Week 13 - EKG Flashcards by Mik Corinne

Rhythm
Rate
P:QRS internal ratio

NSR
60-100
1:1

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represent a slowing of conduction through the AV node

SR with first degree block
PR > 0.2 sec

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Rhythm

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

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

F- usually not symptomatic

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How do P-P intervals differ in Mobitz type I

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

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Wenckebach is a 2nd degree AV block _______ type _____

Mobitz type I

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Name Rhythm

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

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Name Rhythm

Sinus Rhythm with Second Degree AV block- Mobitz Type II

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

constant

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

symptomatic

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represents a complete dissociation between atria and ventricles

3rd degree AV block

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

True

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

F - NORMAL

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

Third degree AV block

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

Third degree AV block

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what rhythm

Third degree AV block

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what rhythm

Third degree AV block

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what rhythm

Third degree AV block

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what rhythm

Third degree AV block

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

symptomatic

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Relationship btwn atrial and ventricular rate in third degree AV block

atrial rate always faster than ventricular rate

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Where does Junctional rhythm originate from

AV node

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T or F: junctional rhythm p waves never present

F - may or may not be present

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what rhythm

junctional rhyth,m

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in junctional rhythm, where is the P wave sometimes at

after QRS complex

what rhythm

what is the blue portion of the strip's rhythm

junctional rhythm,

where does the acelerated junctional rhythm, come from

AV junction

what rhythm

accelerated junctional rhythm

describe AFib QRS interval

normally WNL

uncontrolled rate of afib >100 often called

rapid ventricular reponse

what rhythm

a fib

T or F: A flutter has a P wave present

most common A flutter conduction ratio

2:1

describe Atrial flutter QRS interval

usually WNL

is atrial flutter rate usualy regular or irregular

regular

what rhythm

A flutter

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

irregular

HR range for SVT

140-220 bpm

is SVT usually regular or irregular

regular

where are SVT impulses coming from

collection of tissue around and involving the AV node

what rhythm

SVT

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

hypovolemia d/t blood loss

Vtach rate ususally

100-220 BPM

T or F: Vtach rate is always symptomatic

F - usually symptomatic not always

what rhythm

V tach

rhythm with no observable QRS

VFib

rhythm with chaotic electrical activity

VFib

what rhythm

VFib

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

idioventricular rhythm

rate of idioventriucl;ar rhythm

usually < 40 BPM

what rhythm

idioventricular rhythm

why look at lead II first?

it is most sensitive to changes

direction Lead II reads

RU to LL

which leads should have positive deflections in EKG

I, II, III V4, V5, V6

which leads should have negative deflections in EKG

aVR and VI

which leads should have both + and - deflections in EKG

aVL, V2, and V3

bipolar leads

leads I, II, III

unipolar leads

aVL, aVR, aVF

is left or roight axis deviation more common

left axis deviation (Lead I up and aVF down)

axis deviations for Lead I and aVF: both up

normal

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

left

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

right

axis deviations for Lead I and aVF: both down

severe right... youre in trouble!

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

left hemiblock

what leads should you look at for BBB

leads I, V1, and V6

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

RBBB

what block: large wide R, S pattern in V1

LBBB

what is seen in lead 1 for LBBB

positive deflection and wide

what is usualy seen in V6 of LBBB

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

what block

RBBB check V1 should be negative deflectiopn

what block

RBBB check V1

what block

LBBB

what type of hemiblock is rare

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

negative deeflectionsin II, III, and aVF is a

left anterior hemiblock

what block

left anterior hemiblokc (LAFB)

what leads are best to view ventricular hypertrophy

V1, V2, and V5, V6

other name for a LEft Anterior hemiblock

fasicular block

how to determine if ventricular hypertrophy is present

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

what additional measurements may signify LVH on 12 lead ekg

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)

what is this

Left ventricular hypertrophy

LAD supplies

anterior wall

LAD changes seen in what leads

V1 to V4

what rhythm

anterior wall MI

lateral wall of heart supplied by

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

what does this ekg show

lateral wall mi

inferior wall supplied by

RCA

inferior wall mi seen in what leads

II, III, aVF

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

inferior wall MI RCA

postrerior wall of heart blood supply from

PDA

posterior wall mi seen as depression in what leads

V1 and V2

ST depression signifies ______ and ST elevation signifies

ischemia infarct

in what leads is there ST depression what part of heart is this what supplies blood here

V4-V6 lateral obtuse marignal

Q waves are pathologic if:

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

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

II, III, aVF RCA

what rhythm

atrial flutter

what rhythm

AFib

a couplet is

2 PVC in a row

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

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

do inferior wall MI need more or less fluids

more fluids

what rhythm

RBBB in V1

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

restrict fluids because could cause congestive HF

what rhythm

LBBB

what rhythm

RBBB RSR1 pattern

what rhythm

AFib