Introduction to EKG and Telemetry Flashcards
THE ELECTROCARDIOGRAM ….
Defines the graphic representation of the electrical activity of the heart.
Is the printed record of the electrical activity of the heart on what is called a rhythm strip or an ECG strip.
Records electrical activity from the muscular contractions that spreads throughout the body and can be detected on the surface on the skin.
The term “electrocardiogram” and our modern-day combination of leads started…
around 1890 with Einthoven
Earlier equipment measured slight amounts of electricity using which units….
millivolts or mV
Holter units ….
are named after Dr. N.J. Holter, a Montana Physician
developed in 1949
permit recordings over long periods of time during routine daily life including various activities and exercise.
was originally a 75 lb (34.02 kg) backpack but are now much smaller in size
Where is the heart located in the human anatomy?
in the chest cavity under the sternum, middle-left side
What are the basic four limb electrodes?
right arm
left arm
right leg
left leg
Limb Lead I is oriented from…..
from the right arm (-) toward the left arm (+)
Limb Lead II is oriented from …
from the right arm toward the left leg
Limb Lead III is oriented from…
from the left arm toward the left leg
Limb Lead aVR is the augmented lead toward…
augmented lead toward the right (arm)
Limb Lead aVL is the augmented lead toward…
augmented lead toward the left (arm)
Limb Lead aVF is the augmented lead toward…
augmented lead toward the foot
Chest Leads are represented by which letter and number combinations?
V1 through V6
Which leads create the classic “Einthoven’s triangle”?
Limb Leads I, II, III
Electrocardiograms are often done in which locations?
doctor’s offices
clinics
hospital rooms
Which symptoms indicate that a patient may be in need of an ECG?
Dizziness, lightheadedness or confusion Weakness, fatigue or a decline in ability to exercise. Heart palpitations Rapid pulse Shortness of breath Chest pain
What is a Holter monitor used for?
If symptoms tend to come and go, they may not be captured during a standard ECG recording so a Holter Monitor is used to record a patient over a longer period of time. Holter monitors are typically used continuously for 24-48 hours.
The American Heart Association does not recommend using electrocardiograms to assess adults at low risk who do not have symptoms. True or False?
True
What is the medical terminology for an:
Abnormal Heart Rhythm?
Arrhythmia
What are the 4 main things that an EKC/ECG can determine or detect?
Abnormal heart rhythm (arrhythmias)
If blocked or narrowed arteries in your heart (coronary artery disease) are causing chest pain or a heart attack
Whether you have had a previous heart attack
How well certain heart disease treatments, such as a pacemaker, are working.
What is an Event Monitor used for?
This device is similar to a Holter Monitor but records at certain time intervals (usually a few minutes at a time) for a long period (typically 30 days) when abnormal rhythms are detected.
What is the name for the system that creates the electrical impulses of the heart without any outside influences, thus allowing it to pump on its own?
The Intrinsic Conduction System
What is the path of the electrical impulses that constitute the intrinsic conduction system and pump the heart?
Electrical impulses begin at the SA node (The hearts natural pacemaker)
The impulse then travels through the atria to the AV node
Next it travels down into the ventricles through the Atrioventricular bundle (Bundle of His), splits into the right and left bundle branches, and finally travels into the Purkinje fibers which spread the electrical signal to the ventricular muscle causing the heart to beat in a rhythmic and predictable way
What is occurring physiologically inside the heart when a P wave appears on an EKG/ECG?
The P wave represents the depolarization and contraction of the Atria. This is also known as Atrial systole.
What is occurring physiologically inside the heart when a QRS wave appears on an EKG/ECG?
The QRS wave represents the depolarization and contraction of the Ventricles. This is also known as ventricular systole. This quickly leads to the ejection of blood out of the heart and into the large arteries exiting the heart. At this time atrial diastole occurs.
What is occurring physiologically inside the heart when a T wave appears on an EKG/ECG?
The T wave represents the repolarization of the ventricles (ventricular diastole).
What causes the 2 part heart beat sound referred to as the “lub” and “dub”?
The “lub” occurs when the atrioventricular valves slam shut after blood passes from the atria and into the ventricles preventing blood from flowing from the ventricles back into the atria. (This occurs during the QRS wave)
The “dub” occurs when the blood passes from the ventricles and into the semilunar valves. More specifically the oxygen depleted blood in the right side of the heart passes through the pulmonary valve to pick up more oxygen. The oxygen rich blood in the left side of the heart passes through the aortic valve to be delivered to the rest of the body. Once the semilunar valves (both pulmonary and aortic) slam shut to prevent backflow the “dub” occurs. (This occurs during the T wave)
During which wave is blood ejected out of the ventricles and into the arteries leaving the heart?
During the QRS Wave
Repolarization of the ventricles is represented by which wave?
The T wave
The second heart sound ‘Dub’ is heard when the semilunar valves close. This happens during which wave?
The T wave
What is happening in the heart when the P Wave appears on an ECG?
Atrial depolarization and contraction (systole)
The QRS Wave is associated with which event?
Ventricular depolarization and contraction (systole)
What position should you place your patient in to prepare for an ECG?
Semi-fowlers
Supine
What are the three major ways to reduce further EKG artifact?
Ensure that electronic devices are removed from the patient
Switch off all non-essential electronic devices
Inspect wires and cables for breaks, replace them as needed
What is the proper placement for chest leads V1 - V6?
V1 - Fourth intercostal space to the right of the sternum
V2 - Fourth intercostal space to the left of the sternum
V3 - Midway between V2 and V4
V4 - Fifth intercostal space at the mid clavicular line
V5 - Anterior axillary line on the same horizontal level as V4
V6 - Mid axillary line on the same horizontal as V4 and V5
EKG paper is a grid where ______ is measured on the horizontal axis.
time
EKG paper is a grid where ______ is measured on the vertical axis.
voltage
How long in mm is each small square and what does it represent on the EKG grid?
Each small square is 1mm in length and represents 0.04 seconds of time.
How long in mm is each sbig square and what does it represent on the EKG grid?
Each big square is 5 mm in length and represents 0.2 second of time
What length is equivalent to 1 mV in voltage on an EKG strip?
10 mm (10 little squares or two big squares) is equal to 1 mV
What are the 2 equations used to determine heart rate from an EKG strip?
300 / number of large squares between QRS complexes
or
1500/ number of small squares between QRS complexes
What is a quick way to get a rough estimate of a heart beat on an EKG strip.
Run a 6 second EKG strip and count the number of QRS complexes multiplied by 10. This will give you beats per minute.
What does the word telemetry mean?
The process of recording and transmitting the reading on an instrument ( in this case the EKG)
