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Cardiopulm > Week 1 ECG and Analysis > Flashcards

Week 1 ECG and Analysis Flashcards

1
Q

what do we measure with an ECG

A

electrical signals of the heart

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2
Q

what is electromechanical coupling

A

the electrical signal on the ECG with the functional properties of the heart

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3
Q

what is the electrocardiogram

A

it captures the electrical activity produced by the hearts contraction cycle. it detects the flow of charged particles along the pathway, and detects currents.

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4
Q

in what directions do the heart signals travel, or in which direction does the heart depolarize?

A

right to left and inferior to superior and inside out.

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5
Q

what is the mean cardiac vector

A

what we get from the left ventricle, because it is bigger, and we get more of a signal

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6
Q

what does the QRS represent, and why is it the largest electrical event that occurs?

A

ventricular depolarization, its the largest because the left ventricle is the biggest

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7
Q

which lead has the largest QRS magnitude and why

A

Lead II because the positive lead is on the right arm, and the negative one is on the left leg, so its vector falls almost right in line with the mean cardiac vector.

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8
Q

the positive terminal is essentially the …

A

eye

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9
Q

what does the positive terminal capture

A

receives the signal

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10
Q

how do we capture signals? from negative to positive? or positive to negative?

A

negative to postive

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11
Q

what are the bipolar leads

A

they utilize a positive and negative electrode, and record the activity between them. Leads 1, 2, 3

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12
Q

what are unipolar leads

A

they use a single positive recording electrode and a combo of the other electrodes

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13
Q

what are the two types of unipolar leads

A

pericordial (chest, V1,2,3,4,5,6)

unipolar (augmented) aVL, aVR, aVF

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14
Q

where are the positive and negative for lead I? what side of the heart does it look at

A

(-) is on the right arm, and (+) is on the left arm. looks at the lateral heart

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15
Q

where are the positive and negative for lead II? what side of the heart does it look at

A

(-) is on the right arm, and (+) is on the left leg. Looks at the inferior surface of the heart, and the best for the ventricles.

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16
Q

where are the positive and negative for lead III? what side of the heart does it look at

A

(-) is on the left arm, and (+) is on the left leg.

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17
Q

what are the unipolar precordial chest leads, and what are their positions on the body

A 
V1: 4th IC space right of the sternum 
V2: 4th IC space left of sternum 
v3: between V2 and V4
V4: midclavicular line 5th IC space 
V5: anterior axillary line, at V4 level 
V6: midaxillary line, at level of V4
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18
Q

what sections of the heart do the unipolar precordial leads look at

A

V1 and V2: septal area
V3 and V4: anterior wall
V5 and V6: lateral wall

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19
Q

do the unipolar leads have a positive or negative

A

they are the (+) and the machine is the negative

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20
Q

what are the three augmented leads

A

aVF, aVL, aVR

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21
Q

what does the aVF lead look at

A

the inferior part of the heart, since the positive is closer to the feet

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22
Q

what does the aVL look at

A

lateral wall of the heart, because this lead is placed on the left arm

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23
Q

what does the aVR look at

A

the right side of the heart, because the lead is placed on the right arm

24
Q

why is aVR special (2 things)

A

there is an inverted T and STR waves, because the lead looks at the right side of the heart, so it is backwards. also, this is the only lead that looks at the right side of the heart

25
Q

what is a 3 lead ECG

A

you only use the 3 electrodes, RA, LA and LL to get bipolar leads (I, II, III). you can see the lateral and the inferior parts of the heart

26
Q

what is a 5 lead ECG

A

you use RA, RL, LA, LL and chest. so you use the 3 bipolar leads, and one chest lead (whichever you need)

27
Q

where is the 5 lead ECG commonly used

A

in acute care

28
Q

what is the saying to remember which color lead goes where for a 5 lead ECG

A

white on right
snow over grass
smoke over fire
everyone loves chocolate

29
Q

what is a 12 lead ECG

A

you use all 6 chest leads and then you use all 4 limb leads. This will look at V1-6, leads I II III and then also aVR, aVL, aVF

30
Q

which type of ECG is used for diagnostics

A

12 lead

31
Q

which leads look at the septal part of the heart, and what coronary artery is that

A

V1 and V2, LAD

32
Q

which leads look at the anterior part of the heart, and what coronary artery is that

A

V3 and V4, LAD left anterior descending

33
Q

which leads look at the inferior part of the heart, and what coronary artery is that

A

II, III, aVF, PDA: posterior descending artery (from the RCA and the LCx)

34
Q

which leads look at the lateral part of the heart, and what coronary artery is that

A

I, V5, V6, aVL, LCx (left circumflex)

35
Q

how much time is represented by the thin and thick lines

A

the thin lines are 0.04 seconds and the thick lines are 0.2 seconds

36
Q

five small boxes which are the thick lines are 0.2 sec, so 5 thick line boxes is how much time

A

1 second

37
Q

what do the tick marks on the page represent. they happen every _____ thick boxes

A

3 seconds. every 15 boxes

38
Q

p wave represents…

normal size

A

atrial depolarization

duration should be 3 small boxes and amplitude should be 2.5 small boxes

39
Q

P-R interval represents?

duration should be?

A

the time the AP travels from the atria through the AV node to the ventricles. Duration should be 3-5 small boxes

40
Q

what happens to the PR interval with exercise

A

it decreases, because the heart rate increases

41
Q

what does the QRS represent

A

ventricular depolarization

42
Q

what should the duration of the QRS be

A

between 0.06 and 0.1 seconds, or 1-5-2.5 small boxes

43
Q

what should the amplitude be of the QRS

A

over 0.5 mV, or 5 small boxes in a standard lead
over 10 small boxes in a precordial lead
max: 25 boxes.

44
Q

what else happens during the QRS, and why is it drowned out

A

atrial repolarization happened here, but the ventricular depolarization is so big, it drowns it out.

45
Q

what does the ST segment represent

A

time ventricular depolarization and repolarization.

46
Q

what is the T wave

A

ventricular repolarization

47
Q

TF: the deflection of the T wave should be in the same direction as the QRS

A

true

48
Q

what its he R-R interval? appearance? and what happens with exercise ?

A

the duration between heart beats, should be regular and consistent and shortens with exercise

49
Q

what is the QT interval

A

the time it takes for ventricular depolarization and repolarization.

50
Q

how long should the QT interval be in men and women

A

men: 10-11 small boxes
women: 11-11.5 small boxes

51
Q

what is the normal time for the corrected QT interval

A

less than .44 seconds

52
Q

what is the J point

A

the initiation of ventricular repolarization. where the QRS ends, and the ST begins.

53
Q

what is the R wave progression.

A

from V1-V6, the R waves will get bigger in size, until we get to V4/5. then V6 is smaller again.

54
Q

where does the transition from S>R to R>S usually occur

A

at leads V3, V4.

55
Q

a patient is showing ST depression in leads V3,4,5,6. what could this mean

A

that he is having an anterolateral issue, affecting the LAD and LCx.

56
Q

a patient is showing T wave inversion in leads V2,3,4,5,6. what does this mean

A

that there is issues with anterior, lateral heart, so that again is the LAD and the LCx.

57
Q

what is the most common cause of ST segment elevation

A

myocardial ischemia and infarction

Cardiopulm (22 decks)

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