Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

CCT > EKG > Flashcards

EKG Flashcards

(107 cards)

Start Studying
1
Q

5 Steps for Reading EKG

A

Rate, Rhythm, Axis, Hypertrophy, Infarction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Rate Method:

A

300, 150, 100, 75, 60, 50

Bradycardia: cycles/6 sec. strip x 10

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Rhythm Method:

A

identify basic rhythm, then scan tracing for: prematurity, pauses, irregularity, and abnormal waves

Check: P before each QRS, QRS after each P
Check: PR interval (for AV block), QRS interval (for BBB)
if axis deviation, rule out hemiblock

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Axis Method:

A

QRS above or below baseline for axis quadrant (normal vs L and R axis deviation)
For axis in degrees: find isoelectric QRS in limb lead
Axis rotation in Horizontal plane

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Hypertrophy Method:

A

Check V1: P wave for atrial hypertrophy
R wave for right ventricular hypertrophy
S wave depth in V1 + R wave height in V5 for left ventricular hypertrophy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Infarction Method:

A 
Scan all leads for:
Q waves
Inverted T waves
ST segment elevation or depression
(find location of pathology and then identify the occluded artery)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Sinus Bradycardia

A

rate less 60/ min

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Sinus Tachycardia

A

rate more than 100/ min

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Normal Sinus Rhythm

A

60-100/ min

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Dissociated Rhythms

A

sinus rhythm may coexist with independent focus from lower level, determine rate of each

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Irregular Rhythms

A

Sinus Arrhythmia, Wandering Pacemaker, Multifocal Atrial Tachycardia, Atrial Fibrillation,

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Sinus Arrhythmia

A

irregular rhythm that varies with respiration, all P waves are identical, Considered normal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Wandering Pacemaker

A

Irregular rhythm, P waves change shape as pacemaker location varies, rate under 100/ min

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Multifocal Atrial Tachycardia

A

Irregular rhythm, P waves change shape as pacemaker location varies, rate exceeds 100/ min

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Atrial Fibrillation

A

Irregular Ventricular Rhythm, Erratic atrial spikes (no P waves) from multiple automaticity foci, atrial discharges may be difficult to see

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Escape (def)

A

an unhealthy SA node fails to emit a pacing stimulus (Sinus Block) and an escape beat arises from another automaticity focus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Atrial Escape Beat

A

pause, P’ wave with QRS, Sinus Resumes Pacing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Junctional Escape Beat

A

(idojunctional beat) pause, *usually QRS complex without P wave, Sinus Pacing Resume
*retrograde atrial depolarization, may cause inverted P wave

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Retrograde Atrial Depolarization

A

In junctional Escape Beat or Rhythm, junctional depolarization may depolarize the atria from below, causing inverted P wave

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Ventricular Escape Beat

A

pause, massive QRS with no P, Sinus resumes pacing after one beat

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Atrial Escape Rhythm

A

pause, P’ with pacing of 60-80

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Junctional Escape Rhythm

A

pause, *usually no P wave, pacing of 40-60

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Ventricular Escape Rhythm

A

(idioventricular) pause, no P wave, massive QRS, pacing 20-40

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Premature Beat

A

an irritable automaticity focus suddenly discharges a single stimulus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Atrial and Junctional irritants
``` epinephrine release sympathetic stimulation caffeine or other stimulants excess digitalis, some toxins, ethanol hyperthyroidism stretch (low 02) ```
26
Premature Atrial Beat (PAB)
P' wave produces earlier than expected, produced by atrial focus, may hide in the T wave, resets pacing of SA node (one cycle length
27
PAB with aberrant ventricular conduction
one of the ventricles has not depolarized yet, creating a wide QRS, premature P' with widened QRS (SA pacing one cycle length)
28
non-conducted PAB
AV node is in refractory phase, therefore no QRS | premature P' with no QRS (SA pacing one cycle length)
29
Atrial Bigeminy
PAB coupled to end of each normal cycle
30
Atrial Trigeminy
PAB coupled after each normal cycle of two
31
Premature Junctional Beat
premature beat, no P* may have retrograde atrial depolarization may have aberrant ventricular depolarization
32
Junctional Bigeminy
PJB after each normal cycle
33
Junctional Trigeminy
PJB after each cycle of two normal beats
34
Premature Ventricular Contraction (PVC)
no P', giant ventricular complex, usually opposite of normal QRS
35
Ventricular Irritants
low O2
36
Ventricular Bigeminy
PVC attached to each normal beat
37
Ventricular Trigeminy
PVC attached to each set of two normal beats
38
Ventricular Quadrigeminy
PVC attached to each set of three normal beats
39
Pathological PVC
6 PVC's per minute
40
Ventricular Parasystole
Ventricular focus with entrance block, dual pacing of ventricle and SA node
41
Multifocal PVC's
PVC's from multiple foci, each will have different, distinguishable QRS complex
42
Mitral Valve Prolapse
mitral valve billows into left atrium during ventricular systole, causes PVC's, considered benign
43
PVC on T wave
"R on T phenomenon" vulnerable period, respond quickly
44
Tachyarrhythmias
rapid rhythms originating in very irritable automaticity foci
45
Paroxysmal Tachycardia
150-250bpm
46
Flutter
250-350 bpm
47
Fibrillation
350-450 bpm
48
Paroxysmal Tachycardia
(sudden) a very irritable automaticity focus that suddenly paces rapidly
49
Paroxysmal Atrial Tachycardia
(PAT) rapid atrial beat 150-250, P' wave
50
PAT with AV block
rapid rate spiked P' waves 2:1 ratio of P':QRS suspect digitalis or toxicity
51
Paroxysmal Junctional Tachycardia (PJT)
rapid junctional beat 150-250, no P' or retrograde atrial depolarization
52
Paroxysmal Ventricular Tachycardia (PVT)
rapid 150-250 PVC like wide ventricular complexes
53
Atrial Flutter
continuous rapid sequence of atrial complexes from single atrial focus, many flutters per QRS
54
Ventricular Flutter
rapid series of smooth sine waves, usually leads to V-Fib
55
Atrial Fibrillation
jagged baseline of tiny spikes with irregular QRS 350-450
56
Ventricular Fibrillation
Totally erratic ventricular rhythm, no identifiable waves, multiple foci, immediate treatment
57
SA block
an unhealthy sinus misses one or more cycles
58
AV Block
blocks that delay or prevent atrial impulses from reaching ventricles
59
1st deg. AV block
prolonged PR interval, PR interval great than 0.2s (one large square)
60
2 deg AV block
some P waves without QRS complex, Wenckebach, Mobitz
61
Wenckeback
PR gradually lengthens with each cycle until the last P wave does not produce QRS
62
Mobitz
some P waves dont produce QRS
63
2:1 AV block
may be Wenckebach or Mobitz, PR length, QRS width or vagal maneuvers may help differentiate
64
3 deg block
(complete AV block) no P wave produces QRS response if QRS narrow and 40-60/min junctional focus if QRS- PVC like and rate 20-40 then ventricular rate
65
Bundle Branch Block
find R,R' in right or left chest leads | is QRS within 3 small squares?
66
Hemiblock
block of the anterior or posterior fascicle of left bundle branch check: has axis shifted outside normal range anterior hemiblock: axis shifts left: LAD posterior hemiblock: axis shifts right: RAD
67
anterior hemiblock
axis shifts left: LAD
68
Posterior hemiblock
axis shifts right: RAD
69
Axis
QRS lead 1: positive QRS means normal for left vs right negative: RAD QRS AVF: positive means normal for up vs down Negative: LAD determine axis quadrant, find isoelectric limb lead, 90 deg from that in determined quadrant Axis rotation: find transitional isoelectric QRS in chest lead
70
Atrial Hypertrophy
V1 is best indicator enlarged atrial wall, LR diphasic P wave
71
Right atrial Hypertrophy
V1: large diphasic P wave with tall initial component
72
Left Atrial Hypertrophy
V1: large diphasic P wave with wide terminal component
73
Ventricular Hypertrophy
enlarged ventricle
74
Right Ventricular Hypertrophy
in V1 QRS is normally negative, however with RVH, large R wave in V1 R wave large than S in V1 but R gets progressively smaller from V1-V6 S wave persists in V5 and V6 RAD with slightly widened QRS Rightward rotation in horizontal Plane
75
Left Ventricular Hypertrophy
S wave in V1 plus R wave in V5 is more than 35mm LAD with slightly widened QRS Leftward rotation in horizontal plane Inverted T wave: slants downward gradually, but up rapidly
76
Myocardial Infarction
complete occlusion of a coronary artery
77
myocardial infarction triad
ischemia, injury necrosis
78
ischemia
decreased blood supply, inverted symmetrical T wave
79
injury
acuteness of infarct, | ST segment indicates acute injury
80
Brugada Syndrome
hereditary condition that can cause sudden death in individuals with heart disease, right bundle branch block pattern (RR') with ST elevation in V1 to V3, elevated ST has peculiar peaked down-sloping shape shape in V1 and V2
81
Pericarditis
flat or concave elevated ST segment, the entire T wave is elevated off baseline (inflammation of the membrane (pericardium) surrounding the heart)
82
Right bundle branch block
check QRS in V1 and V2 looking for RR' Double R Is QRS within 3 small squares? criteria for ventricular hypertrophy unreliable
83
Left Bundle Branch Block
Check QRS in V5 V6 for RR' | with LBBB infarction is difficult to determine
84
Horizontal Axis (V2)
placed just anterior to AV node QRS should be negative due to thick left ventricle most reliable information concerning Anterior and Posterior infarction of Left ventricle projects through anterior and posterior wall of left ventricle
85
Horizontal Axis Method
leads normally become isoelectric in V3 and V4, "transitional zone" check chest lead isoelectric, if V5 or V6: leftward rotation if V1 or V2 rightward rotation
86
leftward rotation
isoelectric point is V5 or V6
87
Rightward rotation
isoelectric point is V1 or V2
88
Ischemia
reduced blood supply (from the coronary arteries) symmetrical inverted T-wave, especially in chest leads always check for T wave inversion in all chest leads
89
Wellens Syndrome
stenosis of the anterior descending coronary artery (ischemia) inverted symmetrical T wave in V2 and V3
90
Injury
indicates the acuteness of the infarct | ST segment elevation that returns to the baseline- myocardial infarction is acute
91
Ventricular Aneurism
"ballooning of ventricular wall" | causes an ST elevation that does not return to baseline
92
during angina
ST segment may be temporarily depressed
93
Subendocardial Infarction
infarct that does not extend through full thickness of left ventricular wall may cause flat depressed ST segment type of "non-q-wave infarction)
94
Stress Test
will record ST segment depression if coronary arteries are narrowed
95
Digitalis
can cause a unique ST segment depression
96
significant ST depression in normally upright QRS leads
indicates compromised coronary flow until proven otherwise
97
Necrosis
dead tissue | significant "Q" wave diagnosis infarction (0.04 s) (one small box)
98
infarction
diagnosed by significant Q wave (0.04 s) (one small box) | area of necrosis in the left ventricle
99
q wave (insignificant)
caused by initial mid-septal depolarization from terminal purkinje fibers of the left bundle branch at mid-septal location by definition less than 0.04 s
100
Significant Q wave
(0.04 s) (one small box) 1/3 of QRS amplitude check all leads except aVR
101
aVR Q wave
do not check Q wave in aVR, it will appear significant, but its not
102
lateral leads
?
103
inferior leads
?
104
chest leads
V1-V6
105
Anterior infarct
significant Q wave in V1-V4
106
Lateral infarct
significant Q wave in LI and aVF
107
Inferior infarct
Q on leads II, III, and aVF

CCT (3 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions