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Cardiovascular System > Session 6- Interpreting ECGs > Flashcards

Session 6- Interpreting ECGs Flashcards

1
Q

deflection

A

deviation from straight line- in ECG either an upward or downward wave/peak from the baseline

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2
Q

how many views does a ECG provide

A

12

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3
Q

what is excitation-contarction coupling

A

depolarisation wave causes coordinated contraction of atria and ventricles

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4
Q

sinoatrial node

A
  • fastest rate of depolarisation in the heart - suppresses other pacemakers
  • intrinsic firing rate 50-100 times/minute
  • sets heart rate and rhythm- sinus rhythm
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5
Q

atrioventricular node

A

slows conduction

gives them to atria to contract before ventricles

intrinsic firing rate without stimulation (such as from the SA node) 40-60 times/minute

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6
Q

what are the - LBB RBB

A

ventricular electrical conducting system cells also have am intrinsic firing rate although this is NOT typically manifested

intrinsic firing rate 20-40 times/minute so slow

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7
Q

how does electrical activity spread throughout the heart

A

initiated at SA node

depolarisation right atrium and left atrium

hits AV

from AV to bundle of His- wide conducting muscle fibres that travel through Annulus Fibrosus

bundle of his to interventricular septum then dividides into LBB and RBB

RBB and LBB terminate in extensive network of fast conducting fibres- pukinje fibres

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8
Q

annulus fibrosus

A

separates atria from ventricles

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9
Q

what does an ecg do

A

electrocardiogram

measures changes in electrical potential (in mVolts) produced in successive areas of myocardium during cardiac cycle via a series of LEADS

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10
Q

what does a ECG lead

A

1) cable used to connect electrode to ECG recorder

2) electrical view of the heart obtained from any one combination of electrodes

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11
Q

what is an electrode

A

is conductive pad is attached to skin and enables recording of electrical currents

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12
Q

what is the grounding electrode

A

right leg electrode

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13
Q

what are the chest leads

A 
v1
v2
v3
v4
v5
v6
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14
Q

which leads are bipolar

A

Limb Leads I, II, III

negative and positive electrode

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15
Q

limb lead 1

A

voltage difference between electrode RA and LA; LA (+) electrode

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16
Q

limb lead II

A

voltage difference between electrode RA and LL; LL (+) electrode

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17
Q

limb lead III

A

voltage difference between electrode LA and LL; LL (+) electrode

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18
Q

what are the augmented limb leads

A

aVR, aVL and aVF unipolar

only have a positive electrode

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19
Q

aVR

A

right arm

LL1

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20
Q

aVL

A

left arm

LL2

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21
Q

aVF

A

left leg- f for foot

LL3

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22
Q

septal leads

A

v1 and v2

23
Q

anterior leads

A

v2 v3 and v4

24
Q

lateral precordial leads

A

v4 v5 and v6

25
Q

what determines the height of deflection

A

how directly depolarisation wave is coming towards from the positive electrode and the number of cells generating the signal

26
Q

what is the p wave

A

atrial depolarisation- spreads along atrial muscle fibres and internodal (SA-AV) pathways
-direction- downwards and to the left towards AV

27
Q

what is the isoelectric flat line segment

A

conduction slowed at AV to allow atrial contraction to fill ventricle

signal very small

28
Q

R wave

A

a large upward deflection
upward because depolarisation moving directly towards electrode
large because large muscle mass- more electrical activity
if left ventricle is hypertrophied- R wave will be correspondingly taller

29
Q

s wave

A

Downward because moving away
small because not moving directly away

depolarisation finally spreads upwards to the base of the ventricles

30
Q

ventricular repolarisation

A

begins on the epicardial surface of the heart
spreads in the opposite direction to depolarisation
produces a medium upward deflection- T wave

31
Q

why is the t wave upwards

A

it is a wave of repolarisation moving away from electrode- when repolarisation moves AWAY from lead produces upward deflection- in comparison with when depolarisation moves away from lead produces a negative deflection

32
Q

QRS

A

depolarisation of ventricles not contraction of ventricles

33
Q

what limb leads look at the left side of the heart

A

Leads I and aVL

34
Q

what causes a lateral wall MI

A

occlusion branch left coronary artery-circumflex

35
Q

what leads look at the inferior surface of the heart

A

Lead II III AVF

36
Q

what causes a inferior myocardial wall infarction

A

muscle necrosis due occlusion right coronary artery

37
Q

V1 -V4

A

ANTERO-SEPTAL

38
Q

V1 AND V2

A

FACE RV & SEPTUM ‘septal leads’

39
Q

V3 AND V4

A

FACE APEX AND ANTERIOR WALL OF RV AND LV

40
Q

V5 AND V6

A

face the LV - lateral leads

41
Q

calculating HR

A

1 small square- 40ms
1 large square- 200ms

5 Large squares- 1 second
300 large squares = 1 minute

regular- R-R one heart beat
300 divided by number of large boxes

42
Q

calculating irregular heart beat

A

count number of QRS complexes in 6 seconds- 30 large boxes- then multiply by 10

43
Q

how long should the PR interval be

A

0.12 - 0.2 3-5 small boxes

prolonged if > 1 large box

44
Q

what does a prolonged PR interval indicate

A

delayed conduction through AV node and bundle of His

45
Q

how long should the QRS interval be

A

< 0.12 seconds

< 3 small boxes

46
Q

what does a widened QRS indicate

A

usually a depolarisation arising in ventricle; not spreading via the rapid conducting His-Purkinje system; hence takes more time

47
Q

electrode placement- limb lead

A 
RIDE YOUR GREEN BIKE 
Right arm- red 
left arm- yellow
left leg- green
right leg-black
48
Q

c1

A

fourth intercostal space at the right border of the sternum

49
Q

c2

A

fourth intercostal space at the left border of the sternum

50
Q

c2

A

midway between location c3 and c4

51
Q

c4

A

at the mid-clavicular line in the 5th intercostal space

52
Q

c5

A

at the anterior axillary line on the same horizontal plane at c4

53
Q

c6

A

at the mid axillary line same horizontal plane as c4 and c5

Cardiovascular System (18 decks)

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