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MBChB V Family medicine > ECG > Flashcards

ECG Flashcards

(65 cards)

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1
Q

How fast is standard ecg paper travelling?

A

25mm/s

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2
Q

What is a large ecg square equal to?

A

5mm

0.2s

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3
Q

What is a small ecg square equal to?

A

1mm

0.04s

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4
Q

Which leads measure the inferior surface of the heart?

A

II
III
aVF

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5
Q

Which leads measure the anterior surface of the heart?

A

V1
V2
V3
V4

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6
Q

Which leads measure the lateral surface of the heart?

A

I
aVL
V5
V6

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7
Q

Which leads measure the right atrium and LV cavity?

A

V1

aVR

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8
Q

How do you perform a 15-lead ECG?

A

V4 to the right 5th IC space MCL
V5 round backwards to the inferior tip of scapula
V6 to midway between V5 and spinal column.

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9
Q

What is the P wave showing?

A

Spread of electrical activation through atrial myocardium starting from SA node
Atrial depolarisation

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10
Q

What is the PR interval showing?

A

Time taken by atrial depolarisation

Conduction of impulse through Av node

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11
Q

What is the QRS complex showing?

A

Ventricular depolarisation

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12
Q

What is the ST segment showing?

A

Pause in ventricular electrical activity before repolarisation

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13
Q

What is the T wave showing?

A

Ventricular repolarisation

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14
Q

What is the U wave showing?

A

Uncertain
Possible due to after potentials at beginning of systole
Repolarisation of the mid-myocardial cells, that is, those between the endocardium and the epicardium and the His-Purkinje system

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15
Q

What is the cause of a U wave?

A

Hypokalemia
Hypercalcemia
Can be normal (athletes)

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16
Q

What is a sinus rhythm on ecg?

A

Regular p waves followed by QRS complex

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17
Q

What is the difference between atrial fibrillation and atrial flutter?

A

Atrial fib = irregular ventricular rate

Atrial flutter = regular ventricular rate

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18
Q

How do you calculate ventricular rate?

A

Count number of large squares from R to R

Divide by 300

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19
Q

How do you calculate atrial rate?

A

Count number of large squares from P to P

Divide by 300

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20
Q

What is a left axis?

A

QRS + in I

- in aVF

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21
Q

What is a right axis?

A

QRS - in I

+ in aVF

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22
Q

What is a normal axis?

A

QRS + in I and + in aVF

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23
Q

What is an extreme right axis?

A

QRS - in I and - in aVF

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24
Q

Give causes of left axis deviation

A

Systemic hypertension
IHD
AMI
Increased LV

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25
Give causes of right axis deviation
COPD Increased RV Pulmonary hypertension Pulmonary embolism
26
What does a tall peaked P wave in leads II, III and aVF show?
Right atrium hypertrophy
27
How do you diagnose right atrium hypertrophy on ecg?
A tall peaked P wave in leads II, III and aVF
28
What does a notched broad P wave on ecg show?
Left atrium hypertrophy
29
How do you diagnose left atrium hypertrophy on ecg?
Notched broad P wave
30
Give a cause of left atrium hypertrophy
Mitral stenosis
31
Where do you check on the ecg for atrial hypertrophy?
P wave in V1
32
What is the p wave in atrial hypertrophy on ecg also known as?
P pulmonale
33
Give causes of a prolonged PR interval
Beta blocker Heart blocker Digitalis
34
Give causes of a shortened PR interval
Tachycardia
35
How do you measure a normal P wave?
≤2,5 small squares wide and <2,5 small squares high
36
How do you measure a normal PR interval?
≤5 small squares wide)
37
How do you measure a normal QRS complex?
≤2,5 small squares wide
38
Give causes of a wide QRS complex
Bundle branch block
39
Give causes of tall R waves in V1
Right ventricular hypertrophy
40
Give causes of tall R waves in V6
Left ventricular hypertrophy
41
What is the transition point?
When R and S waves are equal in the chest lead over the interventricular septum, normally V3 or V4
42
Give causes of a flat/depressed ST segment
Ischaemia | Digoxin
43
Give causes of an elevated/raised ST segment
AMI
44
Give the cause of a saddle shaped ST segment elevation with small complexes
Pericarditis
45
How does pericarditis appear on ecg?
A saddle shaped ST segment elevation with small complexes
46
How do you measure a normal T wave?
< 5 small squares wide and <3 small squares high
47
Give causes of a peaked T wave
Hyperkalaemia | Increased LV
48
Give causes of a flat T wave
Hypokalemia
49
Give causes of an inverted T wave
``` Ischaemia AMI Pericarditis LV hypertrophy Pulmonary embolism BBB ```
50
Which leads always have a positive T wave?
``` I II V4 V5 V6 ```
51
Which leads always have a negative T wave?
aVR
52
If the T wave is inverted in V1/2, then...?
Must be upright in V4/5/6
53
How do you measure a normal Q wave?
<1 small square wide and <2 small squares deep
54
What is the cause of a Q wave?
Septal depolarization | AKA septal Q waves
55
Small Q waves are normal in which leads?
``` I II aVL V5 V6 (The leads that look at the heart from the left) ```
56
Q waves are the only firm electrocardiographic evidence of what?
Myocardial necrosis
57
How do you measure a normal QT interval?
0.35-0.45s | Should not be more than half of the interval between adjacent R waves (R-R interval).
58
Name causes of a prolonged QT interval
``` Females Older age Torsades de pontes Anti-malarials Anti-epileptics Anti-psychotics Anti-depressants Antibiotics Antiarrythmics Digoxin ```
59
What is amiodarone?
An antiarrythmic
60
Give a cause of shortened QT interval
Ventricular fibrillation
61
Regarding S waves and R waves, how do you see RV hypertrophy on ecg?
V1 tall R waves | V5/6 deep S waves
62
Regarding S waves and R waves, how do you see LV hypertrophy on ecg?
V5/6 all R waves | V1/2 deep S waves
63
What is a U wave?
Small deflection following T wave Prominent in V2/3/4 Upright except in aVR
64
Which lead is the U wave depressed?
aVR
65
Give signs of pulmonary embolism on ECG
``` Sinus Tachycardia (with a normal ECG) Peaked P waves RBBB/incomplete RBBB Right ventricular strain Axis change (right axis deviation) ST segment and T wave changes Deep S waves in V6 ```

MBChB V Family medicine (10 decks)

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