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Cardiology > Lecture 7: EKG > Flashcards

Lecture 7: EKG Flashcards

1
Q

Standard 12-lead ECG. Where do you put leads I, II, and III?

A

6 precordial (V1 - 6), 6 limb leads (I, II, III, aVR, aVL, aVF); I = right arm, II = left arm, III = left leg

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2
Q

V1

A

Right 4th intercostal space

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3
Q

V2

A

Left 4th intercostal space

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4
Q

V3

A

Halfway between V2 and V4

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5
Q

V4

A

Left 5th intercostal space, mid clavicular line

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6
Q

V5

A

Horizontal to V4, anterior axillary line

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7
Q

V6

A

Horizontal to V5, mid-axillary line

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8
Q

Lead I lies at __ degrees and represents…

A

0; right arm –> left arm

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9
Q

Lead II lies at __ degrees and represents…

A

+60; right arm –> left leg

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10
Q

Lead III lies at __ degrees and represents…

A

+120, left arm –> left leg

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11
Q

Heart lies between…

A

0 and 90 degrees

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12
Q

aVR is at ___ degrees

A

-150

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13
Q

aVF is at ___ degrees

A

+90

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14
Q

aVL is at ___ degrees

A

-30

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15
Q

In a normal heart, what leads should be upright?

A

Lead I, II, III, aVF, aVL

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16
Q

What should be upside down?

A

aVR

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17
Q

II, III, aVF…

A

Inferior wall of L ventricle

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18
Q

I, aVL…

A

Lateral wall of L ventricle

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19
Q

What else tells us about the lateral wall?

A

V5, V6

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20
Q

Each small box is…(horizontally)

A

40 ms

21
Q

Each small box is…(vertically)

A

0.1 mV

22
Q

P wave is depolarization of the…

A

SA node (time it takes for wave to spread through atria)

23
Q

Time it takes depolarization to get from SA node to the AV node

A

PR interval

24
Q

Time it takes ventricles to depolarize after AV node. How long?

A

QRS interval; 100 ms

25
Q

What is the “Q”

A

First negative deflection

26
Q

What is the “S”

A

Second negative deflection

27
Q

T wave is…

A

Repolarization

28
Q

Normal EKG requires looking for…

A

Normal waves (P, QRS, T) and intervals (PR, QRS, QT); normal rate, rhythm, axis

29
Q

Abnormal P wave (left/right)

A

Height > 2.5 mm in lead II = R atrial enlargement; two humps in lead II = L atrial enlargement

30
Q

Where is the best place to view P wave?

A

Lead II because SA node is ~60 degrees axis

31
Q

Normal PR interval; what lead?

A

120 - 200 ms (3-5 small squares); no particular lead (all should have same interval)

32
Q

Normal QRS complex; what lead? What if it’s broad?

A

bundle branch block; V1

33
Q

Normal QT interval requires you to know what two terms…How long?

A

QT and QTc (corrected for HR);

34
Q

How to “cheat” calculate QTc

A

HR > 60, add 20 ms for each 10 increase in HR; if HR

35
Q

EKG indication Normal Sinus Rhythm (3)

A

P wave upright in I, upright in II, inverted in aVR; each P wave followed by QRS, P wave rate = 60-100 bpm (

36
Q

Premature atrial contraction. How do you know it’s atrial?

A

“Extra/Premature beat” coming from another (non-SA node) atrial foci…it’s atrial because you have a P wave.

37
Q

Premature ventricular contraction. How do you know it’s ventricular?

A

“Extra/Premature beat” coming from a ventricular foci…it’s ventricular because the morphology of the QRS is BROAD (non-Purkinje fiber depolarization is slow)

38
Q

How can we see dextrocardia?

A

P wave present but not in sinus node morphology (inverted in I, upright in II, inverted in aVR) w/ reverse R-wave progression along chest leads

39
Q

How can we tell if we’ve switched the leads?

A

P wave present but not in sinus node morphology (inverted in I, upright in II, inverted in aVR) w/ normal R-wave progression along chest leads

40
Q

How do you calculate rate?

A

1500/n (n = number of smalls squares between R-R)

41
Q

How many boxes = 60 bpm. What are the other “Cheat” times?

A

5 big squares; 1 big square = 300, 150, 100, 75, 60…

42
Q

-90 to 0

A

Left deviation

43
Q

0 - 90

A

Normal

44
Q

90 - 0

A

Right deviation

45
Q

0 - -90

A

Indeterminant

46
Q

If both I and aVF are upright…Normal/Abnormal?

A

Normal (normal people are always upright)

47
Q

For axis, we look at which two leads?

A

Lead I and aVF

48
Q

If Lead I is negative but aVF is positive, what happened?

A

Lead I is pointing 180 degrees (to the right), so right deviation (right people meet)

49
Q

If Lead I is positie, but aVF is negative, what happened?

A

aVF is now negative, so you have left deviation (left don’t see eye to eye)

Cardiology (22 decks)

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