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Cardiovascular II Exam One > EKG's with Unrein Day one > Flashcards

EKG's with Unrein Day one Flashcards

1
Q

What causes the P wave?

A

Atrial Depolarization

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2
Q

What is the difference between a sevment and and interval?

A

Segments are the distance between waves, and do not include other waves,

Intervals include other waves

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3
Q

What should a normal PR interval be?

A

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

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4
Q

How long should the QRS interval be?

A

Less than 0.12 seconds

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5
Q

How long a time interval are the big and small boxes?

A

Big = 0.2 seconds

Little = 0.04 seconds

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6
Q

If determining rate from the box method, what does each additional box count bring the heart rate to?

A

300

150

100

75

60

50

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7
Q

If using a six second strip, multiply by?

A

10

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8
Q

What are the six steps for analyzing an ECG?

A
  1. –Rate
  2. –Rhythm
  3. –Axis
  4. –Hypertrophy
  5. –Infarction
  6. –Wave interval and segment abnormalities
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9
Q

Rate and Rhythm?

A

~75

Normal sinus rythym

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10
Q

Unipolar chest leads are in what plane?

A

Horizontal plane

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11
Q

Describe the sequence of ventricular depolarization!

A
  1. Depolarization starts at the ventricular septum (Q wave) and the endocardial surfaces.
  2. Average current flows from the base of the heart to the apex (R wave).
  3. At the end of depolarization, the current reverses, flows toward the outer walls of the ventricles near the base (S wave).
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12
Q

Describe the P waves and QRS complex in an atrial rythm.

A

Upright P waves

Narrow QRS

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13
Q

Describe the P waves and QRS complexes in Junctional rythms.

A

P waves will be absent or inverted

Narrow QRS complex

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14
Q

describe the P waves and QRS complexes in ventricular rythms

A

No P waves

QRS complexes are wide

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15
Q

What are the QRS complexes like for supraventricular rhythms?

A

Narrow QRS complexes

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16
Q

What is the characteristic description of the Atrial flutter rhythm?

What does it tend to deteriorate into?

A

“saw tooth”

Deteriorates into Atrial fibrillation

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17
Q

A-Fib is classically described as?

A

Irregularly irregular

(Wait, I though Steve and Michael described this as “a fuck”? TIL.)

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18
Q

What causes a WPW rhythm, and what does it look like?

A

D/t accessory conduction pathway - Bundle of Kent

Presence of delta waves - P waves merge into the QRS

Shortened PR interval

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19
Q

What is shown here?

A
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20
Q

What do you see here?

A

Wandering pacemaker

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21
Q

Rhythm?

A

Atrial Flutter

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22
Q

What does this patient have?

A

Atrial Fibrillation

Note lack of P waves, and QRS complexes occuring without pattern

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23
Q

Rhythm?

A

Junctional

No P waves before QRS, so not atrial origin

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24
Q

Rhythm?

A

Junctional Tachycardia

note the inverted P waves

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25
Q

Rhythm?

A

WPW

26
Q

Rhythm?

A

WPW

27
Q

What defines a first degree AV block?

A

a prolonged PR interval greater than 0.2 seconds

28
Q

Second degree AV blocks have variable penetration of AV conductions, with lone P waves without QRS following.

What are the types?

A

Type I - Wenckebach: progressively prolonged PR intervals with a subsequent dropped beat and lone P wave. Usually in a fixed ratio/pattern

Type II - Mobitz: Failure of AV conduction in a fixed ratio/pattern, the PR inverval is not gradually increasing in length. Presents with a widened QRS.

29
Q

What goes on in a third degree heart block?

A

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

30
Q

Rhythm?

A

First Degree AV Block

31
Q

Rhythm?

A

Wenckebach (type I second degree heart block)

32
Q

Rhythm?

A

Wenckebach

PR interval becomes progressively longer until it can no longer conduct.

Described as regularly irregular

33
Q

Rhythm?

A

Mobitz type II

3 P waves per depolarization

34
Q

Rhythm?

A

Second Degree AV block

Mobitz type II

Two P waves per depolarization

35
Q

Rhythm?

A

Third degree AV block

Note how the P waves are disconnected from the QRS complex.

The P waves and QRS complexes have their own independent periodicities.

36
Q

What is a typical cause of ventricular tachycardia?

A

–Irritable focus of a ventricular origin – usually reentry mechanism

37
Q

The term “twisted ribbon” would likely refer to what?

A

Torsades de pointes

38
Q

If you hear “multiple irritable automatic foci depolarization” you should think?

A

Ventricular fibrillation

39
Q

What is shown here?

A

Ventricular Bigeminy

40
Q

What is shown here?

A

Ventricular Tachycardia

41
Q

Rhythm

A

Torsades de Pointes

42
Q

Rhythm?

A

Prolonged QT syndrome

43
Q

Rhythm?

A

Prolonged QT syndrome (hypomagnesemia)

44
Q

Rhythm?

A

Ventricular Fibrillation

45
Q

Bundle branch blocks are d/t lack of synchronization of the bundle branches. If the left bundle conducts first then?

Where would this be best viewed (what leads)?

A

Right bundle branch block

View in V1 and V2

46
Q

If the right bundle branch conducts first then?

Best viewed in what leads?

A

Left bundle branch block

Best viewed in V5 and V6

47
Q

Identify the indicated structures!

A
48
Q

What do you see here?

A

Right bundle Branch Block

49
Q

Rhythm?

A

Right bundle branch block

50
Q

Rhythm?

A

Left bundle branch block

51
Q

What is the normal cardiac axis?

A

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

52
Q

Where would you find the cardiac isoelectric point?

A

Right angle from the axis plane

53
Q

The limb leades determine what?

A

Since in the frontal plane, they determine the axis

54
Q

The chest leads determine what?

A

In the horizontal plane, so they determine rotation

55
Q

What is the axis?

A

+30

56
Q

Axis?

A

-90

57
Q

What is the axis?

A

-60

58
Q

What is the axis?

A

0

59
Q

Axis?

A

+100

60
Q
A

Cardiovascular II Exam One (4 decks)

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