Ekg Review

Front 1

A wave of depolarization traveling towards a positive EKG electrode causes _ on the EKG tracing

Back 1

Upward deflection

Front 2

A wave of depolarization traveling away from a positive EKG electrode causes a _ on the EKG tracing

Back 2

Downward deflection

Front 3

A wave of repolarization traveling towards a positive EKG electrode causes _ on the EKG tracing

Back 3

Downward deflection

Front 4

A wave of repolarization traveling away from a positive EKG electrode causes a _ on the EKG tracing

Back 4

Upward deflection

Front 5

Interval vs segment

Back 5

In electrocardiography, an interval includes at least one of the waves that it is named after, whereas a segment does not. In other words, a segment is simply a section of baseline which is between the waves that it is named after

Front 6

distance (time) from beginning of P wave to beginning of QRS complex

Back 6

PR interval

Front 7

distance (time) from beginning of QRS complex to end of T wave(includes the QRS complex and the T wave )

Back 7

QT interval

Front 8

distance (time) from end of QRS complex to end of T wave
(includes the T wave but not the QRS complex)

Back 8

ST interval

Front 9

ST segment - what physiological event

Back 9

repolarization of ventricular tissue = plateau phase of repolarization

Front 10

Where on EKG do you see rapid phase of ventricular repolarization

Back 10

T wave

Front 11

Physiological event of U wave

Back 11

repolarization of Purkinje fibers, Purkinje fibers depolarize very fast but repolarize very slowly which causes U wave

Front 12

The vertical axis of the tracing represents _

Back 12

Voltage

Front 13

At standard calibration, _= 0.1 mV

Back 13

1 mm

Front 14

The horizontal axis of the tracing represents

Back 14

Time

Front 15

At standard paper speed (25 mm/sec.),
1 mm = _ sec. = _msec.

Back 15

0.04 sec = 40 msec

Front 16

How many big blocks per second

Back 16

5

Front 17

Determination of heart rate for very slow or irregular heart rates

Back 17

Count the number of cardiac cycles (R-to-R intervals) over 2 consecutive 3 second intervals, and then multiply this number by 10 in order to determine the heart rate in beats per minute

Front 18

6 limb leads (I, II, III, aVR, aVL, aVF)
Allow determination of axis in the _ plane

Back 18

Frontal

Front 19

6 precordial (chest) leads (V1 – V6)
Allow determination of axis in the _ plane

Back 19

Horizontal

Front 20

Each has 1 positive and 1 negative electrode

Back 20

Bipolar limb leads

Front 21

Each has 1 positive electrode and 1 compound reference electrode (sum of the other 2)

Back 21

Augmented unipolar limb leads

Front 22

RA- LA- which lead, where is positive electrode

Back 22

Lead I, positive electrode on LA

Front 23

RA- LL which lead where is positive electrode

Back 23

Lead II, positive electrode left leg

Front 24

LA - LL, which lead where is positive electrode

Back 24

Lead III, positive electrode left leg

Front 25

Lateral leads

Back 25

I and AvL

Front 26

Inferior leads

Back 26

II, III and avF

Front 27

3 steps for determining the QRS axis in
the frontal plane

Back 27

-Locate the most isoelectric lead (the lead in which the difference between the amount of QRS deflection above and below the isoelectric line is closest to zero)
-Locate the lead 90 degrees from the most isoelectric lead.
-The QRS axis is along this lead (perpendicular to the isoelectric lead), in the direction corresponding to the polarity of the QRS complex in that lead

Front 28

Change from negative to positive occurs at V5, V6 or never - rotation?

Back 28

Left

Front 29

Change from negative to positive occurs at V1 or V2 - rotation?

Back 29

Rightward axis rotation

Front 30

Change from negative to positive occurs at V3 or V4 - rotation?

Back 30

No rotation, normal

Front 31

If QRS at chest leads starts negative and ends negative - rotation?

Back 31

Left

Front 32

If QRS at chest leads starts positive and ends positive - rotation?

Back 32

Right

Front 33

If QRS at chest leads starts positive and becomes negative by V6 - rotation?

Back 33

Left

Front 34

Ability of specialized cells to spontaneously generate electrical impulses which may then spread throughout surrounding tissue.

Back 34

Automaticity

Front 35

Atrial foci automaticity rate

Back 35

60-80 per min

Front 36

Junctional AV nodal foci automaticity rate

Back 36

40-60

Front 37

Ventricular foci automaticity rate

Back 37

20-40

Front 38

The pacemaker with the fastest rate is the dominant pacemaker

Back 38

Overdrive suppression

Front 39

A protective mechanism whereby an automaticity focus with the next highest inherent rate begins pacing in the event of a pause or cessation of pacing activity of the previously dominant pacemaker.

Back 39

Escape

Front 40

Transient escape of an automaticity focus (from overdrive suppression) to generate one beat.


This occurs when?

Back 40

Escape beat -

This occurs when there is a pause in pacing activity in the previously dominant pacemaker.

Front 41

Escape of an automaticity focus (from overdrive suppression) with subsequent pacing by that automaticity focus, at its inherent rate.

This occurs when?

Back 41

Escape rhythm

This occurs when there is a cessation (or arrest) of pacing activity in the previously dominant pacemaker.

Front 42

EKG criteria for sinus rhythm

Back 42

Each QRS complex is preceded by a P wave.

The P waves must be positive in lead II, and negative in lead aVR.

Front 43

If you see a biphasic P wave in lead II - what does it mean?

Back 43

Pacemaker is between SA and AV node - atrial rhythm

Front 44

P wave is absent - where is the foci

Back 44

In the middle of AV node

Front 45

If inverted P wave is after QRS - where is foci

Back 45

In Purkinje fibers

Front 46

An increase in the tendency for automaticity foci to spontaneously generate electrical impulses

Back 46

Irritability

Front 47

Occurs when an irritable automaticity focus spontaneously generates a single electrical impulse prior to the next expected beat from the dominant pacemaker

Back 47

Premature beat

Front 48

Premature beats are caused by _

Back 48

Irritability

Front 49

The delay in ventricular depolarization which usually follows a premature beat

Back 49

Compensatory pause

Front 50

If SA node is reset - is there complete or incomplete compensatory pause

Back 50

Incomplete compensatory pause

Front 51

Most PAC's are followed by _ compensatory pause

Back 51

Incomplete

Front 52

Most PVC's are followed by _ compensatory pause

Back 52

Complete

Front 53

Sustained arrhythmia

Back 53

Arrhythmia that is greater than 30 sec in duration

Front 54

Flutter rate

Back 54

250-350

Front 55

Fibrillation rate

Back 55

350-450

Front 56

Polymorphic V tach which is preceded by marked prolongaiton of QT

Back 56

Torsades de Pointes

Front 57

Torsades de Pointes is due to _

Back 57

Triggered activity - EAD's related to R on T phenomenon facilitated by marked QT prolongation

Front 58

Formula for corrected QT interval

Back 58

QT measured * square root R to R interval

Front 59

Most common cause of SVT

Back 59

AV nodal reentry tachycardia

Front 60

P wave shape varies

atrial rate less than 100

irregular ventricular rhythm

Back 60

Wandering pacemaker

Front 61

P wave shape varies

Atrial rate exceeds 100

Irregular ventricular rhythm

Back 61

Multifocal atrial tachycardia

Front 62

Short PR + delta waves

Back 62

WPW syndrome

Front 63

Short PR + no delta waves

Back 63

LGL syndrome

Front 64

1: 1 ratio of P waves to QRS

PR interval is fixed (consistent)

PR interval exceeds 200 msec (5 small blocks, 1 big block)

Back 64

First degree AV block

Front 65

Progressive lengthening of PR interval util one of P waves is not followed by QRS

Back 65

Wenkebach 2nd degree AV block

Front 66

There are more P waves than QRS complexes

All P waves that immediately precede QRS complexes have equal PR intervals

Back 66

Type II Mobitz 2nd degree AV blocks

Front 67

RsR" pattern in V1, wide S wave in leads I and V6, QRS >0.12

Back 67

RBBB

Front 68

Broad sometimes notched R wave in leads I (and V6), absent q waves in I, AVL, V6, wide and deep S waves in V1

Back 68

LBBB

Front 69

Add mm in V1 (negative) and V5 (pos) if more than 35 and person is over 40 years old_

Back 69

LVH

Front 70

Asymmetrical inverted T wave

Back 70

LVH

Front 71

Right axis deviation

R higher in V1

Deep S wave in V6

Back 71

RVH

Front 72

In sinus rhythm in lead V1 P wave > 1.5 mm high OR > 2.5 mm high in lead II

Back 72

R atrial abnormality

Front 73

In sinus rhythm in lead V 1 P wave > 1 mm deep and > 1 mm wide or in lead II > 120 msec in duration (> 3mm wide), can be notched

Back 73

R atrial abnormality

Front 74

ST elevation in V2, V3, V4

Back 74

Anterior MI

Front 75

ST elevation in V1, V2, V3

Back 75

Anteroseptal MI

Front 76

ST elevation in V4, V5, V6 (can also have V2, V3)

Back 76

Anterolateral MI

Front 77

ST elevation in V1- V6

Back 77

Extensive anterior MI

Front 78

ST elevation in V5, V6, I, AvL

Back 78

Lateral MI

Front 79

ST elevation in I and AvL

Back 79

High lateral MI

Front 80

ST elevation in II, III, AvF

Back 80

Inferior MI

Front 81

ST elevation in II, III, AvF, V5, V6

Back 81

Inferolateral MI

Front 82

Reciprocal changes in V1, V2

Back 82

Posterior MI

Front 83

ST elevation in II, III, AvF, V5, V6 + reciprocal changes in V1, V2

Back 83

Inferoposterolateral MI