Rapid EKG V

Question 1

bundle branch block

Answer 1

conduction block in right or left bundle branches

• see two QRS out of phase
• looks widened

R and R’ (second delayed)

Question 2

widened QRS greater than 0.12s

Answer 2

bundle branch block

Question 3

right BBB

Answer 3

sharp S wave downward

• R’ right ventricle
• R/R’ in V1 and V2

Question 4

left BBB

Answer 4

rounded S wave downward

• R left ventricle
• R/R’ in V5 and V6

Question 5

right chest leads

Answer 5

V1 and V2

Question 6

left chest leads

Answer 6

V5 and V6

Question 7

left bundle branch

Answer 7

has two subdivisions

• fascicles
• hemiblocks

Question 8

hemiblocks

Answer 8

fascicles of left bundle branch

Question 9

intermittent mobitz

Answer 9

occasional dropped QRS due to permanent BBB one side with intermittent BBB other side

• one sided BBB with intermittent dropped QRS
• momentary complete AV block

Question 10

imitators of intermittent mobitz

Answer 10

dropped QRS end of wenckebach
-tell bc of progressive lengthened PR intervals

non-conducted PAB - see P’ with no QRS

tansient sinus block- missing entire P-QRS-T

Question 11

normal P wave with no QRS

Answer 11

second degree AV block

Question 12

P’ with no QRS

Answer 12

non-conducted PAB

Question 13

missing P-QRS-T

Answer 13

sinus block

Question 14

normal mean QRS vector

Answer 14

tail - AV node

• advancing wave of Na ions
• 0 > + 90 degrees

Question 15

lateral limb lead

Answer 15

I and AVL

Question 16

inferior limb leads

Answer 16

II, III, and AVF

Question 17

most isoelectric lead in frontal plane

Answer 17

can give you the correct angle of deviation - mean QRS vector

-bc signal is perpendicular to vector

Question 18

chest lead V2

Answer 18

4th ics - left of sternum

-normally negative

Question 19

posterior/anterior infarction of left ventricle

Answer 19

seen on V2

Question 20

transitional zone

Answer 20

V3 and V4

Question 21

axis deviation

Answer 21

frontal plane

Question 22

axis rotation

Answer 22

horizontal plane

Question 23

chest lead V1

Answer 23

4th ICS - right of sternum

-info about atria

Question 24

diphasic P wave in V1

Answer 24

atrial enlargement

Question 25

right atrial enlargement

Answer 25

initial component of diphasic P wave is larger (in V1)

Question 26

left atrial enlargement

Answer 26

second component of diphasic P wave larger (in V2)

Question 27

height of P wave in any limb lead greater than 2.5mm

Answer 27

suspect right atrial enlargement

Question 28

QRS in lead V1

Answer 28

S normally larger than R

-overall downward deflection

Question 29

right ventricular hypertrophy

Answer 29

will see mainly positive V1
-larger R wave than S

progressively smaller R wave from V1 > V4

also RAD in frontal plane

Question 30

left ventricular hypertrophy

Answer 30

V1 very deep S wave

• LAD in frontal plane
• also large R in V5

-also may see inverted T wave in left chest leads (V5 and V6)

Question 31

math for left ventricular hypertrophy

Answer 31

mm of V1 + mm of V5
-more than 35mm - there is LVH

V1 depth (S) + V5 height (R)

Question 32

strain pattern

Answer 32

with ventricular hypertrophy

-ST segment depressed and humped

Question 33

strain pattern in V1

Answer 33

right ventricular hypertrophy

Question 34

strain pattern in V5

Answer 34

left ventricular hypertrophy

Question 35

R atria, L atria, R ventricle hypertrophy

Answer 35

look at V1

Question 36

L ventricle hypertrophy

Answer 36

look at V1 and V5