EKG interpretations

Question 1

Where are the pacemaker cells located?

Answer 1

SA node
AV node
Bundle of His
Right and left bundle branches
Perkinje fibers

Question 2

What are the two types of cardiac cells? Which is the bulk?

Answer 2

Pacemaker and contractile

Contractile cells make up 99% of myocardium

Question 3

What is your SA node rate?

Answer 3

60 - 100

Question 4

Which system has the biggest influence on your SA node?

Answer 4

PNS

Question 5

What 2 medications can block the PNS response? what type of drugs are they? what do they do?

Answer 5

Atropine
glycopyrrolate

Anticholinergics

increase HR

Question 6

How does electrical signal get from the SA node to the AV node? What are they called?

Answer 6

Internodal pathways:
Anterior/middle/posterior

Question 6

How does electrical signal get from the right atria to the left atria

Answer 6

Bachmann’s bundle

Question 7

What is the rate of the AV node and bundle of His?

Answer 7

40 - 60

Question 8

The AV node has a conduction delay time of ______. Why?

Answer 8

0.1 seconds

To give time for the atria to contract before the ventricle contracts

Question 9

What is the rate of the bundle branches and Purkinje fibers?

Answer 9

20 - 40

Question 10

What rhythm has a rate less than 20? Where is this originating from?

Answer 10

Agonal

Purkinje fibers

Question 11

How long is a whole ECG strip?

Answer 11

6 seconds

Question 12

How much is a a small box on an EKG?

Answer 12

0.2 secs (x-axis)

0.5 mV (y-axis)

Question 13

How long is your P wave? What leads is it upright in?

Answer 13

< 0.12 seconds

Positive in leads: I, II, aVF, V4-V6

Question 14

What is the flat part in the PR represent on the EKG?

Answer 14

The delay in AV node conduction that allows the atria to contract

Question 15

How long is your PR interval on the EKG?

Answer 15

0.10 - 0.20 secs

Question 16

How long is QRS on EKG?

Answer 16

< 0.12 secs

Question 17

What causes a long QRS?

Answer 17

Not following normal conduction pathway –> BBB

Question 18

What does an elevated T wave represent?

Answer 18

Hyperkalemia

Question 19

ST elevation/depression is greater than _______ mm than it is significant.

Answer 19

1 mm

Question 20

What leads are the T wave positive in?

Answer 20

I, II, V3-V6

Question 21

What is the HR for ST?

Answer 21

100 - 150

Question 22

Describe junctional rhythms

Answer 22

Inverted/flat/post QRS p wave
conduction not originating in the SA node

junctional: HR 40-60
junctional Brady: HR <40
Junctional tachy: HR >60

Regular R-R
P for every QRS

Question 23

If you have wide SVT its originating in the ________ and its narrow its originating in the ________

Answer 23

Ventricle

Atria

Question 24

Describe a PAC

Answer 24

results in a reduced amplitude of the QRS and a compensatory pause afterwards

Question 25

Which medications can help Tx A fib?

Answer 25

Amio Digoxin Cardizem Metoprolol **Last 2 rate control only**

Question 26

T/F: caffeine can cause A-flutter & can resolve on its own

Answer 26

T

Question 27

What does it mean/called when your PVCs look the same? When they look different?

Answer 27

Same: Unifocal -originating from the same cells in the vent Different: Multifocal -originating from different cells in the vent

Question 28

Why should we use caution when treating PVC?

Answer 28

These PVCs could be the heart only ventricular perfusion. If you treat them and take that away, the HR could be profoundly reduced. This would profoundly reduce CO.

Question 29

Your PR interval is _______ in 2nd degree, type 2 HB

Answer 29

fixed

Question 30

T/F: You can Tx 2nd degree, type 2 and 3rd degree HB w/ atropine

Answer 30

F Rhythm not due to vagal influence

Question 31

The QRS complexes in 3rd degree HB are ______.

Answer 31

Wide

Question 32

Halothane/enflurane cause _________. What does this do?

Answer 32

myocardium sensitivity Causes dysthymias to be more pronounced

Question 33

Cocaine, Ketamine, & other NE reuptake inhibitors cause _________

Answer 33

tachycardia

Question 34

Sevoflurane causes ________ in infants

Answer 34

bradycardia

Question 35

Desflurane causes ________ during induction

Answer 35

prolong QT

Question 36

Zofran & droperidol causes __________

Answer 36

prolong QT interval

Question 37

Local anesthesia injection can cause ______ but large amounts, such as in spinals, can cause ________.

Answer 37

tachycardia severe bradycardia

Question 38

What happens if you inject large amounts of local anesthesia IV?

Answer 38

Asystole

Question 39

Large amounts of blood transfusion does what to electrolytes?

Answer 39

Increases K+ Decreases Ca++

Question 40

Hypoventilation can cause ____kalemia.

Answer 40

Hyper

Question 41

Intubation can trigger their _____ nerve or cause _______ from pain.

Answer 41

Vagal tachycardia

Question 42

What are ways that the vagal nerve is stimulated?

Answer 42

carotid peritoneum cervix **Think of Sx that manipulate these organs/areas**

Question 43

Children have _____ vagal tone

Answer 43

high

Question 44

How does CVP cannulation affect the heart?

Answer 44

It causes ectopy Which means you're in the right place; pull back out a little.

Question 45

Sx manipulation of the heart can _________ CO

Answer 45

decrease

Question 46

How can we prevent the oculo-cardiac reflex in eye Sx?

Answer 46

Local block

Question 47

Ketamine _____ CO, HR, and contractility

Answer 47

Increases

Question 48

Whats the difference between agonal and idoventricular rhythms?

Answer 48

Agonal: HR <20 & irregular Idiovent: HR 20-40 & regular