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66 Cards in this Set

  • Front
  • Back
The averafge direction of electirical activity with the ventricle's during depolarization is ?
AXIS
The ____ is visualized on a 360 degree circle drawn in a frontal plane, determined by leads I, II, III and AVR, AVL, AVF.
mean qrs vector
Abnormal axis may indicate abnormal __
depolarization
Abnormal axis can help to identify the origin of wide __ tachycardia
complex
Abn. axis may indicate a change in the pt's __ status.
cardiovascular
causes of axis deviation may be mechanical or __.
electrical
name 3 electrical causes of axis deviation
MI
V tach
hemiblocks
name 5 mechanical causes of axis deviation
ascities
obesity
pregnancy
trauma
chamber hypertrophy
A normal axis is located in the _ to_ degrees in the frontal plane
0-90
For a normal axis deviation the P or QRS waves must be in the __ position
positive in Lead I and AVF
Axis is the "______" when given in degrees.
mean qrs vector
the normal axis range is __-__degrees
0-90
Left axis deviation is when the range is from __-__ degrees.
0 to -90
IN LAD in what positions will lead I and AVF be in?
Lead 1-upright/positive
AVF-negative
A + in lead I and + in AVF =
NAD
A + in lead I and negative in AVF=
LAD
name multiple causes of LAD
normal variant
inferior MI
L-anterior sided blocks
mechanical shifts due to pregnancy, obesity, ascites
Left BBB
cardiac pacing
ventricular ectopic rhythms
LAD is __-__ degrees
0 to -90 degrees

positive in I, negative in AVF
In an AMI there is a cecrotic area of heart that has lost its blood supply and does not depolarize. The unopposed vectors from the other side __ the mean qrs vector away from the infarct.
draw
Right Axis Deviation is located between __-__ degrees
90 to 180
In RAD lead I will be _ and AVF will be _.
lead I-negative
AVF-positive
In the axis circle where is RAD located?
bottom left quarter.
in RAD the lead one tracing must be mainly __ to be considered RAD.
negative
Causes of RAD?
normal variant
RVH
anterolateral MI
mechanical shifts
Some other causes of RAD?
Acute PE
dextrocardia
A/V septal defect
ventricular ectopic rhythms
severe pulm. htn
RAD is located between _-_degrees and will have a _ lead I and _ AVF.
90-180
negative lead I
positive AVF
Intermediate Axis is also called ___
no man's land
Intermediate axis is located between __-__ degrees
180-270 (-90)
Inter. axis deviation will show __ in lead I and __ in AVF.
negative in both
A pt. with a + lead I and negative AVF has a __
LAD
A pt. with a - lead I and - AVF has a
intermediate axis located between 180 and -90 (270)
A pt. with a - lead I and +AVF has a __
RAD
An intermediate axis can be caused by what?
right vent. pvc/vt
extreme right vent. hypertrophy
upright in I and AVF is?
NAD
negative in I and AVF is ?
intermediate or no man's land deviation
upright in lead I and negative in AVF is?
LAD
negative in lead I and upright in AVF is ?
RAD
T/F
the EKG is/is not a very accurate diagnostic tool for determining cardiac chamber enlargement.
is not
T/F
EKG is a very sensitive and specific test for determining left ventricular hypertrophy?
false and is even worse with atrial's and rvh
What is the diagnostic test of choice for determining chamber enlargement?
echo
terminology:
there is atrial ___
and ventricular ___
enlargement

hypertrophy
Which lead is the best for detecting atrial enlargement and why?
V1-as it lies right over the left atria
name common causes of RAE
acute cor pulmonale
pulm htn
rvh
copd
PE
CAD
acute left vent. failure
hypoxia
What will you see on an EKG to indicate RAE?
-inc. p-wave amplitude in II, III, and AVF
-amplitude> 2.5mm in lead II
-usually peaked p waves
-biphasic p-waves in V1 with initial deflection more prominent
in what leads are the p waves best visualized?
II and VI
If you see peaked P-waves in II, III, and AVF you must think?
RAE
a biphasic p wave in V1 with initial deflection more prominent is indicative of ?
RAE
peaked p waves in lead II? is also called
p pulmonale
in LAE, name some causes?
mitral valve dx
aortic valve dx
htn
cad
lvh
idiopathic hypertrohic subaortic stenosis
p waves described as:
-wider, more squared, or M-shaped in II, III, and AVF --or--

biphasic p wave in V1 with 2nd deflection more prominent is....
LAE

p-mitrale
p-mitrale means....
wider, squarer, or M shaped p waves in LAE

p-mitrale
a biphasic p wave in V1 with the second deflection more prominent is....
lae
causes of rvh?
mitral stenosis
tricuspid insufficiency
copd
pulm. stenosis
transplantation of great vessels
tetralogy of fallot
what often accompanies rvh?
rae
these findings are suggestive of what other condition?
RAD (or indeterminant axis)
RAE
Incomplete BBB
low voltage ekg
persistant precordial S waves
"STRAIN" in R vent leads (V1,2,3, or II, III, or AVF)
Tall R waves in lead V1
suggest RVH
tall R waves in V1 indicate?
RVH
a ST depression in V5 can indicate?
RVH
causes of lvh?
htn
aortic valve dx
coarctation of the aorta
To dx lvh, which 2 numbers should you remember?
35 and 12
35=deepest S wave in lead V1 or V2 plus TALLEST R wave in lead V5 or V6 =35mm
and/or R wave in lead AVL >12
patient > 35 y.o.
left vent. strain pattern
LVH- what do the numbers 20 and 25 remind you of?
Deep S wave (>20-25mm) in leads V1 or V2
Tall R wave (>25 in lead V5, or >20mm in lead V6)
An R wave >20mm in any inferior lead (II, III, or AVF).
When looking for LVH on an ekg if you add mm of S in V1 and mm of R in V6, if greater than __MM =LVH
S in V1 + R in V6 of greater than 35 mm =LVH
you will often see ___ with LVH.
lae
V1 importance...in chamber sizing...
-initial deflecation of biphasic p-wave is up
rae
second deflection of biphasic p wave is down
lae
larger R than S wave in V1 =
RVH
larger S wave than R wave in V1 =
LVH