12-lead ch.9 Flashcards Preview

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Flashcards in 12-lead ch.9 Deck (17)
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1
Q

Which leads are p waves normally positive in?

A

I, II and V4-V6

2
Q

Which part of the electrical conduction system does the p wave represent?

A

The p wave represents electrical conduction through the internodal pathways (3) within the atria from the SA node to the AV node.

3
Q

What rhythms can cause inverted p’s in II, III and aVF? Why?

A

Any rhythms that are at or below the AV junction, they cause inverted p’s because the impulse is travelling away from the positive poles in those leads.

4
Q

What is the criteria for MAT or WAP?

A

3 different p wave morphologies.

5
Q

If the p waves are inverted but of normal distance from the qrs, what is the rhythm? Where does this rhythm occur?

A

Ectopic Atrial rhythm, because the interval is of normal distance, it will be occurring above the AV node but lower within the atria.

6
Q

What is LAE criteria and the name for the shape?

A

LAE criteria is a p wave notched and wider than .12sec. The name is p-mitrale.

7
Q

What is RAE criteria and the name for the shape?

A

RAE criteria is a p wave which is peaked and greater than 2.4mm high. The name is p-pulmonale.

8
Q

What is the most common reason for P mitrale? How is the pathology caused? What other pathology can occur?

A

Severe mitral valve disease. It’s caused by increasing the muscle mass needed to overpower the valve. Dialation occurs which can lead to mitral regurgitation.

9
Q

What is a common ventricular abnormality with P-mitrale?

A

A common abnormality would be LVH because of the stenosed valve overfilling the left atrium and the atrium putting pressure against the left ventricle with Frank Starling’s law.

10
Q

How can you tell if a beat is abberant or not?

A

When the beat appears to start in the same way and same direction it would be more likely to be abberant than a PVC.

11
Q

Where is RAE most evident?

A

in II and III

12
Q

What EKG findings would exclude a diagnoses of LPH?

A

P-pulmonale with a right axis deviation. Because right sided disease can alter the axis rather than it being altered from the hemi-block itself.

13
Q

Why can’t we use the term hypertrophy rather than enlargement?

A

There is no way to predict whether the enlargement seen on the ECG was due to hypertrophy of the muscle or from dialation.

14
Q

Describe IACD. How is it useful?

A

Intraatrial conduction delay. When there is evidence in V1 that there is a non-specific conduction problem in the atria.

15
Q

What can cause RAE?

A

COPD, pulmonary emboli, pulmonary hypertension, and mitral, tricuspid or pulmonary valve disease.

16
Q

What can cause LAE?

A

sever systemic hypertension, aortic or mitral valve disease, restrictive cardiomyopathy and left ventricle failure.

17
Q

Describe biatrial enlargement. What could cause this?

A

Both right and left atrial enlargement occurs with variations in limb leads and V1. Mitral and aortic stenosis if severe enough cause cause this.