ECG reading and understanding Flashcards

1
Q

What does the ECG detect

A

Electrical potential changes on the body surface caused by the re and depolarisation of the heart

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2
Q

Benefit of the ECG

A

Allows you to indirectly and non invasively monitor the heart

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3
Q

Why can the ECG detect electrical potential changes on the surface of the skin

A

Due to the spread of the electrical current via gap junction in cardiac muscle this causes current flow in surrounding tissue

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4
Q

Describe the propagating current in one beat

A

Positive wave followed by a negative wave

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5
Q

At what potential is the positive wave

A

+30mV

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6
Q

What is a lead?

A

An imaginary line between two electrodes

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7
Q

What is the +ve electrode

A

This is the reading electrode

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8
Q

What is the -ve electrode

A

This is the reference electrode

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9
Q

When is an uplift in the ECG produced?

A

When the wave of depolarisation is towards the +ve reading electrode

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10
Q

When is a down lift in the ECG produced?

A

When the wave of depolarisation is moving away from the +ve reading electrode

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11
Q

What are the names of the standard limb leads?

A

I, II and III

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12
Q

What lead is between the right and left arm?

A

Lead I and the LA is the +ve electrode

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13
Q

What is the lead between the right arm and the left leg?

A

Lead II and the LL is the +ve electrode

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14
Q

What is the lead between the left arm and the left leg?

A

Lead III and the LL is the +ve electrode

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15
Q

Why in lead II is the T wave an uplift?

A

Because its a wave of repolarisation that moves away from the +ve LL electrode which is recorded as an uplift

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16
Q

Why in lead II is the Q wave downwards when its a depolarisation?

A

Because the wave of depolarisation in the inter-ventricular septum is from left to right which is sightly away from the +ve LL electrode

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17
Q

Why in lead 2 is the S wave downwards?

A

This is because in ventricular depolarisation the wave propagates from the apex upwards away from the +ve electrode

18
Q

1 electrode is positive the other to are linked to provide a reference point in the centre of the heart .

A

Augmented limb leads

19
Q

What are the three augmented leads?

A

aVR, right arm aVL, left arm aVF, left foot

20
Q

What is the point of the augmented limb and standard limb leads?

A

To provide a vertical/frontal view of the heart

21
Q

What electrodes when placed give us a horizontal view of the heart?

A

Precordial leads V1-V6

22
Q

V1

A

4th intercostal space directly right of the sternum

23
Q

V2

A

4th intercostal space directly left of the sternum

24
Q

V3

A

Midway between V2 & V4

25
V4
5th intercostal space mid-clavicular line
26
V5
same horizontal plane as V4 but left anterior axillary line
27
V6
Same horizontal plane as V5 but left mid axillary line
28
Calibration of the paper and ECG
1 big squares are 0.2 seconds 5 big squares are 1 second 300 squares are 1 minute Paper moves at 25mm/sec 300 / number of squares between R-R interval is heart rate
29
What leads indicate an inferior STEMI
II,III, aVF
30
What leads indicate an anterior STEMI
V1 to V4
31
What leads indicate an anteroseptal STEMI
V1-V3
32
What indicates a left bundle branch MI
Prolonged ST segment V1-V4 M or W shape
33
What indicates a lateral STEMI
I and aVL
34
ECG showing left axis deviation
35
ECG showing right axis deviation
36
ECG showing left bundle brach block
37
38
Anterolateral STEMI shows what
V4-V6, I, aVL
39
Posterior STEMI
V1-V2 reciprocal
40