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Regions EKG PowerPoint Flashcards

1
Q

For heart rate, 1 small box = 1mm = how many seconds? How about a big box?

A

.04 seconds

.2 seconds

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2
Q

For heart rate, 1 small box = 1mm = how many seconds? How about a big box?

A

.04 seconds

.2 seconds

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3
Q

How many big boxes per second?

A

5

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4
Q

For counting down the rate, what are the big boxes equal to?

A

300, 150, 100, 75, 60, 50, 43, 37, 33, 30

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5
Q

What are the questions to ask yourself regarding rhythm?

A
  1. is it sinus?
  2. If not sinus, where does it originate?
  3. Is it regular or irregular?
  4. Are there premature beats?
  5. Is there a block?
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6
Q

How long is a normal P-wave? How many boxes?

A
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7
Q

A normal p wave is monophasic in lead __ and biphasic in lead __.

A

monophasic in II

bisphasic in V1

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8
Q

What will the P wave look like in right atrial enlargement?

A

Peaked P wave in II (over 2.5 mm) and V1 (over 1.5 mm)

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9
Q

What will the P wave look like in left atrial enlargement?

A

widened P wave II and V1
OR
Biphasic, particularly in V1

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10
Q

What gives us a tip off that a rhythm originates above the ventricle?

A

narrow complex

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11
Q

Are all supraventricular rhythms narrow complex?

A

no (think about PACs)

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12
Q

What gives us clues that the rhythm originates in the atrium?

A

if it originates in the atrium, there will be a p wave (or saw-tooth wave or a-fib waves)

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13
Q

What clues tell us the rhythm is junctional?

A

if there are no p-waves or retrograde P waves.

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14
Q

What clues can we look for to determine if a rhythm is ventricular?

A

wide complex (but this doesn’t necessarily mean it’s ventricular - can be an issue with conduction - His/Purk fibers)

no p

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15
Q

What are the three types of tachyarrythmias in the atria?

A

sinus tachy
paroxysmal supraventricular tachycardia (HR>140)
Atrial flutter

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16
Q

What are the two tachyarrhythmias that are junctional?

A

.accelerated junctional rhythm - 70-130

SVT >140

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17
Q

What are the two tachyarrhythmias originating in the ventricles?

A

.accelerated idioventricular 55-110

ventricular tachycardia >140

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18
Q

What’s the bradyarrhythmia in the atria?

A

.sinus brady

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19
Q

What’s the bradyarrhythmia that’s junctional?

A

junctional escape

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20
Q

What’s the typical rate for junctional escape?

A

40-60 bpm

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21
Q

What’s the typical rate for ventricular escape?

A

20-40 bpm

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22
Q

What characterizes sinus arrhythmia?

A

R-R

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23
Q

Describe supraventricular tachycardia

A

sudden onset

rate typically 120-180

you can often see P waves (retrograde maybe in II and III)

narrow complex

ST segment depression common

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24
Q

What’s the definition of ventricular tachycardia?

A

a run of 3+ PVCs with HR over 140

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25
How long does V tach need to go to be considered sustained?
over 30 sec
26
What are the three examples of junctional rhythms?
junctional escape accelerated junctional paroxysmal SVT
27
How fast is junctional escape?
40-60
28
How fast is accelerated junctional?
70-130
29
Define what happens in a 1st degree AV block?
PR prolongation >.2 S (so one big box) but there will always be a QRS present
30
If there is a dropped QRS complex and the PR lengthens until another QRS is dropped, what type of block is it?
2nd degree - Mobitz Type I
31
If there is a dropped QRS complex and the PR is constant, what type of block is it?
2nd degree, mobitz type II
32
If the PR changes, but the P-P and R-R intervals are constant, what type of block is it?
3rd degree (AV dissociation)
33
How many big boxes per second?
5
34
For counting down the rate, what are the big boxes equal to?
300, 150, 100, 75, 60, 50, 43, 37, 33, 30
35
What are the questions to ask yourself regarding rhythm?
1. is it sinus? 2. If not sinus, where does it originate? 3. Is it regular or irregular? 4. Are there premature beats? 5. Is there a block?
36
How long is a normal P-wave? How many boxes?
37
A normal p wave is monophasic in lead __ and biphasic in lead __.
monophasic in II | bisphasic in V1
38
What will the P wave look like in right atrial enlargement?
Peaked P wave in II and V1
39
What will the P wave look like in left atrial enlargement?
widened P wave II and V1 OR Biphasic, particularly in V1
40
What gives us a tip off that a rhythm originates above the ventricle?
narrow complex
41
Are all supraventricular rhythms narrow complex?
no (think about PACs)
42
What gives us clues that the rhythm originates in the atrium?
if it originates in the atrium, there will be a p wave (or saw-tooth wave or a-fib waves)
43
What clues tell us the rhythm is junctional?
if there are no p-waves or retrograde P waves.
44
What clues can we look for to determine if a rhythm is ventricular?
wide complex (but this doesn't necessarily mean it's ventricular - can be an issue with conduction - His/Purk fibers) no p
45
What are the three types of tachyarrythmias in the atria?
sinus tachy paroxysmal supraventricular tachycardia (HR>140) Atrial flutter
46
What are the two tachyarrhythmias that are junctional?
.accelerated junctional rhythm - 70-130 SVT >140
47
What are the two tachyarrhythmias originating in the ventricles?
.accelerated idioventricular 55-110 | ventricular tachycardia >140
48
What's the bradyarrhythmia in the atria?
.sinus brady
49
What's the bradyarrhythmia that's junctional?
junctional escape
50
What's the typical rate for junctional escape?
40-60 bpm
51
What's the typical rate for ventricular escape?
20-40 bpm
52
What characterizes sinus arrhythmia?
R-R
53
Describe supraventricular tachycardia
sudden onset rate typically 120-180 you can often see P waves (retrograde maybe in II and III) narrow complex ST segment depression common
54
What's the definition of ventricular tachycardia?
a run of 3+ PVCs with HR over 140
55
How long does V tach need to go to be considered sustained?
over 30 sec
56
What are the three examples of junctional rhythms?
junctional escape accelerated junctional paroxysmal SVT
57
How fast is junctional escape?
40-60
58
How fast is accelerated junctional?
70-130
59
Define what happens in a 1st degree AV block?
PR prolongation >.2 S (so one big box) but there will always be a QRS present
60
If there is a dropped QRS complex and the PR lengthens until another QRS is dropped, what type of block is it?
2nd degree - Mobitz Type I
61
If there is a dropped QRS complex and the PR is constant, what type of block is it?
2nd degree, mobitz type II
62
If the PR changes, but the P-P and R-R intervals are constant, what type of block is it?
3rd degree (AV dissociation)
63
What's the difference between multifocal atrial tachycardia and a-fib?
they look similar, but there is a P wave clearly visible before each QRS - although these P waves will look different morphologically
64
What is multifocal atrial tachycardia called when the HR is less than 100 bpm?
wandering pacemaker
65
What do you call it when a premature atrial complex becomes coupled to the end of a normal cycle in a repetitive fashion?
atrial bigeminy or trigeminy
66
What is the most common ventricular arrhythmia?
a PVC
67
Describe a PVC
it's a wide QRS complex that's bizarre - comes too soon after the last beat and followed by a prolonged compensatory pause
68
Describe a-fib
irregularly irregular no organized p waves and atrial rate is very fast the ventricular rate is variable
69
If it's a-fib with RVR, what's the heart rate?
over 100
70
What does hyperkalemia look like on EKG?
peaked T waves, progressing to merging of the p/QRS - this is bad - probs gonna die
71
What happens to an EKG in hypercalcemia?
shortened QT
72
What will you see on EKG in pericarditis?
Diffuse ST elevation in all leads Diffuse T wave inversion diffuse PR depression except for elevation in aVR decreased amplitude if effusion present

EKG (2 decks)

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