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Electrocardiography > Practicum for Exam #1 > Flashcards

Practicum for Exam #1 Flashcards

1
Q

Which leads provide an inferior view of the heart?

A

Lead II; Lead III; aVF.

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2
Q

Which leads provide an anterior view of the heart?

A

V2; V3; V4.

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3
Q

Which leads provide a left lateral view of the heart?

A

Lead I; aVL; V5; and V6.

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4
Q

Which leads provide a view of the right ventricle?

A

V1 and aVR.

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5
Q

What are the criteria for Normal Sinus Rhythm (NSR)?

A

(1) Normal HR (60-100); (2) regular rhythm; (3) normal PR-interval; (4) normal QT-interval.

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6
Q

How do you assess P-waves?

A

Ensure a P-wave precedes each QRS complex (may not be visible on every beat, but consistent throughout); assess amplitude, shape, and duration.

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7
Q

What does a normal P-wave look like?

A

Rounded; not tall, thin, or abnormally wide.

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8
Q

What does a tall, thin P-wave represent?

A

Right atrial enlargement.

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9
Q

What does a wide, often notched, P-wave represent?

A

Left atrial enlargement.

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10
Q

What does a P-wave that is both tall AND wide represent?

A

Biatrial enlargement

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11
Q

How long is a normal PR-interval?

A

Less than 1 large box.

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12
Q

What does a prolonged PR-interval indicate?

A

First-degree heart block.

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13
Q

What does the Q-wave represent?

A

Septal depolarization.

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14
Q

What does a pathologic Q-wave look like?

A

The depth is at least 1/3 the height of the R-wave; drops straight down (no upward divet before deflection)

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15
Q

What does a pathologic Q-wave represent?

A

Past myocardial infarction.

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16
Q

What is R-wave progression?

A

A normal pattern of progressively increasing R-wave amplitude moving right to left in the precordial leads.

17
Q

What does poor R-wave progression indicate?

A

Right-sided hypertrophy.

18
Q

What does a normal QRS complex look like?

A

Narrow is normal; should be less than three small boxes.

19
Q

What does a wide QRS complex indicate?

A

The impulse is not being generated in the SA node (ectopic pacemaker), or is taking an aberrant pathway through the ventricles.

20
Q

What does the ST segment look like?

A

Should line up flat with the PQ segment, and the segment following the T-wave.

21
Q

What does ST elevation indicate?

A

Active myocardial infarction.

22
Q

What does ST depression indicate?

A

Active cardiac ischemia.

23
Q

What is the characteristic shape of a STEMI?

A

“Tombstone appearance”; the presence of an up-slope (concave) ST segment is not STEMI, this is caused by J-point elevation.

24
Q

What does a flattened or inverted T-wave represent?

A

This is a non-specific finding.

25
Q

What is the normal duration for a QT-interval?

A

The T-wave should fall before the halfway point between two consecutive R-waves.

26
Q

What does a prolonged QT-interval indicate?

A

Idiopathic; or can be caused by medications. These patients are at an increased risk of developing a ventricular arrhythmia.

27
Q

Describe the pacemaker potential for the different cells of the heart:

A

SA node (60-100); AV node (40-60); ventricles (20-40).

28
Q

Describe the time axis on an EKG strip:

A

1 small square (0.04s); 1 large square (0.2s); 5 large squares (1s).

29
Q

What is the easiest way to calculate heart rate from an EKG?

A

Divide 300 by the number of large squares between QRS complexes.

30
Q

What is another way to calculate heart rate from an EKG?

A

300-150-100-75-60-50 method.

31
Q

How can you tell if a person has right axis deviation?

A

QRS is negative in Lead I and positive in aVF.

32
Q

What does right axis deviation represent?

A

Right ventricular hypertrophy.

33
Q

How can you tell if a person has left axis deviation?

A

QRS is positive in Lead I and negative in aVF.

34
Q

What does left axis deviation represent?

A

Left ventricular hypertrophy.

35
Q

How can you tell if a person has extreme right axis deviation?

A

QRS is negative in BOTH Lead I and aVF.

36
Q

What is the most important criteria for diagnosing left ventricular hypertrophy?

A

The R-wave amplitude in V5 or V6 plus the S-wave amplitude in V1 or V2 is greater than 7 boxes.

37
Q

What does a down-sloping ST segment indicate?

A

Secondary repolarization abnormality; commonly seen with hypertrophy.

Electrocardiography (2 decks)

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