Term
|
Definition
Lead II 60
Lead III 120
Lead aVF 90 |
|
|
Term
|
Definition
|
|
Term
|
Definition
(Right ventricular)
Lead aVR -150
V1 |
|
|
Term
|
Definition
|
|
Term
|
Definition
atrial depolarization
right first half
left second half
< 2.5 mm high
< 0.12 sec in duration
+ in Lead I, aVL, II, aVF, V5, V6
biphasic in III and V1
- in aVR |
|
|
Term
|
Definition
| ventricular depolarization |
|
|
Term
|
Definition
ventricular repolarization
+ in leads with large, + R waves |
|
|
Term
| How long should the QRS interval be? |
|
Definition
|
|
Term
| How long should PR interval be? |
|
Definition
|
|
Term
| How do you find the rate from an EKG? |
|
Definition
1. Count boxes between R waves - 300/# of boxes
2. Count # of cycles in 6 secs and multiply by 10 |
|
|
Term
| What results in a positive wave on an EKG? |
|
Definition
| A wave of depolarization moving toward an electrode or a wave of repolarization moving away from an electrode |
|
|
Term
| Explain Einthoven's Triangle |
|
Definition
-/- +/-
+/+
Bipolar leads - limb leads |
|
|
Term
Angles
Lead I
Lead II
Lead III
aVR
aVL
aVF |
|
Definition
Lead I 0
Lead II 60
Lead III 120
aVR -150
aVL -30
aVF 90 |
|
|
Term
|
Definition
I and aVL
Q waves are negative |
|
|
Term
| Explain R wave progression. |
|
Definition
V1 -
V3 to V4 transition
V5 largest R wave
V6 slightly smaller |
|
|
Term
|
Definition
| where QRS complex joins ST segment |
|
|
Term
|
Definition
Look at Lead I and aVF
Lead I + is -90 to 90
aVF + is 0 to 180
Both + is 0 to 90
Look for biphasic wave - 90 from that |
|
|
Term
|
Definition
between 90 and 180
+ aVF
- Lead I |
|
|
Term
|
Definition
between 0 and -90
Lead I +
aVF - |
|
|
Term
| extreme right axis deviation |
|
Definition
between -90 and 180
Lead I -
aVF - |
|
|
Term
| Causes of right axis deviation |
|
Definition
deep inspiration
standing
tall, lanky body habitus
right ventricular hypertrophy
- pulmonary hypertension
- congenital heart disease
myocardial infarction of left ventricle
acute pulmonary embolism |
|
|
Term
| Causes of left axis deviation |
|
Definition
Left ventricular hypertrophy
expiration
laying down
obesity |
|
|
Term
|
Definition
|
|
Term
| Assessment of atrial enlargement |
|
Definition
Look at Lead II and V1
increased amplitude or increased duration |
|
|
Term
| Causes of Right atrial enlargement |
|
Definition
Usually associated with r. ventricular enlargement
Pulmonary disease
- asthma, pulm embolism, COPD
Congenital heart disease
- pulmonic valve stenosis, atrial septal defect, Ebstein's anomoly, tetralogy of Fallot |
|
|
Term
| Causes of left atrial enlargement |
|
Definition
Valvular heart disease
- aortic stenosis, aortic regurgitation, mitral regurgitation, mitral stenosis
Hypertensive heart disease
Cardiomyopathies
Coronary artery disease |
|
|
Term
| Diagnostic criteria for R. ventricular hypertrophy |
|
Definition
Right axis deviation > 100
In lead V1, the R wave > S wave
In lead V6, the S wave > R wave |
|
|
Term
| Causes of R. ventricular hypertrophy |
|
Definition
Congenital heart disease
- pulmonic stenosis, atrial septal defect, tetralogy of Fallot, Eisenmenger's syndrome
Pulmonary disease
Pulmonary artery hypertension
Pulmonary embolism |
|
|
Term
| Diagnostic criteria for L ventricular hypertophy |
|
Definition
Precordial leads more sensitive than limb leads
R wave in V5 or V6 + S wave in V1 or V2 exceeds 35 mm
R wave in V5 exceeds 26 mm
R wave in V6 exceeds 18 mm
R wave in V6 exceeds the R wave in V5
R wave in aVL exceeds 13 mm
R wave in aVF exceeds 21 mm (Ms. J disagrees)
R wave in Lead I exceeds 14 mm
R wave in Lead I + S wave in Lead III exceeds 25 |
|
|
Term
| Repolarization abnormalities |
|
Definition
Down-sloping of ST segment
V1 and V2 for right ventricle
Lead I, aVL, V5, V6 for left ventricle |
|
|
Term
| Arrhythmia clinical manifestations |
|
Definition
palpitations
presyncope or syncope
angina
congestive heart failure
sudden death |
|
|
Term
|
Definition
HIS DEBS
Hypoxia
Ischemia and irritability
Sympathetic stimulation
Drugs
Electrolyte disturbances
Bradycardia
Stretch |
|
|
Term
|
Definition
Lead II
Holter monitor
Cell phone based monitor
implanted event recorder |
|
|
Term
|
Definition
stimulates vagal input
right stimulates SA node
left stimulates AV node
used to slow arrhythmia |
|
|
Term
| Five basic types of arrhythmias |
|
Definition
1. arrhythmias of sinus origin
2. ectopic rhythms
3. reentrant arrhythmias
4. conduction blocks
5. preexcitation syndromes |
|
|
Term
| The 4 Arrythmia Questions |
|
Definition
1. Are normal P waves present?
2. Are the QRS complexes narrow or wide?
3. What is the relationship between the P waves and QRS complexes?
4. Is the rhythm regular or irregular? |
|
|
Term
| Arrythmias of Sinus Origin |
|
Definition
sinus tachycardia
sinus bradycardia
sinus arrhythmia
sinus arrest |
|
|
Term
|
Definition
rate exceeding 100 bpm
causes: anxiety, pain, drugs, fever, infections, pulmonary embolism, acute MI, hyperthyroidism, pheochromocytoma, intravascular volume loss, alcohol intoxication or withdrawal |
|
|
Term
|
Definition
less than 60 cpm
Causes: normal variant, drugs, hypthyroidism, hyperkalemia, sick sinus syndrome, sleep apnea syndromes, carotid sinus hypersensitivity syndrome, vasovagal reaction |
|
|
Term
|
Definition
slight beat-to-beat variation
common in young adults
changes in vagal tone that occur during respiration |
|
|
Term
|
Definition
causes: hypoxemia, myocardial ishcemia or infarction, hyperkalemia, diitalis toxicity, vagal hyperactivity
Escape beats may come from atria, AV node, or ventricles
Asystole - prolonged electrical inactivity |
|
|
Term
|
Definition
|
|
Term
| junctional pacemaker rate |
|
Definition
40-60 bpm
most common
causes retrograde P waves |
|
|
Term
| ventricular pacemaker rate |
|
Definition
|
|
Term
|
Definition
sustained rhythm coming from outside SA node
causes: digitalis toxicity, beta adrenergic meds for asthma or COPD |
|
|
Term
|
Definition
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|
