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Cardiology > The EKG > Flashcards

The EKG Flashcards

1
Q

The heart contains three types of cells - what are they?

A

Pacemaker Cells
Electrical Conducting Cells
Myocardial Cells

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2
Q

These heart cells depolarize spontaneously over and over; rate
determined by innate characteristics

A

Pacemaker Cells

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3
Q

These heart cells carry current rapidly and efficiently throughout heart

A

Electrical Conducting Cells

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4
Q

These heart cells are a major part of heart tissue, responsible for the heavy labor of contraction

A

Myocardial Cells

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5
Q

The dominant pacemaker
60-100bpm influenced by SAS and vagal

A

SA node

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6
Q

The only conducting path between the atria and ventricles autonomic control also

A

AV node

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7
Q

QRS represents

A

ventricular contraction (depolarization)

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8
Q

depolarization of atria and simultaneous contraction

A

P wave

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9
Q

What is the resting potential of cardiac cells?

A

-90mV

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10
Q

What is the threshold of cardiac cells?

A

-70mV

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11
Q

K+ is also very important in cardiac cells - explain the effects of too low or too high potassium on the cardiac cells

A

High K+: depolarize cardiac cells (cardiac arrest)

Low K+: hyperpolarizes the tissue (harder to stimulate)

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12
Q

Cardiac cells rely on what substance?

A

Na+

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13
Q

In cardiac cells, what is the function of Na+?

A

Cell to cell depolarization

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14
Q

In cardiac cells, what is the function of K+?

A

Repolarization

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15
Q

In cardiac cells, what is the function of Ca2+?

A

Myocyte contraction and AV node conduction

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16
Q

What substances enhance Ca2+ movement= increased action potential = enhanced contraction?

A

Catecholamines

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17
Q

What is the max negative voltage of the pacemaker cells?

A

-60mV

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18
Q

What cells have properties of automaticity and undergo spontaneous depolarization?

A

Pacemaker Cells

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19
Q

A single contraction of cardiac muscle is completed before a second action potential can be generated. Why is this?

A

Designed to take a pause so the heart can get blood to itself

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20
Q

A period where muscle cannot be restimulated

Necessary to allow ventricles sufficient time to empty their contents and refill before next contraction

A

Refractory Periods

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21
Q

Cell is completely unexcitable to a new stimulation

A

Absolute refractory periods

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22
Q

Includes absolute refractory period and extends beyond to include short interval of phase 3

Many anti-arrhythmic drugs alter the ERP

A

Effective refractory period (ERP)

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23
Q

Stimulation triggers an action potential that is conducted, but because cell is stimulated from a voltage less negative than the resting potential, upstroke is less steep and lower amplitude

A

Relative refractor period

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24
Q

On the EKG, the vertical axis measures what?

A

measures voltage

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25
Q

On the EKG, the horizontal axis represents what?

A

represents time

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26
Q

How long is a normal PR interval?

A

0.12-0.2 seconds (3-5 small boxes)

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27
Q

How long is a normal QRS interval?

A

<0.12 seconds (3 small boxes)

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28
Q

List some conditions that the EKG detects

A

Heart rhythm abnormalities
Myocardial ischemia and infarction
Electrolyte imbalances
Effect of certain medications
Anatomical orientation of the heart
Size of atria/ventricles
Path taken by action potentials (did it go the proper way)

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29
Q

What can you NOT determine from an EKG?

A

cannot tell you how well the heart is pumping/squeezing

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30
Q

The 12-lead EKG includes what components?

A

3 limb leads (bipolar) - I, II, III

3 augmented leads (unipolar) - aVR, aVL, aVF

6 precordial leads - V1-V6

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31
Q

Which EKG lead is described below?

Left arm positive and right arm negative

Looks at left lateral side of heart

A

Lead I

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32
Q

Which EKG lead is described below?

Left leg positive and right arm negative

Looks at bottom part of the heart

A

Lead II

33
Q

Which EKG lead is described below?

Left leg positive and left arm negative

Looks at the bottom part of the heart

A

Lead III

34
Q

Which EKG lead is described below?

no man’s land (we don’t care about this one)

A

aVR

35
Q

Which EKG lead is described below?

Left hand positive

Looking at left lateral side of heart

A

aVL

36
Q

Which EKG lead is described below?

Positive in the heart

A

aVF

37
Q

Which EKG leads are described below?

called precordial leads

Looking at conduction

A

Chest Leads - V1-V6

38
Q

If the R wave progression is altered in leads V1-V6, what is your next step?

A

check lead placement or ask patient about previous MI (dead or damaged tissue can alter this)

39
Q

These are the anterior leads

A

V1, V2, V3, V4

40
Q

These are the inferior leads

A

II, III, aVF

41
Q

These are the left lateral leads

A

I, aVL, V5, V6

42
Q

EKG precordial lead placement:

4th intercostal (right)

A

V1

43
Q

EKG precordial lead placement:

4th intercostal (left)

A

V2

44
Q

EKG precordial lead placement:

Between leads V2 and V4

A

V3

45
Q

EKG precordial lead placement:

Midclavicular (mid collarbone)

A

V4

46
Q

EKG precordial lead placement:

5th intercostal space (anterior axillary line)

A

V5

47
Q

EKG precordial lead placement:

5th intercostal space (midaxillary line)

A

V6

48
Q

Right coronary artery is assessed by which EKG leads?

A

Leads II, III, aVF

49
Q

The LAD is assessed by which EKG leads?

A

Leads V1-V4

V1-V2: septal

V3-V4: anterior

50
Q

The CCA is assessed by which EKG leads?

A

Leads I, aVL

51
Q

The LAD and CCA are assessed by which EKG leads?

A

V5-V6

52
Q

P wave equals what?

A

atrial contraction of both atrial 🡪 atrial depolarization

53
Q

AV nodal delay: allows the atria to top off the ventricle

measured from the end of the P wave to the beginning of the QRS
complex

A

PR Segment

54
Q

Atrial depolarization plus AV nodal delay (Pulse to get to AV node and have a delay)

Measured from the beginning of the P wave to the beginning of the QRS complex

Represents the amount of time the action potential takes to travel from SA node through AV node

A

PR Interval

55
Q

Ventricular depolarization (Depolarization of both ventricles; beginning of ventricular contraction)

Also atrial repolariztion

How long did it take the pulse to travel to ventricles – interval of time the action potential takes to travel from AV node through ventricles

A

QRS Complex

56
Q

What is a normal QRS Complex duration?

A

Normal: .05 to .10 seconds; 25mm to 30mm

57
Q

What is a normal PR Interval duration?

A

Normal: .12 to .20 seconds

58
Q

What is a normal P wave duration?

A

Normal: <.11 seconds; <2.5mm tall

59
Q

Plateau phase of ventricular repolarization

A

ST Segment

60
Q

Duration of ventricular systole

QRS complex to end of T wave

Proportionate to the heart rate

About 40% of the normal cardiac cycle

A

QT Interval

61
Q

Peak of S to end of T

Ventricular repolarization (end of S to end of T)

Plateua phase: ST segment
Rapid phase: T wave

A

ST Interval

62
Q

Rapid phase of ventricular repolarization

K+ leaving the cell (Where you’ll see K+ abnormalities)

A

T Wave

63
Q

Q waves represent what?

A

Q waves show that an area of the heart is infarcted (dead)

64
Q

What conditions need to be present for Q waves to be significant?

A

They need to be greater than 1 box wide

Deeper than 1/3 height of the QRS complex

Present in 2 or more consecutive leads

65
Q

Measured from the beginning of the QRS to the end of the T wave

Normal is dependent on age, gender, heart rate (Female: 0.43; Male: 0.42)

Considered prolonged if this is greater than ½ RR interval

A

QT Interval

66
Q

Inverted T wave represents what?

A

ischemia

67
Q

Hyperacute T wave represents what?

A

ischemia

68
Q

Peaked T wave represents what?

A

hyperkalemia

69
Q

An U Wave represents what?

A

hypokalemia

70
Q

If SA node fails, one of other potential pacemakers takes over. What is the pace you’d see with the following backup potential pacemakers:

Atria
AV junction
Ventricles

A

Atria: 60-80 bpm

AV junction: 40-60 bpm

Ventricles: 20-40 bpm

71
Q

How do you determine the exact rate on an EKG?

A

1500 divided by the number of small boxes between two R waves

72
Q

Diffuse ST elevation

A

pericarditis

73
Q

Marked T wave inversion in leads V2 and V3 is the hallmark
for what?

A

Wellen’s Syndrome (stenosis of left anterior descending artery)

74
Q

ST Depression

A

Ischemia

75
Q

ST Elevation

A

Infarction

76
Q

Shortened QT interval

A

Hypercalcemia

77
Q

Prolonged QT interval (may trigger Torsades de Pointes)

Early: T wave flattening

ST segment starts to depress and
can invert the T wave

Late: severe characteristic U
wave

A

Hypocalcemia

78
Q

Peaked T waves: earliest and most common finding

P waves may be flattened or absent

Severe: QRS widening and fuses with T wave (sine waves)

A

Hyperkalemia

Cardiology (13 decks)

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