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Cardio > Intro to EKG > Flashcards

Intro to EKG Flashcards

1
Q

What is the normal axis for an EKG?

A

-30 to +90

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2
Q

How many seconds are in one small box on EKG?

A

40 ms

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3
Q

How many seconds are in one big box EKG?

A

200 ms

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4
Q

How can you determine HR for normal rhythm?

A

count the number of big boxes between 2 RR waves

divide 300 by # of big boxes

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5
Q

How can you determine HR for irregular rhythm?

A

count the number of QRS complexes on bottom strip and multiply by 6

we were multiplying by 6 in class

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6
Q

What are limits for tachycardia and bradycardia?

A

Tachy : >100 bpm

Brady : < 60 bpm

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7
Q

If lead I is positive and lead aVF is positive, what is your axis?

A

0 - +90º (normal)

(remember that positive 90 is downwards for lead aVF)

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8
Q

If lead I is positive and lead aVF is negative, what is your axis?

A

axis between (-) 30º - (-) 90º

this is a left shift!

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9
Q

If lead I is negative and lead aVF is positive, what is your axis?

A

axis between +90º - +180º

this is a right shift

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10
Q

How big is PR interval normally?

A

normally 1 big box

120-200 ms

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11
Q

How big is QRS duration normally?

A

normally < 3 small boxes

< 120 ms

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12
Q

How long is QT interval normally?

A

T wave is < halfway between RR interval

QT should be < 440 ms

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13
Q

How can you determine if there is a ST segment elevation or depression?

A

compare to PR line for reference

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14
Q

Which leads are left sided?

A

leads 4-6

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15
Q

Which leads are right sided?

A

leads 1-3

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16
Q

What are the lateral leads?

A

I, aVL, V5-V6

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17
Q

What do the lateral leads give us information about?

A

LCx or diagonal of LAD

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18
Q

What are the inferior leads?

A

II, III and aVF

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19
Q

What do the inferior leads give us information about?

A

RCA and/or LCx

20
Q

What are the anterior/septal leads?

21
Q

What do the anterior/septal leads give us information about?

22
Q

If you have an inferior block on EKG (leads II, III and aVf) what are we concerned about?

A

the posterior wall could be hiding on EKG and there could be a block there (perhaps coming off the RCA)

23
Q

How do you check for a posterior block?

A

look at if there are deep depressions on VI-V4

24
Q

What are the 3 stages of a worsening MI that pop up on the EKG?

A

1) ST depression / T-wave inversion

2) ST elevation

3) Q-waves

25
Q

ST depression / T-wave inversion indicates (in setting of MI) …

A

ischemia

(some area is not getting enough blood, but there isn’t true cell death yet)

26
Q

ST elevation indicates (in setting of MI) …

A

cell injury

(not necessarily infarct / cell death yet)

27
Q

Q waves indicate (in setting of MI) …

A

cell death / infarct

Q-waves get worse if MI is untreated

28
Q

How many boxes from baseline = an ST elevation?

A

2 small boxes above baseline

29
Q

What is your flow for reading an EKG? 5 steps

A

1) look at P-waves (are they there? is PR interval normal?)

2) look at QRS (are they normal intervals? are they wide?)

3) look at ST (is there elevation / depression)

4) look at QT (is there lengthening)

5) look at rate!!

30
Q

What does VT look like on EKG?

A

p-waves embedded in QT wave

AV dissociation is hallmark of VT (type 3 AV block)

also tachycardia and wide QRS

31
Q

1st degree AV block

A

prolonged PR interval with conducting p-wave

32
Q

Mobitz I AV block

A

progressively prolonged PR interval with eventually nonconduction

irregular RR grouped beating

33
Q

Mobitz II AV block

A

equal PR interval (may not be prolonged) with eventual nonconduction

indicates a His-Purkinje block

34
Q

Which blocks do we treat with pacemakers?

A

Mobitz II

3rd degree AV block

35
Q

3rd degree AV block

A

no p-wave conduction, QRS complex is coming from another pacemaker (escape rhythm)

RR interval is normal!! But it is detached from p-wave

36
Q

RBBB

A

wide QRS complex with VI positive

also can see T-wave inversion (don’t freak)

37
Q

LBBB

A

wide QRS complex with VI negative

also can see T-wave inversion (don’t freak)

38
Q

RVH

A

enlarged Right sided lead (VI) and right axis deviation

39
Q

LVH

A

enlarged Left sided lead (aVl, 1, V5, and V6)

large S wave in V1

40
Q

Atrial fibrillation

A

absent P-waves

irregularly, irregular RR interval

41
Q

Digoxin effect on EKG

A

peaked T-wave, scooped out ST interval, shortened QT interval

42
Q

Hypokalemia

A

T wave inversion, ST depression, and prominent U wave

43
Q

Hyperkalemia

A

Peaked T-wave, P wave flattening, PR prolongation, wide QRS

44
Q

EKG of AVRNT

A

no p-waves before QRS

see retrograde p-waves

also narrow QRS

45
Q

EKG of WPW

A

very short PR interval

QRS is widened

delta wave is present in QRS complex!

Cardio (8 decks)

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