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*EXERCISE PRESCRIPTION LAB > LAB2- EKG > Flashcards

LAB2- EKG Flashcards

1
Q

electrocardiogram

A

the process of recording the electrical activity of the heart using electrodes placed on the patient’s body

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2
Q

electrocardiogram is a graphic record of what

A

the DIRECTION + MAGNITUDE of the electrical activity generated by the depolarization + repolarization of the atria + ventricles

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3
Q

who first described the modern ECG with known landmarks PQRST waves in 1893

A

William Einthoven
-received Nobel Prize in 1924 for developing the modern ECG

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4
Q

the first 30 years, what was used to perform an ECG

A

string galvanometer

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5
Q

in 1942, who added 9 augmented leads to Einthoven’s traditional 3 lead ECG, leading to the 12 lead ECG used today

A

Emmanuel Goldberger

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6
Q

how many leads did Einthoven’s ECG have

A

3

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7
Q

how many leads did Goldberger’s ECG have

A

12

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8
Q

why is ECG also known as EKG

A

original spelling in German is elektrocardiogram (EKG)

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9
Q

purpose of ECG testing

A

often used (with other tests) to help diagnose + monitor conditions affecting the heart

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10
Q

what can ECG be used to investigate

A

symptoms of possible heart problems such as chest pain, palpitations, dizziness, + shortness of breath

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11
Q

what 4 things can ECG help detect

A

-arrythmias
-coronary heart disease
-heart ischemia (heart attacks)
-cardiomyopathy

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12
Q

P wave

A

atrial contraction (depolarization)

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13
Q

QRS complex

A

ventricular contraction (depolariziation)

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14
Q

QRS complex or P wave is larger + why

A

QRS complex is larger
-more muscle mass in the ventricle

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15
Q

T wave

A

ventricular relaxation + reset (repolarization)

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16
Q

QT interval

A

represents the complete depolarization + repolarization of the ventricular tissue

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17
Q

prolonged repolarization of ventricular tissue (QT interval) can lead to what

A

life-threatening arrhythmias

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18
Q

where does the P wave originate from

A

SA node

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19
Q

break down the QRS complex

A

-Q wave: initial downward deflection
-R wave: upward deflection
-S wave: downward deflection

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20
Q

PR interval

A

time from the beginning of the P wave to the beginning of the Q-wave (QRS complex)

SA node -> atria -> ventricles

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21
Q

PR interval is what in terms of depolarization/repolarization

A

the start of atrial depolarization to start of ventricular activation

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22
Q

PR segment

A

-from the end of the P wave to the beginning of the QRS segment
-represents the time delay between atrial + ventricular activation

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23
Q

ST segment

A

segment from the end of QRS complex to the beginning of the T wave
-represents time between ventricular depolarization + repolarization

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24
Q

what does the ST segment represent

A

the absolute refractory period (plateau of the AP) of the ventricular contractile cells

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25
Q

elevation or depression of the ST segment is based off what

A

PR segment

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26
Q

U wave

A

repolarization of papillary muscles or Purkinje fibers
-NOT ALWAYS SEEN
-origin is still being debated

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27
Q

which type of ECG is most often used in the health field

A

12-lead
-however, a 2-lead, 3-lead, 6-lead + many other variations can be used

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28
Q

ECG electrode

A

a conductive pad that is attached to the skin to record changes in electrical activity

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29
Q

pair of electrodes

A

any pair can measure the electrical potential difference between the 2 corresponding locations of attachment

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30
Q

ECG lead

A

consists of 2 surface electrodes that are either bipolar or unipolar

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31
Q

bipolar lead

A

opposite polarity
-1 positive + 2 negative

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32
Q

unipolar lead

A

1 positive surface electrode + a reference point

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33
Q

each lead gives an opportunity to do what

A

to look at the heart from a different electrical position

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34
Q

for the common 12-lead ECG, how many electrodes are positioned on the body

A

10

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35
Q

depolarization of the heart towards the positive electrode produces positive/negative deflection

A

positive

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36
Q

depolarization of the heart away from the positive electrode produces positive/negative deflection

A

negative

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37
Q

repolarization of the heart towards the positive electrode produces positive/negative deflection

A

negative

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38
Q

repolarization of the heart away from the positive electrode produces positive/negative deflection

A

positive

39
Q

what are the 12 leads

A

Lead 1, 2, 3
aVR, aVL, aVF
V1, V2, V3, V4, V5, V6

40
Q

limb leads

A

leads 1, 2, 3

41
Q

lead 1

A

measures difference in electrical activity between L arm + R arm

42
Q

ground electrode

A

R leg

43
Q

lead 2

A

between L leg + R arm

44
Q

lead 3

A

between L leg + L arm

45
Q

Einthoven’s triangle

A

created by the 3 limb leads
-provides view of heart’s activity from the front

46
Q

augmented leads

A

aVR, aVL, aVF
-augmented stands for average
-combines signals differently to “augment” the view from certain directions; gives additional angles to see heart’s electrical activity

47
Q

aVR

A

views heart from R arm

48
Q

aVL

A

views heart from L arm

49
Q

aVF

A

views heart from L leg

50
Q

chest leads

A

V1-6

51
Q

what leads provide a horizontal view of the heart

A

chest leads (V1-6)

52
Q

which leads provide an anterior view of the heart

A

limb leads (1-3)

53
Q

V1 + V2

A

look at the septum

54
Q

V3 + V4

A

look at the anterior part of heart

55
Q

V5 + V6

A

look at lateral part of heart

56
Q

inferior leads

A

2, 3, aVF
-look at lower part of heart

57
Q

lateral leads

A

1, aVL, V5, V6
-look at side of heart

58
Q

septal leads

A

V1 + V2
-look at heart’s septum

59
Q

anterior leads

A

V3 + V4
-look at front part of heart

60
Q

electrode placement for 12-lead ECG (modified Mason-Likar)

A

-this is what we use in lab
-leg electrodes are not placed on legs but rather all on chest/stomach

61
Q

modified Mason-Likar 12-lead ECG placements

right arm

A

right infraclavicular fossae medial to the deltoid muscle roughly 2cm below border of clavicle

62
Q

modified Mason-Likar 12-lead ECG placements

left arm

A

left intfraclavicular fossae medial to the deltoid muscle roughly 2cm below border of clavicle

63
Q

modified Mason-Likar 12-lead ECG placements

left leg

A

in line with left anterior axillary line halfway between costal margin + iliac crest

64
Q

modified Mason-Likar 12-lead ECG placements

right leg

A

in line with right anterior axillary line halfway between costal margin + iliac crest

65
Q

modified Mason-Likar 12-lead ECG placements

V1

A

4th intercostal space right sternal edge

66
Q

modified Mason-Likar 12-lead ECG placements

V2

A

4th intercostal space left sternal edge

67
Q

modified Mason-Likar 12-lead ECG placements

V3

`

A

midway between V2 + V4

68
Q

modified Mason-Likar 12-lead ECG placements

V4

A

5th intercostal space, mid-clavicular line

69
Q

modified Mason-Likar 12-lead ECG placements

V5

A

anterior axillary line in straight line with V4

70
Q

V6

A

mid-axillary line in straight line with V4 + V5

71
Q

which electrodes might need to be altered in female patients due to breast tissue

A

V4, V5, V6
-place electrode as close as possible to anatomical location directly under breast

72
Q

if you had to modify electrodes for female patient, what might occur in ECG

A

mild rightward shift in QRS axis

73
Q

small square represents

A

0.04 seconds

74
Q

large square (5mm) represents

A

0.2 seconds

75
Q

sinus rhythm

A

a regular ECG
-P wave is upright in leads 1 + 2
-each P wave is followed by a Q
-heart rate is 60-100 bpm

76
Q

tachyarrhythmia

A

an abnormal rhythm with a ventricular heart rate over 100 bpm

77
Q

supraventricular tachycardia

A

arrhythmia originating from above the AV node

78
Q

types of supraventricular tachycardia

A

-atrial fibrillation
-atrial flutter
-atrial tachycardia

79
Q

types of ventricular tachycardia

A

-ventricular fibrillation
-ventricular tachycardia

80
Q

ventricular or atrial fibrillation is more critical

A

ventricular fibrillation

81
Q

atrial fibrillation

A

-absence of P waves
-irregular QRS rhythm

82
Q

ventricular fibrillation

A

absence of normal PQRST components, replaced by chaotic uncoordinated electrical activity

83
Q

bradyarrhythmia

A

a heart rate below 60 bpm + comprises multiple disorders

84
Q

types of bradyarrhythmia

A

-sinus bradycardia
-first degree AV block
-second degree AV block
-third degree AV block
-SA node exit block

85
Q

normal ST segment

A

flat + isoelectric

86
Q

how is ST segment deviation (elevation or depression) measured

A

the height difference between the J point + the baseline (PR segment)

87
Q

what amount of ST segment depression is considered pathological

A

5 mm or more

88
Q

what naturally occurs to ST segment during exercise + is considered normal

A

upsloping ST segment depression

89
Q

when does ST segment indicate ischemia

A

-downsloping or horizontal ST segment depression
-OR ST segment elevation

90
Q

ECG electrode placement protocol

A

-locate anatomical areas that will be used
-prepare skin by removing any excessive hair
-if possible clean each site thoroughly with soap + water
-use ECG skin prep pad, paper, or abrasive tape
-explain the electrode application procedure to the patient to decrease anxiety
-when only 1 patient is present, attach the lead wire to the electrode before placement
-apply the electrode by pressing about the entire edge of the electrode center since it spreads the gel out + may create air pockets that contribute noise

91
Q

should you use alcohol or soap + water before applying electrode

A

soap + water
-alcohol dries the skin + can diminish electrical flow

92
Q

what does using skin prep pad, paper, or abrasive take do

A

-removes stratum corneum to allow better electrical signals
-scratches stratum ganulosum to reduce motion artifact

93
Q

depolarization = contraction/relaxation

A

contraction

94
Q

during depolarization, what does ECG do

A

go up

*EXERCISE PRESCRIPTION LAB (10 decks)

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