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CVS > Interpreting ECG > Flashcards

Interpreting ECG Flashcards

1
Q

depolarisation

A
  • na influx making membrane more +
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2
Q

repolarisation

A
  • k efflux to decrease mp
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3
Q

deflection

A
  • deviations from the isoelectric line (+ deflation = goes upwards, -ve deflection = downwards)
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4
Q

action propgoation

A

same as AP

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5
Q

exctiitioan -contration coupling

A

depolarisation wave c co ordained contraction of the atria and ventricles

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6
Q

exctiitioan -contration coupling

A

depolarisation wave c co ordained contraction of the atria and ventricles

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7
Q

cellular level

A

myocardial cells via gap junctions to the next cll so threshold reachAP fired influx of na+

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8
Q

tissue level

A

SAN atrial wall AVN (bottom left of the R A) slower rate b don’t want v to contract same rate as a b no filling of the v Bundle of His located in the ANNULAR FIBROSIS; so electrical activity spreads down the 2 … Bundle branches R and L so R bundle branch, and L bundle branch terminates at the Purkinje fibres where spreads depolarisation through the ventricles

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9
Q

annual fibrosis

A
  • consists of 4 fibrous rings ( Fibrous ring of pulmonary valve / F r of aortic v/ right fibrous trigone/ left fibrous trigone ) - anchors myocardium and cardiac valves (just like how muscles are anchored by bones) - electrical insulator bw A and V b we don’t want chaotic movement of the e between them
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10
Q

Bundle of his

A

2 branches -R= carries impulses to R V - L= carries impulse to LV - work very fast so implies sent at the same rate c same contraction - terminate at the purkinjue fibres

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11
Q

why doesn’t AVN cause the rhythm

A
  • SAN fires more rapidly so surpasses the other rhythms
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12
Q

firign rate of the conducting systems of the heart

A

SAN 60-100 time/min AVN 40-60/min LBB RBB - 20-40/min

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13
Q

whats an ECG ? a lead? an electrode? how many leads? how many views?

A

-measures changes in electrical potential produced by successive area of the myocardium during the cardiac cycle via a series of leads attached to the body - via of the heart / electrical capable that connects electrode to an ECG recorder - a conductive pad attached to skin and enables recording of electrical currents. - 10 leads, 12 views

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14
Q

COPD (large chest d air) and obesity (large chest ) how does this change to ECG recording

A
  • e activity is altered be must travel through air/fat
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15
Q

what should you be aware of

A

when interpreting an ECG be aware of the ECG you’re thinking about - when describe the changes of e activity specificy the lead to specificy the view - lead 2 gives you really good view of P WAVE since It gives good view of the heart rate

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16
Q

P wave

A

-

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17
Q

1 wave?

A

1 wave - moe than 1 wave is a deflection so PQRST complex

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18
Q

electrodes

A

-10 { 4 limbs R arm L arm R L leg) - R leg no view of the heart it is just a grounding one , but you must put it on or the ECG looks weird - compare electrical activity of R L R L arm and leg) -preicordianl electrode = heart - called 12 leads be 12 views of the ehart

19
Q

now we out

A
  • R arm = R shoulder - R leg = bottom quadratic under the umbilicus ) - this is because you get eh same reading as the limb placement but less movement so less artefact - compare e activity over time 123
20
Q

leads 123

A

123 bipolar ( have negative and positive end)

21
Q

positive electrode

A
  • if depolarisation current is going towards the positive electrode you get a upwards deflection -ifrepolaristoncurrent is going towards positive electrode you get downwards deflection
22
Q

augmented limb lead

A
  • no bipolar - one the leads is +avR ( R arm) -avL (left arm)+ -avF(F for left leg) + - avR (R values the average of the L arm and L leg) - avL (L arm is average of R arm and L leg -avF (L leg is average of R arm and L arm)
23
Q

limb leads

A

6 view from the vertical plane from top to bottom

24
Q

limb lead 2

A

RA and LL measures electrical difference between them and since the heart is diagonal its a straight line through to the inferior aspect of the heart

25
Q

lateral

A

1 AVL

26
Q

right side of heart

A

AVR

27
Q

bottom

A

LL3 AVF LL2

28
Q

Pericordinal / chest leads

A

view of the heart in a horizontal plane from front to back -unipoar -info about interventrial septum side -

29
Q

deflection

A

-oblique deflection is smaller is not straight at you - if perpendicular straight line or nothing - going away = negative deflection

30
Q

SAN

A
  • ot detected
31
Q

atrial depolarisation is

A

P wave (upwards b from leads 2, going towards the LL)

32
Q

delay

A

don’t see it sicne its very small but we infer - but it is represented by a isoelectric line - f heart not contracting for long the AVN will be longer - prolonged P-R interval

33
Q

as e goes into ventricles

A
  • you get deflection b lots of cells in the ventriclestherfore large deflection ,
34
Q

QRS complex

A

depolarisation of the ventricles lead 2

35
Q

small squares 5 small squats make 1 large square

A

-0.04 sexonds - 0.2

36
Q

P-R

A

3/4 small squares (

37
Q

P wave

A
  • atrial depolarisation ( positive deflection because the depolarisation is moving towards the positive electrode
38
Q

Q wave

A
  • SAN node - can be straight line or just downwards b the heart is a 3D model and so there’s bound to be deflection from a certain angle
39
Q

R wave

A
  • ventricular depolarisation - very high b ^^ of myocardial cells, the AP is moving through the bundle of his towards the apex of the heart hence the positive deflection as you’re moving towards the Lead 2
40
Q

S wave

A
  • AVN node inference - downwards again b heart 3D model there’ll be some deflection from an angle
41
Q

T wave

A
  • Ventricular repolarisation - still get a positive deflection because although its repolarising its moving towards the LLL wc is the positive electrode
42
Q

where are the precordial leads placed and how many?

A
  • 6 -
43
Q

describe the leads and the view they allow

A
  • vertical view (top to bottom of heart) -Right side of the heart avR - bottom view L2 avF L3 - lateral side/ left ventricle = L1 AVL
44
Q

precordial leads HOW MANY? type of leads? placements

A
  • 6 - unipolar - reading horizontal place allow front to back so look at walls -V1 = 4th intercostal right [antero-septal] -V2= 4th intercostal left [a-s] -V3 = inbetween V2 and V4[a-s] -V4 = 5th intercostal midcollar bone L[a-s] -V5 = 5th intercostal anterior axillary line -V6 = 5th intercostal midaxillary line

CVS (23 decks)

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