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cardio pulm midterm > Lecure 5: ECG > Flashcards

Lecure 5: ECG Flashcards

1
Q

what are the 4 steps to ECG interpretation

A
  1. too fast , too slow?
  2. QRS wide or narrow?
  3. Check the P wave
    4> is the rhythm regular or irregular
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2
Q

if the HR is to slow/low then it does not produce enough what

A

CO

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3
Q

if Hr is to high then it doesn’t give the heart enough time to ___ the ventricles which then leads to ___ CO and ____ BP

A

fill
decrease 2x

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4
Q

if HR is < 60 then what is that called

A

bradycardia

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5
Q

if HR is >100 then what is that called

A

tachycardia

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6
Q

what represents the depolarization of the R and L atria

A

P wave

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7
Q

what complex represents the R and L ventricular depolarization

A

QRS complex

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8
Q

what wave represents the ventricular repolarization

A

ST wave

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9
Q

what represents the time it takes ventricles to depolarize and repolarize

A

QT interval

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10
Q

if the QT interval is to long then it can lead a Patient into what

A

V tac

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11
Q

what interval is the time it takes for the nerve impulse to go from teh SA node to the AV node which then depolarizes the ventricles

A

PR interval

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12
Q

if the ST segments elevates or depresses what can we suspect

A

myocardial infarction or ischemia

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13
Q

how many beats per minute is the SA node

A

60-100

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14
Q

how many beats per minute is the AV junction

A

40-60 bpm

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15
Q

how many beats per mins at the purkinje networks

A

20-40 bpm

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16
Q

how many beats per minute from bundle of his

A

40-60 bpm

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17
Q

if the ST segment is elevated 2 boxes then it indicates what

A

myocardial infarction

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18
Q

if the ST segment is depressed 2 boxes then it indicates what

A

myocardial ischemia

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19
Q

if the T wave is upside down when it is suppose to be upright then what does that indicate

A

myocardial infarction or ischemia

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20
Q

if there is a long QT interval what can that lead to

A

arrhythmias

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21
Q

Limb lead 1 is going in what direction

A

from R to L

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22
Q

limb lead 2 is going in what direction

A

right to Left downwards

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23
Q

limb leads 3 is going in what direction

A

from L to right going downwards

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24
Q

aVF lead is going in what direction

A

from top to bottom

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25
Q

aVL is going from what direction

A

middle to left

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26
Q

aVR is going in what direction

A

middle to right

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27
Q

which limb lead is the most important

A

lead 2

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28
Q

V1, V2, V3, and V4 are on which wall of the heart

A

anterior wall

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29
Q

which precordial leads are on the lateral wall

A

V5 V6

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30
Q

which precordial lead presents lead 2

A

V2

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31
Q

which precordial lead represents limb lead 1

A

V5

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32
Q

which precordial lead represents limb lead 3

A

V1

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33
Q

limb lead 2, 3 and AVF are looking at which part of the heart

A

inferior

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34
Q

limb lead 1, AVL , V5, V6 are looking at what part of the heart

A

lateral

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35
Q

if the heart rate is to fast then there is ____ filling time

A

insufficient

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36
Q

if the heart rate is to slow then there is an ___-rate

A

insufficient

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37
Q

impulses traveling away from a positive electrode and/or towards a negative electrode will produce a ____ deflection

A

downward

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38
Q

impulses traveling toward a positive electrode will produce a ____ deflection

A

upwards

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39
Q

if there is an impulse coming from the ventricle what will that change in the ECG

A

QRS wave will become wider

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40
Q

what is it called when we have cells in ventricles that depolarize and causes a wider QRS wave

A

PVCs

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41
Q

what is teh compensatory pause during a PVC

A

the time for the ventricles to repolarize

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42
Q

what is it called when there is a PVC every 2 complexes ( so normal QRS and then PVC and then normal QRS then PVC)

A

ventricular bigeminy

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43
Q

what is it called if there is a PVC every 3rd complex

A

ventricular trigeminy

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44
Q

what is ventricular couplet

A

when there are 2 PVCs in a row

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45
Q

what is a ventricular triplet

A

3 PVCs in a row

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46
Q

what is it called is someone has a ventricular triplet but it subsides within 30 secs with HR >100

A

non sustained ventricular tachycardia

47
Q

what do you do if you see a ventricular triplet for a patient

A

stop doing everything

48
Q

what can ventricular triplet lead to

A

V fib

49
Q

if there is a negative P wave what can that indicate

A

something wrong in atria

50
Q

if there is no P wave on the ECG what can that indicate

A

impulse is not coming from SA node

51
Q

if the P wave going up and down then what does that indicate

A

impulse not coming from SA node

52
Q

if there is a ventricular rate about 120 bpm or below 45 bpm what can we consider

A

ischemia , hypotension or sepsis

53
Q

if someone presents with atrial fibrillation what can we suspect

A

mitral valve disease
alcoholism
ischemia
infection

54
Q

if someone has a complete heart block or 2nd degree heart block what we can consider

A

any heart disease

55
Q

if there is an abnormal T wave inversion than what we can suspect

A

infraction
ischemia
pulmonary embolism

56
Q

wide QRS width can be bc of

A

any heart disease

57
Q

is A fib life threatening?

A

naur

58
Q

what can A-fib lead to

A

stroke

59
Q

complete heart block can lead to what

A

A systole

60
Q

what does V tac look like

A

a lot for steep hills

61
Q

what happens when impulse comes from atria but not SA node

A

supra ventricular tachycardia

62
Q

is the QRS wide or narrow in supracentircular tachycardia

A

narrow

63
Q

what does it mean if QRS is really narrow ?

A

impulse is not coming from ventricles

64
Q

is a junctional rhythm fast or slow

A

slow ( 40-60 bpm)

65
Q

is there P waves with junctional rhythm?

A

no

66
Q

since there is no P wave with junctional rhythm where does the pulse come from

A

prob AV junction

67
Q

P wave inversion is normal for lead ___ , ____ lead and precordial leads ___ and ____

A

– Lead III
– Is normal for AVR lead
– Leads V1 and V2

68
Q

P wave inversion is not normal when looking at which side of the heart

A

L side

69
Q

for all other leads besides 3 and AVR , P wave inversion is NORMAL (T/F)

A

F only at leads 3 and avr is it normal)

70
Q

if the P wave is buried within the QRS what can we suspect

A

junctional rhythm

71
Q

digoxin causes teh ST segments to ___ sometimes

A

depress below the isoelectric line

72
Q

after having an MI what will happen to the QRS complez

A

may be irregular

73
Q

if the patient has hyperkalemia what may happen to the T wave

A

peaked bc of electrolyte imbalance

74
Q

if there is an inverted T wave what can we consider

A

myocardial infarction or ischemia

75
Q

is T wave inversion normal or not normal for the following things
– Myocardial ischaemia and infarction
– Bundle branch block
– Ventricular hypertrophy (‘strain’ patterns)
– Pulmonary embolism
– Hypertrophic cardiomyopathy
– Raised intracranial pressure

A

not normla

76
Q

Is T wave inversion normal or to normla for the following things
– Lead III
– Lead V1 (adults)
– AVR leads
– Leads V1, V2, V3 children

A

normal

77
Q

what are premature beats

A

beats before the SA node

78
Q

what are beats within the heart that take on its own role ?

A

ectopic beats

79
Q

what does V fib look like

A

a bunch of little mountains

80
Q

what does A fib look like

A

little mountains before the QRS complex

81
Q

what is multiple etopic cells firing at different rates

A

A fib

82
Q

what does A flutter look like

A

a saw (little hills) before the QRS complex

83
Q

what is it called when 1 ectopic cell creates spiral like circular current patterns

A

atrial flutter

84
Q

which one is worse A flutter or A fib

A

A fib

85
Q

what is ventricular tachycardia from prolonged QT interval

A

torsades de pump

86
Q

what does torsades de pump look like

A

a bunch of lines goes up and down w QRS complex being hard to tell

87
Q

the right bundle branch block cause a ____ depolarization of the R ventrical

A

delayed

88
Q

Right Bundle is blocked causing delayed depolarization of the right ventricle; it will not start until the ___ ventricle is almost fully depolarized.

A

left

89
Q

how does the right bundle branch block change on the ECG when looking at the right side of the heart

A

you will see 2 R’s

90
Q

how does the right bundle branch block change on the ECG when looking at the left side of the heart

A

deep s wave

91
Q

when there is a left bundle branch block it causes a delayed ____ of the ___ ventricle and will not stat until the ___ ventricle is almost fully depolarized

A

depolarization
left
right

92
Q

how does the left bundle branch block change on the ECG when looking at the right side of the heart

A

deep S wave

93
Q

how does the left bundle branch block change on the ECG when looking at the left side of the heart

A

double R wave

94
Q

what does “william morrow” meant

A

for leads V1 and V6
if LBBB then V1 will have a “w” and V6 will have a “m” (bc reading form left to right )
if RBBB then V1 will have “m” and V6 will have “w” (bc reading from right to left)

95
Q

which lead is best to see LBBB

A

V6

96
Q

what is it called if impulses are blocked or delayed from atria to ventricles

A

AV blocks

97
Q

someone with a first degree AV block will have a long ____ interval

A

P-R

98
Q

first degree AV block causes the HR to

A

slow down

99
Q

First degree AV block is common in

A

athletes

100
Q

second degress block: type 1 is what

A

PR interval gets longer and longer then you have a drop of ARS and then you have a wenckebach

101
Q

what is another name for second degree AV block type 1

A

mobitz 1 ( wenckebach)

102
Q

if you are reading someone ECG and you see they have normal PR interval length and then alll the sudden no QRS what does this indicate

A

second degree AV block type 2

103
Q

what is another name for second degree AV block

A

mobitz 2

104
Q

second degree AV block type 2 is a sudden drop in QRS without prior change in PR interval which can cause what

A

systole or sinus arrest

105
Q

is second degree AV block type 1 or 2 more dangerous

A

2 do not work w patient

106
Q

what is 3rd degree heart block (complete)

A

you have p waves and QRS complex but it does not match up

107
Q

If your P’s and Q’s don’t agree then you have a _____ degree

A

third

108
Q

can you work with pateint if that present with 2nd degree as block type 2 or third degree heart block if they have a pacemaker

A

yes

109
Q

prolonged QT interval can lead to ___

A

torsades de pump whcih then can lead to vtac

110
Q

V1 , V2 and aVR looks at what side of the heart

A

right vent

111
Q

Lead 2 , lead 3 and aVF look at what part of the heart

A

inferior wall

112
Q

lead 1 , aVL, V5 and V6 look at what side of the heart

A

lateral wall of left ventricle

113
Q

V1-V4 look at what part of the heart

A

anteriorseptal part of the ventricles

114
Q
A

cardio pulm midterm (11 decks)

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