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cardiovascular system > electrocardiography 1 > Flashcards

electrocardiography 1 Flashcards

1
Q

why cant you use a defibrillator when there is a flat line on anm ECG

A

it is an unshockable rhythm

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2
Q

what are electrodes

A

the things that you stick on the patient

conductive material in contact with the skin

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3
Q

what are wires

A

the things that attach to the electrodes

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4
Q

what are leads

A

perspective of heart activity from a given view

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5
Q

what is a vector

A

a quantity that has both magnitude and direction

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6
Q

how do you represent a vector

A

with an arrow in the net direction of movement

size reflects the magnitude

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7
Q

what is represented by an isoelectric line

A

no net change in voltage

vectors are perpendicular to lead

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8
Q

what does the width of deflection denote

A

the duration of the event

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9
Q

what is denoted by the steepness of the deflection

A

the velocity of the AP

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10
Q

which way do downward deflections travel

A

to the anode

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11
Q

which direction do upward deflections travel

A

to the cathode

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12
Q

what do you use to measure deflection

A

the cathode and the anode

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13
Q

when is there no isoelectric line between waves

A

when they overlap

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14
Q

describe the axis of an ECG

A

x = time (ECG paper/recording moves at a certain speed)
y = amplitude
one in the function of the other = velocity of wave forms

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15
Q

what do the combination of down and upstrokes denote

A

a wave

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16
Q

what is donated by P

A

atrial depolarisation

electrical impulse that propagates through the atrial muscle that causes contraction

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17
Q

why is there no atrial repolarisation

A

hidden by QRS

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18
Q

what is donated by QRS

A

electrical signal that stimulates the contraction opf the ventricles

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19
Q

what is donated by T

A

electrical signal that signifies ventricular relaxation/repolarisation

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20
Q

role of the sinoatrial node

A

starts conduction

spontaneously depolarising at a given rate

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21
Q

action of atrial myocardium

A

rapidly conducts

22
Q

role of the AVN

A

slow impulse to facilitate the mechanical activity of the heart
protective

23
Q

describe the bundle of His

A

common bundle - bificates into L and R bundle branches
insulated
impulse can’t leave
impulse travels to the bottom of the ventricle
the insulation of the L branch is not as far as the R branch - L septum contracts first - right in middle so give rest of myocardium anchor to contract around
fibres go into apex - muscular

24
Q

role of nodal branches

A

rapidly conduct impulse through atria, and to AVN

25
Q

why is it important for the heart to contract upwards

A

because the great vessels leave at the top of the heart

26
Q

why is lead 2 the best

A

it goes from cathode in right arm to left leg

which follows the direction of the heart from SAN to apex

27
Q

describe the cardiac vectors

A

SAN causes P wave - not big, but broad - there is little muscle
AVN depolarisation - isoelectric - gap between P and QRS
end of isoelectric line - from impulse down bundle of his to mid septum - insulated and really fast
Q wave - bundle branches - escaping bundle wave from L bundle branch - down because towards the -ve, really fast
R - apex, lots of cells and lots of muscle - really to +ve electrode = massive spike
ST - impulse up the walls of the ventricle - a lot of cavity
T - reset - not big because no specific electrical event, broader than P

28
Q

which is longer contraction/activation(systole)

A

contraction

29
Q

features of the electrocardiogram

A 
details - name and date and time (want to see change over time) 
where
interval and axis
each double big square is 1mv 
running speed - rate it would print 25mm/s 
10mm/mv - double big square = 1mv 
.2 seconds for large square 
.04 seconds for a small square 
leads 1, 2, 3 - primary bipolar leads
aVF, aVL, aVR - augmented leads
V1-6 chest leads 
rhythm strip - evaluate rhythm 
HR 
intervals 
interpretation
30
Q

leads that give inferior view of heart

A

2, 3 aVF

31
Q

leads that give lateral view of heart

A

1 aVL V5 V6

32
Q

leads that give an anterior view of the heart

A

V3 and V4

33
Q

what are augmented leads calculated from

A

principle bipolar leads

34
Q

which leads give a septal view of the heart

A

V1 and V2

35
Q

Where does lead 1 measure

A

right arm to left arm

36
Q

where does lead 2 measure

A

Right arm to L leg

37
Q

where does lead 3 measure

A

L arm to L leg

38
Q

which way do you read a lead

A

L to R
top to bottom
anode is always first

39
Q

where are the chest leads placed

A

V1 - R sternal border (4th intercostal space)
V2 - L sternal border (4th intercostal space)
V3 - halfway between V2 and 4
V4 - midclavicular line level 5th intercostal space
v5 - anterior axillary line - level of V4
v6 - mid axillary line - level of V4

40
Q

why do you put on conductive spray

A

so you can read activity

41
Q

features of the 12 leads

A

anode is the calculation for 9 leads

42
Q

which leads are in the coronal plane

A

1-3 and augmented leads

43
Q

which leads are in the horizontal plane

A

chest leads

44
Q

what does it mean by bipolar leads

A

both anode and cathode are physical leads

45
Q

hwo do you work out cardiac axis

A

calculate the net deflection for lead 2 and lead aVL
use trig to calculate the angle
subtract accordingly to make it from 0degrees

46
Q

why is aVL small

A

it goes from bottom right to top left

shows the heart is on the correct side of the body

47
Q

effect of ECG being subjective

A

have to make judgement calls
how you act depends on the patient as a whole
might be normal for them

48
Q

effect of putting cables in a different place

A

different ECG

49
Q

what happens during inspiration and expiration if you have arrhythmia

A 
inspiration heart rate up 
expiration heart rate down
this is respiratory sinus arrhythmia - breathing cycle affect heart beat
heart rate controlled by PNS - slow down
breath in remove inhibition
50
Q

how many people have respiratory sinus anaemia

A

50%

51
Q

which views of the heart link to which coronary arteries

A 
lateral = LCx ( L circumflex) 
septal = LAD (L anterior descending) 
anterior = RCA (right coronary artery)

cardiovascular system (22 decks)

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