X Jackie Ekg Ppts 3

Front 1

P normally pos in

Back 1

I,II, V4-6

Front 2

P normally neg

Back 2

AVR

Front 3

p wave duration

Back 3

.08-.11

Front 4

` do PACs look different than normal p waves

Back 4

yes

Front 5

WAP and MAT must have at least how many different pacemakers?

Back 5

3

Front 6

do PACs change the rate?

Back 6

yes

Front 7

T waves should always appear the same in any give lead; if you have a T wave that looks different, it is probably because

Back 7

a p wave is buried inside

Front 8

are PACs usually compensatory?

Back 8

no

Front 9

What causes inverted p waves?

Back 9

low atrial or AV nodal (retrograde conduction of the atria)

Front 10

P mitrale

Back 10

P> .12 and notched, left atrial enlargement

Front 11

P pulmonale

Back 11

P is peaked more than 2.5mm, right atrial enlargement

Front 12

When the first half of the P wave in V1 is taller than the first half of the P wave in V6, think

Back 12

right atrial enlargment

Front 13

When the second half of the P wave is wider and deeper than 1 small block, think

Back 13

left atrial enlargement

Front 14

length of pr interval

Back 14

.11 to .2

Front 15

what does the pr interval include

Back 15

atrial depolarization, atrial repolarization, AV node stim, his stim, BBB stim and purkinje stim

Front 16

where should the pr interval be measured

Back 16

widest p to the beginning of the widest qrs

Front 17

if pr interval is long in all leads, think

Back 17

meatabolic problem (maybe hyperkalemia)

Front 18

causes of short pr intervals

Back 18

1. junctional p waves
2. PACs
3. LGL or WGW

Front 19

Wolff-Parkinson White syndrome

Back 19

young individuals, atria to ventricles through the Kent bundle without AV node, could pass out, circus rhythm

Front 20

Lown Ganong Levine Syndrome

Back 20

short pr, no tachy, benign bypass around AV, no signs of WPW

Front 21

signs of WPW**
know this slide

Back 21

1. short ps interval
2. wide qrs
3. delta wave
4. St-t wave changes
5.associated with paroxysmal tachy (Syndrome)
first 4=pattern

Front 22

delta wave

Back 22

two impulses meet each other, WPW, initial slurring of the qrs, 3 types with A most common; negative delta wave is a pseudoinfarct

Front 23

AV node that has a long refractory period until it drops a beat

Back 23

Wenkebach

Front 24

more dangerous mobitz II blocks

Back 24

infranodal or infrahisian

Front 25

Accrochage

Back 25

p waves and qrs go marching along together but independent; third degree heart block

Front 26

significant Qs

Back 26

.03 s or wider and depth equal to or greater than 1/3 of the R wave

Front 27

A negative wave after an R wave must be a

Back 27

S wave

Front 28

ST-T help diagnose a

Back 28

acute MI

Front 29

Q waves are more indicative of

Back 29

previous MI damage

Front 30

MI Q signs

Back 30

significant size and in a minimum of 2 continuous leads

Front 31

length of normal qrs**
Know this

Back 31

.06 to .11
axis -30 to 105, downward and to the left

Front 32

qrs deflection transition zone

Back 32

between V3 and V4

Front 33

increase in muscle mass does what to the size of qrs

Back 33

larger

Front 34

qrs size after MI and decrease in ventricular muscle mass and effusions

Back 34

smaller

Front 35

why dose qrs voltage look smaller if you have COPD or are over weight

Back 35

leads further away from the heart

Front 36

pericardial effusions

Back 36

limb leads less than 5 mm (QRS)
precordial leads less than 10 mm

Front 37

left ventricular hypertrophy

Back 37

increased muscle mass causes increased action potential, increased vector with resultant increased EKG amplitude

Front 38

EKG criteria for LVH

Back 38

S in V1 or V2 added to R of V5 or V6> 34mm *
Any precordial lead > 45mm
R wave in aVL is >10mm
R wave in lead I is > 11mm
R in AVF > than 19mm

Front 39

cant call LVH if what is present?

Back 39

LBBB present

Front 40

RVH

Back 40

look at V1 and V2: R waves >S wave; cant make diagnosis with RBBB; could be due to WPW or posterior wall myocardial infarction

Front 41

if tachy >100 with wide qrs, think

Back 41

v tach until proven otherwise

Front 42

3 possibilities for >.11 QRS

Back 42

RBBB, LBBB or hyperkalemia

Front 43

significant Q waves

Back 43

dead muscle, must be in more than 1 lead, >1/3 of height and >.03 sec

Front 44

osborn wave

Back 44

aka J wave, hypothermia, elevated notch after qrs, often associated with bradycardia