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614 General Principles Of Anesthesia > Week 13 - EKG > Flashcards

Week 13 - EKG Flashcards

1
Q

Rhythm
Rate
P:QRS internal ratio

A

NSR
60-100
1:1

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2
Q

represent a slowing of conduction through the AV node

A

SR with first degree block
PR > 0.2 sec

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3
Q

Rhythm

A

SR with 1st degree block
represent a slowing of conduction through the AV node

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4
Q

T or F: pts with SR with degree AV block are ususally symptomatic

A

F- usually not symptomatic

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5
Q

How do P-P intervals differ in Mobitz type I

A

Mobitz Type I = SR with 2nd degree AV block
P-P are constant

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6
Q

Wenckebach is a 2nd degree AV block _______ type _____

A

Mobitz type I

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7
Q

Name Rhythm

A

Sinus Rhythm with Second Degree AV block- Mobitz Type I (Wenckebach)

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8
Q

Name Rhythm

A

Sinus Rhythm with Second Degree AV block- Mobitz Type II

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9
Q

Sinus Rhythm with Second Degree AV block- Mobitz Type II PR intervals are > 0.20 seconds and ________

A

constant

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10
Q

Sinus Rhythm with Second Degree AV block- Mobitz Type II are usually (asymptomatic/symptomatic)

A

symptomatic

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11
Q

represents a complete dissociation between atria and ventricles

A

3rd degree AV block

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12
Q

T or F: P waves normal in 3rd degree heart block

A

True

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13
Q

T or F: P-P intervals are irregular in 3rd degree heart block

A

F - NORMAL

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14
Q

What rhythm:
QRS morphology and width vary depending on where the escape pacemaker is located in the conduction system

A

Third degree AV block

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15
Q

What Rhythm:
P waves and QRS have nothing to do with eachother

A

Third degree AV block

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16
Q

what rhythm

A

Third degree AV block

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17
Q

what rhythm

A

Third degree AV block

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18
Q

what rhythm

A

Third degree AV block

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19
Q

what rhythm

A

Third degree AV block

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20
Q

patients with third degree AV blokc are usually (asymptomatic/symptomatic)

A

symptomatic

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21
Q

Relationship btwn atrial and ventricular rate in third degree AV block

A

atrial rate always faster than ventricular rate

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22
Q

Where does Junctional rhythm originate from

A

AV node

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23
Q

T or F: junctional rhythm p waves never present

A

F - may or may not be present

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24
Q

what rhythm

A

junctional rhyth,m

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25
Q

in junctional rhythm, where is the P wave sometimes at

A

after QRS complex

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26
Q

what rhythm

A
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27
Q

what is the blue portion of the strip’s rhythm

A

junctional rhythm,

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28
Q

where does the acelerated junctional rhythm, come from

A

AV junction

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29
Q

what rhythm

A

accelerated junctional rhythm

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30
Q

describe AFib QRS interval

A

normally WNL

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31
Q

uncontrolled rate of afib >100 often called

A

rapid ventricular reponse

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32
Q

what rhythm

A

a fib

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33
Q

T or F: A flutter has a P wave present

A

T

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34
Q

most common A flutter conduction ratio

A

2:1

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35
Q

describe Atrial flutter QRS interval

A

usually WNL

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36
Q

is atrial flutter rate usualy regular or irregular

A

regular

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37
Q

what rhythm

A

A flutter

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38
Q

firs thing that should come to mind when you hear “a fib”

A

irregular

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39
Q

HR range for SVT

A

140-220 bpm

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40
Q

is SVT usually regular or irregular

A

regular

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41
Q

where are SVT impulses coming from

A

collection of tissue around and involving the AV node

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42
Q

what rhythm

A

SVT

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43
Q

if a patient crept up on SVT… NSR higher then higher then higher, what is a likely cause

A

hypovolemia d/t blood loss

44
Q

Vtach rate ususally

A

100-220 BPM

45
Q

T or F: Vtach rate is always symptomatic

A

F - usually symptomatic not always

46
Q

what rhythm

A

V tach

47
Q

rhythm with no observable QRS

A

VFib

48
Q

rhythm with chaotic electrical activity

A

VFib

49
Q

what rhythm

A

VFib

50
Q

rhythm where is is usually last ditch attempt to maintain cardiac output

A

idioventricular rhythm

51
Q

rate of idioventriucl;ar rhythm

A

usually < 40 BPM

52
Q

what rhythm

A

idioventricular rhythm

53
Q

why look at lead II first?

A

it is most sensitive to changes

54
Q

direction Lead II reads

A

RU to LL

55
Q

which leads should have positive deflections in EKG

A

I, II, III
V4, V5, V6

56
Q

which leads should have negative deflections in EKG

A

aVR and VI

57
Q

which leads should have both + and - deflections in EKG

A

aVL, V2, and V3

58
Q

bipolar leads

A

leads I, II, III

59
Q

unipolar leads

A

aVL, aVR, aVF

60
Q

is left or roight axis deviation more common

A

left axis deviation (Lead I up and aVF down)

61
Q

axis deviations for Lead I and aVF:

both up

A

normal

62
Q

axis deviations for Lead I and aVF:
I up and aVF down

A

left

63
Q

axis deviations for Lead I and aVF:

I down and aVF up

A

right

64
Q

axis deviations for Lead I and aVF:

both down

A

severe right… youre in trouble!

65
Q

if leads II, III, and aVF are negative its what issue

A

left hemiblock

66
Q

what leads should you look at for BBB

A

leads I, V1, and V6

67
Q

what block
wide QRS and R, S, R1 configuration in V1

A

RBBB

68
Q

what block: large wide R, S pattern in V1

A

LBBB

69
Q

what is seen in lead 1 for LBBB

A

positive deflection and wide

70
Q

what is usualy seen in V6 of LBBB

A

“bunny ears” but if not a notched QRS somewhere in V leads

71
Q

what block

A

RBBB check V1 should be negative deflectiopn

72
Q

what block

A

RBBB

check V1

73
Q

what block

A

LBBB

74
Q

what type of hemiblock is rare

A

left posterior hemiblock
- right axisd deviation
- normal QRS but widening

75
Q

negative deeflectionsin II, III, and aVF is a

A

left anterior hemiblock

76
Q

what block

A

left anterior hemiblokc (LAFB)

77
Q

what leads are best to view ventricular hypertrophy

A

V1, V2, and V5, V6

78
Q

other name for a LEft Anterior hemiblock

A

fasicular block

79
Q

how to determine if ventricular hypertrophy is present

A

add depth of s wave in V1 or V2 (whichever is deepest) to the height of the R wave in V5 or V6 (whichever is tallest)

> /= 35 mm is LVH

80
Q

what additional measurements may signify LVH on 12 lead ekg

A
  1. any precordial >/= 44 mm
  2. R wave of aVL >/= 11 mm
  3. R wave of LEad I >/= 12 mm
  4. R wave of lead aVF >/= 20 mm
  5. if precordial lead QRS complexes overlap its probably LVH)
81
Q

what is this

A

Left ventricular hypertrophy

82
Q

LAD supplies

A

anterior wall

83
Q

LAD changes seen in what leads

A

V1 to V4

84
Q

what rhythm

A

anterior wall MI

85
Q

lateral wall of heart supplied by

A

LAD or obtuse marginal
seen in I, aVL, V5 and V6

86
Q

what does this ekg show

A

lateral wall mi

87
Q

inferior wall supplied by

A

RCA

88
Q

inferior wall mi seen in what leads

A

II, III, aVF

89
Q

what does this ekg show and what blood supply is in trouble

A

inferior wall MI
RCA

90
Q

postrerior wall of heart blood supply from

A

PDA

91
Q

posterior wall mi seen as depression in what leads

A

V1 and V2

92
Q

ST depression signifies ______ and ST elevation signifies

A

ischemia

infarct

93
Q

in what leads is there ST depression

what part of heart is this

what supplies blood here

A

V4-V6

lateral

obtuse marignal

94
Q

Q waves are pathologic if:

A
  1. more than 1/3 total height of QRS
  2. wider than 0.03 sec (more significant)
95
Q

where are the ST elevations and what is the blood supply to this area

A

II, III, aVF

RCA

96
Q

what rhythm

A

atrial flutter

97
Q

what rhythm

A

AFib

98
Q

a couplet is

A

2 PVC in a row

99
Q

if you think you have an MI, which is better for perfursion

ephedrine
neosynephrine

A

neosynephrine

bc ephedrine is “weak epi” which will make heart squeeze harder and decrease o2 to brain

100
Q

do inferior wall MI need more or less fluids

A

more fluids

101
Q

what rhythm

A

RBBB in V1

102
Q

if you think youre having anterior wall mi should you give fluids or restrict fluids

A

restrict fluids because could cause congestive HF

103
Q

what rhythm

A

LBBB

104
Q

what rhythm

A

RBBB

RSR1 pattern

105
Q

what rhythm

A

AFib

614 General Principles Of Anesthesia (14 decks)

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