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Cardiology (SP23) > Module 3: C7: ECG 1 > Flashcards

Module 3: C7: ECG 1 Flashcards

1
Q

Basis of ECG:
Action potentials are happening in the _______________ level

A

Cellular

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2
Q

Basis of ECG:
Phase 0 ->

A

P wave | QRS complex

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3
Q

Basis of ECG:
Phase 3 ->

A

ST segment and T wave

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4
Q

What is the type of ECG that we use in large animal species?

A

Base-Apex Lead

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5
Q

Base-Apex Lead in Large Animals:
- (-) electrode or white electrode goes on the =>
- (+) electrode or Black electrode goes on the =>

A
  • RIGHT jugular furrow or scapular spine (“right arm”)
  • LEFT apex (“left arm”)
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6
Q

Frontal Leads: Einthoven’s Triangle
Right arm to (-) –> Left arm (+)

Which lead is this?

A

Lead I

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7
Q

Frontal Leads: Einthoven’s Triangle
Right arm (-) –> Left leg (+)

Which lead is this?

A

Lead II

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8
Q

Frontal Leads: Einthoven’s Triangle
Left arm (-) –> Left leg (+)

Which lead is this?

A

Lead III

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9
Q

Frontal Leads: Einthoven’s Triangle
Summed left arm and left leg (-) –> Right arm (+)

A

aVR

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10
Q

Frontal Leads: Einthoven’s Triangle
Summed right arm and left leg (-) –> Left arm (+)

A

aVL

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11
Q

Frontal Leads: Einthoven’s Triangle
Summed right and left arm (-) –> Left leg (+)

A

aVF

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12
Q

Genesis of the ECG:
1. Impulse starts in the _____ node

A

SA

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13
Q

Genesis of the ECG:
2. The signal travels through atria and _____ node

A

AV

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14
Q

Genesis of the ECG:
3. Signal travels through ___________ system

A

His-Purkinje

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15
Q

Genesis of the ECG:
4. Ventricular ____________

A

depolarization = Increases the membrane potential

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16
Q

Genesis of the ECG:
5. Ventricular ____________ (T-Wave)

A

repolarization = Decreases the membrane potential, restoring the resting membrane potential

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17
Q

ECG Paper:
When using 50 mm/sec paper speed, how many seconds is each little box?

A

0.02 secs (20 msec)

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18
Q

ECG Paper:
What is the baseline of an ECG?

A

Horizontal line preceding P wave

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19
Q

ECG Paper:
What are deflections?

A

Waves (positive or negative)

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20
Q

ECG Paper:
The paper speed is represented by which axis?

A

X-axis
- 25 mm/sec
- 50 mm/sec
(the higher the heart rate, the higher the speed we use)

21
Q

ECG Paper:
The sensitivity is represented by which axis?

A

Y-axis
- also called Amplitude
- 10 mm/mV
- 5 mm/mV
- 20 mm/mV

22
Q

Determining Heart Rate:
Describe the Instantaneous HR Method
- Count: ____________
- Paper speed? _____
- Divide: ____________

A
  • 42 little boxes between complexes
  • 25 mm/sec
  • 1500/42 = 36 bpm
    If paper speed is 50 mm/sec then take 3000/# little boxes
23
Q

Determining Heart Rate:
Describe the Average HR Method
- Paper speed? 25 mm/sec
- Count amount of time: 3 or 6 seconds (the more seconds you count, the more representative is going to be)
- Count number of complexes in that time: 2
- Extrapolate to 1 minute: _____________

A

2 complexes in 3 seconds, 3 seconds x 20 = 60 seconds; 2 x 20 = 40 bpm

24
Q

(T/F) When referring to a regular vs irregular rhythm, it means that normal vs abnormal

A

False
- perfectly spaced R to R intervals
- Premature beats? Pauses? are there any repetitive patterns?

25
Q

Sinus rhythms: Normal sinus rhythm

Fill in the blanks of the Normal Ranges for the following species:
1. Dogs: _____ - _____ bpm
2. Cats: _____ - _____ bpm
3. Equine: _____ - _____ bpm

(must know this)

A
  1. 60 - 160
  2. 140 - 240
  3. 35 - 50
26
Q

Sinus rhythms: Definition
- Very common and normal in large animals and dogs (abnormal in Cats -> high sympathetic tone in hospital)
- Associated with variable vagal tone
- Often associated with respirations (i.e. respiratory sinus arrhythmia)
- Inspiration: faster
- Expiration: slower

A

Sinus arrhythmia

27
Q

Sinus rhythms:
In combination with Sinus arrhythmias, we can have a “Wandering pacemaker” which is …

A
  • Gradual change in the morphology of the P waves
  • Often associated with RSA (respiratory sinus arrhythmia) and high vagal tone
  • Shifts in the pacemaker from within the sinus node
28
Q

(T/F) Sinus arrhythmia is normal in cats

A

False, NEVER normal in cats, look for cause of high vagal tone

29
Q

Sinus rhythms: Sinus tachycardia
- “warm up” and “cool down”
- Sometimes the P waves are buried in the T waves

What would be considered tachycardia for the following species?
1. Dogs: > ________ bpm
2. Cats: > ________ bpm
3. Equine: > ________ bpm

A
  1. 150/160
  2. 220
  3. 70
30
Q

Sinus rhythms: Sinus bradycardia
What would be considered bradycardia for the following species?
1. Dogs: < _______ bpm
2. Cats: < _______ bpm
3. Equine: < _______ bpm

A
  1. 60
  2. 140
  3. 35
31
Q

Definition:
Average direction of electrical potential generated by the heart during the cardiac cycle

A

Mean electrical Axis (MEA)

32
Q

Mean Electrical Axis:
What is the normal range in a cat?

A

0-160 degrees

33
Q

Mean Electrical Axis:
What is the normal range in a dog?

A

45-100 degrees

34
Q

What is the most common lead we would be looking at?

A

Lead II

35
Q

Determining MEA:
Describe the Simplified approach.

A
  • Look at your ECG leads (Ideally 6 leads)
  • Look at the direction the QRS in each lead
    - Starting with the most positive and most negative
  • Envision these against Einthoven’s triangle
  • Determine the general direction of electrical activity
36
Q

Determining MEA: Simplified approach

For normal axis:
- QRS is usually _______ (neg/pos)
- II, III, avF
- QRS is either isoelectric or positive in lead ___
- QRS should be _______ (neg/pos)
- avR
- QRS is either isoelectric or negative in _____

A
  • Positive
  • Lead I
  • Negative
  • aVL
37
Q

What can it mean when you have axis deviation?

A
  • Conduction abnormality
  • Cardiac remodeling
38
Q
  • Deep S waves in leads I, II, aVF (negative complexes)
  • Positive QRS in aVR (may be positive in III)
  • Possible causes: right ventricular enlargement, right bundle branch block
    What axis deviation is this?
A

Right axis deviation

39
Q
  • Lead I & aVL are tallest (usually lead II & aVF are tallest)
  • Possible causes: Left bundle block, Left ventricular enlargement
    What axis deviation is this?
A

Left axis deviation

40
Q

Atrial Enlargement:
What are we seeing with Right atrial enlargement?

A

Tall P waves (P-pulmonale)

41
Q

Atrial Enlargement:
What are we seeing with Left Arial enlargement?

A

Wide P waves (P-mitrale)

42
Q

Right atrial enlargement on ECG:
In the following species, what would be considered a tall P-wave in lead II?
- Dogs: > ______
- Cats: > ______

A
  • 0.4 mV
  • 0.2 mV
43
Q

Left atrial enlargement on ECG:
In the following species, what would be considered a wide P-wave in lead II?
- Dogs: >_____
- Cats: >_____
- Horses: >_____

A
  • 40 ms (> 50 ms in large/giant breeds)
  • 35 ms
  • 160 ms
44
Q

In what species is seeing a “double hump” P-wave normal?

A

Horse

45
Q

What would it mean if the P-waves were tall and wide?

A

Biatrial enlargement

46
Q
  • Deep S waves in Lead II
    - Negative QRS in I & II
    - Positive QRS in avR
  • Right axis deviation
  • Can indicate RV hypertrophy and/or dilation
    This is describing …
A

Right ventricular enlargement

47
Q

(T/F) RV enlargement is a cause of a right axis deviation, but not all right axis deviations indicate RV enlargement

A

True

48
Q
  • Tall R-waves in Lead II
  • QRS duration prolonged
  • +/- Left axis deviation
  • Doesn’t work for large animals
    This is describing …
A

Left ventricular enlargement

Cardiology (SP23) (8 decks)

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