EKG Strips

Question 1

What is an EKG

Answer 1

Records electrical depolarization of cardiac muscle to create a graphical representation of conduction of the heart

Question 2

What is the isoelectric line

Answer 2

Baseline when no electrical activity occurs

Question 3

What is the p wave

Answer 3

Atrial depolarization

Question 4

What is the PR interval

Answer 4

0.12-0.20 seconds

Question 5

What is the PR segment

Answer 5

Travel time
Ventricular ejection 25%?

Question 6

What is the QRS complex

Answer 6

Ventricular depolarization

Question 7

What is the J point

Answer 7

Beginning of ST segment

Question 8

What is the ST segment

Answer 8

Should be flat

Question 9

What is the T wave

Answer 9

Ventricular depolarization

Question 10

What is the QT interval ***

Answer 10

Less than 0.44-0.46 seconds

Question 11

How many leads do you need for a 5-lead EKG

Answer 11

6 leads

Question 12

What is the most common lead used as a rhythm strip for a 5 lead ekg

Answer 12

Lead II

Question 13

Where are the leads placed for the 12 lead ECG

Answer 13

Leads placed on anterior chest wall

Question 14

What do leads V1 and V2 read in the heart?

Answer 14

R ventricle / interventricular septum

Question 15

What do leads V3 and V4 read in the heart?

Answer 15

Septum/anterior wall

Question 16

What do leads V5 and V6 read in the heart?

Answer 16

Lateral wall

Question 17

Which leads would detect the INFERIOR VIEW of the heart

Answer 17

Leads II, III, aVF

Question 18

Which leads would detect the LATERAL VIEW of the heart

Answer 18

leads I, aVL, aVR, V5, V6

Question 19

Which leads would detect the ANTERIOR VIEW of the heart

Answer 19

Leads V3, V4

Question 20

Which leads would detect the SEPTAL VIEW of the heart

Answer 20

Leads V1, V2

Question 21

How do you identify an ATRIAL FLUTTER

Answer 21

Quick short P waves
“Saw tooth pattern”
2:1, 4:1 QRS variable

Question 22

What is the A-rate and V rate of an atrial flutter

Answer 22

A rate: 250-350bpm
V rate: <300bpm

Question 23

Is an atrial flutter stable or unstable

Answer 23

Stable

Question 24

How can you identify an ATRIAL FIB

Answer 24

Continuous rapid firing of multiple irritable foci within the atria
NO DISCERNABLE P WAVES
Quivering

Question 25

What is the rate of A FIB

Answer 25

350-450bpm

Question 26

How much will the cardiac output be decrease in A FIB

Answer 26

20%

Question 27

What is a premature atrial contraction

Answer 27

Signal for atrial contraction originates OUTSIDE of the SA node

Question 28

How do you identify a PAC

Answer 28

Early abnormal P wave Early QRS but will look normal Followed by a pause before NSR resets

Question 29

What is supraventricular tachycardia (SVT)

Answer 29

Atrial arrhythmia Abnormal signal arises above the ventricle / AV node

Question 30

What is the HR for SVT

Answer 30

140-250bpm

Question 31

How do you identify SVT

Answer 31

QRS is jelly narrow Lacks clearly defined P wave Unrelated to exertion Looks like sinus tachycardia

Question 32

What is an AV heart block

Answer 32

Slow or absent conduction between the atria and ventricles

Question 33

How do you identify a 1st degree heart block

Answer 33

Prolonged PR interval One P wave for every QRS

Question 34

What is the HR for 1st degree heart block

Answer 34

60-100bpm *most people aren’t aware they have this !!!*

Question 35

How do you identify a type I 2nd degree heart block

Answer 35

Lengthened PR interval Progressive prolongation of PR until there is a P wave with no QRS-beat is DROPPED Occurs in a repetitive pattern

Question 36

In a type 1 2nd degree heart block, which HR is normal and irregular? (Atrial/ventricular)

Answer 36

Atrial = normal Ventricular = irregular

Question 37

How to identify a Mobitz II 2nd degree heart block

Answer 37

Pattern is normal until sudden DROP of QRS Block in bundle branches **may be 2-4 p waves for every QRS**

Question 38

What is a 3rd degree heart block

Answer 38

Complete heart block

Question 39

How do you identify a 3rd degree heart block

Answer 39

P waves present and regular No relationship btw P waves and QRS Regular RR intervals but potentially prolonged QRS

Question 40

Is a 3rd degree heart block safe?

Answer 40

No Life threatening

Question 41

What is a bundle branch block

Answer 41

Abnormal conduction through the bundle branches causes delay in ventricular depolarization that leads to changes in QRS

Question 42

How do you identify a bundle branch block

Answer 42

RABBIT EARS Wide QRS

Question 43

Is the HR for bundle branch block normal or abnormal

Answer 43

Normal

Question 44

What is a PVC

Answer 44

Wide, irregular looking QRS complexes without an associated P wave

Question 45

in a PVC, where does the stimulus for the contraction arise from?

Answer 45

WITHIN the ventricle

Question 46

In a PVC, ventricular depolarization occurs when ?

Answer 46

BEFORE SA node fires

Question 47

What is a unifocal PVC

Answer 47

All PVCs look the same

Question 48

What is a multifocal PVC

Answer 48

All PVCs look different

Question 49

What is a couplet PVC

Answer 49

2 PVC’s in a row

Question 50

What is a triplet PVC

Answer 50

3 PVCs in a row

Question 51

What is a bigeminy PVC

Answer 51

Every other beat is a PVC

Question 52

What is a trigeminy PVC

Answer 52

Every 3rd beat is PVC

Question 53

What is a quadragminy

Answer 53

Every 4th beat is PVC

Question 54

How can you identify ventricular tachycardia

Answer 54

Non-discernible P waves Multiple wide bizzare QRS in a row 4 OR MORE PVC’S IN A ROW *** Poor cardiac output

Question 55

What is the most frequently encountered arrhythmia in adults with out of hospital cardiac arrest ?

Answer 55

Ventricular fib

Question 56

Is ventricular fib safe?

Answer 56

No LETHAL

Question 57

What is the HR for ventricular fib

Answer 57

> 350-600bpm

Question 58

How to identity ventricular fib

Answer 58

No discernible P wave or QRS complexes Literally looks like squibble

Question 59

What is asystole

Answer 59

Flat line No rate Isolated p waves Multiple wide

Question 60

What is the survival rate for asystole

Answer 60

4-5%

Question 61

ST depression can also be seen as what?

Answer 61

NSTEMI

Question 62

What is a T wave inversion

Answer 62

Changes in repolarization in ventricles related to ischemic changes in the myocardium Notable changes following episodes of chest pain

Question 63

What is ST elevation

Answer 63

Myocardial infarction from transmural ischemia Complete occlusion of coronary artery with full thickness of CELL DEATH

Question 64

How do you identify a pacemaker

Answer 64

“Spike” on ECG