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Clinical Skills EKG > EKG Other > Flashcards

EKG Other Flashcards

1
Q

impulse headed toward the recording electrode

A

Positive (↑) Deflection

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2
Q

impulse headed away from the recording electrode

A

Negative (↓) Deflection

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3
Q

Placement of 3 lead ECG Electrodes

A
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4
Q

Placement of 12 lead ECG Electrodes

A
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5
Q

Tiny box= # seconds/# mm

Larger box= # seconds/# mm

How many tiny boxes for 1 large box?

A

Tiny: 0.04 seconds/1 mm

Larger: 0.20 seconds/5 mm

5 tiny boxes for 1 large box

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6
Q

4 methods to calculate rate

A
  • 6 second rule
  • 300, 150, 100, 75, 60, 50…
  • Rate=1500/small boxes between similar waves
  • Rate=300/large boxes between similar waves
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7
Q

SA node intrinsic rate

A

–From SA Node 60 – 100 bpm

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8
Q

AV node intrinsic rate

A

–From the AV Node 40 – 60 bpm

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9
Q

Ventricles intrinsic rate

A

–From the Ventricular 20 – 40 bpm

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10
Q

bradycardia is HR less than

A

60

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11
Q

tachycardia is HR greater than

A

100

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12
Q

Normal QRS interval

A

•QRS interval

–Normal <0.12s (3 small boxes)

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13
Q

Normal PR interval

A

•PR interval

–Beginning of P to beginning of q

–0.12 to 0.2s normal (3 to 5 small boxes)

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14
Q

Normal P wave

A

•Less than 0.12s and amplitude less than 2mm

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15
Q

Always place the chest leads in the ______ space

A

intercostal space

(less interference)

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16
Q

Placement of V1

A

placed in the 4th

right

intercostal space @ sternal border

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17
Q

Placement of V2

A

placed in the 4th

left

intercostal space at the sternal border

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18
Q

Placement of V3

A

placed halfway between v2 and v4

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19
Q

Placement of V4

A

5th intercostal space

@midclavicular line

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20
Q

Placement of V5

A

placed in the anterior axillary line at the same horizontal plane as V4

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21
Q

Placement of V6

A

placed in the midaxillary line at the same horizontal plane as V4

22
Q

Augmented Limb Leads:

aVR

A

Right arm +

left arm/foot is -

23
Q

Augmented limb leads:

aVL

A

left arm is +

right arm/foot is -

24
Q

Augmented limb leads:

aVF

A

left foot is +

both right/left arms are -

25
Q

Lead I

A

Right arm: Negative

Left arm: Positive

26
Q

Lead II

A

Right arm: negative

Left leg: positive

27
Q

Lead III

A

Left leg: positive

Left arm: negative

28
Q

Average electrical activity of the heart primarily occurs in which quadrant of the axis?

A

30 to 60 degrees

29
Q

What is the normal axis?

A

The quadrant from 0 to 90 degrees

30
Q

If there is hypertrophy, how does the axis shift?

A

Vector axis points toward hypertrophied side

31
Q

If there is an area of infarction, how does the axis shift?

A

The axis shifts away from the infarction

(i.e. infarction on left shifts axis right)

32
Q

Can blocks cause axis deviations?

A

yes

33
Q

How do we know we are in the normal range for axis?

A

Look at Lead I and Lead aVF.

If both positive, you are in the normal range for axis

34
Q

What if:

Lead I: Negative

Lead aVF: Negative

A

Extreme right axis deviation

(CHECK LEADS, very rare)

35
Q

What if:

Lead I: Negative

Lead aVF: Positive

A

Right axis deviation

36
Q

What if:

Lead I: Positive

Lead aVF: Positive

A

NORMAL

37
Q

What if:

Lead I: Positive

Lead aVF: Negative

A

Left axis deviation

(most common axis deviation)

38
Q

Lead I is positive on the ____ side and negative on the ____ side

___________________________

Lead aVF is positive on the ______ and negative on the _______

A

Lead I: Positive on the LEFT

Lead I: Negative on the RIGHT

_______

Lead aVF: Positive on BOTTOM

Lead aVF: negative on TOP

39
Q

Physiological Left Axis Causes

A
  1. Obesity
  2. Athletes
  3. Normal variant
40
Q

Right axis deviation causes

A
  • Right ventricular hypertrophy
  • MI of the lateral wall of the left ventricle
  • pulmonary hypertension (cor pulmonale) or massive pulmonary embolism
41
Q

Formulation of axis DOES NOT INCLUDE which leads?

A

any of the V leads

no V1, V2, V3, V4, V5, or V6

42
Q

Extreme Right axis deviation can be caused by

A

Ventricular Tachycardia

(extreme right axis plus upright complex in lead V1 is diagnostic for this)

43
Q

What is the order of steps for ECG analysis?

A
  1. •Rhythm
  2. •Rate
  3. •Axis
  4. •Waves
  5. •Intervals
  6. •Hypertrophy
  7. •Infarction
44
Q

Irregular Rhythm/Rate Causes

A

•Irregular

  1. –Sinus arrhythmia
  2. –Wandering pacemaker
  3. –Multifocal atrial tachycardia
  4. –A- fib
  5. –V- fib
45
Q

Axis is determined by what?

A

Determined by the Mean QRS Vector, in other words the average general direction of ventricular depolarization

46
Q

•Patients are 4 times more likely to arrest with a hemiblock and “chest pain” if there is what axis deviation?

A

Left axis deviation

Lead I: Positive

Lead aVF: negative

47
Q

Pathological left axis causes

A
  • Axis -45¡ — -90¡
  • Disease process

•Suggests left anterior hemiblock

•Patients are 4 times more likely to arrest with a hemiblock and “chest pain”

48
Q

Location of Infarction: Anterior

A
  • V3 and
  • V4
49
Q

Location of Infarction: Septal

A
  • V1 and
  • V2
50
Q

Location of Infarction: Inferior

A
  • II,
  • III, and
  • AVF
51
Q

Location of Infarction: Lateral

A
  • I,
  • AVL,
  • V5, and
  • V6

Clinical Skills EKG (2 decks)

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