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NREMT® Paramedic > EMT-P (2) Cardiology and Resuscitation > Electrophysiology > Flashcards

Electrophysiology Flashcards

Essential practice and understanding of the electrical activity of the heart

1
Q

Where are the limb leads placed?

A
  • R leg and L leg
  • R arm and L arm
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2
Q

List ways to ensure the best ECG reading.

A
  • shave body hair
  • remove oils
  • attach to cables prior to placement
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3
Q

What are the limb leads?

A

I, II, III, aVR, aVL, aVF

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4
Q

What are the precordial leads?

A

V1 - V6

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5
Q

If you are obtaining a 12-lead ECG, how should you alter the placement of the limb leads?

A

Leads should be placed on the wrists and ankles.

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6
Q

Describe the placement of V1-V6 precordial leads.

A

V1:

  • right of sternum
  • 4th ICS

V2:

  • left of sternum
  • 4th ICS

V3:

  • midway
  • between V2 and V4

V4:

  • midclavicular
  • 5th ICS

V5:

  • anterior axillary line
  • 5th ICS

V6:

  • midaxillary line
  • 5th ICS
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7
Q

How is a posterior ECG obtained?

A
  • V7: Between V6 and V8
  • V8: Left midscapular line
  • V9: Left paraspinal line

5th ICS

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8
Q

Define:

Augmented Unipolar Leads

A

It contains one true pole, and the other end is referenced against other leads.

aVR, aVF, aVL

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9
Q

Define:

Bipolar Leads

A

Each of the leads has positive and negative poles.

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10
Q

How much time passes in one small box of ECG paper?

A

.04 seconds

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11
Q

How many small boxes are inside one large box of ECG paper?

A

5

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12
Q

How much time passes in one large box of ECG paper?

A

.20 seconds

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13
Q

What does the P wave represent?

A

atrial depolarization

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14
Q

What does the PR interval represent?

A

Atrial depolarization and impulse conduction through the AV node.

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15
Q

What does the QRS complex represent?

A

ventricular depolarization

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16
Q

What does the J Point represent?

A

End of depolarization and beginning of repolarization.

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17
Q

What does the ST Segment represent?

A

early ventricular repolarization

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18
Q

What does the T wave represent?

A

ventricular repolarization

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19
Q

What is the first half of the T wave?

A

absolute refractory period

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20
Q

What is the second half of the T wave?

A

relative refractory period

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21
Q

What does the QT interval represent?

A

Electrical activity of one ventricular cycle.

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22
Q

How do you use the 6 second method for calculating the HR on ECG paper?

A

Count the QRS complexes in a 6 second ECG strip and multiply by 10.

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23
Q

What is the sequence method for determining HR on ECG paper?

A

Find an R wave and count with the sequence below until you reach the next R wave for each large box.

300, 150, 100, 75, 60, 50

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24
Q

Rhythm:

A

Normal sinus

  • HR 60-100 bpm
  • P waves present
  • regular rhythm
  • narrow <120 ms QRS
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25
Q

Rhythm:

A

Sinus Tachycardia

  • HR > 100 bpm
  • P waves present
  • regular rhythm
  • narrow <120 ms QRS
26
Q

Rhythm:

A

Sinus Brady

  • HR < 60 bpm
  • P waves present
  • regular rhythm
  • narrow <120 ms QRS
27
Q

Rhythm:

A

Sinus Dysrhythmia

  • HR 60-100 bpm
  • P waves present
  • regular rhythm
  • narrow <120 ms QRS
  • Slight deviation of contraction timing during inspiration.
28
Q

Rhythm:

A

Sinus Arrest

  • HR 60-100 bpm
  • P waves present
  • regular rhythm
  • narrow <120 ms QRS
  • Sudden pause in rhythm to indicate cessation of sinus contraction.
29
Q

Rhythm:

A

Atrial Flutter

  • HR 60-100 bpm
  • P waves present; 3:1 conduction
  • regular rhythm
  • narrow <120 ms QRS
30
Q

Rhythm:

A

Atrial Fibrillation

  • Irregular HR/QRS.
  • No discernible P waves.
  • narrow <120 ms QRS
31
Q

Rhythm:

A

Supraventricular Tachycardia

  • HR > 150 bpm
  • P waves present (sometimes blends with T wave)
  • regular rhythm
  • narrow <120 ms QRS
32
Q

Rhythm:

Hint: Complex

A

Premature Atrial Complex

  • A complex within another rhythm
  • P waves present
  • narrow <120 ms

PAC

33
Q

Rhythm:

A

Junctional Escape Rhythm

  • HR 40-60 bpm
  • P waves absent
  • regular rhythm
  • narrow <120 ms QRS
34
Q

Rhythm:

A

Accelerated Junctional

  • HR 60-100 bpm
  • P waves absent
  • regular rhythm
  • narrow <120 ms QRS
35
Q

Rhythm:

A

Junctional Tachycardia

  • HR >100 bpm
  • P waves absent
  • regular rhythm
  • narrow <120 ms QRS
36
Q

Rhythm:

Hint: Complex

A

Premature Junctional Complex

  • complex within a rhythm
  • P waves absent
  • QRS <120 ms
37
Q

Type of heart block.

A

First degree heart block

  • PR Interval >200 ms
  • QRS <120 ms
  • regular rhythm
  • P waves present
38
Q

Type of heart block.

A

Second degree type I

  • QRS <120 ms
  • HR 60-100 bpm
  • P waves are delayed a little longer each beat, until an entire complex is dropped.
  • regular rhythm
39
Q

Type of heart block.

A

Second degree type II

  • PR interval is constant; several impulses do not contract.
  • QRS <120 ms
  • HR 60-100 bpm
  • regular or irregular rhythm
40
Q

Type of Heart block.

A

Third degree

  • Impulses reaching the AV node are not conducted to the ventricles; ventricles become their own pacemaker.
  • ventricular rate <60 bpm
  • SA rate 60-100 bpm
  • QRS >120 ms (but can be <120 ms)
41
Q

Rhythm:

A

Idioventricular

  • HR 20-40 bpm
  • P waves absent
  • regular rhythm
  • wide >120 ms QRS
42
Q

Rhythm:

A

Ventricular Tachycardia

  • HR >100 bpm
  • P waves absent
  • regular rhythm
  • wide >120 ms QRS
43
Q

Rhythm:

Hint: Complex

A

Premature Ventricular Complex

  • Complex within a rhythm.
  • P wave absent
  • QRS >120 ms
44
Q

Rhythm:

A

asystole

No electrical activity is present.

45
Q

Rhythm:

A

Ventricular Fibrillation

  • The heart is quivering, and there is no contraction of the heart.
  • No P waves or QRS.
  • chaotic baseline
46
Q

Rhythm:

A

Ventricular Pacemaker

  • wide QRS
  • Pacer spikes present before ventricular contraction.
47
Q

Rhythm:

A

AV Sequential Pacemaker

  • Pacer spikes before P waves and ventricular contraction.
48
Q

Name the axis deviation.

I is up

aVF is up

A

normal axis

49
Q

Name the axis deviation.

I is up

aVF is down

A

left axis

50
Q

Name the axis deviation.

I is down

aVF is up

A

right axis

51
Q

What is the Axis Deviation?

I is down

aVF is down

A

extreme right

52
Q

What type of bundle branch block is present?

When you have a QRS >120 ms and a terminal R wave in V1.

A

right bundle branch block

53
Q

What type of bundle branch block do you have?

When you have a QRS >120 ms and terminal S wave in V1.

A

left bundle branch block

54
Q

How do you determine right ventricular Hypertrophy in a 12-lead?

A
  • large R wave in V1
  • R wave in lead aVR >5 mm
55
Q

How do you determine left ventricular Hypertrophy in a 12-Lead?

A
  • tallest R wave in V5/V6 + deepest S wave in V1/V2 >35 mm
  • R wave in lead aVL >11 mm
56
Q

Fill in the blank.

Q waves are pathologic if they are in ___ small square on an ECG paper.

A

1

40 ms

57
Q

List the progression of ischemia to infarction.

A
  1. Ischemia begins with an inverted T wave and leads to elevated ST segment.
  2. Injury begins when a Q wave starts forming.
  3. Infarction occurs after the ST segment reaches its maximum elevation and returns to baseline; a pathologic Q wave remains.
58
Q

What are contiguous leads?

A

Leads that view similar areas of the heart.

Eg. V1, V2 : II, III, aVF

59
Q

Fill in the blank.

About ___% of people having an Inferior MI also have ______ ventricular involvement.

A

40, right

60
Q

Interpret what’s being shown in this picture.

A

Inferior STEMI

  • Elevation in II, III, aVF.
  • Eeciprocal changes in I and aVL.
  • Elevation is >1 mm in two contiguous leads.

EMT-P (2) Cardiology and Resuscitation (8 decks)

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