EKG Flashcards
(121 cards)
1
Q
Where is the current EKGs measure?
A
ECM
2
Q
Cardiac Dipole
A
in the ventricle, there is a zone of + resting and a zone of - excitation
3
Q
which way does a vector point
A
towards the positive side
4
Q
Mean electrical vector
A
the sum of the indiv. instant. vectors; ECG records this
5
Q
V1
A
4th ICS, 2 cm right of sternum
6
Q
V2
A
4th ICS, 2 cm left of sternum
7
Q
V4
A
5th ICS, left midclavicular
8
Q
V5
A
5th ICS, left anterior axillary line
9
Q
V6
A
left midaxillary line
10
Q
What is the oddball lead?
A
aVR (all negative)
11
Q
bipolar limb leads
A
I, II, III
12
Q
what is Einthoven’s triangle?
A
Leads I, II, III
13
Q
aVR
A
-150*
14
Q
aVF
A
+90*
15
Q
aVL
A
-30*
16
Q
I
A
0*
17
Q
II
A
+60*
18
Q
III
A
+120*
19
Q
axis of lead
A
the direction from - to + of a lead
20
Q
Mean QRS axis
A
average direction of MEV during ventricular depolarization
21
Q
where should you look at for quick axis diagnosis?
A
Leads I and AVF
22
Q
normal axis
A
+90 to 0/-30* (both positive)
23
Q
left axis deviation
A
0/-30* to -90* (I positive, AVF negative)
24
Q
extreme right axis deviation
A
-90* to 180* (both negative)
25
right axis deviation
+90 to 180 (I negative, AVF positive)
26
dimensions of EKG
small (1x1 mm); lg (5x5 mm)
27
horizontal reading
time--> small (0.04 sec); lg (0.2 secs)
28
vertical reading
voltage--> sm (0.1 mV); lg (0.5 mV)
29
P-wave
atrial depolarization
30
What leads show a normal + P wave?
I, II***, AVL, AVF, V5, V6
31
What leads show a normal - P wave?
aVR
32
What leads show a normal BIP P wave?
III, V1
33
What leads show a normal variable P wave?
V2, V3, V4
34
Which leads show a normal septal Q wave?
I, AVL, V5, V6***
35
What leads show a normal R wave?
I, II, III, AVL, AVF, V5***, V6
36
What is the J point?
origin of ST segment at end of QRS
37
What leads show a normal S wave?
AVR, V1, V2
38
What leads show a normal transition QRS wave?
V3, V4
39
What leads show a normal - T wave?
AVR
40
What leads show a normal + T wave?
III, AVL, AFV, V2-V6
41
What leads show a normal BIP/- T wave?
V1, V2
42
What leads show no T wave?
I, II
43
How long is PR Interval?
0.12-0.20 sec
44
How long is QRS Interval?
<= 0.10 sec
45
How long is QT Interval?
0.35 sec
46
How long is corrected QT interval?
<= 0.44 sec
47
anterior apical leads
V3, V4
48
hi left lateral leads
I, aVL
49
lo left lateral leads
V5, V6
50
inferior leads
II, III, aVF
51
anterior septal leads
V1, V2
52
Q wave
1st deflection is down (sm=n, lg=infarct)
53
R wave
1st deflection is up
54
R' wave
second up deflection
55
S wave
1st down deflection after up deflection
56
QS
1 down deflection w/o R present
57
+
current towards electrode
58
-
current away from electrode
59
biphasic
perpendicular to electrode
60
T wave
repolarization of cells
61
T wave changes
sensitive to electrolytes, ischemia, & drugs
62
U wave
follows T wave, represents repol of Purkinje
63
Heart Rate Method 1
60/R-R interval (rhythm strip X6)
64
HR Method 2
300-150-100-75-60-50
| wherever 2nd QRS falls is HR
65
HR Method 3
count # in 3 sec interval, mult. by 20
*irregular HR
66
What is PR interval?
onset of P wave to onset of QRS
67
What is QRS interval
from beg. to end of complex
68
What is QT interval
from beginning of Q to end of T
69
What is corrected QT interval
QT/sqrt(R-R)
70
When does Lt Axis Dev. occur?
inferior wall MI
LAFB
LVT (occ.)
71
When does Rt Axis Dev. occur?
RV Hypertrophy
Acute Right Heart Strain (PE)
LPFB
72
Rt Atrial Enlargement
Inc. P-wave + amplitude in Lead II
| Pulmonary etiology
73
Lt Atrial Enlargement
Inc P wave - amp and duration in V1
mitral etiology
74
Which side does the QRS axis deviate to in VH?
hypertrophied side
75
Which leads do you spot VH in?
I, AVF
76
Which leads do you spot AE?
II, V1
77
Rt VH
R>S in lead I; Right Axis Deviation
etiology pulmonary & congenital
78
Lt VH
Lt Axis Deviation;
S in V1 plus R in V5/V6 => 35 mm
OR R in aVL >11 mm OR R in I >15 mm
etiology HTN, valvular disease
79
Main difference between AE and VH
duration change in AE (Lt)
| axis shift in VH
80
Bundle branch blocks
myocyte-myocyte spread of conduction; QRS WIDENS
81
RBBB
widened QRS; RSR' in V1
| prom. S in lead V6
82
LBBB
widened QRS
absent R, prominent S in V1
absent Q, broad R in V6
83
Where does left anterior fascicle run
ant., superior, lat portion of LV
84
where does left posterior fascicle run
post., inferior, med. LV
85
why don't hemiblocks have widened QRS
purkinje fibers bridge gaps
86
LAFB
left axis deviation
| Q in I and wide/deep S in III
87
LPFB
right axis deviation
| deep S in I and Q in III
88
posterior MI
Inc R in V1&2 with NO Axis Dev.
| RCA affected
89
inferior MI
Q wave in II, III, AVF
| RCA
90
anteroseptal MI
Q V1-V2
| LAD
91
Anterioapical MI
Q V3,V4
| LAD
92
Extensive Anterior MI
Q V1-V6
| LCA
93
Anterolateral MI
Q V5-V6, I, aVL
| CFX
94
Transient Myocardial Ischemia
T wave inversion in V2-V6 (negative)
95
Acute ST segment Elev MI
elevated over infarct,
deep over opposite side
**ionic leak**
96
Acute Non-ST segment Elev MI
***acute POC thrombus***
| ST depression over infarct
97
Sinus Bradycardia
normal EKG with HR <60 bpm
ischemia, cardiomyopathy, meds, metabolic promblems
athletes
98
Sick Sinus Syndrome
intermittent SB
dizziness, syncope, confusion
common in pts with AFib
99
Escape Rhythms
No P Waves
| Junctional and Ventricular
100
Junctional escape rhythm
arise from AV node/bundle of His
normal QRS complex
rate 40 to 60 bpm
101
Ventricular Escape Rhythm
depolarized past His
| WIDENED QRS, 30-40 bpm
102
1* AV Block
increased PR interval (>0.2 sec)
103
2* AV Block
P waves with no QRS
104
Type I 2* AV block
progressive Inc. in PR Interval until QRS skipped and then restarts
*benign*
105
Type II 2* AV block
severe blockage of bundle of His/Purkinje
| sudden loss of QRS (widened when present)
106
3* AV block
"complete heart block*
no relation btwn P & QRS
if @ AV, normal QRS with 40-60
if @ His, wide QRS and dec. rate
107
3* AV Block @ His
wide QRS and dec. rate
108
3* AV block @ AV
normal QRS with 40-60
109
Sinus tachycardia
100-180 bpm, normal EKG otherwise
110
Atrial Premature Beats (APB)
not related to SA! P-wave abnormal. early
111
Atrial Flutter
100-350 bpm
| 2 A:1 V
112
atrial fibrillation
A 350-600 bpm/ V 140-160
| no p-waves
113
Paroxysmal Supraventricular Tachycardia
sudden onset/termination with rate of 140-250 bpm
114
AVNRT
most common in adults
| NO P-wave, normal QRS
115
orthodromic AVRT
no change in wave or widened QRS
| Retrograde P waves visible
116
antidromic AVRT
widened QRS
117
ventricular pre-excitation syndrome
| "wolff-parkinson-white"
decreased PRT interval (<0.12 secs)
| slurred, widened QRS
118
VPB
widened QRS, inverted T
119
VT
series of =>3 VPBS
| 100-200 bpm
120
Torsades de Pointe
(VT)
| polymorphic, early afterdepol
121
VFib
morbidity increased, cessation of cardiac output
