ECG

Question 1

describe the angles and location of the ecg leads?

Answer 1

aVF - from the bottom
aVR - from right armpit - diagonal
aVL - from left armpit diagonal

I - left 0 degree flat
II - bottom left
III - bottom right

Question 2

when putting on the limb leads, what sides are the + and -?

Answer 2

I = + on left arm, - on right arm
II = + on left leg, - on right arm
III = + on left leg, - on left arm

always + on left leg

Question 3

what does 1 small square and 1 large square mean on ecg?

Answer 3

small = 0.04s
large = 0.2s

Question 4

what should the normal size of a PR interval be?

Answer 4

120-200ms
3-5 little squares

Question 5

what should the normal size of a QRS complex be?

Answer 5

shouldn’t exceed 110ms
less than 3 little squares

Question 6

P wave

Answer 6

• positive in I and II
• negative in aVR
• <3 small squares long
• < 2.5 high
• commonly biphasic in V1
• best seen in leads II

Question 7

what is a pulmonale P wave and what does it indicate?

Answer 7

tall pointed P wave
R atrial enlargement

Question 8

what is a mitral P wave and what does it indicate?

Answer 8

notched / bifid Pwave
mitrale

Question 9

short PR interval <120 and delta wave

Answer 9

WPW syndrome

Question 10

long PR interval >120?

Answer 10

first degree heart block

Question 11

what is a pathological Q wave?

Answer 11

> 2mm deep
1mm wide
25% amplitude of R wave

Question 12

how to determine HR?

Answer 12

300 / n.o of large boxes between R waves

Question 13

HR of tachycardia

Answer 13

> 100bpm

Question 14

normal HR?

Answer 14

60-100bpm

Question 15

HR of bradycardia?

Answer 15

<60bpm - bardycardia

Question 16

sinus tachycardia

Answer 16

> 100bpm tachycardic
consistant RR
short PR
narrow QRS

Question 17

atrial flutter

Answer 17

> 100bpm tachycardic
flutter (F) waves
2:1 (atrial beats 2 to every 1 ventricle)
QRS normal bc AV absorbs some of this
narrow QRS

Question 18

paroxysmal supraventricular tachycardia

Answer 18

> 100bpm tachycardic
no P waves
narrow QRS

Question 19

atrial fibrilation

Answer 19

variable R-R intervals
indistinct P waves with variable activity
narrow QRS
taccycardic

Question 20

atrial flutter with variable block

Answer 20

narrow QRS
tachycardic
irregular R-R

Question 21

multifocal atrial tachycardia

Answer 21

narrow QRS
inconsistant R-R
>3 morphologically different P waves

Question 22

ventricular tachycardia

Answer 22

wide QRS
tachycardic
regular R-RF

Question 23

ventricular fibrillation

Answer 23

no visible p waves
tachycardic
wide QRS

Question 24

torsades de pointes

Answer 24

wide QRS
tachycardic
irregular

Question 25

sinus bradycardia

Answer 25

normal P-R long R-R no drop in QRS bradyc

Question 26

first degree AV block

Answer 26

prolongues P-R >200 no drop in QRS bradyc

Question 27

2nd degree heart block mobitz 1

Answer 27

P-R getting progressively longer drops a QRS complex bradyc

Question 28

2nd degree heart block mobitz 2

Answer 28

constant P-R drops a QRS bradyc

Question 29

3rd degree heart block

Answer 29

wide QRS lots of space between them bradyc

Question 30

right axis deviation- RBBB / RVH / LPFB

Answer 30

lead 1 - neg lead avF - pos

Question 31

left axis deviation - LBBB / LVH / LAFB

Answer 31

lead 1 - pos aVF - neg lead 11 - neg (if lead 11 was pos it would be a normal reading)

Question 32

extreme R axis deviation - Vtach

Answer 32

lead 1 - neg avF - neg

Question 33

hyperCa / hyperK

Answer 33

short QT

Question 34

LA enlargement

Answer 34

lead II - bifid P leav VI - biphasic P

Question 35

RA enlargement

Answer 35

lead II - > 2.5 P wave lead V1 - biphasic

Question 36

LBBB

Answer 36

V1/V2 - very long inverted RS V5/V6 - notches R wave

Question 37

causes of LBBB

Answer 37

LHF MI LVH

Question 38

RBBB

Answer 38

V1/V2 - biphasic equal QRS V5/V6 - wide slurred S wave

Question 39

LVH

Answer 39

V1/V2 - deep S wave V5/V6 - tall R wave

Question 40

RVH

Answer 40

V1/V2 - tall R wave V5/V6 - deep S wave

Question 41

pericarditis

Answer 41

PR depression