EKG: Abnormal Interpretations

Question 1

The P Wave is associated with the activation of what area of the heart?

Answer 1

Activation of the Atria

Question 2

The QRS Complex is associated with the activation of what area of the heart?

Answer 2

Activation of the Ventricles?

Question 3

The T Wave is associated with the activation of what wave of the heart beat?

Answer 3

The Recovery Wave

Question 4

How much time is equivalent to one square on an ECG readout?

Answer 4

1 square = 0.04 sec (40 m/s)

Question 5

What is a normal HR for an ECG analysis?

Answer 5

60-100 bpm.

Question 6

What is a normal PR Interval for an ECG analysis?

Answer 6

0.12 - 0.20 sec (about small 3 boxes)

Question 7

What is a normal QRS Interval for an ECG analysis?

Answer 7

< 0.12 sec

Question 8

How do you calculate rate on an ECG?

Answer 8

Count the number of large boxes between consecutive R waves and divide 300 by this number.

Question 9

What is Paroxysmal Supraventricular Tachycardias (PSVT)?

Answer 9

Sudden run of >3 premature beats (both sustained for up to hours or longer + brief & non-sustained: 3 beats up to 30 sec)

Question 10

What are some characteristics of Atrial Flutter’s?

Answer 10

Atrial rate is constant, Ventricular rate depends on AV junction, Variable Rhythm (regular or irregular), and No Observable P Waves.

Question 11

In Atrial Fibrillations Atrial Rates are _____ and Ventricular Rates are ______ ?

Answer 11

Atrial: Chaotic | Ventricular: Irregular

Question 12

How would you describe the Rhythm of Atrial Fibrillation?

Answer 12

Irregular, with no specific pattern. No stable relationship between fibrillary atrial waves and the QRS complex’s.

Question 13

How would you describe the P waves of Atrial Fibrillation?

Answer 13

No identifiable P waves, only fibrillary (f) waves, irregular movements of baseline.

Question 14

Is the PR Interval measurable in Atrial Fibrillation?

Answer 14

Not measurable.

Question 15

What triggers an Atrial Fibrillation?

Answer 15

Rapid electrical activity starting in the pulmonary vein and spreading to the atrium.

Question 16

What is AV (Atrio-Ventricular) heart block?

Answer 16

Conduction disturbances, impaired transmission from atria to ventricles. (AV node dysfunction)

Question 17

What is the primary measure of AV Heart Blocks?

Answer 17

PR Interval

Question 18

How many types of AV Heart Block are there?

Answer 18

1st Degree, 2nd Degree (Type 1 & Type 2), and 3rd Degree

Question 19

How would you describe 1st Degree AV Heart Block?

Answer 19

Mildest, more of a delay & not a block. Impulses moving through the AV node too slowly.

Question 20

What is the PR Interval of 1st Degree AV Heart Block?

Answer 20

> 0.20 sec

Question 21

What are some causes of 1st Degree AV Heart Block?

Answer 21

Medication-Induced, Myocardial Infarction, and Hyperkalemia.

Question 22

How would you characterize 2nd Degree Heart Block Mobitz Type I?

Answer 22

Progressive lengthening of PR interval w/non-conducted P wave. (usually only 2-3 P waves occur before a QRS is dropped)

Question 23

What are some causes of 2nd Degree Heart Block Type 1?

Answer 23

Medication-Induced, Ischemic Heart Disease, Acute Inferior Wall Infarction, and Enhanced Vagal tone (Athletes)

Question 24

How would you describe the Rhythm of 2nd Degree Heart Block Type 2?

Answer 24

Irregular with “grouped” beats.

Question 25

How would you describe the Rate of 2nd Degree Heart Block Type 2?

Answer 25

Atrial: Constant between 60-100 bpm. Ventricular: Varies due to non-conducted P wave.

Question 26

How would you describe the P wave & PR Interval of 2nd Degree Heart Block Type 2?

Answer 26

P Wave: sudden appearance of a non-conducted P wave PR Interval: NO progressive lengthening.

Question 27

What is 2nd Degree Heart Block Type 2 a general sign of & what is the treatment?

Answer 27

General sign of severe conduction system disease (AV node & below) Treatment: Pacemaker

Question 28

How would you describe 3rd Degree Heart Block?

Answer 28

PR Interval is irregular & not related to the flow of electrical stimuli.

Question 29

How is the pacemaker rhythm recognized?

Answer 29

Easily recognized through pacemaker spikes (vertical signals that represent the electrical activity of the pacemaker)

Question 30

How do Premature Ventricular Contractions occur?

Answer 30

Randomly or may alternate with normal beats in a regular pattern.

Question 31

What are some EKG rhythm properties associated with PVC's?

Answer 31

P Wave: not conducted PR Interval: not measurable QRS Complex: > 0.12 secs with abnormal form Rhythm: irregular Rate: variable

Question 32

A Triplet PVC is what shape?

Answer 32

Non-Sustained VTach

Question 33

A Multifocal PVC is what shape?

Answer 33

More than one shape

Question 34

What is Ventricular Tachycardia (V-Tach)?

Answer 34

Fast heart rhythm that originates in one of the ventricles.

Question 35

A Ventricular Tachycardia has a run of ___ QRX complex's?

Answer 35

> 3 (single, non-sustained, or sustained for > 30 sec)

Question 36

What are some EKG rhythm properties associated with V-TACH?

Answer 36

Rate: Ventricular rate is 150-200 bpm Rhythm: Regular or Slightly Irregular P Wave: Usually not distinguishable PR Interval: Not Measurable QRX Complex: Wide & Bizarre (>0.12 secs)

Question 37

What is a Ventricular Fibrillation (V-Fib)?

Answer 37

Uncoordinated contraction of the ventricles resulting in a "quivering" rather than a normal contraction.

Question 38

What are some EKG rhythm properties?

Answer 38

P Wave: Not Identifiable PR Interval: Not Measurable QRS Complex: Not Identifiable Rhythm: Chaotic, not identifiable Rate: cannot be determined

Question 39

In V-TACH & V-FIB, if the ventricles are not contracting properly, what is the outcome?

Answer 39

Decrease in cardiac output.

Question 40

How is V-FIB identified?

Answer 40

Most commonly identified as arrhythmia in cardiac arrest patients.

Question 41

What are Bundle Branch Blocks?

Answer 41

Delays in electrical signal conduction to the R & L ventricular tissue

Question 42

How do you determine the presence of BBB?

Answer 42

Primarily examine QRS waves

Question 43

How is a R Bundle Branch Block typically spotted? (characteristics)

Answer 43

"Bunny Rabbit Ears"

Question 44

How is a L Bundle Branch Block typically identified?

Answer 44

Produced an R, R' in the left chest leads V5/V6 with accompanying broad R-wave and deep S and inverted T-Wave.