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BRS1 - Valentine > ECG > Flashcards

ECG Flashcards

(48 cards)

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1
Q

Draw and labels the waves in the standard ECG reading for LEAD 2 during a normal heart beat

A
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2
Q

Draw a standard ECG wave in lead 2 but label the stages in heart conduction

A
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3
Q

For a person with a resting heart rate of 60bpm, what is the duration of each period in ECG wave

A
  • P wave- 0.1 s
  • PR interval - 0.2s
  • QRS complex- 0.08s
  • T wave- 0.16s
  • QT Interval- 0.4s
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4
Q

Which part of the heart generates electrical activity the fastest? What is the significance?

A

SA node

hence it becomes the natural pacemaker for the heart

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5
Q

What does the ECG measure

A

The collective electrical activity of the heart

direction of deflection depends on electrode configuration

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6
Q

What determines the deflection (positive or negative or None)

A

If depolarisation flow in same direction as lead (negative to positive) there’s a postive deflection on ECG

the eye in the diagram shows the position of the POSITIVE ELECTRODE

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7
Q

How many electrodes are used to create the 12 different leads

A

10

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8
Q

What are the standard limb leads and where are the electrodes placed

A

They are bipolar limb leads

Leads 1 to 3

they form Einthoven triangle

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9
Q

What are the augmented limb leads and what is their configuration

A

Unipolar limb leads

avR, avF and aVL

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10
Q

Where do you place the unipolar percoridal lead? (Chest leads)

A
  • V1- Right 4th ICS parasternal
  • V2- Left 4th ICS; parasternal
  • V3- midway between V2 and V4
  • V4- Left 5th ICS; MCL
  • V5- left 5th ICS; Anterior axillary line
  • V6: left 5th ICS, MAL

N.B- the chest leads are only positive electrodes

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11
Q

Describe the shape of P waves in V1 and V2

A

Postive or biphasic

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12
Q

In what precordial leads are P waves always positive

A

V4 to V6

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13
Q

In what chest leads may T waves be inverted?

A

V1 and V2

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14
Q

In what precordial leads are T waves ALWAYS postive

A

V3 to V6

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15
Q

For the chest leads describe what part of the heart each lead faces?

A

V1 and V2- face the wall of the RIGHT ventricle

V3 and V4- face the interventricular septum

V5 and V6- face the left ventricle at a distance from the heart

Axial plane

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16
Q

Chest Leads viewing heart form the right side have a large negative S wave

why? What does it mean for chest leads viewing the heart from the left side

A

LEFT ventricle is thicker than right

hence leads facing the left side of the heart will have a large positive R wave

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17
Q

Why does chest leads V3 and V4 have varying prominent R and S waves

A

Depends on their closeness to interventricular septum

Due to anatomical variation, difffernt people have crying heart position in the thorax and this will affect QRS complex between leads.

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18
Q

What does a standard ECG reading look like

A
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19
Q

Define Ischemia, myocardial infarction, Aryythmia and Aberrant conduction

what’s their significance in ECG

A

ECGs can be used to diagnose and discern them

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20
Q

What other niche conditions can be diagnosed by ECG

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A

Abnormal blood electrolytes

pericarditis /cardiac inflammation

cardiac effects of various heart lung or systemic diseases like High BP, emphysema

21
Q

Can cardiac output and early stage hypertension be detectable on ECG

22
Q

For myocardial infarction

what does inverted T waves suggest

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A

Ischaemia is in epicardium : causing the wave of repolarization to travel outwards

23
Q

For MI, WHAT DOES peaked T waves suggest?

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A

Ischaemia in endocardium

24
Q

Why can prolonged Q wave be seen in MI

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A

Infarcted area is silent so the electrode see the depolarisation occurring as a retiring wave in opposite ventricles

25
Contrast the ECG readings for MI for : ischaamic tissue, injured tissue and infarcted tissue
26
Where would you see ST elevation and ST depression if there was an Anterior infarction
ST elevation - V1 to V4 occlusion in left anterior descending artery No reciprocal ST depression
27
In what leads would you see ST elevation and ST depression in lateral infarction
ST elevation - leads 1, aVL, v5 and V6 ST depression - Leads 2, 3 and aVF occlusion in circumflex artery or lateral branch of left anterior descending artery
28
In what leads would you see ST elevation and ST depression if there was an Inferior infarction
ST elevation - leads 2, 3 and aVF ST depression - LEADS 1 AND aVL Occulsion in right coronary artery
29
In what leads would you see ST elevation and ST depression if there was a posterior infarction
ST elevation- leads 2, 3 and aVF, V7 to V9 ST depression- V2 and V3
30
What happens in Respiratory sinus arrhythmia what's the ECG reading
Changes in heart rate during breathing - seen in bot children and ADULTS Increased heart rate during inspiration and decreased heart rate during expiration
31
Contrast Atrial flutter to Atrial fibrillation
Atrial flutter - more regular. But leads to Avery fast but steady heart beat. Sometimes atria doesnt empty Atrial fibrillation- irregularly regular . Atria cells depolarise in an uncoordinated manner due to ectopic focus
32
What is the ECG reading for premature supraventricualr contractions
Atrial ectopic focus fires before the next sinus node firing. Causing aberrant ventricular excitation and contraction
33
What is premature nodal contraction
Nodal ectopic focus fires before next sinus node causing aberrant ventricular excitation and contraction. Same ECG reading as premature atrial contractions
34
What occurs in Supraventricular tachycardia. Descirbe the ECG reading
One or more ectopic focus cause episode of rapid aberrant ventricular excitation and contraction in paroxysmal tachycardia; the repeated periods of very fats heart beats begin and end suddenly
35
What occurs in Premature ventricular complexes
36
What is the ECG reading for 1st degree AV block
PR interval longer than 0.20s
37
What is the ECG reading for 2nd degree AV block - type 1
PR interval gets too long until one p wave is completely blocked and it produces no QRS complexes there's a pause as AV nodes recovers and cycle is repeated
38
What happens in 2nd degree AV block- TYPE 2. What's the ECG reading
Conduction ratio fo P waves: QRS complexes are 2:1, 3:1 and 4:1 QRS complexes is wide and it involves both bundle branches Atrial rate is regular and after that ventricular rate (also irregular
39
What occurs in 3rd degree heart block. What's the ECG reading
P waves dissociated from QRS complexes atrial rate is 100bpm , Ventricular rate is 40bpm conduction between atria and ventricles is absent
40
What is ECG reading characteristic of LEFT bundle branch
Wide abnormal QRS complexes in V1 and V6
41
What is the ECG reading characteristic of RIGHT bundle branch
Abnormal and wide QRS complexes in V1 and V6 NOTE: rSR wave in V1 and slurred S wave in V6
42
What line should the ST segment stay in (range)
Shouldn't deviate form isoelectric line by more than 1mm
43
What does a saw toothed p wave indicate
Implies Atrial flutter
44
What does prolonged p wave indicate
Implies left atrial enlargement
45
What does absent p wave represent
Atrial fibrillation
46
What's the procedure for interpreting ECG
47
what is the normal range for PR intevral and QRS complex? how do you check cardiac axis without calculation
PR- 0.12s to 0.2s QRS- less than 0.12s cardiac axis: can look at leads with highest QRS complex. or just check QRS complex of avL and lead 1 and find tan angle
48
What plan does limb and precordial limb work?
limb- coronal precordial- axial

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