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EKG
Quiz I
72
Other
Professional
06/09/2013

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Cards

Term
At rest the interior of a muscle cell has what kind of charge? The outside of the cell has what charge?
Definition
Negative/Positive
Term
During depolarization the interior of the muscles cell takes on what charge?
Definition
Positive
Term
The recovery phase that follows depolarization is called this
Definition
Repolarization
Term
Atrial depolarization shows up on the EKG as this
Definition
The P wave
Term
T/F. A normal EKG has 2 separate waves to represent the two atrial contractions.
Definition
False, the 1 P wave represents the simultaneous atrial contraction
Term
These structures electrically insulate the ventricles from the atria
Definition
AV valves - mitral and tricuspid valves
Term
T/F. There is a brief pause between atrial and ventricular contractions because depolarization slows within the AV node
Definition
True
Term
The atria are depolarized by what ion?
Definition
Na+
Term
The AV node is depolarized by what ion?
Definition
Ca+
Term
When depolarization normally occurs the electrical impulse goes through what structures from beginning to end of cardiac cycle.
Definition
SA node > AV node > Bundle of His > Bundle Branches > Purkinje fibers
Term
T/F. The QRS complex represents the depolarization down the ventricular conducting system.
Definition
False, the depolarization down the ventricular conducting system is too weak to show up on EKG. The QRS complex represents the depolarization of the ventricular myocardium
Term
What ion depolarizes the ventricular myocardium rapidly?
Definition
Na+ - in general this ion is responsible for rapid depolarization and Ca+ is a slower moving ion and does not depolarize as quickly
Term
T/F. The purkinje fibers depolarize the ventricular myocardium from the outside in (epicardium to the endocardium)to create a squeezing effect.
Definition
False, the purkinje fibers are located beneath the endocardium so depolarization occurs from the inside out towards the epicardium
Term
What is the benefit of using 12 leads?
Definition
This allows you to trace electric vector in all three planes of interest
Term
On ECG paper what does one small box represent horizontally?
Definition
.04 seconds
Term
On ECG paper what does one large box represent horizontally?
Definition
.20 seconds
Term
On ECG paper what does one large box represent vertically?
Definition
.5 mV
Term
How much time is represented between hashes on ECG paper?
Definition
3 seconds
Term
T/F. During myocardial infarction the infarct portion of the heart is electrically silent.
Definition
True
Term
The T wave represents what?
Definition
Ventricular repolarization
Term
What does the PR interval represent?
Definition
Atrial depolarization to the delay in AV junction (AV node/Bundle of His)
Term
What are the 5 steps of Rhythm Analysis
Definition
1. Calculate rate

2. Determine regularity

3. Assess the P waves

4. Determine PR interval

5. Determine QRS duration
Term
There are 45mm between 3 beats on a ECG strip. What is the pulse?
Definition
4500/45 = 100 bpm
Term
In 6 seconds a PT finds 7 R waves. What is the pulse?
Definition
7 x 10 = 70 bpm
Term
You find a R wave on a bold line on the ECG strip and the next R wave is 3 1/2 large boxes away. What is the pulse
Definition
75-100 bpm
Term
How do you determine regularity?
Definition
Look at R-R wave distances using a caliper or markings on a pen or paper
Term
T/F. There should be two P waves for each QRS.
Definition
False
Term
What is the normal time range for a PR interval?
Definition
.12-.20 seconds or 3-5 small boxes
Term
What is the normal time range for QRS duration?
Definition
.04-.12 seconds or 1-3 small boxes
Term
If a QRS is wide what does that indicate about the electrical system of the heart?
Definition
The heart is not using the His-purkinje system. The heart is using a slower conduction method.
Term
Normal Sinus Rhythm parameters: Rate, Regularity and P waves
Definition
Rate: 60-100 bpm

Regularity: regular

P waves: normal
Term
Normal Sinus Rhythm parameters: PR interval and QRS duration
Definition
PR interval: .12-.20 seconds

QRS duration: .04-.12 seconds
Term
Condition where SA node fires too fast but other parameters are normal.
Definition
Sinus Tachycardia
Term
Condition where parameters are normal but then there is a brief pause in electrical activity
Definition
Sinus Arrest
Term
Rhythm with an early beat and the P wave may change shape
Definition
Premature Atrial Contraction (PAC)
Term
A rhythm with three premature atrial contractions in a row
Definition
Paroxysmal Atrial Tachycardia (PAT)
Term
A rhythm where the atria fires 200-300 times per minute at a regular rate
Definition
Atrial Flutter
Term
What is Premature Atrial Contraction Trigeminy? Bigeminy?
Definition
A PAC every third beat

A PAC every other beat
Term
Rhythm where there is a wavy baseline and there are no clear cut P waves (can be described as irregularly irregular)
Definition
Atrial Fibrillation
Term
Rhythm where P to P waves vary and the P waves change shape
Definition
Wandering Atrial Pacemaker
Term
T/F. During atrial fibrillation the heart has a bigger atrial kick.
Definition
False the heart loses the atrial kick. This can be seen since no p waves are present (the equivalent of 2 units of blood are lost when no atrial kick)
Term
What is a re-entrant pathway?
Definition
Occurs when an impulse loops and results in a self-perpetuating impulse formation
Term
A possible explanation for atrial flutter
Definition
Re-entry Phenomenon
Term
A ECG strip has a late, narrow QRS. There is also an inverted P wave. What is the rhythm?
Definition
Junctional Escape
Term
On a ECG strip there are 3 early narrow QRS complexes, 2 inverted P waves and 1 absent P wave. What is the rhythm?
Definition
Paroxysmal Tachycardia - made up of 3 premature junctional contractions
Term
What catch all term is used when the QRS is narrow but PAT, PJT, and Atrial Fibrillation with Rapid Ventricular Response cannot be differentiated?
Definition
Supraventricular Tachycardia (SVT)
Term
On a ECG strip the p wave is absent and the QRS complex is wider than normal. The intrinsic rate is 20-40. What is the rhythm?
Definition
Ventricular escape beat
Term
What rhythm has a run of three ventricular escape beat with a rate above 40?
Definition
Accelerated Idioventricular Rhythm (AIVR)
Term
On an ECG strip there are two early ventricular beats in a row. What is the rhythm?
Definition
A pair of Premature Ventricular Contractions(PVC)
Term
PVCs that look alike are described as...?

PVCs that look different from each other are referred to as....?
Definition
Uniform

Multiform
Term
What is an ICD and what does it do?
Definition
Implantable Cardioverter Defibrillator - it detects Ventricular Tachycardia and after 15 seconds shocks the heart to try to restore normal rhythm
Term
What is generally the cause of ventricular tachycardia?
Definition
Myocardial Infarction
Term
This rhythm is characterized by chaotic ventricular depolarization and is ineffective at pumping blood.
Definition
Ventricular Fibrillation - death can occur within minutes
Term
What is the probable cardiac output during ventricular fibrillation?
Definition
0 - life cannot be sustained
Term
What rhythms do you not want to see a patient have? (4)
Definition
1. Ventricular Fibrillation

2. Idioventricular Rhythm

3. Ventricular Standstill

4. Asystole
Term
This rhythm is characterized by nothing but P waves
Definition
Ventricular Standstill
Term
What is Asytole?
Definition
Flat line aka go get a nurse asap
Term
What are 4 reasons for a wide QRS?
Definition
1. Ventricular beat such as PVC

2. Bundle Branch block

3. Aberrant conduction

4. Pacemaker
Term
A QRS over .12 seconds is referred to as what kind of rhythm? What is a it called if the QRS is .10 to .12 seconds?
Definition
Complete Bundle Branch Block

Incomplete Bundle Branch Block
Term
What two things can cause Left Bundle Branch Block?
Definition
1. Hypertension

2. Cardiomyopathy
Term
What 3 things can cause Right Bundle Branch Block?
Definition
1. Congenital

2. Pulmonary Disease

3. Pulmonary Emboli
Term
What 2 things can cause a bundle branch block on either side?
Definition
1. Ischemia

2. Myocarditis
Term
During ventricular repolarization there are 2 phases, the ST interval and the T wave. Which is the rapid phase and what ion regulates repolarization?
Definition
T wave and both phases are regulated by the K+ ions leaving the ventricles
Term

Name the Rhythm

[image]

Definition
3rd Degree Block
Term

Name the Rhythm

[image]

Definition
Atrial Fibrillation
Term

Name the Rhythm

[image]

Definition
Atrial Flutter
Term

Name the Rhythm

[image]

Definition
AV 1st Degree Block
Term

Name the Rhythm

[image]

Definition
AV 2nd Degree Block
Term

Name the Rhythm

[image]

Definition
Sinus Rhythm with PVC
Term

Name the Rhythm

[image]

Definition
Ventricular Tachycardia
Term

Name the Rhythm

[image]

Definition
Ventricular Fibrillation
Term

What is the Rhythm if there are 3+ of these in a series?

[image]

Definition
Idiopathic Ventricular Rhythm
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