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CVPR > CV - introduction to the ECG > Flashcards

CV - introduction to the ECG Flashcards

1
Q

the ____________ node is the pacemaker of the heart.

A

sinoatrial (SA)

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2
Q

electrical impulses initiated by the sinoatrial node proceed through ____________ which activate a wave of ____________ in the atrium that converges on the ____________ node.

A

internodal tracts
depolarization
atrioventricular (AV)

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3
Q

there is a brief delay at the atrioventricular node, after which the impulses rapidly flow through the ____________ and activate the ventricles through the ____________.

A

bundle of his

right and left bundles

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4
Q

after traveling through the right and left bundles, the impulses then diverge into ____________ which activate ____________ and ____________.

A

purkinje fibers
ventricular myocardial cell depolarization
contraction

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5
Q

the initial deflection is the ____________ wave.

A

P

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6
Q

the P wave is due to ____________.

A

atrial depolarization

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7
Q

the deflection following the P wave is the ____________.

A

QRS

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8
Q

the QRS is due to ____________.

A

ventricular depolarization

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9
Q

the Q is ____________, the R is ____________ and the S is a ____________ deflection.

A

negative
positive
late negative

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10
Q

the normal duration of the QRS is ____________ seconds.

A

0.06 to 0.10

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11
Q

the ____________ wave is the deflection following QRS.

A

T wave

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12
Q

the T wave is due to ____________.

A

ventricular repolarization

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13
Q

a normal PR interval is ____________ seconds.

A

0.12 to 0.20

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14
Q

the QT interval represents ____________.

A

the total duration of depolarization and repolarization

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15
Q

unipolar leads measure the difference in electrical potential between ____________ and ____________.

A

a point on the body

virtual reference point with zero electrical potential located in the center of the heart

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16
Q

bipolar leads measure the difference in electrical potential between ____________.

A

two different points on the body

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17
Q

depolarization moving towards a limb lead will produce a ____________ deflection.

A

positive

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18
Q

define ischemia

A

ischemia occurs when blood supply is insufficient to meet the oxygen demand in the ventricles

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19
Q

ischemic changes in the EKG alter ____________ and affect the ____________ and ____________ wave.

A

ventricular repolarization
ST segment
T

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20
Q

ischemia due to sudden high oxygen demand in the presence of fixed coronary obstruction causes ____________ of the ST segment.

A

depression

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21
Q

typically, T waves and Q waves go in the ____________ direction.

A

same

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22
Q

an inverted T wave is a sign of ____________.

A

ischemia

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23
Q

ST ____________ is a sign of transmural injury in an acute pericarditis or acute coronary syndrome, usually with a clot due to platelet aggregation obstructing a coronary artery.

A

elevation

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24
Q

Q waves in inferior leads (II, III aVF) are due to ____________.

A

inferior infarcts

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25
Q waves in leads V1-V4 are due to ____________.
anterior wall infarcts
26
Q waves in leads I, aVL and the anterolateral leads (V5, V6) are associated with ____________.
lateral wall infarcts
27
the normal duration of a P wave is ____________ seconds.
0.08 to 0.10
28
with a paper speed of 25mm/sec, the light lines of an ECG are spaced by ____________ seconds.
0.04
29
with a paper speed of 25mm/sec, the heavy lines of an ECG are spaced by ____________ seconds.
0.2
30
typically, the major dominating force in an ECG is what happens in the ____________.
left ventricle
31
summary of leads: name the three bipolar limb leads
I II III
32
lead I is ____________ in the right arm and ____________ in the left arm.
positive | negative
33
summary of leads: name the unipolar limb leads:
aVR aVL aVF
34
what are the three inferior leads?
II III aVF
35
what are the two lateral leads?
I | aVL
36
where do the lateral leads detect damage?
high in the left ventricle
37
what are the two left-sided leads?
V5 | V6
38
what are the two right-sided leads?
V1 | V2
39
the right-sided leads V1 and V2 are able to describe which two structures of the heart?
right ventricle | septum
40
in ventricular hypertrophy, more muscle = ____________ volts = ____________ amplitude of the QRS segment of an ECG.
more | greater
41
in what two ways can ischemia manifest itself? what are the respective ECG findings associated with these manifestations?
1 ischemia due to sudden high oxygen demand, potentially in the presence of fixed coronary obstruction - depression of ST segment 2 ischemia due to acute artery obstruction that causes insufficient oxygen supply even during periods of low oxygen demand - T wave inversion
42
what are the unipolar precordial leads?
V1-V6
43
what are the bipolar precordial leads?
there are none!
44
how is left ventricular hypertrophy ready by left-sided leads on ECG?
big R waves in left-sided leads (I, aVL, V5, V6)
45
how is right ventricular hypertrophy read by right-sided leads on ECG?
big R waves in right-sided leads (V1, V2)
46
absence of normal transmural vector produces a ____________ deflection in leads over infarcted myocardium (____________).
negative | Q wave
47
abnormal Q wave appearance indicates ____________.
necrosis/infarction
48
what are the three criteria necessary to define a "significant" Q wave?
1 is >/= one fourth the amplitude of the R wave 2 is >/= one small box (0.04 seconds) wide 3 must be in at least 2 leads reflecting the same region of the left ventricle (i.e. at least two inferior leads must display the Q wave)
49
what is the sequence of stages of an evolving transmural myocardial infarct?
peaked T wave (hyper acute stages) T wave inversion (early stage) ST elevation (most common in transmural infarcts) Q wave, ST elevation, T wave inversion (common in transmural infarct, late stage)
50
define transmural myocardial infarction
ischemic necrosis of the full thickness of the infected myocardial segment, extending from the endocardium through the epicardium
51
define subendocardial myocardial infarction
infarction involves only the layer of muscle subjacent to the endocardium
52
what are the ECG findings typical of transmural myocardial infarction?
ST elevation with Q waves
53
what are the ECG findings typical of subendocardial myocardial infarctions?
ST depression with no Q wave
54
V1 and V2 leads are typically involved when there is a ____________ infarct.
anteroseptal
55
V3 and V4 leads are typically involved when there is an infarct of the ____________ wall, septal or lateral.
anterior
56
V5 and V6 leads are typically involved when there is an ____________ infarct.
anterolateral
57
II, III and aVF leads are typically involved when there is an infarct of the ____________ wall.
inferior
58
anterior infarcts are generally ____________ and ____________ than inferior infarcts.
larger | more serious
59
I and aVL leads are typically involved when there is an infarct of the ____________ wall.
high lateral
60
what are the causes of a long QT interval? (4)
``` electrolyte abnormalities (hypocalcemia, hypokalemia, hypomagnesemia) drug therapy (class Ia, Ic or III anti arrhythmic drugs) hypothermia congenital long QT syndrome ```
61
hypercalcemia causes a ____________ QT interval, while hypocalcemia causes a ____________ QT interval.
short | long
62
a ____________ T wave is indicative of hypokalemia, and the presence of a ____________ wave is unique to hypokalemia, though is not seen in all hypokalemeias.
flattened | U
63
the commonest finding unique to mild hyperkalemia is the presence of a ____________ T wave on ECG.
tall, peaked & symmetrical
64
in moderate hyperkalemia, P and R waves ____________, QRS and T waves ____________, and big ____________ waves develop.
flatten broaden S
65
in severe hyperkalemia, P and R waves ____________, S and T waves ____________ in a ____________ pattern.
disappear broaden sine wave

CVPR (14 decks)

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