Nagi's 3rd/4th lecture CVS Flashcards by Mohamad asas

How long is the square that in the ECG means

40 msec

0.04 sec

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How many voltages does the square in the ECG stand for

It is 0.1mV

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How does the vector of the atrial depo look like

Downward and to the left

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How does the 1V if the ventricular depo looks like and what is its name

It looks upward and to the right

Septum vector

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How does the 2V if the ventricular depo looks like and what is its name

Downward to the left

Lateral wall

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How does the 3V if the ventricular depo looks like and what is its name

Upward to the left

Base of the ventricular

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Why is the the electricity is stronger in the ventricular than atrial

Because the voltage directly proportional with the mass of the tissue

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What is the relation between the duration and the velocity of the conduction

The duration is reversely proportional to the velocity of the conduction

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What happens if the vector is parallel to the lead

Maximum reading

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What happens if the vector is perpendicular to the lead

No reading at all

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What are the limbs leads

1,2,3,aVL,aVR,aVF

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What are the chest leads

V1-V6

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According the type of the lead the leads are grouped as

Bipolar has two electrodes exploring

Unipolar one exploring electrodes

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What are the location of the electrodes of the limbs leads

1st +ve on the LH and -ve on RH
2nd +ve on LG and -ve on RH
3nd +ve LG and -ve LH

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What are the augmented unipolar leads

aVR +ve on RH against LH and LG
aVL +ve on LH against RH and LG
aVF +ve on LG againstRH and LH

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What are the places of the unipolar chest leads

V1 right 4th intercostal space by edges
V2 left 4th intercostal space by edges
V3 left 5th rib between the V2 and V4
V4 left 5th intercostal space by midclavicular
V5 left intercostal space by anterior axillary
V6 left intercostal apace by mid axillary

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Which leads show the left ventricle ,septum,right ventricle

V1,V2 right ventricle
V3,V4, septum
V5,V6, left ventricle

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What does the P wave represent

Atrial depo

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What is the duration of the P waves

80mSec

2 squares

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What is the height (voltage ) of the P waves

1/4 mV

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What is the shape of the P waves

1st half for RA

2nd half for LA

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Qhat is the direction of the P waves

Mostly it is upright in all leads except

aVR

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The clinical correlation that are related with the P wave

Absent in the A fibrillation
prolonged in the A hypotrophy
If it was inverted in any lead but the aVR
The patient have an ectopic pacemaker

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What does the QRS complex represent

Ventricle depo

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What is the duration of the QRS complex

It is 80ms | 2 squares

What is the voltage of the QRS complex

It is 1mV in limbs leads | But 3-4 in chest

What is he shape | Of QRS

كل شيء يبدأ صغيراً الا ال sadness يبدأ كبيرا ثم يصغر In V1,V2 the R are small and S are big V5,V6 the S are big and R are small

What is the direction of the QRS

R always +ve Q is -ve before R S is -ve after R

When is the QRS are absent

In death

What does means is the QRS is more than 3 squares

1-ectopic focus 2-increased K 3- bundle brach block 4- left ventricle hypotrophy

What is the name of the anti depressant drug that cause prolonged QRS

Tricyclic antidepressant

In which caese the QRS is very low

1_ pericardial effusion

At which level of potassium the kidney cleaning is a require

At 8

What is the duration of the T waves

160ms | 4 squares

What does the T waves represent

Ventral repo

What is the height voltage of the T waves

1/2mv

What is the shape OF T WAVE

Slightly rounded | Asymmetrical

What is the direction of the T waves

Innervated in the aVR

What does the inverted T waves represent in the other leads

Mycardic ischemia

What does the peaked T waves represent

Increased potassium | Early sign of myocardial infarction

What does flat T waves represent

Low potassium

What is the U waves represent

Depo of papillary muscles

What does the very prominent U waves represent

Low potassium Increased Ca Hypertherodisum

Why the atrial repolarzation is not recorded

Very low in voltage

Why SAN AVN Purkinje depo not recorded

Because too small mass if tissue

What is the P-R segment

It start from the end of the P wave to the beginning of the R complex

What does the P-R segment represent

AVN conduction

What does the depressing of the P-R segment means

Pericarditis

What is the S-T segment

It is between the end of QRS and to the beginning of the T

What does the S-T segment represent

It represent the platue of the ventricular AP

What is does the elevation of the S-T means

Pericarditis MI Ischemia

What does the depressing of the S-T represent

LVH MI or ischemia

What is the drug that cause the depassion of the S-T

Digoxin

What are the measurements of the P-F interval

From the beginning of the P wave to the beginning of the R

What does the P-R interval represent

Atrial depo + AV conduction

What is the time of the P-R interval

120-200msec | 3-5 squares

How does the blocking of the AV node effect the P-R interval

It will prolong it

How does the atrial hypertrophy effect the P-R interval

Prolong it

How does the vegas stimulus effect the P-R interval

Prolong it

How does the sympathetic effect the P-R interval

It will shorten it

How does AV nodal rhythm effect the P-R interval

Shorten it

What is name of the case when there is a by pass around the AV node

Wolf parkinson white syndrome

How does the wolf parkinson white syndrome effects the P-R interval

It will shorten it

What is the measurements of the QT interval

From the beginning of the R waves to the end of the T waves

What does the QT interval represent

Ventricular depo and repol

What is the duration of the QT interval

200-400msec | 5-10 squares

Hiw does the low HR effect the QT interval

Prolong it

What is the QTc

It is QT interval / الجذر التربيعي تبع P-R interval

What does the high QTc represent

Ventricle tachyarrhythmia and sudden death

How does the high HR effect the QT

Shorten it

What is the sign that the low QT gives

Sever hypocalcemia

How to see if the heart has a normal axis deviation

1-We see QRS in lead 1 and lead aVF if there are both positive then it is normal 2- we see QRS in lead 1 and aVF if the lead 1 positive and the aVF is negative we see lead 2 if it is positive

How we know if the patient have a right axis deviation

If the QRS is negative in lead 1

How to know if the patient have a left axis deviation

QRS in leads 1 and aVF will be normal but negative in the lead 2

What does a right axis deviation represent

Right BBB Right side hypertrophy Left infarction

What does the left axis deviation represent

Left BBB Left hypertrophy Tight infarction