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Understanding the ECG and practical ECG methods Flashcards

1
Q

Depolarisation towards the anode - Defletion?

A

Downwards

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2
Q

Depolarisation towards the cathode - Defletion?

A

Upwards

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3
Q

1st row of leads, which arteries?

A

LCx, n/a, LAD, RCA

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4
Q

2nd row of leads, which arteries?

A

RCA, LCx, LAD LCx

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5
Q

3rd row of leads, which arteries?

A

RCA, RCA, RCA, LCx

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6
Q

What is LCx

A

Left circumflex artery

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7
Q

What is RCA

A

Right coronary artery

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8
Q

What is LAD

A

Left anterior descending artery

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9
Q

Lead I
Negative
Positive

A

Between RA, LA
- = RA
+=LA

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10
Q

Lead II
Negative
Positive

A

Between RA, LL
- = RA
+ = LL

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11
Q

Lead III
Negative
Positive

A

Between LA, LL
- = LA
+ = LL

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12
Q

Where do you place V1

A

Right sternal border, in the 4th intercostal space

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13
Q

Where do you place V2

A

Left sternal border

4th intercostal space

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14
Q

Where do you place V3

A

Halfway between V2 and V4

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15
Q

Where do you place V4

A

Mid-clavicular line

5th intercostal space

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16
Q

Where do you place V5

A

Anterior axiliiary line at level of V4

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17
Q

Where do you place V6

A

Mid-axillary line at the level of V4

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18
Q

Why is the bump in atrial depolarisation smaller than the bump in ventricular depolarisation?

A

Atrial myocardium is quite thin and not filled with a lot of conductive cells, gentle P wave

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19
Q

What is connected to the R leg during an ECG? Function?

A

Ground, earth electrode, eliminates noise and acts as a control

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20
Q

What does the P wave represent?

Normal duration?
Amplitude in lead II?

A

R + L Atrial depolarisation

80ms, <110ms
<2.5mm

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21
Q

What does the Q wave represent?

Normal duration?
Amplitude

A

Septal depolarisation

<40ms
<25% of total QRS complex attitude

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22
Q

What does the R wave represent?

A

ventricular depolarisation

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23
Q

What does the S wave represent?

A

Late ventricular depolarisation (depolarisation goes to the sides)

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24
Q

What does the ST-T wave represent?

T wave duration?
How should the ST segment look?

A

Ventricular repolarisation

160ms
It should be isoelectric

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25
Which is the bottom lead on the ECG trace and what does it represent?
Lead II | Rhythm strip
26
How is the anode found?
Mathematical summation of other points on skin
27
Which are the bipolar leads?
Lead I, II, III
28
Depolarisation away from the cathode?
Downwards
29
Repolarisation towards the cathode?
Downwards
30
Repolasitation away from cathode?
Upwards
31
How are augmented leads obtained?
Average voltage of any two points on skin as negative pole and reading from the third electrode (positive pole)
32
How is P wave and QRS complex in Lead I and II?
Both upwards
33
How is P wave and QRS complex in Lead III?
Both downwards
34
Lead aVR Negative electrodes? Positive electrode? Direction?
LA, LL RA See slide 26
35
Lead aVL Negative electrodes? Positive electrode? Direction?
RA, LL LA See slide 28
36
Lead aVF Negative electrodes? Positive electrodes? Direction?
RA, LA LL See slide 30
37
How are the leads shown on ECG | left to right and top to bottom
Lead I, aVR, V1, V4 Lead II, aVL, V2, V5 Lead III, aVF, V3, V6
38
How do augmented leads work?
1 true recording electrode (positive) | Negative electrode obtained by averaging out different point on the skin
39
What does a 5mm x 5mm square on an ECG represent? (time and amplitude)
0. 2 s / 200ms | 0. 5mV
40
What does a 1mm x 1mm square on an ECG represent? (time and amplitude)
0. 04 s / 40 ms | 0. 1mV
41
Draw the QRS axis circle
Check slide 36
42
In which direction(s) would the heart normally depolarise?
Left axis + normal QRS axis
43
Which is the left axis
-90 - -30
44
Which is the normal axis on the diagram
-30 - 90
45
Which is the right axis
90-210
46
How do yo calculate the QRS axis and which are the best leads to use
Pick two leads that are in right angles to each other | Best ones: Lead I and lead aVF
47
Which is the normal axis in practice
-30 - +90
48
Calculating the QRS axis -positive Lead I, direction of arrow in triangle?
To the right
49
Calculating the QRS axis -negative Lead I, direction of arrow in triangle?
To the left
50
Calculating the QRS axis -positive aVF, direction of arrow in triangle?
Downwards
51
Calculating the QRS axis -negative aVF, direction of arrow in triangle?
Upwards
52
What are bipolar leads?
The only leads that record potential difference between TWO electrodes
53
What are unipolar leads?
Only one true electrode recording, the other is a virtual electrode
54
What is Wilson's central terminal?
Composite pole of RA, LA, LL i.e. average potential across the body, using Lead I, II ,III
55
Chest/precordial leads Unipolar or bipolar Which are the positive poles and which are the negative ones
Unipolar Chest lead is positive pole Wilson's central terminal is the negative pole
56
Septal chest leads
V1, V2
57
Anterior chest leads
V3, V4
58
Lateral chest leads
V5, V6
59
Which are the limb leads (both bipolar and unipolar)
I, II, III (standard limb leads, bipolar) | aVR, aVL, aVF (augmented limb leads, unipolar)
60
Which are the precordial limb leads (both bipolar and unipolar)
No bipolar precordial leads | V1 - V6 unipolar
61
PR interval normal duration?
time interval from onset of atrial depolarization (P wave) to onset of ventricular depolarization (QRS complex) 120-200ms generally up to 3 small squares
62
QT interval Normal duration?
duration of ventricular depolarization and repolarization 380-420 ms
63
QRS interval Normal duration? Amplitude of R wave in V6?
duration of ventricular muscle depolarization <120ms, normally less than 3 small squares <25mm
64
RR interval normal?
Duration of ventricular cardiac cycle - an indicator of ventricular rate 0.6-1.2s
65
PP interval
Duration of atrial cycle (indicator of atrial rate)
66
Anything in the direction of the leads (e.g. Lead I, in the direction of RA to LA) -Signal
Will give a large signal
67
Anything perpendicular to the direction of the leads (e.g. Lead I, in the direction of RA to LA) -Signal
No large signal
68
Try to calculate QRS axis from power points
.
69
Normal heart rate
60-100bpm
70
Which are the inferior leads?
Leads II, III, aVF
71
Which are the lateral leads?
Lead I, aVL, V5, V6

CVS-charis (7 decks)

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