EKG Other Flashcards

(51 cards)

1
Q

impulse headed toward the recording electrode

A

Positive (↑) Deflection

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2
Q

impulse headed away from the recording electrode

A

Negative (↓) Deflection

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3
Q

Placement of 3 lead ECG Electrodes

A
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4
Q

Placement of 12 lead ECG Electrodes

A
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5
Q

Tiny box= # seconds/# mm

Larger box= # seconds/# mm

How many tiny boxes for 1 large box?

A

Tiny: 0.04 seconds/1 mm

Larger: 0.20 seconds/5 mm

5 tiny boxes for 1 large box

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6
Q

4 methods to calculate rate

A
  • 6 second rule
  • 300, 150, 100, 75, 60, 50…
  • Rate=1500/small boxes between similar waves
  • Rate=300/large boxes between similar waves
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7
Q

SA node intrinsic rate

A

–From SA Node 60 – 100 bpm

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8
Q

AV node intrinsic rate

A

–From the AV Node 40 – 60 bpm

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9
Q

Ventricles intrinsic rate

A

–From the Ventricular 20 – 40 bpm

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10
Q

bradycardia is HR less than

A

60

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11
Q

tachycardia is HR greater than

A

100

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12
Q

Normal QRS interval

A

•QRS interval

–Normal <0.12s (3 small boxes)

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13
Q

Normal PR interval

A

•PR interval

–Beginning of P to beginning of q

–0.12 to 0.2s normal (3 to 5 small boxes)

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14
Q

Normal P wave

A

•Less than 0.12s and amplitude less than 2mm

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15
Q

Always place the chest leads in the ______ space

A

intercostal space

(less interference)

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16
Q

Placement of V1

A

placed in the 4th

right

intercostal space @ sternal border

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17
Q

Placement of V2

A

placed in the 4th

left

intercostal space at the sternal border

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18
Q

Placement of V3

A

placed halfway between v2 and v4

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19
Q

Placement of V4

A

5th intercostal space

@midclavicular line

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20
Q

Placement of V5

A

placed in the anterior axillary line at the same horizontal plane as V4

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21
Q

Placement of V6

A

placed in the midaxillary line at the same horizontal plane as V4

22
Q

Augmented Limb Leads:

aVR

A

Right arm +

left arm/foot is -

23
Q

Augmented limb leads:

aVL

A

left arm is +

right arm/foot is -

24
Q

Augmented limb leads:

aVF

A

left foot is +

both right/left arms are -

25
Lead I
Right arm: Negative Left arm: Positive
26
Lead II
Right arm: negative Left leg: positive
27
Lead III
Left leg: positive Left arm: negative
28
Average electrical activity of the heart primarily occurs in which quadrant of the axis?
30 to 60 degrees
29
What is the normal axis?
The quadrant from 0 to 90 degrees
30
If there is hypertrophy, how does the axis shift?
Vector axis points toward hypertrophied side
31
If there is an area of infarction, how does the axis shift?
The axis shifts away from the infarction (i.e. infarction on left shifts axis right)
32
Can blocks cause axis deviations?
yes
33
How do we know we are in the normal range for axis?
Look at Lead I and Lead aVF. If both positive, you are in the normal range for axis
34
What if: Lead I: Negative Lead aVF: Negative
Extreme right axis deviation | (CHECK LEADS, very rare)
35
What if: Lead I: Negative Lead aVF: Positive
Right axis deviation
36
What if: Lead I: Positive Lead aVF: Positive
NORMAL
37
What if: Lead I: Positive Lead aVF: Negative
Left axis deviation (most common axis deviation)
38
Lead I is positive on the ____ side and negative on the ____ side \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ Lead aVF is positive on the ______ and negative on the \_\_\_\_\_\_\_
Lead I: Positive on the LEFT Lead I: Negative on the RIGHT \_\_\_\_\_\_\_ Lead aVF: Positive on BOTTOM Lead aVF: negative on TOP
39
Physiological Left Axis Causes
1. Obesity 2. Athletes 3. Normal variant
40
Right axis deviation causes
* Right ventricular hypertrophy * MI of the lateral wall of the left ventricle * pulmonary hypertension (cor pulmonale) or massive pulmonary embolism
41
Formulation of axis DOES NOT INCLUDE which leads?
any of the V leads no V1, V2, V3, V4, V5, or V6
42
Extreme Right axis deviation can be caused by
Ventricular Tachycardia (extreme right axis plus upright complex in lead V1 is diagnostic for this)
43
What is the order of steps for ECG analysis?
1. •Rhythm 2. •Rate 3. •Axis 4. •Waves 5. •Intervals 6. •Hypertrophy 7. •Infarction
44
Irregular Rhythm/Rate Causes
•Irregular 1. –Sinus arrhythmia 2. –Wandering pacemaker 3. –Multifocal atrial tachycardia 4. –A- fib 5. –V- fib
45
Axis is determined by what?
Determined by the Mean QRS Vector, in other words the average general direction of ventricular depolarization
46
•Patients are 4 times more likely to arrest with a hemiblock and “chest pain” if there is what axis deviation?
Left axis deviation Lead I: Positive Lead aVF: negative
47
Pathological left axis causes
* Axis -45¡ — -90¡ * Disease process **_•Suggests left anterior hemiblock_** •Patients are 4 times more likely to arrest with a hemiblock and “chest pain”
48
Location of Infarction: Anterior
* V3 and * V4
49
Location of Infarction: Septal
* V1 and * V2
50
Location of Infarction: Inferior
* II, * III, and * AVF
51
Location of Infarction: Lateral
* I, * AVL, * V5, and * V6