EKG review

Question 1

Steps of EKG reading

Answer 1

1. Rhythm
2. Rate
3. QRS Axis
4. P waves/PR interval
5. QRS complex
6. ST Segment
7. T waves

Question 2

regular rhythm strip

Answer 2

R-R intervals: <0.12 secs

Question 3

if regular rhythm, how to determine rate?

Answer 3

300

150

100

75

60

50

Question 4

if irregular rhythm how to determine rate?

Answer 4

count # of R waves in 6 sec strip and multiply by 10

Question 5

If LAD is based on I and aVF, what lead should be checked?

Answer 5

Lead II

Question 6

QRS predominately positive in Lead II

abnml or nml axis?

Answer 6

normal axis (0-30)

Question 7

If QRS is predominantly neg in Lead II

abnml or nml axis?

Answer 7

LAD < -30 degrees

Question 8

What leads do you look in for P wave morphology?

Answer 8

II & V1

Question 9

P wave morphology in normal sinus rhythm?

Answer 9

positive/upright in I, II, aVF

negative in aVR

each P wave must be followed by a QRS comples

Question 10

How long is a normal PR interval?

Answer 10

between .12-.20 sec

Question 11

What shows left atrial enlargement?

Answer 11

m-shaped P wave in Lead II >0.12secs

biphasic P wave in V1 with larger terminal component

Question 12

What shows R atrial enlargement?

Answer 12

tall P wave in Lead II >3mm

Biphasic P in V1 with larger initial component

Question 13

normal QRS complex

Answer 13

<0.12 sec

Question 14

should you worry about blocks if the QRS is narrow?

Answer 14

NO

Question 15

Left BBB

Answer 15

Wide QRS > 0.12

Broad, slurred R in V5, 6

Deep S wave in V1

Question 16

Right BBB

Answer 16

Wide QRS > 0.12sec

RdR’ in V1,2

Wide S wave in V6

Question 17

Signs of RVH

Answer 17

LOOK IN V1

R>S

or

R > 7mm

Question 18

Signs of LVH

Answer 18

S in V1 + R in V5 or V6 >35mm in men and >30mm in women

Question 19

What is considered a pathological Q wave?

Answer 19

>1 box

Question 20

What is an abnormal ST segment?

Answer 20

ST depression or elevation > 1mm in depth/height

Question 21

Signs of Abnml T wave

Answer 21

T wave inversions

T wave flattening

QT interval prolonging

Question 22

What are the inferior leads?

Answer 22

II, III, aVF

Question 23

What are the anterior leads?

Answer 23

V1-V4

Septal: V1 & V2

Question 24

What are the lateral leads?

Answer 24

Leads I, aVL, V5, V6

Question 25

What will you see on EKG if area of infarction is **anterior wall**? What artery is involved?

Answer 25

**V1-V4 (V1-V2 if septal)** Left Anterior Descending **(LAD)**

Question 26

What will you see on EKG if area of infarction is anterior **lateral wall**? What artery is involved?

Answer 26

**I** **aVL** **V5** **V6** **Circumflex**

Question 27

What will you see on EKG if area of infarction is anterolateral? What artery is involved?

Answer 27

**I** **aVL** **V4 + V5 + V6** **mid LAD or CFX**

Question 28

What will you see on EKG if area of infarction is inferior? What artery is involved?

Answer 28

II, III, aVF Right coronary artery (RCA)

Question 29

What will you see on EKG if area of infarction is posterior wall? What artery is involved?

Answer 29

ST depressions in V1 V2 RCA, CFX

Question 30

Vectors move towards _____ and away from \_\_\_\_\_\_\_

Answer 30

Vectors move towards **_hypertrophy_** and away from **_infarction_**

Question 31

What is the normal QRS axis?

Answer 31

-30 to 90