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Hospital Based Medicine And Surgery > L01: Dysrhymias > Flashcards

L01: Dysrhymias Flashcards

1
Q

What does the p wave represent

A

Atrial contraction

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2
Q

What does the qrs complex represent

A

Ventricular contraction (depolarisation)

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3
Q

What does the t wave represent

A

Ventircular (relaxation) repolarisation

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4
Q

How many ecg electrodes are in a 12 lead ecg

A

10 electrodes
6 on the chest
1 for each limb (4 in total)

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5
Q

What is the standard paper speed for an ecg

A

25mm/s

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6
Q

What are the steps to interpreting an ECG

A
  1. Patient details, dob, check when the ecg was taken, assess the changes, check the speed is 25mm/s
  2. Heart rate
  3. Look at the axis deviation
  4. Is there electrical activity
  5. Is there atrial activity- p wave
  6. Is the qrs complec regular
  7. Is the qrs complex narrow or broad
  8. Is the atrial activity related to the ventricular activity
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7
Q

What is the normal heart rate

A

60-100

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8
Q

How can we calculate the heart rate

A

Multiply the qrs complex number by 6 or

300 Divide the range of squares between r waves if sinus rhytm

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9
Q

If its irregular what do we need to determine

A

If the rhythm is irregulary irregular or regularlry irregular

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10
Q

How big should a qrs complex be

A

Betwen 0.5 to 3 small squares

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11
Q

What are the causes of a broad qrs complex (greater then 3 small squares)

A

Bundle branch block- right or left

Ventricular tachycardia

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12
Q

What is a bundle branch block

A

When the bundle branch is diseased/damaged the impulse travels slow so the impulse travels slower in one than the other. Ventricular depolarisation takes longer so you get a broad qrs complex

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13
Q

Should a qrs complex be broad or narrow if normal

A

Narrow

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14
Q

What does a bundle branch block appear like on a ecg

A

Mmenomic: william marrow
If left: william marrow
If right: marrow william

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15
Q

At which leads should we look at for brundle branch block

A

Lead 1 and 6

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16
Q

If there are no p waves what does this present

A

Atrial fibrillation

17
Q

What does ventricular tachycardia show on a ecg

A

Ventricular rate of 200bpm

Irregulary irregular

18
Q

Is atrial fibrillation and atrial flutter the same

A

No

19
Q

What is atrial flutter

A
  • Supra ventricular tachycardia
    Re-entry circuit in the right atria so whilst electrical activity starts in the SAN it loops back in a circle before it goes to the avn nodes and continues to the pathway
20
Q

How does an atrial flutter present on a ecg

A
  • Not every p wave has a QRS complex as it loops back to the san instead of going straight to the avn in the ventricles
  • saw tooth pattern: lead 2,3,avf
21
Q

What is a heart block

A

When the atria and ventricles conduct seperately

22
Q

What are the causes of a heart block

A

Mi
Avn damage
Beta blocker overdose
Congenital

23
Q

What are the types of heart block

A

First degree
Second degree
Third degree (complete heart block)

24
Q

What are the subtypes of second degree heart block

A

Mobitz type 1

Mobitz type 2

25
Q

What is first degree heart block

A

When there is a prolonger prv interval (should be less than 5 small sqaures)

26
Q

What are the causes of first degree heart block

A 
Due to a delay from san to ventricles:
Athletes icreased vagal tone
Digoxin toxicity
Hyperkalaemia
Coronary artery disease
27
Q

What is mobitx type 1 heart block

A

Prolongation of pr interval until there is a missed qrs complex and the cycel repeats

28
Q

What are the causes of mobitx type 1

A

Digoxin
Amiadrone
Beta bloker
Calcium channel blocker

29
Q

What is mobitx type 2

A

Dropped qrs complex that is not proceeded by pr prolongation or pr shortening

30
Q

What is st elevation

A

Distance more than 1 small sqaures

31
Q

What does st elevation indicates

A

STEMI

32
Q

What does st depression indicate

A

Nstemi

33
Q

Which leads will be affected in an inferioir pathology of the heart

A

2,3,avf

34
Q

Which leads will be affected in a lateral pathology

A

1, avl,avr,v5,v6

35
Q

Which leads will be affected in an anterioir pathology

A

V3,v4

36
Q

Which leads will be affected in septal pathology

A

V1,v2

Hospital Based Medicine And Surgery (30 decks)

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