Physiological Basis of ECG Part 1 Flashcards

1
Q

how many electrodes and readings are placed on the skin for an ECG

A

9 electrodes (12 readings)

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2
Q

what specifically does the Electrocardiogram detect

A

It detects a difference = deflection in the read out that can be negative or positive

if there is no difference = No deflection in the read out

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3
Q

what part of the cell is the ECG measuring

A

changes of electrical activity of Cardiac muscle tissue - depolarization and repolarization

Measures the extracellular potential

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4
Q

why does ECG not report the differences between the atria and ventricles

A

because the atria and ventricles are isolated to insulation from the fibrous skeleton of the heart

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5
Q

what is the axis of the ECG

A

x axis = time

y axis = voltage difference

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6
Q

how does the ECG tracing deflector work when there is a depolarization to a no depolarization to a repolarization to being repolarized

A

Depolarization starts (difference between portions) = leads to a signal

once cells are all depolarized there is no difference = no signal

repolarization starts (there is a difference) = a signal

once all cells are polarized there is no difference = no signal

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7
Q

how does the average current flow in regards to negative and positive

A

negative toward the base of the heart

and with positivity towards the apex

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8
Q

what is the path of depolarization in the heart

A
SA node
Atrial muscle
AV node
Common bundle
bundle branches
purkinje fibers
ventricular muscle
ends at the walls on the sides of the heart in the ventricle
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9
Q

p wave

A

SA node causes atria to depolarize from right to left

represents phase 0 of AP in atrial muscle

all cells of the atria are depolarized at end of p wave

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10
Q

PR interval

A

the delay between all of the atria being depolarized to the start of the ventricle being depolarized

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11
Q

QRS interval

A

Ventricles depolarize generally from right to left, from apex to base, from interior to exterior

represents the phase 0 of AP in ventricular muscle

at the start of the ST interval, all cells in the ventricle have become polarized

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12
Q

ST segment

A

Action potential phase 2 delays for the repolarization of the ventricles

no difference on the ECG

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13
Q

T wave

A

Ventricles repolarize generally from the left to the right, base to the apex (opposite order of depolarization)

Represents phase 3 (repolarization) of AP in ventricular muscle

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14
Q

U wave

A

not typically observed but is a down wave after the T wave

can be alot of different things:

  • delayed repolarization of purkinje cells
  • prolonged repolarization of mid-myocardial cells
  • after potentials from mechanical forces in ventricular walls
  • repolarization of papillary muscle
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15
Q

what is the difference between segments and intervals in an ECG

A

Segment: represents the duration of a single event on the ECG

Interval: represents the duration of two or more events

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16
Q

how are the grids on an EKG measured

A

Horizontally: 5 large boxes equal 1 second
Vertically: 2 large boxes equal 1.0 mv

time between dark lines = .2 sec

time between light lines = 0.04 sec

17
Q

what is the length of PR interval, and ST Interval,

A

PR interval is about 0.16 ms

ST Interval is about 0.35 seconds

18
Q

what is the height in mv of the QRS complex, P wave, and T wave

A

QRS complex: 1 - 1.5 mv

P wave: 0.1 - 0.3 mv
T wave 0.2 - 0.3 mv

19
Q

why do we use 12 leads

A

Each lead displays voltage differences in the myocardium from different perspectives by different electrodes

20
Q

What are the standard bipolar limb leads

A

1: right arm to left arm
2: RA to leg (LL)
3: LA to LL

21
Q

what are the augmented limb leads

A

aVF = augmented vector foot
-(RA+LA) to foot

aVR = augmented vector right
-(LL +LA) to RA

aVL = augmented vector left
-(LL + RA) to LA

22
Q

what are the chest or pecordial leads

A

V1-V6
V1 and V2 mainly negative
V4, V5, V6 mainly positive

they are not assigned an axis

instead assigned a region of the heart and each lead acts as its own positive electrode (moving anterior/lateral)

23
Q

when is a lead positive or negative

A

as AP spreads toward the positive lead of an elctrode set a positive will be observed

24
Q

Einthovens Triangle

A

each limb has a + and - polarity and voltage between

Lead I + = LA

Lead II + = LL

Lead III + = LL

25
Q

Lead region assignments: Inferior

A

II, III, aVF

26
Q

Lead region assignments: Septal

A

V1 and V2

27
Q

Lead region assignments: Anterior

A

V2, V3, and V4

28
Q

Lead region assignments: Lateral

A

V4, V5, V6, I and aVL

29
Q

artery associated with what lead: Lateral Circumflex

A

Lead 1
aVL
V5, V6

30
Q

artery associated with what lead: Inferior right coronary

A

Lead II, III

aVF

31
Q

artery associated with what lead: septal left anterior descending

A

V1, V2

32
Q

artery associated with what lead: Anterior Left Anterior descending

A

V3, V4