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DPT732: MAP II > Lab 2 - Electrocardiography > Flashcards

Lab 2 - Electrocardiography Flashcards

1
Q

What does an EKG record?

A

recording of the electrical activity of the heart

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2
Q

What do the wave forms represent?

A

polarization and depolarization of the cardiac tissue

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3
Q

What 4 things does an EKG measure? (4)

A
  1. Rate and regularity of the heartbeat
  2. Size and position of the chambers
  3. Effects of medications
  4. Effects of pacemakers or other devices.
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4
Q

Why is a 12 Lead EKG only have 10 leads?

A

The final two are a little bit redundant so are left off.

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5
Q

Which leads are the limb leads?

A

Leads I, II, III

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6
Q

Which leads are the Chest/Precordial/Transverse Leads and what do they view?

A

V1 - Views Right Atria
V2 - Views Left Atria
V3 and V4 - View the Intraventricular Septum
V5 and V6 - View the lateral wall of the left ventrical

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7
Q

What are the Augmented Leads?

A

aVR, aVL, aVF

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8
Q

Which leads are the Anterior Chest Leads?

A

V1, V2, V3, V4

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9
Q

Which leads are the Lateral Wall of the Left Ventricle?

A

aVL, Lead I, V5 and V6

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10
Q

Which leads are the Inferior Chest?

A

Lead II, Lead III, and Lead aVF

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11
Q

Which leads are No Man’s Land?

A

aVR

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12
Q

Which lead is used in a single 6 second EKG strip?

A

Lead II

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13
Q

Which 6 leads record electrical signal in the frontal plane?

A
  1. Lead I
  2. Lead II
  3. Lead III
  4. aVR (right arm)
  5. aVL (left arm)
  6. aVF (left leg)
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14
Q

Which 6 leads record electrical signals in the transverse plane?

A
  1. V1
  2. V2
  3. V3
  4. V4
  5. V5
  6. V6
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15
Q

Where does the RA lead go?

A

Right Arm

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16
Q

Where do the hip leads often get placed in the hospital?

A

legs

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17
Q

Where does the LA lead go?

A

Left Arm

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18
Q

Where does the RL lead go?

A

Right Leg

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19
Q

Where does the LL lead go?

A

Left Leg

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20
Q

Where does the V1 lead go?

A

4th intercostal space to the right of the sternum

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21
Q

Where does the V2 lead go?

A

4th intercostal space to the left of the sternum

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22
Q

Where does the V3 lead go?

A

between electrodes 2 and 4

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23
Q

Where does the V4 lead go?

A

5th intercostal space in the mid-clavicular line

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24
Q

Where does the V5 lead go?

A

horizontally even with V4 in the left anterior axilla road

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25
Q

Where does the V6 lead go?

A

horizontally even with V4 and 5 in the mid axillary line

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26
Q

How many electrodes are there typically in a 12 lead ECG?

A

10 electrodes

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27
Q

Where is the normal conduction pathway in the heart? (4)

A
  1. SA node through atria
  2. AV Node (slowed here)
  3. Bundle of HIS
  4. Purkinje Fibers (travel through intraventricular septum to lateral wall of right and left ventricle.)
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28
Q

Is the right lateral wall ventricular wall or left lateral ventricular wall reached first during conduction?

A

Right is reached slightly faster than the left.

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29
Q

Is the SA or AV node the primary pacemaker?

A

SA Node, AV node is backup pacer

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30
Q

What is the BPM range of the SA node?

A

60-100 beats per minute

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31
Q

What is the BPM range of the AV node?

A

40-60 beats per minute

32
Q

T/F: all myocardial cells can act as a pacemaker.

A

TRUE: all myocardial cells can act as a pacemaker in the absence of other pacers and as a result of pathology. Pacer location directly affects cardiac function.

33
Q

What is the horizontal axis in ECG tracing?

A

time

34
Q

What is vertical axis in ECG tracing?

A

amplitude

35
Q

How many seconds is an EKG strip by convention?

A

6 seconds

36
Q

What do the small blocks in an ECG strip represent?

A

0.04 seconds

37
Q

What do the large blocks in an ECG strip represent?

A

0.20 seconds and 0.5mV amplitude

38
Q

Where is the P wave and what does it represent?

A
  • P wave is first wave and is normally an upward wave

- Represents atrial depolarization

39
Q

What does the QRS complex begin with and what is the Q, R, and S? What does the QRS represent?

A

Q - downward deflection (polarization)
R - upward deflection (depolarization)
S - downward deflection (polarization)

Represents ventricular depolarization and contraction (also atrial repolarization but not seen)

40
Q

What is the T wave and what does it represent?

A
  • Normally upward wave.

- Represents ventricular repolarization

41
Q

What is the U wave?

A

Usually not observable upward wave.

Represents recovery of perkinje fibers.

42
Q

What is the 8 step procedure for reading a EKG strip?

A
  1. Rhythm
  2. Rate
  3. P Wave
  4. PR Interval
  5. QRS complex
  6. T wave
  7. QT interval
  8. ST segment
43
Q

Where is the PR interval?

A

Start of P wave to start of QRS complex

44
Q

Where is the PR segment?

A

End of P wave to start of QRS complex

45
Q

Where is the QT interval?

A

Start of QRS complex to end of T wave

46
Q

Where is the ST segment?

A

End of QRS complex to start of T Wave.

47
Q

What do you look at and for when checking Ventricular Rhythm?

A

Look at R to R interval for ventricular rhythm (spikes)

-Are they regularly spaced? (equidistant from one another, 10% variance is acceptable.)

48
Q

What do you look at and for when checking Atrial Rhythm?

A

Look at the P to P intervals

-Same regularly spacing

49
Q

What can cause minor variations in the Atrial Rhythm?

A

breathing

50
Q

How do you identify what you see on a strip?

A
  1. Regularly / Irregularly - is is spaced out the same and repeated
  2. Regular / Irregular - is the wave form regular or irregular
51
Q

How do you calculate rate?

A

Method 1 - Count the QRS complexes over a 6 second period and multiply by 10

Method 2 and 3 are more complicated

52
Q

What does the P wave represent?

A

Atrial Depolarization

53
Q

How many P waves should there be and where should it be located?

A

Should be one per QRS and should precede the QRS

54
Q

What is the normal amplitude of the P wave?

A

0.05 to 0.25

55
Q

What is the normal duration of the P wave?

A

0.06 to 0.11

56
Q

What should the P wave look like?

A

Smooth and rounded

57
Q

What 3 things should you look for when looking at a P wave?

A
  1. Present?
  2. Regular?
  3. Same shape?
58
Q

When you have right atrial enlargement, what will you see?

A

P wave greater than 2.5mm high ( = P Pulmonale)

59
Q

When you have left atrial enlargement, what will you see?

A

P wave greater than 120ms (=P Mitrale)

60
Q

What does the PR interval represent?

A

Conduction time (remember that the AV node slows conduction to give atria time to fire and ventricles time to fill)

61
Q

How do you measure the PR interval?

A

Measure from where the P wave beings to the beginning of the QRS complex

62
Q

How long should the PR interval be?

A

.12 to .20 second in adults?

63
Q

How will the PR interval change in older adults?

A

It will be longer

64
Q

How will the PR interval change with increased heart rate?

A

it will be shorter

65
Q

What should you look for in a PR interval?

A

Are they constant.

66
Q

What does the QRS complex represent?

A

Ventricular Depolarization

67
Q

Is the QRS complex or P wave larger?

A

QRS complex

68
Q

Where do you measure the QRS complex from?

A

end of PR interval to the end of the S wave

69
Q

How long should the QRP complex be?

A

.08-12 seconds

70
Q

What should you look for in a QRS complex?

A

should look similar to each other

71
Q

Where in the conduction pathway is a Ventricular Dysrhythmia?

A

Below the AV node so outside of that pathway in the bundle of HIS in the left and right pathway of the purkinji fibers.

72
Q

With a Ventricular Dysrhythmia, what are you looking for on the strip?

A

“Wide and Weird” with QRS duration > .12s

73
Q

What is a Ventricular Dysrhythmia?

A

Leads to uncoordinated ventricular contraction and decreased ventricular ejection and low blood pressure wave and possible poor perfusion.

74
Q

What is the most common type of Ventricular Dysrhythmia?

A

Premature Ventricular Contraction (PVC)

75
Q

What does a PVC strip look like and what might the patient feel?

A

-QRS is early and followed by a pause, then back to normal rhythm.

DPT732: MAP II (14 decks)

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