EKG V & VI

Question 1

<p>What are the 4 types of AV blocks?</p>

Answer 1

<p>1)1st degree</p>

<p>2)2nd degree Mobitz I(Wenckebach)</p>

<p>3) 2nd degree Mobitz II</p>

<p>4) 3rd degree</p>

Question 2

<p>What interval is key in reading an EKG when differentiating between AV blocks?</p>

Answer 2

<p>PR interval (normal: 0.12-0.20 sec)</p>

Question 3

<p>EKG is normal except the PR interval is prolonged, at a constant duration, in ALL beats. What type of block is this?</p>

Answer 3

<p>First-degree AV block, PRI > 0.20 sec (1 big box) in ALL beats</p>

Question 4

<p>What type of EKG abnormality is this?</p>

Answer 4

<p>First-degree AV block</p>

Question 5

<p>You're looking at an EKG and the PR interval gets longer and longer until a beat completely drops off (P wave, but no QRS). What type of block is this?</p>

Answer 5

<p>Second-degree AV block: Mobitz Type I(Wenckebach)</p>

Question 6

<p>What type of block is this: the PR interval remains<strong>constant</strong>(can be normal or long) until a beat is dropped</p>

Answer 6

<p>Second-degree AV block: Mobitz II</p>

Question 7

<p>What type of block is more dangerous, second-degree AVB Mobitz I or Mobitz II?</p>

Answer 7

<p>Second-degree AVB <strong>Mobitz II</strong>- this often progresses into a complete block</p>

Question 8

<p>True/False: AV blocks will always have a P wave</p>

Answer 8

<p><strong>True,</strong>the SA node is firing, but the impulse gets blocked or delayed at the AV junction in an AV block</p>

Question 9

<p>In this type of block, theatria and ventricles beat independently, with NO communication between the two. P-P is regular & R-R is regular</p>

Answer 9

<p>Third-degree AVB (AKA Complete heart block)</p>

Question 10

<p>These types of blocks are caused by a delay or interruption in the transmission of impulses occurring<strong>below</strong>the bifurcation of the Bundle of His</p>

Answer 10

<p>Bundle branch blocks (RBBB or LBBB)</p>

Question 11

<p>What leads are you looking at on an EKG when diagnosing BBBs?</p>

Answer 11

<p><strong>V1 </strong>and <strong>V6</strong> (looking at R-R')</p>

<p>QRS complex is usually wide (>0.12 sec)</p>

Question 12

<p>Which BBB is more dangerous, left or right?</p>

Answer 12

<p>LBBB <strong>never </strong>occurs in a healthy heart. These are concerning, especially if it's new</p>

Question 13

<p>What are some possible causes of a RBBB?</p>

Answer 13

<ul> <li>Coronary artery disease</li> <li>HTN</li> <li>Acute PE</li> <li>Chronic electrical degeneration</li> <li>Can occur in a healthy heart</li></ul>

Question 14

<p>What are some common causes of a LBBB?</p>

Answer 14

<ul> <li>HTN</li> <li>Cardiomyopathy</li> <li>Acute MI</li> <li>Aortic stenosis</li> <li>Extensive CAD</li> <li>Diseased electrical system</li></ul>

<p>*Most often due to an organic heart disease, does NOT occur in a healthy heart</p>

Question 15

<p>What characteristic feature will you see in the R waves in the V6 lead during a LBBB?</p>

Answer 15

<p>"Rabbit ears"</p>

Question 16

<p>If you're using the turn signal method of determing R vs L BBB, what direction is this BBB?</p>

Answer 16

<p>RBBB, you are looking at<strong>V1 -</strong>you click your turn signal <strong>UP </strong>to turn <strong>Right</strong> (LBBB also has the "rabbit ears" in V6)</p>

Question 17

<p>When looking at BBB, the deflection of the QRS is going the opposite direction of the T wave. What is this called? Is it good or bad?</p>

Answer 17

<p>This is called<strong>discordance,</strong>and it's<strong>good</strong></p>

Question 18

<p>The QRS deflection is going the same direction as the T wave in a BBB. What is this called? What does it suggest?</p>

Answer 18

<p>This is<strong>concordance,</strong>it may suggest<strong>ischemia or myocardial infarction</strong></p>

Question 19

<p>What is the Sgarbossa criteria tool used for?</p>

Answer 19

<p>It is used to identify an MI in the presence of a LBBB</p>

Question 20

<p>\_\_\_\_\_\_\_ refers to reduced blood supply secondary to partial occlusion or spasm, heart muscle is savable.</p>

<p>\_\_\_\_\_\_\_\_ refers to no blood supply due to full vessel occlusion, the heart muscle is dead.</p>

Answer 20

<p><u><strong>Ischemia</strong></u><strong></strong>refers to reduced blood supply secondary to partial occlusion or spasm, heart muscle is savable.</p>

<p><u><strong>Infarction</strong></u><strong></strong>refers to no blood supply due to full vessel occlusion, the heart muscle is dead.</p>

Question 21

<p>What leads on an EKG correspond to the septum of the heart (septal leads)?</p>

Answer 21

<p><strong>V1, V2</strong></p>

Question 22

<p>What are the anterior leads?</p>

Answer 22

<p><strong>V2, V3, V4</strong></p>

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