Mod 2: ECG Fundamentals, Arrhythmias, and Ischemia

Question 1

What does the presence of a P wave mean? What is the normal time and length of a P wave?

Answer 1

SA node has activated and waves of depolarization travel through atria
< 0.11 sec
< 2-3mm

Question 2

What is the normal time for the P-R interval?

Answer 2

0.12-0.20 sec

Question 3

What is the normal time for the QRS complex?

Answer 3

0.06-0.10 sec

Question 4

What is the ST segment?

Answer 4

isoelectric to TP line at 0.08 sec past the J point

Question 5

What is the length of the T wave? What is the U wave?

Answer 5

< 5mm in limb
<10 mm in chest leads
U wave follows T wave, is very low amplitude

Question 6

What is the normal time for the Q-T interval?

Answer 6

0.35-0.45 sec

Question 7

What part of the ECG correlates to HR?

Answer 7

Q-T interval

beginning to end of ventricular activation

Question 8

What is the order of numbering for the ECG graph?

Answer 8

300
150
100
75
60
50

Question 9

What are the 3 sinus beats?

Answer 9

1) normal sinus rhythm
2) sinus bradycardia
3) sinus tachycardia

Question 10

What is a normal sinus rhythm?

Answer 10

impulses originate at SA node at normal rate, 60-100bpm

Question 11

What is sinus bradycardia?

Answer 11

impulses originate at SA node at slow rate, < 60/minute

Question 12

What is sinus tachycardia?

Answer 12

impulses originate at SA node at rapid rate, > 100/minute

Question 13

What are the 4 atrial rhythms?

Answer 13

1) premature atrial contraction (beat)
2) atrial tachycardia
3) atrial flutter
4) atrial fibrillation

Question 14

What is premature atrial contraction (PAC)?

Answer 14

• beat comes early
• P wave looks different
• QRS looks normal
• P-R interval may be short

Question 15

What is atrial tachycardia?

Answer 15

• rate is 140-250 bpm
• all P waves looking different than sinus P’s
• QRS usually normal (sustained or paroxysmal)

Question 16

What is atrial flutter?

Answer 16

• not all atrial impulses can pass through the AV node
• may see a patter (3:1 or 4:1) where P waves look identical like a “sawtooth”
• rate 250-350 bpm
• regular QRS complex

Question 17

What is atrial fibrillation?

Answer 17

• disorganized patter
• rate >400bpm
• no distinct P waves (may be coarse or fine)
• irregular QRS rate 110-180 bpm

Question 18

What are the 2 types of junctional rhythms?

Answer 18

1) premature junctional contraction?

2) junctional tachycardia

Question 19

What is premature junctional contraction (PJC)?

Answer 19

• beat comes earlier than expected
• P wave is either absent or inverted
• normal QRS

Question 20

What is junctional tachycardia?

Answer 20

• HR >100
• absent P waves or inverted P waves
• normal QRS complex

Question 21

What are the 3 types of ventricular rhythms?

Answer 21

1) premature ventricular beat
2) ventricular tachycardia
3) ventricular fibrillation

Question 22

What is a premature ventricular contraction (PVC)?

Answer 22

• occur before beat is expected
• wide QRS (>0.12 sec)
• may have a T wave abnormality

Question 23

What does a ventricular tachycardia mean physiologically?

Answer 23

slowed conduction in margin of ischemic area permits circular course of impulse and reentry with rapid repetitive depolarization

Question 24

What are things to pay attention to regarding PACs?

Answer 24

origin, frequency, and pattern

Question 25

What is ventricular tachycardia?

Answer 25

rapid rate of PVCs all in a row (3 or more PVCs in a row)

rate > 120

Question 26

What is ventricular fibrilation?

Answer 26

chaotic ventricular depolarization

Question 27

What are paired PVCs?

Answer 27

normal, normal, PVC, normal, normal, PVC

Question 28

What are supraventricular tachycardia?

Answer 28

• above ventricles
• P waves there, QRS present
• If you’re not positive which other one this is? *

Question 29

What is a flat line called?

Answer 29

asystole

Question 30

What id used in defibrillation?

Answer 30

AED and ICD