2) ECG Flashcards by Connor Hancock

QT interval:
RR interval:

= any action in ventricles
= measuring HR

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(ECG Horizontal Boxes) small box is how long
5 small boxes:
Each large box is how long

= 0.04 sec
= 1 large box
= 0.20 sec

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(ECG Vertical Boxes) Each small box is & what:
5 small boxes equal:
Each large box is:
2 large boxes equal

= Each small box 1 mm & 0.1mV
= 1 large box
= 0.5 mV & 5mm
= 1mV & 10mm

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PRI measured by:
PRI “PR/PRI” interval rep/s:
A normal PRI interval range:
prolonged PRI indicates:

= distance from beginning of P wave to beginning of QRS complex.
= time impulse takes from atria-ventricles “Gatekeeper Gandolf”
= 0.12-0.20 sec / 3-5 SB
= a delay in the AV node & possible HB

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QRS interval measured:
QRS interval represents
QRS interval range:
QRS interval Q,R,&S:

= distance from 1st deflection of complex to last deflection
= time needed for ventricle depolarization (bundle of his > ventricles)
= 0.04-0.12secs / 1-3SB
= 1st -deflection not >1SB, 1st +deflection, -deflection after R

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T wave represents:
T wave amplitude:

= Repolarization of ventricles
= <5mm in LL <10mm in precordial

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Absolute refractory period:
Relative refractory period:

= Apex of T wave Q-T wave apex of wave: ventricle not ready to work
= T wave top to end of T wave: (commodo cordis) cells not repolarized (torsades de pointes more dead from repolarization not in sync)

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who 1st noted skeletal M.s are excitable by shocking frogs:
who Pub/ed 1st ECG using a capillary metter w/ salt water:

= 1786 Dr. Luigi Galvani> “Muscle contract w/ elect”
= 1821, Augustus Waller > (couldn’t recreate same impinge)

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1786 Dr. Luigi Galvani:

1821, Augustus Waller:

= 1st noted skeletal muscles were excitable by shocking frogs “Muscle contract w/ elect”
= Pub/ed 1st ECG using a capillary metter w/ salt water (couldn’t recreate same impinge)

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Resting potential of the cardiac contractile cell occurs at:
Action potential of the cardiac contractile cell occurs at:
What ion causes the cardiac contractile cell to depolarize?
What ion causes the cardiac contractile cell to repolarize?

= -90mV
= -85mv
= Sodium
= Potassium

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A normal QRS has a duration between:
A normal PRI has a duration between:

= 0.04-0.12 secs / 1-3SB
= 0.12 - 0.20 secs/ 3-5SB

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On ECG paper, one small vertical box represents:
On ECG paper, one large vertical box represents:

= 0.1mV/ 1mm
= 0.5mV/ 5mm

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Purkinje System has an inherent firing rate of:
AV Node has an inherent firing rate of:
SA Node has an inherent firing rate of:

= 15-40BPM
= 40-60BPM
= 60-100BPM

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Natural pacemaker of the heart is:
If SA Node failed to initiate a impulse, what is 1st back-up firing site?
If both SA & AV fails what is last firing site:

= SA node
= AV node
= Purjunkie

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impulse traveling towards a positive electrode will produce a:
Impulse traveling away from a positive electrode will produce a:

= positive deflection wave ECG
= negative deflection wave ECG

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Action potential of autorhythmic cell occurs at:
Resting potential of autorhythmic cell occurs at:
ion causes autorhythmic cell to depolarize:
ion causes autorhythmic cell to repolarize:

= -40mV
= -60mV
= Calcium
= Potassium

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The SA Node is found where in the heart?
The AV Node is found where in the heart?
Purjunkie System found where in the heart?

= Upper right of atrium
= In the lower right of atrium
= Septum to bottom of ventricles

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Cardiac cell communication w/ ions
Phase 0 of the cardiac contractile cell:
Phase 1 of the cardiac contractile cell:
Phase 2 of the cardiac contractile cell:
Phase 3 of the cardiac contractile cell:
Phase 4 of the cardiac contractile cell:

= gab junction & intercalated disc 400x faster
= P0) Depolarization
= P1) slow K efflux
= P2) Plateau> Slow Ca in & K out “- for +”
= P3) Repolarization> rapid K efflux
= P4) Refractory Na/K pumps & Ca pumps out

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What does the P wave represent on an ECG:
What does the T wave represent on an ECG:
What does the QRS wave represent on an ECG:

= Arterial depolarization
= Ventricular depolarization
= electrical activity in ventricles

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Normal ECG paper speed is
On ECG paper, 1 Small horizontal box represents:
On ECG paper, 1 Large horizontal box represents

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= 25mm/sec
= 0.04 secs
= 0.20 secs

A normal P wave in Precordial leads should be:
A normal P wave Limb leads should be:

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= nice & round w/ amplitude <1.5mm
= nice & round w/ amplitude <2.5mm

Na> affect on heart:
Ca> affect on heart:
K> affect on heart:

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= depolarizing myocardium
= M. contraction depolarization
= influences repolarization

IF RAAS freaks out:

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= BP & afterload increases

ANP Atrial Natriuretic Peptide:
BNP “Brain” Natriuretic Peptide:

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= released by + pressure/ atrial dilation & stress
= myocytes stretched out releases more BNP, Starlings law correlates w/ BNP “BNP + = CHF/Heart failure”

Cardiac artifacts: Causes of artifacts:

= hard to decipher iso-electrical lines w/ 0 & skewed = M. tremors/shivering, PT mnt(moves baseline), Loose electrodes, 60-hertz interference(ungrounded electricity near you (AC current alternating in house), Machine malfunction (Dotted flat line),& electrode bad connection/ off

Eintovhens triangle (bipolar) camera always at L1 + & - leads: L2 + & - leads: L3 + & - leads:

= positive > Bipolar - to + = -RA to +LA = -LL to + LL = -LL to + LL

Unipolar leads: Unipolar lead camera: aVR: aVL: aVF:

= 1 polarity(need 4 LL): AvR,LvR, (Wilson’s central terminal) = Starts at middle point of lines look to center terminal = augmented voltage right (right (looks at R-atrium) = augmented voltage Left Positive Left arm +, L-wall = augmented voltage Foot: Left Leg positive inferior

Precordial leads: V1 location: V2 location: V3 location: V4 location: V5 location: V6 location: V ”5” 8 location: V ”6” 9 location:

= “chest” = V1: 4th ICS R of sternum = V2: 4th ICS L of sternum = V3: ½ in between = V4: 5th ICS mid-clavicularly = V5: 5th ICS anter auxillary = V6: mid auxillary = V ”5” 8: 5th ICS mid scapular = V ”6” 9: ½ between spine & midscapular

(KEV interpretation APPROACH) step 1: Step 2: Step 3: Step 4: Step 5:

= 1st (what is rate per min) = 2nd Rhythm: is it regular, regularly irregular, or totally irregular = 3rd P waves> present? All same/location, P wave in front every QRS = 4th: PR interval> w/in norm limits, Same w/ every beat = 5th QRS> all present, same, QRS after each P wave, w/in norm limits

Wandering atrial pacemaker: Double hump morphology: Sharp P morph/:

= dif/ morph b/c coming from dif/ spots in atrium = atrium ballooning & way dif = Pulmonale from right atrium pulmonary

WNL :

Within Normal Limits

Wide QRS=

ventricular problem /slow

(Limb leads) placement: positive to negative makes wave: positive to negative makes wave:

= mid forearm on M. & inside of calf (if amputee/ go less distally) = positive wave = negative wave

U wave:

= “late bloomers” repolarization (hypothermic PTs)

(P wave) Limb leads amplitude: Precordial "chest" leads amplitude:

= <2.5mm in limb leads Avl (2.5mV) = <1.5mm in precordial (1.5mV)

(T wave) Limb leads Amplitude: Precordial "chest" leads amplitude:

= <5mm in LL = <10mm in precordial

(Dysfunctions) Wandering pacemaker: no P wave bc No QRS: Premature ventricular contractions: R prime:

= > no similarities in P waves = pathways/AV node dysfunction, block, or death = AV node pacing and/or heart block = Ventricle fires premature after initial ventricle contraction = 2 R waves “dub hump” b/c pathways not in sync

!!Starling's Law of heart:

= states that the more the myocardium is stretched, up to a certain amount, the more forceful the subsequent contraction will be

(Einthoven's triangle) Negitive & Positive lead 1 sites: Negitive & Positive lead 2 sites: Negitive & Positive lead 3 sites:

=negative @ RA & positive @ LA = negative @ RA & positive @ LL = negative @ LA & positive @ LL

!!!Einthoven's triangle: green electrode: Blue electrode: Red electrode:

=neutral/ground “ground grass” = Negative “feeling blue” = Positive

The 3 types of ECG leads are:

bipolar, augmented "unipolar", and precordial.

1957, Dr. J. Frank Pantridge & his colleague Dr. John Geddes made:

= modern concept of cardiopulmonary resuscitation (CPR) for the early treatment of cardiac arrest.

feeling a pulse is from what:

= ventricles/QRS contracting

(3 internodal pathways) 1: 2: 3:

= SA node to Bachmann's bundles left atrium = AV junction to AV node, = Junction AV node, Sinus SA node

(only in heart) Intercalated discs: Discs speed Vs standard cell membrane: Syncytium:

= Special tissue bands inserted between myocardial cells that increase the rate(400x) in which AP is spread from cell-cell thus Syncytium = 400x faster than standard cell membrane drom/Inotropy = Group of cardiac cells physiologically function as a unit, “working together in sync” “top in syncytium to bottom”

OMI:

Occlusion Myocardial infarction (V2)

Precordial "Chest" leads help in viewing:

L-ventricle & septum.

prolonged QT interval related to:

= increased risk of certain ventricular arrhythmias & sudden death. Numerous meds, (particularly some antipsychotics)

(leads veiws) I and aVL: II, III, and aVF: aVR: V1 and V2: V3 and V4: V5 and V6:

= Left side of the heart in a vertical plane = Inferior (diaphragmatic) side of the heart = Right side of the heart in a vertical plane = Right ventricle = Interventricular septum and the anterior wall of the left ventricle = Anterior and lateral walls of the left ventricle

2) ECG Flashcards

(49 cards)