Normal EKG

Question 1

Portion of EKG: artrial depolarization

Answer 1

P wave

Question 2

Term: Straight line on EKG [baseline]

Answer 2

Isoelectric [Line]

Question 3

Portion of EKG: Delay at AV node

Answer 3

PR Segment

Question 4

Define the PR interval

Answer 4

P wave + PR segment

Question 5

Portion of EKG: 1st downward relfection in the complex

Answer 5

Q wave

Question 6

Portion of EKG: 1st upward deflection of complex

Answer 6

R wave

Question 7

Portion of EKG: Ventricular repolarization

Answer 7

ST Segment

Question 8

Portion of EKG: Looks at the timing of the complex and repolarization

Answer 8

QT Interval

Question 9

The primary concern is to determine whether the _____1_____ of rhythm is the _____2_____ or another area (____3____).

Answer 9

1. Source
2. SA Node
3. Ectopic

Question 10

Define Sinus Rhythm

Answer 10

P wave for every QRS complex

Question 11

Term: Beginning of ST segment

Answer 11

J Point

Question 12

P Waves: Represent ______1______ of the atrial myocardium. The normal P wave is no wider than __2__ sec or under __3__ little boxes and not taller than __4__ mm. Taller indicated ____5____. The wave is not ___6___ or ____7____. If it were it would indicate that they atria are ______8_______.

Answer 12

1. Depolarization
2. 0.11
3. 3
4. 3
5. Hypertrophy
6. Notched
7. Peaked
8. unsynchronized

Question 13

P Waves: Positive and rounded in leads _1_, _2_, ___3___ in __4__% of normals. Usually upright in ____5____. ____6____ P waves in these leads are either abnormal or due to ____7____ ___8___ _____9_____. Negative in ___10___. Positive, negative, or biphasic in lead __11__, __12__, and ___13___.

Answer 13

1. I
2. II
3. aVF
4. 94
5. V4-V6
6. Inverted
7. Improper
8. Lead
9. Placement
10. aVR
11. III
12. aVL
13. V1-V3

Question 14

PR Interval: Represents atrial depolarization plus the __1__ ___2___ at the __3__ node to optimize _____4_____ filling. Normal lengths is ____5____ sec. Increased length indicates a __6__ ____7____ ____8____.

Answer 14

1. Normal
2. Delay
3. AV
4. Ventricular
5. 0.12-0.20
6. 1st
7. Degree
8. Block

Question 15

PR Segment: Begins at the end of the P wave and ends with the onset of the ___1___ ____2____. Should be _____3_____. Can be elevated with ___4___ ____5____ or _____6_____.

Answer 15

1. QRS
2. Complex
3. Isoelectric
4. Atrial
5. Infarction
6. Pericarditis

Question 16

QRS Complex: Represents depolarization of the _____1______ myocardium. All ____2____ waves in the complex are labeled R waves. The Q wave which represents the ___3___ tissue which is why it is so ____4____. The Q wave should be __5__ the height of the R wave, if taller it is considered _____6_____. If the R wave is peaked the ventricles are out of ___7___ and the are labed _8_ __9__ and _10_ ____11____

Answer 16

1. Ventricular
2. Positive
3. Septal
4. Small
5. 1/3
6. Pathological
7. Sync
8. R
9. Wave
10. R
11. Prime

Question 17

Not all leads record a _1_ wave. Normal Q waves represent ___2___ depolarization. Normal Q waves are only present in leads _3_, __4__, __5__, and __6__. Q waves are small in ___7___ and __8__. Q waves should be less than __9__ sec and no deep than __10__ of the QRS complex.

Answer 17

1. Q
2. Septal
3. I
4. aVL
5. V5
6. V6
7. aVF
8. V5
9. 0.04
10. 1/3

Question 18

Describe the importance of a narrow QRS and implications of a wide QRS

Answer 18

Narrow = for adequate SV need high speed to get all the blood out

Wide = hypertrophy, noncompliant/scar tissue/damage to bundle of HIS

**Taller than 25-30 mm = Ventricular Hypertrophy [Bigger in V1-2 = R side; V5-6 = L side]

Question 19

R wave: Starts of primarily negative (rS) in __1__ and gradually becomes primary positive (qRs) with the _____2_____ R wave in __3__ or __4__. The transition occurs in __5__ and __6__. Normally the R wave in __7__ is always less in the R wave in __8__.

Answer 19

1. V1-V2
2. Tallest
3. V5
4. V6
5. V3
6. V4
7. V6
8. V5

Question 20

Small R wave, large S wave in _________. Bigger R wave, small S wave in _________.

Answer 20

V1-V2, V5-V6

Question 21

_____ __ ______ ___________: R waves do not begin to dominate QRS until V5 or V6. This may represent infarction or injury of the anterior LV and carries almost as much significance as Q waves

Answer 21

Poor R Wave Progression

Question 22

Portion of the EKG: Represents the time when ventricular cells are in the plateau phase

Answer 22

ST Segment

Question 23

Portion of the EKG: represent a time when the ventricles are in their absolute refractory period and will not respond to stimulation

Answer 23

QRS and ST Segment

Question 24

ST segment should be ____1____ can have a ____2____ contour. ST elevation indicates ____3____ while ST depression indicates _____4_____. The two can be seen together.

Answer 24

1. Isoelectric
2. Smooth
3. Infarction
4. Ischemia

Question 25

T wave: Represents \_\_\_\_\_\_1\_\_\_\_\_\_ of the ventricles. \_\_\_\_\_2\_\_\_\_ time the ventricles can response to another stimulus usually coincides with the \_\_3\_\_ of the T wave. The T wave should have the same poliarity as the \_\_\_\_\_\_4\_\_\_\_\_\_. Dozens of conditions cause abnormal looking T waves in leads with \_\_\_\_\_5\_\_\_\_\_ QRS waveforms. T waves are very \_\_\_\_6\_\_\_\_ and not as reliable as \_\_7\_\_ changes.

Answer 25

1. Repolarization 2. Earliest 3. Apex 4. QRS Complex 5. Positive 6. Fickle 7. ST

Question 26

Describe the difference in depolarization between the heart and skeletal mm.

Answer 26

The heart depolarizes all together as opposed to after the depolarization passes through channel by channel. This allows maximal filling time.

Question 27

Describe the flat line between the P wave and the QRS complex

Answer 27

B/t the P wave and QRS complex the AV node fires. The AV node is thicker, it takes longer for the signal to get through, this delay is needed to optimize filling, thus the isoeletric line.