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SPR2015_Week2 > Intro to ECG > Flashcards

Intro to ECG Flashcards

1
Q

Direction of QRS

A

Q = negative

R = positive

S = late negative deflection

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2
Q

normal duration of QRS

A

0.06-0.10 sec

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3
Q

U waves are ____

A

inconsistent

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4
Q

___ wave is inconsistent

A

U wave

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5
Q

paper speed of ECG

A

25 mm/sec

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6
Q

thin lines are ___ long and ___ sec

thick lines are ___ long and ___ sec

A

thin = 1 mm, 0.04 sec

thick = 5 mm, 0.20 sec

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7
Q

PR interval means?

normal PR interval

A

PR interval = conduction time across AV node

normal PR interval = 0.12-0.20 sec

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8
Q

Equation for HR

A

HR = 300/ # heavy lines between 2 QRS

HR = 1500/ # mm between 2 QRS

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9
Q

Leads are electrodes that measure difference in electrical potential between ____

1)

2)

A

Leads measure difference in potential between

1) 2 diff points on body (bipolar lead)
2) 1 point on body and virtual reference point with 0 electrical potential (center of heart) = unipolar lead

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10
Q

what is a unipolar lead

A

lead locate in center of heart (0 electrical potentail)

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11
Q

Depolarization toward a positive electrode produces _____

A

positive deflection

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12
Q

Direction of QRS based on left and lateral lead

vs. right sided leads

A

QRS in left/lateral lead = UPRIGHT (+)

QRS in right side lead = DOWNWARD (-)

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13
Q

LOCATION OF bipolar Limb LEAD
1
2
3

A

1) BETWEEN BOTH HANDS (L = +, R = -)
2) BETWEEN R HAND AND L FOOT (HAND = -, FOOT = +)
3) BETWEEN L HAND AND L FOOT

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14
Q

what are the bipolar limb leads

A

leads 1, 2,3 (standard limb leads)

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15
Q

what are the bipolar precordial leads

A

NONE

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16
Q

what are the unipolar limb leads

A

aVR, aVL, aVR (augmented limb leads)

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17
Q

what are the unipolar precordial leads

A

V1- V6

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18
Q

Direction of Augmented unipolar leads
aVL
aVF
aVR

A

aVL (L hand diagonally to right side) Hand = +

aVF (vertical down body)

aVR (R hand diagonally to left side) Hand = -

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19
Q

which are the lateral leads

A

aVL and lead I

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20
Q

which are the inferior leads

A

II, III, aVF

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21
Q

which leads monitor the RV

A

V1 and V2

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22
Q

which leads monitor the LV

A

V5 and V6

23
Q

signs of ventricular hypertrophy

A

more muscle = more volts = greater amplitude

24
Q

ECG changes in LVH

A

big R waves in L-sided leads

1, aVL, V5, V6

25
Q

ECG changes in RVH

A

big R waves in R-sided leads

V1, V2

26
Q

What does depression of ST segment indicate?

A

ischemia due to sudden high O2 demand with fixed coronary obstruction

27
Q

what does ischemia due to high O2 demand due to coronary obstruction appear on ecg?

A

depression of ST segment

28
Q

what does T wave inversion indicate?

A

ischemia due to acute coronary artery obstruction and LOW OXYGEN DEMAND

29
Q

what does ischemia due to acute coronary artery obstruction and low O2 demand appear on ecg?

A

T wave inversion

30
Q

how does stress-induced myocardial ischemia appear?

A

normal at rest

ST depression with exercise (inability to incr coronary flow appropriately and incr O2 consumption)

31
Q

how does acute coronary syndrome appear?

A

inverted T wave due to decr coronary flow without incr O2 consumption

32
Q

how does transmural current of injury appear?

A

ST elevation

clot due to platelet clot

33
Q

what happens if you open up obstructed artery on ecg?

A

ST elevation can be partially or reversed

34
Q

what do Q waves mean?

A

transmural infarct (no transmural vector–> negative deflection)

35
Q

what is a significant Q wave

A

1) > 1/4 amplitude of R wave
2) > 1 small box (0.04 sec) wide
3) in @ least 2 leads (same area of LV)

36
Q

evolution of transmural MI

A

1) peak T wave (few min)
2) T wave inversion (ischemia)
3) ST elevation (current injury)
4) Q wave, ST elev, T inversion

37
Q

Transmural infarcts usually involve how much damage?

A

full thickness of LV wall = large

38
Q

transmural vs. subendocardial MI on ecg

A

transmural = ST elev with Q wave

subendocardial = ST depression NO Q WAVE

39
Q

V1-V2

A

anteroseptal wall infarct

40
Q

V3-V4

A

anterior wall infarct

41
Q

V5-V6

A

anterolateral wall infarct

42
Q

II, III, aVF

A

inferior wall infarct

43
Q

I, aVL

A

high lateral wall infarct

44
Q

when is QT interval prolonged?

A

> 1/2 RR interval

45
Q

what are causes of prolonged QT

A

1) hypocalcemia, hypokalemia, hypomagnesium
2) class 1A or 3 anti-arrhythmic drugs
3) hypothermia

46
Q

if T wave merges with U wave what does that mean?

A

hypokalemia

47
Q

how does hypercalcemia appear on ecg?

A

shortened QT

48
Q

what is the most common cause of shorten QT interval

A

hyperparathyroidism –> hypercalcemia

49
Q

signs of hypokalemia

A

1) QT prolong

2) T wave inverted

50
Q

changes in hyperkalemia

K+ 5.5-7.5 mmol/L

A

tall T waves- peaked and symmetrical

51
Q

changes in hyperkalemia

K+ 7.5-9.0 mmol/L

A

P & R waves flatten
QRS & T broaden
Big S wave

52
Q

changes in hyperkalemia

K+ ? 9.0 mmol/L

A

P& R waves gone
S and T broaden
“sine wave”

53
Q

ABNORMALITIES IN THE QT INTERVAL AND T WAVE DUE TO DRUGS, ABNORMAL ELECTROLYTES, OR OTHER CAUSES
PREDISPOSE TO ARRHYTHMIAS USUALLY THROUGH ___

A

alterations in repolarization

SPR2015_Week2 (19 decks)

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