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Cardiovascular > Intro To ECG > Flashcards

Intro To ECG Flashcards

1
Q

What does an ECG provide information about?

A

Rate and rhythm
Chamber size
Electrical axis

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2
Q

What is an ECG the main test for?

A

Myocardial ischaemia and infarction

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3
Q

What causes current flow within tissue and surrounding tissue?

A

Electrical activity in and between (gap junctions) of myocytes

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4
Q

What generates potential differences on the body surface?

A

Extracellular current

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5
Q

Name of sensitive recording device

A

ElectrocardioGRAPH

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6
Q

How an ECG works

A

Action potentials spread through conducting system and heart muscles in sequence, causing potential differences in different regions and makes up an electrical dipole

Theses potential differences are detected by electrodes on skin, which are linked to an electrocardiograph and then printed on an ECG

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7
Q

What determines magnitude of electrical axis of heart?

A

Cardiac muscle mass (A+V dominate)

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8
Q

What determines direction of electrical axis of heart?

A

Overall activity of heart at any time, which varies throughout the cycle

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9
Q

ECG lead

A 
Lead axis (imaginary line) between at least 2 electrodes
***not the wire
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10
Q

Line generated on ECG when depolarisation moves towards positive/ recording electrode

A

Upward deflection

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11
Q

Electrodes which lead I connects

A

RA-ve to LA+ve

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12
Q

Electrodes which lead II connects

A

RA-ve to LL+ve

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13
Q

Electrodes which lead III connects

A

LA-ve to LL+ve

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14
Q

From what position does lead II view the heart?

A

Inferior position

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15
Q

Which part of cardiac cycle does the P wave represent?

A

Atrial depolarisation, which spreads inferiority and left from SAN, thus moving towards electrode (upward deflection)

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16
Q

Which part of cardiac cycle does the QRS complex represent?

A

Ventricular activation and depolarisation

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17
Q

What direction is Q wave deflected? What causes this?

A

Downward deflection
Ventricular activation starts in intraventricular septum, moving to right thus depolarisation is moving away from recording electrode and results in downward deflection

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18
Q

What direction is R wave deflected? What causes this?

A

Upward deflection

Main free walls of ventricles depolarise towards recording electrode

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19
Q

What direction is T wave deflected? What causes this?

A

Upward deflection

Repolarising wave is spread away from recording device (think double negatives)

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20
Q

Which part of cycle does the PR interval reflect?

A

SAN impulse to reach ventricles, which is influences by delay in AVN

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21
Q

Why is elevation or depression in ST segment diagnostically important?

A

It is usually isoelectric (which means there should be no deflection)

22
Q

What does the QT interval reflect?

A

Ventricular depolarisation and repolarisation

23
Q

What comprises the 12 lead ECG?

A

3 standard limb leads
3 augment voltage (aV) leads
6 chest/ precordial leads

24
Q

Which leads help create a vertical/ coronal picture of heart?

A

augmented voltage and standard limb leads

25
Q

Which leads help create a horizontal/ transverse picture of heart?

A

precordial/ chest leads

26
Q

Standard limb leads are unipolar. True/ false?

A

False
They are bipolar
aV leads are unipolar

27
Q

Goldberger’s Method

A

1 +ve electrode (recording) and 2 -ve linked electrode, positing the reference electrode in centre of heart where the recording electrode looks

This is how augmented limb leads are linked

28
Q

Electrodes which aVR connects

A

RA(+) to [LA & LF] (-)

29
Q

Electrodes which aVL connects

A

LA(+) to [RA &LF] (-)

30
Q

Electrodes which aVF connects

A

LF (+) to [RA & LA] (-)

31
Q

Hexaxial reference system

A

View of heart in frontal/ coronal plane provided by the standard and augmented limb leads

32
Q

What are lateral leads and which leads are lateral?

A

Lead I, aVL

The recording electrode is on the left arm and views heart from left

33
Q

What are inferior leads and which leads are inferior?

A

Lead II, III and aVF

Recording electrode is on left for and views heart from inferior direction

34
Q

aVR waves are negative. True/ false?

A

Depolarisation moving away from recording electrode is the predominant vector

35
Q

Where is V1 placed?

A

4th intercostal space, right sternal border

36
Q

Where is V2 placed?

A

4th intercostal space, left sternal border

37
Q

Where is V3 placed?

A

Halfway between V2 and V4

38
Q

Where is V4 placed?

A

5th intercostal space, left midclavicular line

39
Q

Where is V5 placed?

A

Left anterior axillary line, on same horizontal plane as V4 and V6

40
Q

Where is V6 placed?

A

Left midaxillary line, on same horizontal plane as V4 and V5

41
Q

Which chest electrodes are looking at the interventricular septum?

A

V1 and V2

42
Q

Which chest electrodes are looking at the anterior of the heart?

A

V3 and V4

43
Q

Which chest electrodes are looking at the lateral aspect/ left ventricle of the heart?

A

V5 and V6

44
Q

R wave progressively increases from V1 to V6 whereas S wave gradually decreases. True/ false?

A

True

45
Q

How to calculate HR from ECG trace

A

300/ number of large squares between beats (if regular rhythm)

300/number of large squares between R-R interval

46
Q

What is the rhythm strip and which lead usually shows this?

A

Prolonged reading of one lead which allows HR and cardiac rhythm to be identified

Lead II

47
Q

What change is crucial for diagnosing chamber hypertrophy?

A

Voltage criteria changes

48
Q

What change is crucial in diagnosing Ischaemic Heart Disease?

A

Any ST segment or T wave changes in specific regions of heart

49
Q

Questions to consider when working out rate and rhythm using rhythm strip

A
  1. is electrical activity present?
  2. is the rhythm regular?
  3. what is the HR?
  4. is there a P-wave present?
  5. what is the PR interval?
  6. is each P-wave followed by a QRS-complex?
  7. is the QRS duration normal?
50
Q

What is indicative of an MI in an ECG?

A

ST elevation MAY occur- doesn’t always show up and therefore cannot always be diagnosed via an ECG

51
Q

Which significant heart diseases do not show up on a normal ECG?

A

MI may show up (ST elevation)
Intermittent Rhythm Disturbance- if suspected do AECG for 24hr or 7 days
Stable angina- if suspected, do exercise ECG

Cardiovascular (14 decks)

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