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Spring 2020 - Physiology 1 > 12 Lead EKG - Quiz 8 - THIS DECK WILL NOT HELP AT ALL - YOU WILL FAIL > Flashcards

12 Lead EKG - Quiz 8 - THIS DECK WILL NOT HELP AT ALL - YOU WILL FAIL Flashcards

(61 cards)

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1
Q

What does the EKG Record?

A

Electrical Activity of the Heart Beat

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2
Q

What is the Dominant Pacemaker of the Heart?

A

Sino-Atrial Node

@ SVC & RA Junction

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3
Q

What is Automaticity?

A

Ability of Cardiac Cells to spontaneously generate Action Potentials

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4
Q

List 1 - 9

A
  1. P
  2. Q
  3. R
  4. S
  5. T
  6. PR Interval
  7. QRS Interval
  8. ST Segment
  9. ST Interval
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5
Q

Slowing of depolarization at the AV node allows for what to happen?

A

Allows for the Atria to contract right before the Ventricles

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6
Q

What is the QT Interval a physiological marker for?

A

QT Interval represents Ventricular Depolarization & Repolarization

Risk markers for Arrythmias & Sudden Death

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7
Q

What are the Limb Leads on a 12-Lead EKG?

A

Leads I, II, III, aVF, aVR, aVL

Up-Down, Right-Left

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8
Q

What are the chest leads/precordial leads?

A

V1 - V6

Back-Front, Right-Left

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9
Q

What is Einthoven’s Triangle?

A

Triangle formed by the Limb Leads

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10
Q

What info can we get by looking at the multiple leads?

A

Region of the heart effected

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11
Q

What are two different ways to measure heart rate on a EKG?

A
  1. Since EKG is 10 seconds, Count QRS complex and multiply by 6
  2. Measure RR interval using the big boxes: 300-150-100-75-60-50

(So if its only 1 big box, then HR 300, 2 big box HR 150, and so on)

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12
Q
A

Sinus Arrhythmia

  • Irregular Rhythm that varies w/ respiration
  • All P-waves identical
  • Considered Normal
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13
Q
A

Wandering Pacemaker

  • Irregular Rhythm
  • P-Waves Change Shape
  • Rate < 100 bpm
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14
Q
A

Multifocal Atrial Tachycardia

  • Irregular Rhythm
  • P-Waves change shape
  • Rate > 100 bpm
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15
Q
A

A-Fib

  • Irregular Rhythms
  • No P-Waves
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16
Q
A

Atrial Escape Beat

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17
Q
A

Junctional Escape Beat

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18
Q
A

Ventricular Escape Beat

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19
Q
A

Atrial Escape Rhythm

  • 60-80 bpm
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20
Q
A

Junctional Escape Rhythm
or
Idiojunctional Rhythm

  • 40-60 bpm
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21
Q
A

Ventricular Escape Rhythm
or
Idioventricular Rhythm

  • 20-40 bpm
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22
Q
A

NSR w/ PACs

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23
Q
A

Premature Junctional Beat

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24
Q
A

Premature Ventricular Contraction

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25
SVT or Paroxysmal Atrial Tachycardia * 150-250 bpm
26
Ventricular Tachycardia * 150-250 bpm
27
Torsades de Pointes
28
Ventricular Flutter * 250-350 bpm
29
Ventricular Fibrillation
30
Sinus (SA) Block
31
First Degree AV Block * PR Interval \> 0.2 seconds
32
Second Degree AV Block - Type I or Wenckebach * PR longer, longer, then drops = Wenckebach
33
Second Degree AV Block - Type II * PR Constant * Intermittent Drop QRS
34
3rd Degree (Complete) Heart Block or AV Dissociation
35
Left Bundle Branch Block * Dominant S-wave in V1 * Broad "M"-shaped R-wave in V6
36
Right Bundle Branch Block * Broad QRS \> 0.12 sec * RSR pattern in V1-3 * Wide, Slurred S-wave in lateral leads (I, aVL, V5-6)
37
What wave might you see on an EKG with Hypokalemia?
U-wave
38
What EKG changes would you expect with Hyperkalemia?
Tall, Peaked T-waves
39
When would you see a Delta wave on an EKG?
Wolf Parkinsons White Syndrome Slurring Upstroke on QRS
40
What are the different phases of Coronary Artery Disease?
* Asymptomatic - insignificant plaque * Stable Angina - known disease, collateral circulation, predictable symptoms * Accelerating Angina - unstable plaque, unpredictable symptoms * ACS - NSTEMI, STEMI
41
What happens with NSTEMIs?
* _Partiall__y_ blocked artery * Small portion of heart tissue dies * Difficult to distinguish from unstable angina - need cardiac enzymes
42
What happens with STEMIs?
* Complete Block of Artery * Lots of cardiac tissue dies * Needs early intervention
43
How do you work up chest pain?
1. Assess the kind of chest pain 2. **12-Lead EKG** - _primary_ study for decision making 3. Cardiac Enzymes
44
What are _permanent_ markers of heart damage on an EKG?
Q Waves More leads with abnormal Q's = More heart damage
45
What is the criteria for abmnormal Q-Waves?
\> 0.04 seconds wide \> 25% height of R-Wave Permanent
46
How does depolarizaton happen in Left Bundle Branch Blocks?
Spreads from Right-to-Left instead of normally Left-to-Right Impulse goes first to RV then LV
47
What are some causes of LBBB?
**Anterior MI** Aortic Stenosis HTN Dilated Cardiomyopathy Hyperkalemia Digoxin Toxicity
48
What is Normal R-Wave Progression?
R waves should get bigger as you progress thru the precordial leads V1--\> V6
49
What happens on the EKG w/ Myocardial Ischemia?
ST Segment and/or T Wave Inversion (Can return to normal if O2 supply returns to normal)
50
Which lead is NOT useful and can be ignored when looking for ischemia, injury, or infarction?
aVR
51
What are **abnormal** levels of: CK: ? CK/MB: ? Troponin I: ?
CK: \> 170 IU/L CK/MB: \> 6 mg/mL Trop I: \> 2 ng/mL
52
Would Transient Myocardal Ischemia result in elevated Cardiac Markers?
There would be changes in ST-T waves, but the patient will **NOT** have elevated Cardiac markers b/c there is no actual heart cell damage
53
When would you see abnormal Q develop?
1-4 Days after STEMI
54
What are the Major Branches of the Coronary Arteries?
Right Coronary Artery (RCA) Left Main Coronary Artery (LM) Left Anterior Descending (LAD) Circumflex Artery (CX)
55
Which part of the heart does the RCA supply?
Right Atrium Right Ventricle Posterior Wall AV Node PDA --\> Inferior Wall
56
Which Leads represent the Anterior Wall?
V1-V4
57
Which Leads represent the Inferior Wall?
II, III, aVF
58
Which Leads represent the Lateral Wall?
I, aVL, V5-V6
59
Which Leads represent the Posterior Wall?
V1-V2
60
What does the Left Anterior Descending branch supply?
Anterior Wall Septum Left Bundle Branch Right Bundle Branch Papillary Muscles to Mitral Valve
61
What does the Left Circumflex supply?
Latereral and Posterior Left Ventricle

Spring 2020 - Physiology 1 (24 decks)

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