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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

23
Q

anterior leads

A

v2 v3 and v4

24
Q

lateral precordial leads

A

v4 v5 and v6

25
what determines the height of deflection
how directly depolarisation wave is coming towards from the positive electrode and the number of cells generating the signal
26
what is the p wave
atrial depolarisation- spreads along atrial muscle fibres and internodal (SA-AV) pathways -direction- downwards and to the left towards AV
27
what is the isoelectric flat line segment
conduction slowed at AV to allow atrial contraction to fill ventricle signal very small
28
R wave
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
s wave
Downward because moving away small because not moving directly away depolarisation finally spreads upwards to the base of the ventricles
30
ventricular repolarisation
begins on the epicardial surface of the heart spreads in the opposite direction to depolarisation produces a medium upward deflection- T wave
31
why is the t wave upwards
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
QRS
depolarisation of ventricles not contraction of ventricles
33
what limb leads look at the left side of the heart
Leads I and aVL
34
what causes a lateral wall MI
occlusion branch left coronary artery-circumflex
35
what leads look at the inferior surface of the heart
Lead II III AVF
36
what causes a inferior myocardial wall infarction
muscle necrosis due occlusion right coronary artery
37
V1 -V4
ANTERO-SEPTAL
38
V1 AND V2
FACE RV & SEPTUM 'septal leads'
39
V3 AND V4
FACE APEX AND ANTERIOR WALL OF RV AND LV
40
V5 AND V6
face the LV - lateral leads
41
calculating HR
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
calculating irregular heart beat
count number of QRS complexes in 6 seconds- 30 large boxes- then multiply by 10
43
how long should the PR interval be
0.12 - 0.2 3-5 small boxes | prolonged if > 1 large box
44
what does a prolonged PR interval indicate
delayed conduction through AV node and bundle of His
45
how long should the QRS interval be
< 0.12 seconds | < 3 small boxes
46
what does a widened QRS indicate
usually a depolarisation arising in ventricle; not spreading via the rapid conducting His-Purkinje system; hence takes more time
47
electrode placement- limb lead
``` RIDE YOUR GREEN BIKE Right arm- red left arm- yellow left leg- green right leg-black ```
48
c1
fourth intercostal space at the right border of the sternum
49
c2
fourth intercostal space at the left border of the sternum
50
c2
midway between location c3 and c4
51
c4
at the mid-clavicular line in the 5th intercostal space
52
c5
at the anterior axillary line on the same horizontal plane at c4
53
c6
at the mid axillary line same horizontal plane as c4 and c5

Cardiovascular System (18 decks)

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