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CV 2 Exam 1 > EKG > Flashcards

EKG Flashcards

1
Q

The basics- what do we check every time?

A

Rate

Rhythm

Axis

Hypertrophy

Infarction

Wave interval and segment abnormalities

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2
Q

Waves and Segments

A

Waves - Summation Vectors
P, Q, R, S, T, U

Segments
ST

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3
Q

Intervals

A

PR less than 0.2 seconds (one big – five little boxes)

QRS less than 0.12 seconds (three little boxes)

QT 0.44 seconds Bazett’s formula

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4
Q

Rate

A

300, 150, 100, 75, 60, 50

Six second strip - Multiply by 10

(where the leads break is 3 seconds)

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5
Q

Leads

A

Lead I- across chest,

Lead 2- down across the heart, “physiologic lead”

Lead 3-

AVF - straight down

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6
Q

V leads- what plane?

A

horizontal

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7
Q

QRS Sequence of Ventricular Depolarization

A

Depolarization starts at the ventricular septum (Q wave) and the endocardial surfaces.

Average current flows from the base of the heart to the apex (R wave).

At the end of depolarization, the current reverses, flows toward the outer walls of the ventricles near the base (S wave).

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8
Q

Atrial rhythm

A

Up right P waves, narrow QRS

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9
Q

Junctional rhythm

A

Absent or inverted P waves, narrow QRS

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10
Q

Ventricular rhythm

A

No p waves

Wide QRS complexes

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11
Q

Repetitive sequence rhythms

A

Bigeminal, Trigeminal, Quadrigeminal

A series-pattern of ectopic depolarizations, either atrial or ventricular in origin

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12
Q

Automaticity issues

A

Escape beats with refractory periods

premature beats- irritable focus, reentry

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13
Q

Supraventricular rhythms with narrow QRS complexes

A

Sinus/ Atrial

Junctional

Wolf-Parkinson-White (WPW)

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14
Q

Sinus/Atrial

rhythm

A

Sinus arrhythmia
Wandering pacemaker, multifocal atrial tachycardia (MAT)
Paroxysmal atrial tachycardia (PAT)

Artial flutter- Singular atrial focus – reentry mechanism

Artial fib- Lack of any organized atrial activity

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15
Q

Junctional rhythms

A

Paroxysmal junctional tachycardia (PJT)

AV nodal reentry

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16
Q

Wolf-Parkinson-White (WPW)

A

Accessory conduction pathway (bundle of Kent)
Delta waves
Often has the appearance of an IWMI, this determination must be interpreted carefully
Shortened PR interval

17
Q

Wandering pacemaker

A

irregular rhythm
P’ wave shape varies
atrial rate less than 100
irregular ventricular rhytm

18
Q

What does atrial flutter look like?

A

sawtooth

2 or 3 P waves per QRS

19
Q

what makes a junctional rhythm?

A

no p waves.

also, slower, because intrinsic rate of junction is slower

20
Q

wolf parkinson white

A

p wave smashing into the QRS

21
Q

First degree AV block

A

Prolonged PR interval - > 0.2 seconds

22
Q

Second degree AV block

A

Variable penetration of AV conductions – lone P waves without a QRS conduction following

2 types: Wenckebach and Mobitz

23
Q

Type I Second degree AV block

A

(conduction abnormality in the AV node and heavy parasympathetic influence)
Wenckebach
Progressively prolonged PR intervals with a subsequent dropped beat and lone P wave – usually a fixed ratio/pattern
Vagal maneuvers

24
Q

Type 2 Second degree AV block

A

Mobitz
Failure of AV conduction in a fixed ratio/pattern, the PR interval is not gradually increasing in length
Widened QRS

25
Q

Third degree AV block

A

Complete Atrial and Ventricular dissociation – both are being independently paced

26
Q

Ventricular Dysrhythmias

A

Wide QRS complex tachycardia
- Supraventricular vs. ventricular

Ventricular Tachycardia
- Irritable focus of a ventricular origin – usually reentry mechanism

Torsades de Pointes - twisted ribbon

Ventricular fibrillation
Multiple irritable automatic foci depolarizing

27
Q

number one cause of prolonged QT syndrome

A

hypomagnesemia

can also be caused by medications, etc.

28
Q

Ventricular Blocks: Bundle branch blocks

A

Lack of synchronization of the bundle branches

Right Bundle Branch Block

  • Left bundle conducts first
  • Best viewed inV1 V2

Left

  • Right bundle conducts first
  • Best viewed in V5 V6
29
Q

QRS sequence of depolarization

A

Depolarization starts at the ventricular septum (Q wave) and the endocardial surfaces.

Average current flows from the base of the heart to the apex (R wave).

At the end of depolarization the current reverses, flows toward the outer walls of the ventricles near the base (S wave).

30
Q

Axis

A

Vector direction and mass summation

  • Limb leads – frontal plane (Determine axis)
  • Chest Leads – horizontal plane (Determine rotation)
  • 0-90 degrees is normal (actually -30 to 110)
  • Isoelectric point
  • —Right angle from the axis plane

CV 2 Exam 1 (3 decks)

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