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CVS A > Session 6 > Flashcards

Session 6 Flashcards

1
Q

What does ECG stand for?

A

Electrocardiogram

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2
Q

Function of the SA node?

A

Sets the rhythm - sinus rhythm

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3
Q

Function of the bundle of His?

A

Conduction path from atria to ventricles

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4
Q

Where are the right and left bundle branches?

A

Lie sub-endocardially in the intraventricular septum.

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5
Q

What are the purkinje fibres?

A

Fine branches of the bundles of His. Rapid spread of depolarisation.

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6
Q

Where is the SAN situated?

A

Where the superior vena cava meets the right atrium

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7
Q

Why is there a hold up of electrical conduction at the AVN?

A

In order to allow time for the atria to contract

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8
Q

What part of the heart is the first to depolarised and therefore contract?

A

Intraventricular septum

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9
Q

What part of the heart is the last to depolarise and therefore contract?

A

Base of the ventricles

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10
Q

What does as ECG record?

A

Records changes on extracellular surface of cardiac myocytes during wave of depolarisation and repolarisation.

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11
Q

How do you get a positive depolarisation complex on an ECG?

A

When the heart depolarises from right to left.

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12
Q

How do you get a positive repolarisation complex?

A

If the pulse is going away (from positive to negative)

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13
Q

In a resting state, what is are the charges of a cardiac muscle cell?

A 
Inside = negative
Outside = positive
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14
Q

What happens to the inside of the cardiac muscle cell when depolarisation occurs?

A

Inside gets more positive because sodium enters

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15
Q

What would the depolarisation wave look like if coming directly towards the electrode?

A

Tall positive complex

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16
Q

What would the depolarisation wave look like if wav comes obliquely towards electrode?

A

Smaller positive complex

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17
Q

What would the depolarisation wave look like if the wave is 90degrees to electrode?

A

No complex

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18
Q

What would happen if the depolarisation wave goes directly away from electrode?

A

Deep negative complex

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19
Q

How is the SAN depolarisation depicted on an ECG?

A

Start of the p wave

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20
Q

How is atrial depolarisation shown on an ECG?

A

Produces the P wave

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21
Q

What happens after the atrial depolarisation and how is this shown on an ECG?

A

Delay at AV node shown by an isoelectric (flat line) segment 1b.

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22
Q

Why is there no direct contact between atrial and ventricular myocytes?

A

Fibrous ring between atria and ventricles

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23
Q

What also contributes to the isoelectric segment?

A

Depolarisation via bundle of His and conduction via His-purkinje system

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24
Q

What is the first part of the heart to depolarise?

A

Muscle in the IV septum

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25
Q

How does the IV septum depolarise and how is this shown on an ECG?

A

Depolarised form left to right and produces q wave

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26
Q

Describe the q wave

A

Small downward deflection

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27
Q

How is the depolarisation of apex and free ventricular wall shows on an ECG?

A

R wave

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28
Q

Describe the R wave

A

Large upward deflection

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29
Q

Why is the R wave upwards?

A

Because depolarisation moving directly towards electrode

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30
Q

What is the R wave large?

A

Because it is a larger muscle mass hence is more electrically active

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31
Q

What happens to the R wave if the left ventricle hypertrophies?

A

The R wave will be correspondingly taller

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32
Q

What happens at the end of depolarisation?

A

Depolarisation finally spreads upwards to the base of the ventricles

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33
Q

How is the end of depolarisation shown on an ECG?

A

S wave - small downward deflection

34
Q

Why is the S wave downwards?

A

Moving away

35
Q

Why s the S wave small?

A

Not moving directly away

36
Q

Where does ventricular repolarisation occur?

A

Epicardial surface

37
Q

What does ventricular repolarisation look like on an ECG?

A

Produces a medium upward deflection - T wave

38
Q

Why is the T wave upwards?

A

Upwards because it is a wave of repolarisation moving AWAY from electrode

39
Q

What does the P wave represent?

A

Atrial depolarisation

40
Q

What does QRS represent?

A

Ventricular depolarisation

41
Q

What is the Q wave?

A

Initial downwards deflection after the p wave

42
Q

What is the R wave?

A

Initial upward deflection after the q wave

43
Q

What is the S wave?

A

Downward deflection after R wave

44
Q

How many electrodes are used in an ECG?

A

10 electrodes

45
Q

Where are the electrodes placed?

A

4 electrodes on limbs

6 electrodes on the chest

46
Q

How many views do the electrodes provide?

A

12 views of the heart

47
Q

What are views also called?

A

Leads

48
Q

How many views do the 4 limb electrodes provide?

A

6 view in the vertical plane

49
Q

What are the unipolar limb leads?

A

aVR, aVF and aVL

50
Q

Lead 1

A

Right arm to left arm (positive)

51
Q

Lead 2

A

Right arm to left leg (positive)

52
Q

Lead 3

A

Left arm to left leg (positive)

53
Q

aVR

A

Positive electrode on right arm

54
Q

aVF

A

Positive electrode on left leg

55
Q

aVL

A

Positive electrode on left arm

56
Q

What does aVR stand for?

A

Augmented vector right

57
Q

Which limb leads look at the inferior surface of the heart?

A

Leads II, III and aVF

58
Q

Give examples of problems that occur at the inferior of the heart

A

Muscle necrosis due to a inferior myocardial infarction

59
Q

Which leads look at the left side of the heart?

A

Leads I and aVL

60
Q

How many chest electrodes and how many views?

A

6 views

6 electrodes

61
Q

In what plane do the chest leads view the heart?

A

Horizontal plane

62
Q

Leads V1 and V2

A

Face the right ventricle and septum ‘septal leads’

63
Q

Leads V3 and V4

A

Face the apex and anterior wall of ventricles ‘anterior leads’

64
Q

Leads V5 and V6

A

Face the left ventricle ‘lateral leads’

65
Q

On an ECG, what is the horizontal axis?

A

Time

66
Q

On an ECG what is the vertical axis?

A

Voltage

67
Q

What is the normal ECG paper speed?

A

25mm/second

68
Q

How many squares is equal to 1 second?

A

25 small squares

5 large squares

69
Q

How many seconds is 1 large square equivalent to?

A

0.2 seconds (200ms) 1/5th of a second

70
Q

How many seconds is a small square equivalent to?

A

0.04 s (40ms)

71
Q

How many squares are there in 1 minute?

A

300 large squares

72
Q

On an ECG, what is one cardiac cycle?

A

PQRST complex (from start of P wave to start of next P wave)

73
Q

How do you calculate heart rate from an ECG?

A

Work out how many complexes fit into 300 large boxes eg 4

300/4 = 75

74
Q

How do you calculate an irregular heart rate from an ECG?

A

Calculate how many complexes in 6 seconds and then multiply by 10

75
Q

Normally, how long is the PR interval?

A

0.12 - 0.20 secs 3-5small boxes

76
Q

How do you know if PR interval is prolonged?

A

> 1 large box

77
Q

How long is the normal QRS complex?

A

<0.12 seconds

<3 small boxes

78
Q

What is the normal QT interval?

A

Varies with heart rate. Calculation to correct for heart rate (charts available)

79
Q

What is the upper limit of corrected QT?

A

0.45 in adult males
0.47 adult females
(11-12 small boxes)

80
Q

When does sinus rhythm change?

A

Varies its respiration. If you breathe deep, heart rate will increase

81
Q

What is sinus brachycardia?

A

Sinus rhythm with rate<60/min

82
Q

What is sinus tachycardia?

A

Sinus rhythm with rate>100/min

CVS A (18 decks)

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