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Cardiovascular > EXAM #1: BASIC ECG > Flashcards

EXAM #1: BASIC ECG Flashcards

1
Q

Where does the Bundle of His lie?

A

Left side of the IV septum

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2
Q

What is the first part of ventricular depolarization?

A

High left ventricular septum

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3
Q

Is the sinus node depolarization contained in the PR interval?

A

No

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4
Q

Why is the T-wave upright?

A

Myocardium repolarizes in the opposite direction of depolarization

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5
Q

What is the clinical importance of the relative refractory period and the supranormal period?

A

Arrhythmiogenesis

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6
Q

Draw and label the hexaxial diagram.

A

p. 21

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7
Q

What does a small square on the ECG correspond to? What is one big square on the ECG?

A
  1. 04 sec

0. 20 sec

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8
Q

List the numbers that correspond to each large square in interpreting heart rate.

A 
300 
150 
100 
75 
60 
50 
43 
37 
35 
30
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9
Q

Vertically, what does one small square correspond to?

A

0.1 mV

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10
Q

Vertically, what does 1 mV equal?

A

2x large boxes

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11
Q

How do you check the regularity of the heart rhythm?

A

Check the R-R interval

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12
Q

What does the p-wave correspond to?

A

Atrial depolarization

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13
Q

Where should you look at the p-wave?

A

II and V1

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14
Q

In what leads are p-wave upright?

A

Inferior (II, III, and aVF)

Lateral (I and aVL)

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15
Q

Where will the p-wave normally be negative?

A

aVR

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16
Q

What is the normal p-wave duration?

A

Less than 0.12 sec or 120 msec

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17
Q

What is the normal p-wave amplitude?

A

Less than 0.25 mV or 2.5mm (small boxes)

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18
Q

What are the indications of a RAA? Where do you look?

A

II and V1= Tall/ narrow (greater than 2.5mm)

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19
Q

What are the indications of a LAA? Where do you look?

A 
II= notched and greater than 0.12 sec 
V1= wide and biphasic
20
Q

What does the PR interval correspond to?

A

Depolarization in:

  • AVN
  • His Bundle
  • Bundle branches
  • Purkinje fibers
21
Q

What is the normal PR interval?

A

0.12-0.20 sec

22
Q

What is the definition of a 1st degree AV block?

A

PR interval greater than 0.20sec

*Note that there are NO pathologic implications regarding a 1st degree AV block

23
Q

What is a short PR interval?

A

PR interval less than 0.12

24
Q

What does a short PR interval correspond to?

A

Pre-excitation

25
Q

What is the normal QRS interval?

A

0.07 sec to 0.11sec

26
Q

What does a wide ORS interval correspond to?

A

Bundle branch block

27
Q

What is “low voltage?”

A

QRS complex is less than 5mm in amplitude in I, II, and III

28
Q

What does low voltage indicate?

A

Current is not getting to the surface ECG

  • Obesity
  • Pericardal effusion
29
Q

Where are Q-waves normal?

A 
aVR 
II 
III 
aVF 
aVL 
V4-V6
30
Q

What is the normal duration of a Q-wave?

A

Less than 0.03 sec (less than 1 small box)

31
Q

What is the criteria for a pathologic Q-wave?

A
  • More than 25% of the r-wave amplitude

- Wider than 0.03 sec

32
Q

Where is the R-wave coming from?

A

Upper left IV septum

33
Q

What is the normal R-wave progression?

A

Small r-wave in V1 and then getting bigger laterally

34
Q

What is the normal S-wave progression?

A

Big s-wave in V1 and then getting smaller laterally

35
Q

Where is the normal R/S transition?

A

V3 or V4

Transition between S-predomination to R-predomination

36
Q

What does the ST segment correspond to?

A

Phase 2 or plateau phase

37
Q

What is the normal amplitude of T-waves?

A 
Limb= less than 5mm 
Chest= less then 10mm
38
Q

What is concordance of the T-wave?

A

T-wave should have same deflection as QRS i.e.

  • QRS +, T-wave +
  • QRS -, T-wave -
39
Q

What are very tall peaked t-waves an indication of?

A

1) Very early signs of MI

2) Hyperkalemia?

40
Q

What is a U-wave?

A

Small rounded wave after the T-wave

41
Q

What causes U-waves?

A

1) Hypokalemia

2) Quinidine

42
Q

What is the QT interval?

A

Measurement of the duration of the entire cardiac cycle i.e. depolarization to repolarization

Remember that you measure from the beginning of the Q-wave to the end of the T-wave

43
Q

How does the QT interval change with increased HR?

A

QT Interval gets SHORTER

44
Q

What is associated with prolonged QT interval?

A

Sudden cardiac death

45
Q

What is the normal QRS axis in the frontal plane?

A
  • 15 to 100+

* Typically ~60+

46
Q

How can you calculate the specific QRS axis in the frontal plane?

A

1) Find equipotential QRS complex

2) Go 90 degrees to that (positive)

Cardiovascular (38 decks)

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