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CVS-charis > Understanding the ECG and practical ECG methods > Flashcards

Understanding the ECG and practical ECG methods Flashcards

1
Q

Depolarisation towards the anode - Defletion?

A

Downwards

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2
Q

Depolarisation towards the cathode - Defletion?

A

Upwards

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3
Q

1st row of leads, which arteries?

A

LCx, n/a, LAD, RCA

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4
Q

2nd row of leads, which arteries?

A

RCA, LCx, LAD LCx

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5
Q

3rd row of leads, which arteries?

A

RCA, RCA, RCA, LCx

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6
Q

What is LCx

A

Left circumflex artery

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7
Q

What is RCA

A

Right coronary artery

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8
Q

What is LAD

A

Left anterior descending artery

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9
Q

Lead I
Negative
Positive

A

Between RA, LA
- = RA
+=LA

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10
Q

Lead II
Negative
Positive

A

Between RA, LL
- = RA
+ = LL

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11
Q

Lead III
Negative
Positive

A

Between LA, LL
- = LA
+ = LL

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12
Q

Where do you place V1

A

Right sternal border, in the 4th intercostal space

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13
Q

Where do you place V2

A

Left sternal border

4th intercostal space

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14
Q

Where do you place V3

A

Halfway between V2 and V4

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15
Q

Where do you place V4

A

Mid-clavicular line

5th intercostal space

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16
Q

Where do you place V5

A

Anterior axiliiary line at level of V4

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17
Q

Where do you place V6

A

Mid-axillary line at the level of V4

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18
Q

Why is the bump in atrial depolarisation smaller than the bump in ventricular depolarisation?

A

Atrial myocardium is quite thin and not filled with a lot of conductive cells, gentle P wave

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19
Q

What is connected to the R leg during an ECG? Function?

A

Ground, earth electrode, eliminates noise and acts as a control

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20
Q

What does the P wave represent?

Normal duration?
Amplitude in lead II?

A

R + L Atrial depolarisation

80ms, <110ms
<2.5mm

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21
Q

What does the Q wave represent?

Normal duration?
Amplitude

A

Septal depolarisation

<40ms
<25% of total QRS complex attitude

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22
Q

What does the R wave represent?

A

ventricular depolarisation

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23
Q

What does the S wave represent?

A

Late ventricular depolarisation (depolarisation goes to the sides)

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24
Q

What does the ST-T wave represent?

T wave duration?
How should the ST segment look?

A

Ventricular repolarisation

160ms
It should be isoelectric

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25
Q

Which is the bottom lead on the ECG trace and what does it represent?

A

Lead II

Rhythm strip

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26
Q

How is the anode found?

A

Mathematical summation of other points on skin

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27
Q

Which are the bipolar leads?

A

Lead I, II, III

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28
Q

Depolarisation away from the cathode?

A

Downwards

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29
Q

Repolarisation towards the cathode?

A

Downwards

30
Q

Repolasitation away from cathode?

A

Upwards

31
Q

How are augmented leads obtained?

A

Average voltage of any two points on skin as negative pole and reading from the third electrode (positive pole)

32
Q

How is P wave and QRS complex in Lead I and II?

A

Both upwards

33
Q

How is P wave and QRS complex in Lead III?

A

Both downwards

34
Q

Lead aVR
Negative electrodes?
Positive electrode?
Direction?

A

LA, LL
RA
See slide 26

35
Q

Lead aVL
Negative electrodes?
Positive electrode?
Direction?

A

RA, LL
LA
See slide 28

36
Q

Lead aVF
Negative electrodes?
Positive electrodes?
Direction?

A

RA, LA
LL
See slide 30

37
Q

How are the leads shown on ECG

left to right and top to bottom

A

Lead I, aVR, V1, V4
Lead II, aVL, V2, V5
Lead III, aVF, V3, V6

38
Q

How do augmented leads work?

A

1 true recording electrode (positive)

Negative electrode obtained by averaging out different point on the skin

39
Q

What does a 5mm x 5mm square on an ECG represent? (time and amplitude)

A
  1. 2 s / 200ms

0. 5mV

40
Q

What does a 1mm x 1mm square on an ECG represent? (time and amplitude)

A
  1. 04 s / 40 ms

0. 1mV

41
Q

Draw the QRS axis circle

A

Check slide 36

42
Q

In which direction(s) would the heart normally depolarise?

A

Left axis + normal QRS axis

43
Q

Which is the left axis

A

-90 - -30

44
Q

Which is the normal axis on the diagram

A

-30 - 90

45
Q

Which is the right axis

A

90-210

46
Q

How do yo calculate the QRS axis and which are the best leads to use

A

Pick two leads that are in right angles to each other

Best ones: Lead I and lead aVF

47
Q

Which is the normal axis in practice

A

-30 - +90

48
Q

Calculating the QRS axis -positive Lead I, direction of arrow in triangle?

A

To the right

49
Q

Calculating the QRS axis -negative Lead I, direction of arrow in triangle?

A

To the left

50
Q

Calculating the QRS axis -positive aVF, direction of arrow in triangle?

A

Downwards

51
Q

Calculating the QRS axis -negative aVF, direction of arrow in triangle?

A

Upwards

52
Q

What are bipolar leads?

A

The only leads that record potential difference between TWO electrodes

53
Q

What are unipolar leads?

A

Only one true electrode recording, the other is a virtual electrode

54
Q

What is Wilson’s central terminal?

A

Composite pole of RA, LA, LL i.e. average potential across the body, using Lead I, II ,III

55
Q

Chest/precordial leads
Unipolar or bipolar
Which are the positive poles and which are the negative ones

A

Unipolar
Chest lead is positive pole
Wilson’s central terminal is the negative pole

56
Q

Septal chest leads

A

V1, V2

57
Q

Anterior chest leads

A

V3, V4

58
Q

Lateral chest leads

A

V5, V6

59
Q

Which are the limb leads (both bipolar and unipolar)

A

I, II, III (standard limb leads, bipolar)

aVR, aVL, aVF (augmented limb leads, unipolar)

60
Q

Which are the precordial limb leads (both bipolar and unipolar)

A

No bipolar precordial leads

V1 - V6 unipolar

61
Q

PR interval

normal duration?

A

time interval from onset of atrial depolarization (P wave) to onset of ventricular depolarization (QRS complex)

120-200ms
generally up to 3 small squares

62
Q

QT interval

Normal duration?

A

duration of ventricular depolarization and repolarization

380-420 ms

63
Q

QRS interval

Normal duration?
Amplitude of R wave in V6?

A

duration of ventricular muscle depolarization

<120ms, normally less than 3 small squares
<25mm

64
Q

RR interval

normal?

A

Duration of ventricular cardiac cycle - an indicator of ventricular rate
0.6-1.2s

65
Q

PP interval

A

Duration of atrial cycle (indicator of atrial rate)

66
Q

Anything in the direction of the leads (e.g. Lead I, in the direction of RA to LA) -Signal

A

Will give a large signal

67
Q

Anything perpendicular to the direction of the leads (e.g. Lead I, in the direction of RA to LA) -Signal

A

No large signal

68
Q

Try to calculate QRS axis from power points

A

.

69
Q

Normal heart rate

A

60-100bpm

70
Q

Which are the inferior leads?

A

Leads II, III, aVF

71
Q

Which are the lateral leads?

A

Lead I, aVL, V5, V6

CVS-charis (7 decks)

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