Introduction to the ECG Flashcards
what is an SLL I ECG?
standard limb lead I, recordings made from left arm with respect to right arm
what is an SLL II ECG?
recordings made from left leg with respect to right arm
what is an SLL III ECG?
recordings made from left leg with respect to left arm
a wave of depolarisation moving from left leg to right arm will show what sort of blip on a SLL II ECG?
a negative blip
a wave of depolarisation from the right arm to the left leg will show what on a SLL II ECG?
a positive blip, like in atrial depolarisation and ventricular depolarisation
a wave of repolarisation moving from the left leg to the right arm will show what on a SLL II ECG?
a positive blip, like in ventricular repolarisation
what is the PR interval?
time from atrial depolarisation and ventricular depolarisation, the time is mainly due to the transmission through the AV node
what is the QT interval?
time spent while ventricles are depolarised
why can’t atrial repolarisation be seen on the ECG?
Because atrial repolarisation coincides with ventricular depolaristion. Ventricular depolarisation involves much more tissue depolarising much faster so it swamps any signal from atrial repolarisation.
why does the QRS complex contain three blips?
1st blip – the interventricular septum depolarises from left to right, direction is towards right arm so is negative
2nd blip – the bulk of the ventricle depolarises from the endocardial to the epicardial surface, this produces a vector towards the left leg
3rd – the upper part of the interventricular septum depolarises towards the right arm so is negative
why is the T wave positive
Because the action potential is longer in endocardial cells than in epicardial cells, so the wave of repolarisation runs in the opposite direction to the wave of depolarisation. ie a wave of repolarisation moving away from the recording electrode produces another positive-going blip.
Why is the R-wave bigger in SLL II than in SLL I or SLL III?
Because the main vector of depolarisation is in line with the axis of recording from the left leg with respect to the right arm.
What happens to the magnitude of the R wave whe the heart is rotated left or develops hypertrophy on the left or atrophy on the right?
this causes axis deviation. which means that, blip in SLL I will be larger and the blips in SLL II and III willl be smaller
what are the augmented limb leads?
aVR, aVL, aVF
what is aVR?
a recording made from the right arm with respect to half way between the left leg and arm (SLL III)