ECG

Question 1

EKG electrode placement for 3 electrode system?

Answer 1

• white on right

- smoke over fire – black over red

Question 2

SBAR?

Answer 2

S - situation
B - background
A - assessment
R - recommendations

Question 3

What records electrical activity of the heart?

Answer 3

ECG

Question 4

On 12 lead ECG, why are only 10 used?

Answer 4

because the final 2 leads are redundent

Question 5

What 6 leads record electrical signals in the frontal plane?

Answer 5

• leads I, II, III
• aVR
• aVL
• aVF

Question 6

What 6 leads record electrical signals in the transverse plane?

Answer 6

• V1-6

Question 7

Placement of 10 electrodes?

Answer 7

• right arm
• left arm
• right leg
• left leg
• V1 = 4th intercostal space to the right of the sternum
• V2 = 4th intercostal space to the left of the sternum
• V3 = between electrodes 2 and 4
• V4 = 5th intercostal space in the mi-clavicular line
• V5 = horizontally even with V4 in the left anterior axilla
• V6 = horizontally even with V4 and 5 in mid axillary line

Question 8

What is contracting during systole?

Answer 8

left ventricle

Question 9

Normal conduction pathway?

Answer 9

SA node through atria –> AV node –> bundle of His –> purkinjie fibers –> (travel through intraventricular septum to lateral wall of right and left ventricle)

Question 10

What is the primary pacemaker?

Answer 10

SA node

Question 11

All myocardial cells can act as what?

Answer 11

a pacemaker in the absence of other pacers and as a result of pathology

Question 12

R to R rhythms represent what?

Answer 12

ventricular rhythm

Question 13

P to P rhythms represent what?

Answer 13

atrial rhythm

Question 14

What does the PR interval represent?

Answer 14

• conduction time (the atria node slows conduction to give atria time to fire and ventricles time to fill)
• from where the p wave begins to the beginning of the QRS complex

Question 15

What 2 things does the QRS complex represent?

Answer 15

• ventricular depolarization

- atrial repolarization

Question 16

What is contracting during systole?

Answer 16

left ventricle

Question 17

Normal conduction pathway?

Answer 17

SA node through atria –> AV node –> bundle of His –> purkinjie fibers –> (travel through intraventricular septum to lateral wall of right and left ventricle)

Question 18

What is the primary pacemaker?

Answer 18

SA node

Question 19

All myocardial cells can act as what?

Answer 19

a pacemaker in the absence of other pacers and as a result of pathology

Question 20

R to R rhythms represent what?

Answer 20

ventricular rhythm

Question 21

P to P rhythms represent what?

Answer 21

atrial rhythm

Question 22

What does the PR interval represent?

Answer 22

• conduction time (the atria node slows conduction to give atria time to fire and ventricles time to fill)
• from where the p wave begins to the beginning of the QRS complex

Question 23

What 2 things does the QRS complex represent?

Answer 23

• ventricular depolarization

- atrial repolarization

Question 24

What is occurring during a Premature Ventricular Contraction (PVC)?

Answer 24

• wide and weird QRS
• QRS is early and followed by a pause then back to normal rhythm
• occur below the atria and outside the normal conduction pathway
• lead to uncoordinated ventricular contraction and decrease ventricular ejection and low blood pressure wave and poor perfusion

Question 25

What does the QT interval represent?

Answer 25

- time of complete ventricular activity from depolarization to repolarization - beginning of Q wave to the end of the T wave

Question 26

What does the ST segment represent?

Answer 26

- early ventricular repolarization | - from the end of the QRS complex to the beginning of the T wave

Question 27

What happens to the ST segment during ischemia?

Answer 27

ST segment depression

Question 28

What happens to the ST segment during infarction?

Answer 28

ST segment elevation

Question 29

What is it called when the BPM is less than 60bpm?

Answer 29

sinus bradycardia

Question 30

What is it called when the BPM is greater than 150bpm?

Answer 30

sinus tachycardia

Question 31

What changes on the ECG are caused by a premature atrial contraction?

Answer 31

changes in P wave morphology

Question 32

What is it called when the ECG has no discernable P wave and illustrates an irregular and inconsistent R to R interval?

Answer 32

atrial fibrillation

Question 33

What is it called when the ECG illustrates a saw tooth or picket fence appearance and there is a lack of a P wave?

Answer 33

atrial flutter (regularly irregular)

Question 34

What occurs below the atria ad outside the normal conduction pathway and is more severe and life threatening than atrial dysrhythmias?

Answer 34

ventricular dysrhythmias

Question 35

What is it called when the ECG illustrates 3 or more PVC's with a rate > 100 bpm

Answer 35

Ventricular tachycardia

Question 36

What is the most lethal ventricular dysrhythmia?

Answer 36

ventricular fibrillation -- ventricles are not contracting and there is no perfusion