias

Ventricular Tachycardia

A

–Irritable focus of a ventricular origin –usually reentry mechanism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Ventricular Dysrhythmias

Torsades de Pointes

A

twisted ribbon

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Ventricular Dysrhythmias

Ventricular fibrillation

A

–Multiple irritable automatic foci depolarizing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Prolonged QT syndrome leads to?

A

Torsades de pointes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Prlonged QT syndrome can be caused by hypo-

A

magnesemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Right Bundle Branch Block

A

»Left bundle conducts first

»Best viewed inV1 V2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Left Bundle Branch Block

A

»Right bundle conducts first

»Best viewed in V5 V6

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Axis

Vector direction and mass summation

A

–Limb leads –frontal plane (Determine axis)

–Chest Leads –horizontal plane (Determine rotation)

–0-90 degrees is normal (actually -30 to 110)

–Isoelectric point

•Right angle from the axis plane

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Atrial Hypertrophy

Lead V1

A

–Used to assess atrial enlargement
–Positioned over the atria right side of the chest

•Biphasic P wave – the predominate vector deflection determines the hypertrophy
–positive right atrial hypertrophy
–negative left atrial hypertrophy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Atrial Hypertrophy

Leads II, III, aVF (heart lays on its side)

A

–amplitude is increased to greater than 2.5 mm in leads II, III, aVF is also indicative of right atrial hypertrophy (also referred to as p-pulmonale)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Ventricular Hypertrophy Overview

A

•Can be determined electrically with caution in the presence of a Bundle Branch Block

•Electrical size
–Chamber size increase – dilation
–Increased muscle mass

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Ventricular Hypetrophy

V1

A

–positioned over the atria right side of the chest
–Used to assess atrial enlargement
•Biphasic P wave

–Used to assess right ventricular hypertrophy - abnormally large R wave
–Used to assess left ventricular hypertrophy - abnormally large S wave

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Ventricular Hypertrophy

V5

A

–Used to assess left ventricular hypertrophy - abnormally large R wave

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

Left ventricular hypertrophy

A

–Millimeters on EKG of S wave in V1 plus the R wave in V5 > 35mm
–Inverted/asymmetric T waves (repolarization abnormality)
–Strain pattern depressed and humped ST segment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

Infarction - Ischemia

A

–Symmetrically inverted T waves
–ST segment depression subendocardial infarction, angina, stress tests

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

Infaction - injury

A

–Acute
•ST segment elevation transmural infarction

49
Q

Infarction - Necrosis

A

–Q waves
•Old injury

50
Q

Myocardial Infarction - inferior

A

II,III,AVF

51
Q

Myocardial Infarction - anterior

A

V1-4

52
Q

Myocardial Infarction - lateral

A

I,AVL,V5-6

53
Q

Myocardial Infarction - Posterior

A

V1,V2 - tall R wave and ST depression

54
Q

Myocardial Infarction - LBBB

A

EKG is invalid diagnostic tool for Acute MI

55
Q

Firemans hat sign shows what?

A

MI

56
Q

Posterior-lateral Wall MI Artery?

A

Circumflex Artery (with anterior reciprocal changes)

57
Q

Hyperkalemia

A
  • Flattened/widened P waves
  • Widened ORS complexes
  • Peaked T waves
58
Q

Hypokalemia

A
  • Flattened T waves
  • Prominent U waves
59
Q

Hypercalcemia

A
  • Shortened QT interval
  • Widened T wave
60
Q

Hypocalcemia

A
  • Prolonged QT interval
  • Flattened T waves
61
Q

Hypothermia

A

•Severe sinus Bradycardia
•Prolonged PR interval
•Widened QRS complex
•Prolonged QT interval
•Osborn wave
–Extra deflection at the end of the QRS complex

62
Q

Pericarditis

A
  • ST segment elevation that is flattened with T wave elevated off the baseline
  • Usually present in all leads
  • Convincing evidence of PR segment depression
63
Q

Paced Rhythm

A
  • Sharp depolarizations - spikes
  • Unable to interpret anything beyond that it is a paced rhythm
  • Can be atrial, ventricular or AV sequential pacers
64
Q
A

Atrial Flutter

65
Q
A

Atrial Bigeminy

66
Q
A

Atrial fibrillation

67
Q

Rhythm

A

Junctional

68
Q

Rhythm

A

Junctional

69
Q
A

Wolf-Parkinson-White (WPW)

70
Q
A

Wolf-Parkinson-White (WPW)

71
Q
A

First degree AV block

72
Q
A

Wenckebach

73
Q
A

Wenckebach

74
Q
A

Second Degree AV Block Mobitz type II

75
Q
A

Second Degree AV Block Mobitz type II

76
Q
A

Third Degree AV Block

77
Q
A

Ventricular Bigeminy

78
Q
A

Ventricular Tachycardia

79
Q
A

Ventricular Tachycardia

80
Q
A

Torsades de Pointes

81
Q
A

Prolonged QT Syndrome

82
Q
A

Prolonged QT Syndrome (Hypomagnesemia)

83
Q
A

Vetricular Fibrillation

84
Q
A

RBBB

85
Q
A

RBBB

86
Q
A

LBBB

87
Q

Axis

A

+30

88
Q

Axis

A
  • 90
89
Q

Axis

A
  • 60
90
Q

Axis

A

0

91
Q

Axis

A

+100

92
Q
A

Left Atrial Hypertrophy

93
Q
A

Left Atrial Hypertrophy

94
Q
A

Right Atrial Hypertrophy

95
Q
A

Left Ventricular Hypertrophy

96
Q
A

Left Ventricular Hypertrophy - with Strain Pattern

97
Q
A

Left Ventricular Hypertrophy - with Strain Pattern

98
Q
A

Anterior Ischemia

99
Q
A

Inferior Wall MI

100
Q
A

Inferior Wall MI

101
Q
A

Anterolateral Wall MI

102
Q
A

Posterior MI

103
Q
A

Posterior-lateral Wall MI - ircumflex Artery (with anterior reciprocal changes)

104
Q
A

Hyperkalemia

105
Q
A

hypercalcemia

106
Q
A

Hypocalcemia

107
Q
A

Hypothermia

108
Q
A

Hypothermia

109
Q
A

Hypothermia

110
Q
A

Hypothermia

111
Q
A

Hypothermia

112
Q
A

Hypothermia

113
Q
A

Pericarditis

114
Q
A

Reciprocal changes in V1, I and aVL

115
Q
A

Pericardial effusion?

116
Q
A

Paced Rhythm

117
Q
A

Paced Rhythm

118
Q
A

Paced Rhythm

119
Q
A

Dextrocardia

CV II (2 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions