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S&F III: Exam 1 > EKG > Flashcards

Flashcards in EKG Deck (121):
1

Where is the current EKGs measure?

ECM

2

Cardiac Dipole

in the ventricle, there is a zone of + resting and a zone of - excitation

3

which way does a vector point

towards the positive side

4

Mean electrical vector

the sum of the indiv. instant. vectors; ECG records this

5

V1

4th ICS, 2 cm right of sternum

6

V2

4th ICS, 2 cm left of sternum

7

V4

5th ICS, left midclavicular

8

V5

5th ICS, left anterior axillary line

9

V6

left midaxillary line

10

What is the oddball lead?

aVR (all negative)

11

bipolar limb leads

I, II, III

12

what is Einthoven's triangle?

Leads I, II, III

13

aVR

-150*

14

aVF

+90*

15

aVL

-30*

16

I

0*

17

II

+60*

18

III

+120*

19

axis of lead

the direction from - to + of a lead

20

Mean QRS axis

average direction of MEV during ventricular depolarization

21

where should you look at for quick axis diagnosis?

Leads I and AVF

22

normal axis

+90 to 0/-30* (both positive)

23

left axis deviation

0/-30* to -90* (I positive, AVF negative)

24

extreme right axis deviation

-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