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EKG Cert > Module 2 > Flashcards

Module 2 Flashcards

1
Q

• The P wave represents

A

activated depolarization of the atria.

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2
Q

• The QRS complex represents the

A

activation and depolarization of the ventricles.

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3
Q

• The ST segment – The T-wave represents the

A

recovery (repolarization) of the ventricles.

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4
Q

The U wave follows the T wave and represents the

A

finalization of ventricular repolarization.

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5
Q

Atrial recovery is rarely shown on the EKG since it

A

occurs during ventricular depolarization in the QRS complex with much stronger electrical signals.

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6
Q

The PR interval represents the

A

spread of electrical impulses beginning at the P wave through the point of R in the QRS complex. This interval indicates the length of time the impulse takes to travel through the atria and the AV junction.

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7
Q

The P-QRS-T interval represents

A

one complete cycle of an impulse beginning with depolarization to repolarization.

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8
Q

Each phase of the cardiac cycle records the electrical currents on

A

specialized graph paper.

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9
Q

Each small horizontal square represents ________seconds and__________?

A

0.04 seconds and 1 millimeter squared (1 mm2).

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10
Q

). A dark line separates five small squares that equal

A

0.2 seconds with the graph paper moving at a speed of 25 mm/sec.

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11
Q

The time in each phase of the cardiac cycle can be determined by

A

reading the squares on the graph paper.

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12
Q

The vertical EKG graph measures the

A

electrical voltage or amplitude of each waveform or deflection.

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13
Q

The electrocardiograph is calibrated and standardized, so the amplitude produces a

A

deflection of 10 mm for each 1 mV signal (1 mV = 10 mm).

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14
Q

Each deflection produces either a

A

positive or a negative wave.

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15
Q

An upward wave produces a

A

positive deflection, whereas a downward wave produced a negative deflection.

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16
Q

An isoelectric waveform is a deflection that

A

rests on the baseline; it is neither positive or negative.

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17
Q

A biphasic waveform is either

A

partially positive or negative

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18
Q

Three consecutive heartbeats that display identical waveforms on the EKG define

A

the heart rhythm.

The waveform of all three heartbeats is identical at the origin.

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19
Q

Define the elements shown here

A

The figure above has a positive P wave, negative T-wave, the QRS complex is biphasic, and the ST segment is isoelectric.

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20
Q

The P wave located before the QRS complex represents

A

atrial depolarization and has either a positive or negative deflection.

The P wave is before the QRS complex when the SA node is pacing the heart.

Abnormal conditions occur if a secondary pacemaker is pacing the heart; the P wave and QRS complex will not have a relationship with each other.

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21
Q

The measure of the PR interval begins

A

begins before the P wave through the beginning of the QRS complex, to the point of R.

The PR interval may vary slightly between leads, and only the shortest PR interval is noted by using the small squares on the graph paper and recording the time.

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22
Q

A regular PR interval is between

A

0.12 and 0.20 seconds in adults.

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23
Q

PR interval indicates the length of time the impulse takes to travel

A

through the atria and the AV junction.
A delay at the AV junction allows the ventricles to fill with blood before ventricular activation.
A longer PR interval represents a prolonged delay.
First-degree heart block occurs when the PR interval prolongs longer than 0.20 seconds.

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24
Q

The QRS complex represents the

A

depolarization of the ventricles

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25
Q

The features of a QRS complex:

A
  • The Q wave is the first negative deflection.
  • The R wave is the first positive deflection.
  • The S wave is the negative deflection following the R wave.
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26
Q

The direction of the deflection, either positive or negative, is based on

A

the location of the origin.

An upward direction is not positive if it is still below the origin.

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27
Q

This location of the deflections determines if a waveform could be missing from the QRS complex. Explain this

A

For example, the QRS complex below is missing the R wave because the positive deflection after the Q wave is below the baseline, named a QS wave rather than a QRS complex.

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28
Q

How do you name QRS Complex

A

Uppercase letters indicate a larger amplitude, and lowercase signifies small amplitudes of the QRS complex.

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29
Q

An R wave occurs when a QRS complex presents with

A

only a positive deflection.

30
Q

A QRS complex can contain more than one positive or negative deflection.

A

The R’ (R prime) waves are the extra positive waves, and negative waves are called S’ (S prime) waves.

31
Q

The time for the impulse to depolarize the ventricles presents

A

within the width (interval) of the QRS complex, typically about 0.10 seconds.
The time can prolong if the impulse slows during travel through the ventricles.

32
Q

The ST segment represents

A

represents the phase after the QRS complex to the beginning of the T wave and signifies ventricular repolarization.
The ST segment is most likely isoelectric but can be slightly elevated or depressed on the baseline as a result of a pathologic condition.

33
Q

J ]point is where

A

QRS complex ends and the ST segment begins signifies as the J point.

34
Q

The T wave represents

A

represents a part of the last phase of the cardiac cycle, and the peak is closer to the end of ventricular repolarization.

35
Q

A positive T wave __________

whereas a negative T wave__________

A

rises slowly and suddenly returns to the baseline,

descends slowly then suddenly returns to the baseline.

36
Q

The QT interval represents

Measure the beginning of the QRS complex to the end of the T wave to determine

A

The QT interval represents

the QT interval in the lead showing the most prolonged interval.

37
Q

The average of several intervals determines

A

QT interval.

38
Q

The heart rate determines a regular

A

QT interval

39
Q

An increased heart rate will

A

shorten the RR interval or lengthens when the heart rate decreases.

40
Q

The RR interval is the

A

time distance between the QRS complexes. The normal QT interval range is 0.40 to 0.44 seconds.

41
Q

U waves represent the

A

last phase of ventricular repolarization and usually have the same direction of the T wave

42
Q

A negative U wave with a corresponding positive T wave is

A

an abnormal condition that occurs during left ventricular hypertrophy and myocardial ischemia.

43
Q

There are two methods to calculate the heart rate from the EKG,

A

box counting, and QRS counting.

44
Q

The Box Counting Method

A

In the above image, there are four large boxes between each QRS complex.

300 ÷ 4 = 75
The heart rate is 75 beats per minute.
Count the number of small boxes (0.04 seconds) between two consecutive R waves and divide by a constant (1500) if a more accurate heart rate measured from the EKG.
In the above image, there are 20 small boxes between each R wave.
1500 ÷ 20 = 75
The heart rate is 75 beats per minute.

45
Q

The box counting method will be inaccurate if

A

the heart rate is irregular because of the intervals between QRS change between each heartbeat.

46
Q

The QRS counting method determines the average heart rate with both

A

regular and irregular heart rates.

47
Q

The QRS Counting Method

A

Count the number of QRS complexes in easily identifiable time, such as 10 seconds, and then multiply the QRS number by the appropriate interval.

For example, there are 12 QRS complexes within a 10-second interval on the electrocardiogram paper.

12 x 6 = 72

The heart beat is 72 beats per minute.

48
Q

An electrocardiogram can measure and record the

A

strength of electrical impulses through the placement of electrodes on the skin.

49
Q

The standard 12 lead EKG measures different electrical strength by placing the electrodes in specific positions on the skin. The leads monitor

A

the same P-QRS-T cycle from different angles.

50
Q

Lead Placement on Chest

A
51
Q

Each lead is labeled separately and named. The leads monitor the

The six limb leads subdivided into

A

voltages of the heart and transmit it to the appropriate electrode.

Two groups

52
Q

Leads I, II, III are standard

A

bipolar leads because they record the electrical difference between each leg.

53
Q

Lead I

A

The difference between the left arm and right arm.

54
Q

Lead II

A

The difference between the left leg and right arm.

55
Q

Lead III

A

= The difference between the left leg and left arm.

56
Q

Einthoven’s triangle,

A

shows the relationship and difference of lead placement on the limbs.

Incorrect placement or electrical recording of the leads will result in different electrical values and will need repositioning.

57
Q

The remaining limb leads labeled as aVR, aVL, and aVF represent

A

augmented bipolar leads.

58
Q

A unipolar lead measures

A

the voltage in any one direction or a single reference point and has one positive electrode.

59
Q

In contrast, bipolar leads have

A

two reference points and two electrodes of opposite polarity.

60
Q

The meaning of the lead abbreviations are:

a=
V=
R=
L=
F=
A 
a = augmented
V = voltage
R = right arm
L = left arm
F = left foot (leg)
61
Q

The six chest leads referred to as

A

V1, V2, V3, V4, V5, and V6.

62
Q

The limb leads record on the EKG before

A

the chest limbs.

63
Q

The leads on the arms and legs should be

A

applied to the skin first.

64
Q

Although, the right leg limb only functions as an

A

electrical ground.

65
Q

Apply the arm leads ________, and the leg leads ___________

A

above the wrists,

above the ankles.

66
Q

The electrodes applied to the wrists will

A

monitor electrical impulses on the same side below the shoulder.

67
Q

The impulses near the

A

left thigh or groin monitored through the left leg electrode.

68
Q 
Placement of Chest Leads  
Lead V1 – 
Lead V2 – 
Lead V3 – 
Lead V4 – 
Lead V5 – 
Lead V6 –
A

Lead V1 – Place the electrode in the fourth intercostal space to the right of the sternum.
Lead V2 – Place the electrode in the fourth intercostal space to the left of the sternum.
Lead V3 – Place the electrode midway between V2 and V4.
Lead V4 – Place the electrode in the midclavicular line in the fifth intercostal space.
Lead V5 – Place the electrode in the anterior axillary line within the same level as V4.
Lead V6 – Place the electrode in the midaxillary line within the same level as V4.

69
Q

To locate the fourth intercostal space,

A

place a finger at the top of the sternum and move it downward about 1½ inches until feeling a horizontal ridge called the angle of Louis.

The second intercostal space is below and lateral to the angle of Louis. Move down two spaces to reach the fourth intercostal space.

70
Q

Performing a full 12 lead EKG may not be necessary for all patients or situations.

Bedside cardiac monitors can ______
A Holter portable cardiac monitor is ________
Event recorders and mobile continuous telemetry (MCT)________________
An insertable cardiac monitor surgically inserted under the skin may________________

A

Record continuous cardiac activity in nonambulatory patients and only require 3 or 5 leads.

Available to ambulatory patients and to assess arrhythmic activity over an extended period without causing interruptions in normal daily activities. Two leads generally placed on the chest wall and lower abdomen will record on a unique digital monitor. The EKG graphs view on a different screen for evaluation, digitally archive, or print sections from the portal monitor.

Additional options for ambulatory patients.

Directly monitor life-threatening arrhythmias that were undetectable with the other types of portable monitors.

EKG Cert (4 decks)

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