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EKG > Leads > Flashcards

Leads Flashcards

1
Q

which leads do you look at to determine axis deviation?

A

I, II, and III

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2
Q

how do you determine normal axis deviation?

A

leads I, II, and III QRS complex are all deflected upright

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3
Q

how do you determine right axis deviation?

A

Lead I should be deflected downwards

II and III should remain upwards

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4
Q

what makes up lead I? where is lead I looking?

A

shoulder to shoulder deflection

-it looks from the left shoulder (looks at lateral heart wall)

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5
Q

what makes up lead II? where is lead II looking?

A

right shoulder to left hip

-it looks from left hip looking up at the heart (looks at inferior heart wall)

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6
Q

what makes up lead III? where is lead III looking?

A

left shoulder to left hip

-it looks from left hip and up towards the heart (looks at inferior heart wall)

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7
Q

how do you determine physiological left axis deviation? what is the deviation degree range?

A

III will have a negative deflection
(I and II will still be upright)
0 to -30 degrees

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8
Q

how do you determine pathologic left axis deviation? what is the deviation degree range?

A

II AND III will have a negative deflection (I will still be upright)
anything past -30 degrees

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9
Q

what is the degree range of normal axis deviation?

A

0 to +90

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10
Q

can you have a normal axis deviation in V tach?

A

NO, the ventricles have control so all the current is going from the bottom of the heart up to the atria

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11
Q

what direction is AVR pointing from?

A

right shoulder

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12
Q

what direction is AVL pointing from?

A

left shoulder (looks at lateral heart wall)

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13
Q

what direction is AVF pointing from?

A

under the heart (looks at inferior wall)

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14
Q

what are two components of SVT?

A

QRS has to be narrow complex and rate over 150

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15
Q

systematic way to read EKGs

A

1). identify rate and rhythm
2). Check to see if EKG is on correct
3). determine axis deviation
4). look at QRS complex (see if narrow or wide) AND check intervals
5). if narrow, look at infarct leads (inferior, lateral, anterior, and then septal)
6). if normal sinus rhythm and wide, determine BBB (look at V1)
7). if RBBB, look at infarct leads
if LBBB use sgarbossa criteria to read ST elevation for determining infarcts

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16
Q

what do you look at to make sure the EKG is on correctly?

A

make sure AVR has a downward deflection

17
Q

what two criteria determines a STEMI?

A

ST elevation in 2 continguous leads and at least one mm elevation

18
Q

which condition do you see PR depression?

A

pericarditis

19
Q

what is ST elevation a sign of?

A

heart ischemia and muscle about to infarct

20
Q

in a normal electrical heart, which two precordial leads should be down and which two should be up?

A

down- V1 and V2

up- V5 and V6

21
Q

what direction should V1 be in a right BBB?

A

upright because current is diverted towards the right side of the heart (towards V1)

22
Q

which direction should V1 be in a left BBB?

A

downward because current is being diverted towards the left side of the heart (away from V1)

23
Q

what is the J point of an EKG?

A

its when the ST segment takes off from the QRS complex

24
Q

normal interval times:
PR
QRS

A

PR: 0.12-0.2s
QRS <0.12s = narrow
QRS >0.12s = wide

25
Q

One 1mm on an EKG corresponds to how many small boxes? how many seconds is this?

A

1

0.04 s (40ms)

26
Q

how do you treat prolonged QT?

A

magnesium sulfate

27
Q

which coronary artery feeds the inferior heart? lateral? anterior?

A 
Inferior = RCA
Lateral = Left circumflex
Anterior = LAD
28
Q

what is the next step if a patient is showing an inferior wall infarct? why is this important?

A

bring V4 over to the right side to look at how high the infarct is up the RCA

  • if no ST elevation in V4, then you can give the patient nitro
  • if there IS ST elevation in V4, only give nitro if BP is over 130
29
Q

how can you tell a posterior MI?

A

look at the septal leads

-if these have ST depression then there is ST elevation posteriorly

30
Q

what is the reciprocal of inferior infarct?

A

ST depression in lateral leads I and AVL

EKG (1 decks)

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