MAPIISG1 - EKG Flashcards
What is the SA node bmp?
60-100 bpm
What is the AV node bpm?
40-60 bpm
What is the Purkinje Fibers bpm?
20-40 bpm
What are the limb leads and their corresponding placement?
I, II, III limb and trunk
What are Augmented limb leads:
aVR, aVL, aVF: average of limb leads
Where does Precordial V1 lead go?
right 4th intercostal space
Where does Precordial V2 lead go?
left 4th intercostal space
Where does Precordial V3 lead go?
midway between V2 and V4
Where does Precordial V4 lead go?
mid-clavicular line, 5th intercostal space
Where does Precordial V5 lead go?
anterior axillary line @ level of V4
Where does Precordial V6 lead go?
mid-axillary line @ level of V4
What does 1 box on a paper strip mean?
0.04 seconds
What does 5 boxes on a paper strip mean?
0.2 seconds
What does the P wave look like and what is happening?
atrial depolarization, smooth and rounded
What is the PR Interval?
atrial activity up to the point of ventricular depolarization, from beginning of P wave to onset of QRS complex
What is the normal length of a PR interval?
0.12 to 0.2 seconds (3-5 boxes)
What does a prolonged PR interval mean?
AV block
What does the QRS complex look like and what is happening?
ventricular depolarization; narrow, sharply pointed
What is the normal length of a QRS complex?
0.08 to 0.12 sec (2-3 boxes) or less
What does too wide of a QRS complex mean?
BBB
What does a Q wave mean?
can be patholigic (previous cardiac event if greater than one small box wide or greater than 1/3 of entire QRS amplitude
What does the ST segment represent?
early ventricular repolarization
How should an ST segment be?
flat and level with baseline, PR interval
What does an elevated ST segment mean? (>1-2 small boxes)
STEMI - infarction full blockage
What does a depressed ST segment mean? (>1-2 small boxes)
NSTEMI - ischemi not full blockage
What is happpening during the T wave?
ventricular repolarization
What are T wave pathology or ischemia?
inverted, flat
peaked/ tombstone
What is the QT interval?
onset of QRS thru end of T wave; absolute and relative refractoy periods
too long - expanded relative refractory period
How do you identify heart rate from a six minute strip?
count QRS complexes over a 6 second period and multiply by 10
Describe Normal EKG and what each part of the EKG represents
P Wave: first wave normally upward represents atrial depolarization and contraction
QRS Complex: down, up, down deflection represents ventricular depolarization and contraction (atrial repolarization)
T: upward wave represents ventricular reporlaization
Identify time increments represented on an EKG strip
Small Box = 0.04 sec
Large Box = 0.2 sec
Identify the normal length of time for a cardiac cycle
from systole to systole is normally 60-100 bpm, thus 0.6 to 1 sec for normal cardiac cycle
Describe accurate electroode and lead placement
V1 - 4th intercostal space right of sternum
V2 - 4th intercostal space left of sternum
V3 - between V2 and V4
V4 - 5th intercostal space mid left clavicular line
V5 - level with V4 anterior axillary line
V6 - level with V4/5 mid-axillary line
Right arm and L arm lateral and immediatly below clavicle
Right Leg and Left Leg lateral and below umbilicus
What is Regularly Irregular
ectopic source although rate of the abnormality is consistent and predictable (atrial flutter)
What is Irregularly Irregular
usually multiple ectopic sources with no discernible pattern to the rate or rhythm (atrial fibrillation)
What does sinus rhythm mean?
HR between 60-100 bpm which has normal complex generated by SA node
Atrial Ryhtm arrhthmias __
are generated by the atria such as afib and aflutter
What is a PAC? How does it look on an EKG?
Premature Atrial Contraction
-Shorter RR interval
What is a PVC? How does it look on an EKG?
Premature Ventricular Contraction
- Shorter RR interval
- NO P wave (contraction is generated by ventricle not atrium)
- Bizarre QRS complex
- Compensatory pause
What is Atrial Flutter? How does it look on an EKG?
Sawtooth appearance
Regularly Irregular
No P wave (SA node is not pacemaker) so 40-60 bpm
What is Atrial Fibrillation? How does it look on an EKG?
Irregular and Inconsistent R to R interval (irregularly ireegular
No discernable P wave
May be asymptomatic
What is a Ventricular Tachycardia? How does it look on a EKG?
3+ PVCs with HR >100bpm
no P wave
Most serious
What is a Ventricular Fibrillation?
No discernable p, qrs, or T wave
Rapid rate
LETHAL
no perfusion
Supraventricular Tachycardia
Can be sinus, atrial or junctional in origyn
What is meant by “ventricular dysrhythmias”
Arryhmias that are generated by the ventricles such as vtach, vfib, vbrady
