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EKG > Regions EKG PowerPoint > Flashcards

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
Q

How long does V tach need to go to be considered sustained?

A

over 30 sec

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26
Q

What are the three examples of junctional rhythms?

A

junctional escape
accelerated junctional
paroxysmal SVT

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27
Q

How fast is junctional escape?

A

40-60

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28
Q

How fast is accelerated junctional?

A

70-130

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29
Q

Define what happens in a 1st degree AV block?

A

PR prolongation >.2 S (so one big box)

but there will always be a QRS present

30
Q

If there is a dropped QRS complex and the PR lengthens until another QRS is dropped, what type of block is it?

A

2nd degree - Mobitz Type I

31
Q

If there is a dropped QRS complex and the PR is constant, what type of block is it?

A

2nd degree, mobitz type II

32
Q

If the PR changes, but the P-P and R-R intervals are constant, what type of block is it?

A

3rd degree (AV dissociation)

33
Q

How many big boxes per second?

A

5

34
Q

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

A

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

35
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?
36
Q

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

A
37
Q

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

A

monophasic in II

bisphasic in V1

38
Q

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

A

Peaked P wave in II and V1

39
Q

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

A

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

40
Q

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

A

narrow complex

41
Q

Are all supraventricular rhythms narrow complex?

A

no (think about PACs)

42
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)

43
Q

What clues tell us the rhythm is junctional?

A

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

44
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

45
Q

What are the three types of tachyarrythmias in the atria?

A

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

46
Q

What are the two tachyarrhythmias that are junctional?

A

.accelerated junctional rhythm - 70-130

SVT >140

47
Q

What are the two tachyarrhythmias originating in the ventricles?

A

.accelerated idioventricular 55-110

ventricular tachycardia >140

48
Q

What’s the bradyarrhythmia in the atria?

A

.sinus brady

49
Q

What’s the bradyarrhythmia that’s junctional?

A

junctional escape

50
Q

What’s the typical rate for junctional escape?

A

40-60 bpm

51
Q

What’s the typical rate for ventricular escape?

A

20-40 bpm

52
Q

What characterizes sinus arrhythmia?

A

R-R

53
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

54
Q

What’s the definition of ventricular tachycardia?

A

a run of 3+ PVCs with HR over 140

55
Q

How long does V tach need to go to be considered sustained?

A

over 30 sec

56
Q

What are the three examples of junctional rhythms?

A

junctional escape
accelerated junctional
paroxysmal SVT

57
Q

How fast is junctional escape?

A

40-60

58
Q

How fast is accelerated junctional?

A

70-130

59
Q

Define what happens in a 1st degree AV block?

A

PR prolongation >.2 S (so one big box)

but there will always be a QRS present

60
Q

If there is a dropped QRS complex and the PR lengthens until another QRS is dropped, what type of block is it?

A

2nd degree - Mobitz Type I

61
Q

If there is a dropped QRS complex and the PR is constant, what type of block is it?

A

2nd degree, mobitz type II

62
Q

If the PR changes, but the P-P and R-R intervals are constant, what type of block is it?

A

3rd degree (AV dissociation)

63
Q

What’s the difference between multifocal atrial tachycardia and a-fib?

A

they look similar, but there is a P wave clearly visible before each QRS - although these P waves will look different morphologically

64
Q

What is multifocal atrial tachycardia called when the HR is less than 100 bpm?

A

wandering pacemaker

65
Q

What do you call it when a premature atrial complex becomes coupled to the end of a normal cycle in a repetitive fashion?

A

atrial bigeminy or trigeminy

66
Q

What is the most common ventricular arrhythmia?

A

a PVC

67
Q

Describe a PVC

A

it’s a wide QRS complex that’s bizarre - comes too soon after the last beat and followed by a prolonged compensatory pause

68
Q

Describe a-fib

A

irregularly irregular
no organized p waves and atrial rate is very fast

the ventricular rate is variable

69
Q

If it’s a-fib with RVR, what’s the heart rate?

A

over 100

70
Q

What does hyperkalemia look like on EKG?

A

peaked T waves, progressing to merging of the p/QRS - this is bad - probs gonna die

71
Q

What happens to an EKG in hypercalcemia?

A

shortened QT

72
Q

What will you see on EKG in pericarditis?

A

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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