MAPIISG1 - EKG

Question 1

What is the SA node bmp?

Answer 1

60-100 bpm

Question 2

What is the AV node bpm?

Answer 2

40-60 bpm

Question 3

What is the Purkinje Fibers bpm?

Answer 3

20-40 bpm

Question 4

What are the limb leads and their corresponding placement?

Answer 4

I, II, III limb and trunk

Question 5

What are Augmented limb leads:

Answer 5

aVR, aVL, aVF: average of limb leads

Question 6

Where does Precordial V1 lead go?

Answer 6

right 4th intercostal space

Question 7

Where does Precordial V2 lead go?

Answer 7

left 4th intercostal space

Question 8

Where does Precordial V3 lead go?

Answer 8

midway between V2 and V4

Question 9

Where does Precordial V4 lead go?

Answer 9

mid-clavicular line, 5th intercostal space

Question 10

Where does Precordial V5 lead go?

Answer 10

anterior axillary line @ level of V4

Question 11

Where does Precordial V6 lead go?

Answer 11

mid-axillary line @ level of V4

Question 12

What does 1 box on a paper strip mean?

Answer 12

0.04 seconds

Question 13

What does 5 boxes on a paper strip mean?

Answer 13

0.2 seconds

Question 14

What does the P wave look like and what is happening?

Answer 14

atrial depolarization, smooth and rounded

Question 15

What is the PR Interval?

Answer 15

atrial activity up to the point of ventricular depolarization, from beginning of P wave to onset of QRS complex

Question 16

What is the normal length of a PR interval?

Answer 16

0.12 to 0.2 seconds (3-5 boxes)

Question 17

What does a prolonged PR interval mean?

Answer 17

AV block

Question 18

What does the QRS complex look like and what is happening?

Answer 18

ventricular depolarization; narrow, sharply pointed

Question 19

What is the normal length of a QRS complex?

Answer 19

0.08 to 0.12 sec (2-3 boxes) or less

Question 20

What does too wide of a QRS complex mean?

Answer 20

BBB

Question 21

What does a Q wave mean?

Answer 21

can be patholigic (previous cardiac event if greater than one small box wide or greater than 1/3 of entire QRS amplitude

Question 22

What does the ST segment represent?

Answer 22

early ventricular repolarization

Question 23

How should an ST segment be?

Answer 23

flat and level with baseline, PR interval

Question 24

What does an elevated ST segment mean? (>1-2 small boxes)

Answer 24

STEMI - infarction full blockage

Question 25

What does a depressed ST segment mean? (>1-2 small boxes)

Answer 25

NSTEMI - ischemi not full blockage

Question 26

What is happpening during the T wave?

Answer 26

ventricular repolarization

Question 27

What are T wave pathology or ischemia?

Answer 27

inverted, flat | peaked/ tombstone

Question 28

What is the QT interval?

Answer 28

onset of QRS thru end of T wave; absolute and relative refractoy periods too long - expanded relative refractory period

Question 29

How do you identify heart rate from a six minute strip?

Answer 29

count QRS complexes over a 6 second period and multiply by 10

Question 30

Describe Normal EKG and what each part of the EKG represents

Answer 30

P Wave: first wave normally upward represents atrial depolarization and contraction QRS Complex: down, up, down deflection represents ventricular depolarization and contraction (atrial repolarization) T: upward wave represents ventricular reporlaization

Question 31

Identify time increments represented on an EKG strip

Answer 31

Small Box = 0.04 sec | Large Box = 0.2 sec

Question 32

Identify the normal length of time for a cardiac cycle

Answer 32

from systole to systole is normally 60-100 bpm, thus 0.6 to 1 sec for normal cardiac cycle

Question 33

Describe accurate electroode and lead placement

Answer 33

V1 - 4th intercostal space right of sternum V2 - 4th intercostal space left of sternum V3 - between V2 and V4 V4 - 5th intercostal space mid left clavicular line V5 - level with V4 anterior axillary line V6 - level with V4/5 mid-axillary line Right arm and L arm lateral and immediatly below clavicle Right Leg and Left Leg lateral and below umbilicus

Question 34

What is Regularly Irregular

Answer 34

ectopic source although rate of the abnormality is consistent and predictable (atrial flutter)

Question 35

What is Irregularly Irregular

Answer 35

usually multiple ectopic sources with no discernible pattern to the rate or rhythm (atrial fibrillation)

Question 36

What does sinus rhythm mean?

Answer 36

HR between 60-100 bpm which has normal complex generated by SA node

Question 37

Atrial Ryhtm arrhthmias __

Answer 37

are generated by the atria such as afib and aflutter

Question 38

What is a PAC? How does it look on an EKG?

Answer 38

Premature Atrial Contraction | -Shorter RR interval

Question 39

What is a PVC? How does it look on an EKG?

Answer 39

Premature Ventricular Contraction - Shorter RR interval - NO P wave (contraction is generated by ventricle not atrium) - Bizarre QRS complex - Compensatory pause

Question 40

What is Atrial Flutter? How does it look on an EKG?

Answer 40

Sawtooth appearance Regularly Irregular No P wave (SA node is not pacemaker) so 40-60 bpm

Question 41

What is Atrial Fibrillation? How does it look on an EKG?

Answer 41

Irregular and Inconsistent R to R interval (irregularly ireegular No discernable P wave May be asymptomatic

Question 42

What is a Ventricular Tachycardia? How does it look on a EKG?

Answer 42

3+ PVCs with HR >100bpm no P wave Most serious

Question 43

What is a Ventricular Fibrillation?

Answer 43

No discernable p, qrs, or T wave Rapid rate LETHAL no perfusion

Question 44

Supraventricular Tachycardia

Answer 44

Can be sinus, atrial or junctional in origyn

Question 45

What is meant by "ventricular dysrhythmias"

Answer 45

Arryhmias that are generated by the ventricles such as vtach, vfib, vbrady