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EXERCISE PRESCRIPTION LAB > LAB2- EKG > Flashcards

LAB2- EKG Flashcards

1
Q

electrocardiogram

A

the process of recording the electrical activity of the heart using electrodes placed on the patient’s body

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2
Q

electrocardiogram is a graphic record of what

A

the DIRECTION + MAGNITUDE of the electrical activity generated by the depolarization + repolarization of the atria + ventricles

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3
Q

who first described the modern ECG with known landmarks PQRST waves in 1893

A

William Einthoven
-received Nobel Prize in 1924 for developing the modern ECG

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4
Q

the first 30 years, what was used to perform an ECG

A

string galvanometer

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5
Q

in 1942, who added 9 augmented leads to Einthoven’s traditional 3 lead ECG, leading to the 12 lead ECG used today

A

Emmanuel Goldberger

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6
Q

how many leads did Einthoven’s ECG have

A

3

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7
Q

how many leads did Goldberger’s ECG have

A

12

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8
Q

why is ECG also known as EKG

A

original spelling in German is elektrocardiogram (EKG)

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9
Q

purpose of ECG testing

A

often used (with other tests) to help diagnose + monitor conditions affecting the heart

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10
Q

what can ECG be used to investigate

A

symptoms of possible heart problems such as chest pain, palpitations, dizziness, + shortness of breath

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11
Q

what 4 things can ECG help detect

A

-arrythmias
-coronary heart disease
-heart ischemia (heart attacks)
-cardiomyopathy

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12
Q

P wave

A

atrial contraction (depolarization)

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13
Q

QRS complex

A

ventricular contraction (depolariziation)

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14
Q

QRS complex or P wave is larger + why

A

QRS complex is larger
-more muscle mass in the ventricle

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15
Q

T wave

A

ventricular relaxation + reset (repolarization)

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16
Q

QT interval

A

represents the complete depolarization + repolarization of the ventricular tissue

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17
Q

prolonged repolarization of ventricular tissue (QT interval) can lead to what

A

life-threatening arrhythmias

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18
Q

where does the P wave originate from

A

SA node

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19
Q

break down the QRS complex

A

-Q wave: initial downward deflection
-R wave: upward deflection
-S wave: downward deflection

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20
Q

PR interval

A

time from the beginning of the P wave to the beginning of the Q-wave (QRS complex)

SA node -> atria -> ventricles

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21
Q

PR interval is what in terms of depolarization/repolarization

A

the start of atrial depolarization to start of ventricular activation

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22
Q

PR segment

A

-from the end of the P wave to the beginning of the QRS segment
-represents the time delay between atrial + ventricular activation

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23
Q

ST segment

A

segment from the end of QRS complex to the beginning of the T wave
-represents time between ventricular depolarization + repolarization

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24
Q

what does the ST segment represent

A

the absolute refractory period (plateau of the AP) of the ventricular contractile cells

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25
elevation or depression of the ST segment is based off what
PR segment
26
U wave
repolarization of papillary muscles or Purkinje fibers -NOT ALWAYS SEEN -origin is still being debated
27
which type of ECG is most often used in the health field
12-lead -however, a 2-lead, 3-lead, 6-lead + many other variations can be used
28
ECG electrode
a conductive pad that is attached to the skin to record changes in electrical activity
29
pair of electrodes
any pair can measure the electrical potential difference between the 2 corresponding locations of attachment
30
ECG lead
consists of 2 surface electrodes that are either bipolar or unipolar
31
bipolar lead
opposite polarity -1 positive + 2 negative
32
unipolar lead
1 positive surface electrode + a reference point
33
each lead gives an opportunity to do what
to look at the heart from a different electrical position
34
for the common 12-lead ECG, how many electrodes are positioned on the body
10
35
depolarization of the heart towards the positive electrode produces positive/negative deflection
positive
36
depolarization of the heart away from the positive electrode produces positive/negative deflection
negative
37
repolarization of the heart towards the positive electrode produces positive/negative deflection
negative
38
repolarization of the heart away from the positive electrode produces positive/negative deflection
positive
39
what are the 12 leads
Lead 1, 2, 3 aVR, aVL, aVF V1, V2, V3, V4, V5, V6
40
limb leads
leads 1, 2, 3
41
lead 1
measures difference in electrical activity between L arm + R arm
42
ground electrode
R leg
43
lead 2
between L leg + R arm
44
lead 3
between L leg + L arm
45
Einthoven's triangle
created by the 3 limb leads -provides view of heart's activity from the front
46
augmented leads
aVR, aVL, aVF -augmented stands for average -combines signals differently to "augment" the view from certain directions; gives additional angles to see heart's electrical activity
47
aVR
views heart from R arm
48
aVL
views heart from L arm
49
aVF
views heart from L leg
50
chest leads
V1-6
51
what leads provide a horizontal view of the heart
chest leads (V1-6)
52
which leads provide an anterior view of the heart
limb leads (1-3)
53
V1 + V2
look at the septum
54
V3 + V4
look at the anterior part of heart
55
V5 + V6
look at lateral part of heart
56
inferior leads
2, 3, aVF -look at lower part of heart
57
lateral leads
1, aVL, V5, V6 -look at side of heart
58
septal leads
V1 + V2 -look at heart's septum
59
anterior leads
V3 + V4 -look at front part of heart
60
electrode placement for 12-lead ECG (modified Mason-Likar)
-this is what we use in lab -leg electrodes are not placed on legs but rather all on chest/stomach
61
# modified Mason-Likar 12-lead ECG placements right arm
right infraclavicular fossae medial to the deltoid muscle roughly 2cm below border of clavicle
62
# modified Mason-Likar 12-lead ECG placements left arm
left intfraclavicular fossae medial to the deltoid muscle roughly 2cm below border of clavicle
63
# modified Mason-Likar 12-lead ECG placements left leg
in line with left anterior axillary line halfway between costal margin + iliac crest
64
# modified Mason-Likar 12-lead ECG placements right leg
in line with right anterior axillary line halfway between costal margin + iliac crest
65
# modified Mason-Likar 12-lead ECG placements V1
4th intercostal space right sternal edge
66
# modified Mason-Likar 12-lead ECG placements V2
4th intercostal space left sternal edge
67
# modified Mason-Likar 12-lead ECG placements V3 ## Footnote `
midway between V2 + V4
68
# modified Mason-Likar 12-lead ECG placements V4
5th intercostal space, mid-clavicular line
69
# modified Mason-Likar 12-lead ECG placements V5
anterior axillary line in straight line with V4
70
V6
mid-axillary line in straight line with V4 + V5
71
which electrodes might need to be altered in female patients due to breast tissue
V4, V5, V6 -place electrode as close as possible to anatomical location directly under breast
72
if you had to modify electrodes for female patient, what might occur in ECG
mild rightward shift in QRS axis
73
small square represents
0.04 seconds
74
large square (5mm) represents
0.2 seconds
75
sinus rhythm
a regular ECG -P wave is upright in leads 1 + 2 -each P wave is followed by a Q -heart rate is 60-100 bpm
76
tachyarrhythmia
an abnormal rhythm with a ventricular heart rate over 100 bpm
77
supraventricular tachycardia
arrhythmia originating from above the AV node
78
types of supraventricular tachycardia
-atrial fibrillation -atrial flutter -atrial tachycardia
79
types of ventricular tachycardia
-ventricular fibrillation -ventricular tachycardia
80
ventricular or atrial fibrillation is more critical
ventricular fibrillation
81
atrial fibrillation
-absence of P waves -irregular QRS rhythm
82
ventricular fibrillation
absence of normal PQRST components, replaced by chaotic uncoordinated electrical activity
83
bradyarrhythmia
a heart rate below 60 bpm + comprises multiple disorders
84
types of bradyarrhythmia
-sinus bradycardia -first degree AV block -second degree AV block -third degree AV block -SA node exit block
85
normal ST segment
flat + isoelectric
86
how is ST segment deviation (elevation or depression) measured
the height difference between the J point + the baseline (PR segment)
87
what amount of ST segment depression is considered pathological
5 mm or more
88
what naturally occurs to ST segment during exercise + is considered normal
upsloping ST segment depression
89
when does ST segment indicate ischemia
-downsloping or horizontal ST segment depression -OR ST segment elevation
90
ECG electrode placement protocol
-locate anatomical areas that will be used -prepare skin by removing any excessive hair -if possible clean each site thoroughly with soap + water -use ECG skin prep pad, paper, or abrasive tape -explain the electrode application procedure to the patient to decrease anxiety -when only 1 patient is present, attach the lead wire to the electrode before placement -apply the electrode by pressing about the entire edge of the electrode center since it spreads the gel out + may create air pockets that contribute noise
91
should you use alcohol or soap + water before applying electrode
soap + water -alcohol dries the skin + can diminish electrical flow
92
what does using skin prep pad, paper, or abrasive take do
-removes stratum corneum to allow better electrical signals -scratches stratum ganulosum to reduce motion artifact
93
depolarization = contraction/relaxation
contraction
94
during depolarization, what does ECG do
go up

EXERCISE PRESCRIPTION LAB (10 decks)

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