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xD3 Med Mgmt Ex1 > EKG (Strauss) > Flashcards

EKG (Strauss) Flashcards

1
Q

The P wave corresponds to what?

A

Atrial contraction

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2
Q

The QRS complex corresponds to what?

A

Ventricular contraction

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3
Q

The T wave corresponds to what?

A

Ventricular re-polarization

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4
Q

What is the term for an electrical picture of the heart?

A

Electrocardiogram

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5
Q

What is the pacemaker of the heart, located in the right atrium?

A

The SA node

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6
Q

What is the flat line between the P wave (atrial contraction due to SA node) and the start of the QRS complex?

A

PR interval - pause of the current for a moment at the AV node to allow blood to flow from the atria to the ventricles.

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7
Q

How does current flow from the AV node?

A

Down the left and right Bundle of His up the Purkinjie fibers which squeezes the ventricles to eject blood

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8
Q

Is there atrial re-polarization recordable by the ampmeter for the EKG?

A

Yes, but the atria are so small muscularly, their re-polarization is hidden in the QRS complex

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9
Q

How long is the P-R interval?

A

0.16 seconds

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10
Q

How long is the QRS complex?

A

0.08 seconds

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11
Q

What is the total number of leads possible for an EKG?

A

12

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12
Q

OMFS used a 3-lead EKG, placing leads where?

A

Left shoulder/arm
Right shoulder/arm
Left leg

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13
Q

On a 3 lead, where is the greats positive deflection and why?

A

Right arm to left leg because it follows the approximate axis of the heart in the same direction the current of the heart is traveling

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14
Q

Will the deflection be as great when reading from right arm to left arm?

A

No but will still be positive

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15
Q

If you measure from left arm down to left leg will it still be a positive deflection?

A

Yes, because the current is going from top to bottom as well

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16
Q

If you measure from left leg up to right arm, what deflection will you get: positive or negative?

A

Negative because measurement is going opposite to direction of current in the heart

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17
Q

Lead 1 is from where to where in a 3-lead EKG?

A

Right arm to Left arm

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18
Q

Lead 2 is where to where in a 3-lead EKG?

A

Right arm to Left leg

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19
Q

Lead 3 is where to where in a 3-lead EKG?

A

Left leg to left arm

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20
Q

In a 3-lead EKG, which area has 2 positive charges on it?

A

Left leg

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21
Q

In a 3-lead EKG, which area has one positive and one negative charge on it?

A

Left arm

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22
Q

Which lead do we use in a 3-lead EKG?

A

Lead 2

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23
Q

How many total vectors can be attained from a 3-lead EKG and how?

A

12 vectors. Switch up polarity of leads to give 6 different directional readings. Can then bisect each of these readings and get 12 total readings.

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24
Q

How is the heart positioned anatomically?

A

Right to left angle, left ventricle is angled posterior

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25
Q

If you set 6 leads around the heart with V1 in front and V6 going around to axilla, which lead would have the greatest positive deflection?

A

V5 because it is closest to the apex

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26
Q

What are 5 things to look for on every EKG?

A
  1. Rate
  2. Rhythm
  3. Axis
  4. Hypertrophy
  5. Infarction
27
Q

What is created by the SA node and is usually 60-100 bpm?

A

Rate

28
Q

Do you want a faster or slower bpm and why?

A

Slower to allow for more diastolic filling time (when the heart feeds itself)

29
Q

Is there only one pacemaker in the heart?

A

No. Any heart cell can pick up the pacemaking

30
Q

What happens to the rate as other cells take over pacemaking from the SA node?

A

The rate slows

31
Q

What is the rate if the AV node takes over pacemaking?

A

60 bpm

32
Q

If the ventricles become pacemakers, what will be their rates?

A

30-60 bpm

33
Q

Any pacemaker, whether SA node or one taking over, can fire at what emergency rate and what will this lead to?

A

150-200 bpm but will cause MI because there is no diastolic filling time for the heart to feed itself

34
Q

What is the dark line and box time on an EKG?

A

Each dark line = 0.2 sec

Each box = 0.04

35
Q

How do you read the rate on an EKG?

A

Each EKG has a 3 second tick mark. Count beats for 2 ticks = 6 seconds. Multiply by 10.

36
Q

What are 2 variants for pulse?

A

Regular irregular

Irregular irregular

37
Q

An ectopic atrial pacemaker would give what rate?

A

75 bpm

38
Q

What 3 things should you look for when analyzing rhythm?

A
  1. Normal P wave
  2. Positive QRS
  3. Normal T wave
39
Q

What is another name for a normal P wave indicating the SA node is pacemaking?

A

Normal sinus rhythm (NSR)

40
Q

What are 4 rhythm abnormalities?

A
  1. Varying
  2. Extra beats and skips
  3. Rapid rhythm
  4. Heart blocks (slow rhythm)
41
Q

Deep breaths do what to heart rhythm?

A

Slow the rhythm down

42
Q

Sinus arrhythmia has what P wave character and what does it cause?

A

Normal P wave, rhythm is different as breathing slows heart

43
Q

What is the P wave appearance and rhythm for a wandering arrhythmia caused by an ectopic Atrial pacemaker?

A

P wave shape changes and rhythm varies

44
Q

What will be seen as varying rhythm, no real P wave, but multiple ectopic atrial spikes, caused by multiple atrial ectopic pacemakers?

A

Atrial fibrillation

45
Q

What will the QRS be during atrial fibrillation and why?

A

Intermittent because not all ectopic impulses will get to the AV node to fire the ventricle

46
Q

Atrial fibrillation rhythm will give what type of pulse clinically?

A

Irregular irregular

47
Q

What is a common drug for a patient with atrial fibrillation to be on?

A

Anticoagulants

48
Q

Premature beats will have a P wave with what shape and what does that mean?

A

There will be an abnormal P wave and it means the ectopic focus sent out an extra impulse

49
Q

If the AV node takes over pacemaking, will there be any P wave?

A

No

50
Q

What is the term for an ectopic current from the ventricle that puts a big negative wave (because it fires in the opposite direction of the leads)?

A

Premature Ventricular Contraction (PVC)

51
Q

What are the layman’s terms for premature ventricular contraction

A
  1. Palpation

2. Heart skips a beat

52
Q

What is caused when the SA node stops working and another atrial foci takes over?

A

Atrial escape, EKG will have a delay and then a different P wave

53
Q

If atrial escape happens once, what is it called?

A

Atrial escape beat

54
Q

If atrial escape happens consistently, what is it called?

A

Atrial escape rhythm

55
Q

Will there be a P-wave if the SA node stops working and the AV node takes over?

A

No

56
Q

What will be the difference between paroxysmal atrial and nodal or ventricular tachycardia?

A

Both are taking over for the SA node but atrial would have fast rhythm and a P-wave, while Nodal or ventricular would be fast but with no P-wave

57
Q

What will be the EKG that indicates a block, and what will the patient’s heart rate be?

A

Multiple P-waves and no QRS. patient would have a slow heart rate

58
Q

A bundle branch block occurs where and how does it appear on the EKG?

A

Occurs in ventricles in the Bundle of His. There will be a wide QRS on the EKG that looks like an M.

59
Q

An infarction does what to the heart?

A

Changes its axis

60
Q

If a patient had an infarction and you used a 3-lead EKG which gave you a negative WRS, what does that mean for the axis of the heart and its shift?

A

Right axis deviation. Think about the right as having 2 negatives in the lead set-up.

61
Q

Hypertophy causes what on the EKG?

A

Huge deflections due to more heart material

62
Q

A premature Q wave before the normal QRS complex is a classic indicator of what?

A

Classic heart attack indicator. Q-wave infarction. note the Q wave normally is small, but here it is huge.

63
Q

T-wave will look how for ischemia?

A

Negative deflection

64
Q

Injury (acute or recent) would do what to the ST interval?

A

Increase it. Looks like a hill coming off the R-wave.

xD3 Med Mgmt Ex1 (6 decks)

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