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EKG: quiz 1 info
quiz 1 EKG
54
Anatomy
Graduate
06/04/2011

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Term
24 hour EKG used for symptomatic palpitations and syncope:
Definition
Holter Monitoring
Term
Heart Rate Variability is a format of EKG study used as a __ __ for cardiovacular disease.
Definition
prognostic indicator
Term
Signal Averaging EKG is a format of EKG used to identify __ __ patients at risk for ___.
Definition
- post-MI
- dysrhythmias
Term
Electrophysiologic studies are ___ studies for heart dysrhythmias.
Definition
invasive
Term
Exercise stress testing utilizes an EKG to screen for ___ __.
Definition
coronary disease
Term
Each little box on EKG paper is 1 mm or __ seconds, and each big box is __ seconds. So __ little boxes or __ big boxes equals 1 second.
Definition

- 0.04 seconds

- 0.2 seconds

- 25 little boxes

- 5 big boxes

Term
The vertical axis on EKG paper represents ___. ___ mm (squares) equals 1 mV.
Definition
- voltage
- 10
Term
One large box on EKG paper represents __ seconds across or ___ mV high.
Definition
0.2 seconds
0.5 mV (remember one big box is 5 little squares, it takes 10 squares to make 1 mV)
Term
One small square represents __ seconds across or ___ mV high.
Definition
0.04 seconds
0.1 mV
Term
You can use Dubin's method to determine heart rate when there is ___ rhythm.
Definition
sinus
Term
The EKG is a collective measure of changes in __ __ from many cells.
Definition
voltage potential
Term
Multiple cells depolarizing in the same direction produce additive voltage readings (the “Y” axis)
Multiple cells depolarizing in the opposite directions produce diminutive voltage readings (ALSO the “Y” axis at any given point in time and cancel each other out)
Cells depolarizing later occur farther down the graph (the “X” axis of the moving graph)
Definition
Term
The parasympathetic NS increases ___ ___ levels causing cell to resist depolarization.
Definition
intracellular potassium
Term
Absence of all PNS activity permits full SA rate potential
Definition
Term
Sympathetic nervous system
Influences calcium influx and in the rate of decline of cellular potential to threshold potential
Definition
Term
The T wave is the first __ or ___ deflection following the QRS complex. It is usually upright in all leads except AVR.
Definition
upward or downward
Term
"Flipped" T wave suggests ___.
Definition
infarction
Term
Normal PR interval is ___ to ___ seconds. This interval represents the time it takes for the stimulus to pass through the ___ and through the ___ __.
Definition

- 0.12-0.20 seconds (3-5 little boxes)

- atria

- AV junction

Term
QT interval is the duration of __ __. Long QT intervals are vulnerable to dangerous ventricular rhythms. Normal if less than half of __ to __.
Definition
ventricular systole
R to R
Term
Interpretation usually requires confirmation in at least two leads
Definition
Term
Rolls Royces In Seattle Are High Priced Investments.
Definition
- Rhythm
- Rate
- Intervals
- Shape of Complex
- Axis
- Hypertrophy
- Progression of R waves
- Ischemia/Infarction/Interpretation
Term
4 questions to ask to determine if rhythm is sinus?
Definition
- Is there a P wave for every QRS complex?
- Is there a QRS complex for every P wave?
- Is the P wave upright in lead II?
- Are the PR and QRS intervals normal?
Term
Irregular rhythms require a ___ ___ __ __ to determine heart rate. Regular rhythms do NOT require this.
Definition
6 second rhythm strip
Term
SA Node (60-100 bpm)

Atrial foci (60-80 bpm)

Junctional foci (40-60 bpm)

Ventricular foci (20-40 bpm)
Definition
Term
junctional rhythm:
Definition
Lone QRS waves

P wave
Either missing (absorbed into QRS complex)
Or appears as retrograde depolarization of atria (P wave opposite direction of QRS, usually downward)

Results from sinus arrest AND failing atrial foci

40-60 BPM
Term
atrial escape rhythm:
Definition
Originate in an atrial focus/foci

Different looking P’ wave (not identical)

60-80 bpm
Term
Premature ventricular contraction shows ___ ___ complexes on the EKG.
Definition
widened QRS
Term
ventricular escape rhythm:
Definition
Giant QRS complexes

May or may not have P waves (often different rate or nonexistent)

20-40 bpm (syncope)

Ventricular focus escapes to become active pacemaker if conduction block or total failure of SA Node
Term
Leads show the voltage potential difference between a reference electrode (or set) and a detector electrode (the positive electrode)
Definition
Term
leads I + III should equal __.
Definition
II
Term
unipolar augmented leads are Leads mathematically calculated relative to a zero potential
Voltages enhanced electronically to be readable
Vector directions are 30 degrees off from leads I, II, and III
Definition
Term
aVR + aVL + aVF should equal:
Definition
zero mV, if the sum of the QRS voltages does not equal 0 check the leads, may be set up wrong
Term
Axis is the direction of ___ and is described by a ___. It is measured in ___ referenced from __ _.
Definition
- depolarization
- vector
- degrees
- lead I
Term
Two groups of triaxial leads together comprise the hexaxial leads and determine the frontal axis

See Hexaxial Lead Diagram…
Definition
Term
A positive (upward) deflection is seen in any lead if the depolarization spreads toward the positive pole of the lead
A negative (downward) deflection is seen in any lead if the depolarization spreads away from the positive pole of the lead
The negative pole is not a detector
If the mean depolarization path is directed at right angles to any lead, a small biphasic complex (RS or QR) is seen
Definition
Term
Lead I and ___ should be opposite.
Definition
aVF
Term
Lead II and __ should be opposite.
Definition
aVR
Term
V1 location:
Definition
4th intercostal space right side of sternum
Term
V2 location:
Definition
4th intercostal space left side of sternum
Term
V3 location:
Definition
directly between V2 and V4
Term
V4 location:
Definition
5th intercostal space at midclavicular line
Term
V5 location:
Definition
5th intercostal space (level with V4) at anterior axillary line
Term
V6 location:
Definition
5th intercostal space (level with V4 and V5)at midaxillary line
Term
bipolar leads are on a __ plane, unipolar leads are on a __ plane.
Definition
- frontal
- horizontal
Term
chest leads:
Definition
Unipolar leads on a horizontal plane
Reference (-) is electronically derived
Chest leads point anteriorly to laterally moving right to left across the chest
Well suited for examining the posterior and anterior aspects of the heart
Positioning of the electrodes are critical
Term
Axis is the direction of:
Definition
depolarization
Term
Axis is determined by the overall QRS AXIS
Normal is 0 to +90
Different patterns in different chest and limb leads
The thickness of the muscle contributes to both amplitude and duration of QRS
The “thicker” the heart muscle, the higher the voltage potentials
Definition
Term
To determine axis look at the __ __ in __ _ and __.
Definition
QRS complex
lead I
aVF
Term
A normal axis has a __ QRS complex in lead I and a __ QRS complex in aVF.
Definition
positive
positive
Term
When determining axis if lead I is negative and aVF is positive, you have __ __ __.
Definition
right axis deviation
Term
If lead I is positive and aVF is negative, you have __ __ __.
Definition
left axis deviation
Term
If both leads I and avF are negative (extreme right axis deviation), what does this mean?
Definition
something is technically wrong with EKG setup- LEADS ARE USUALLY TRANSPOSED
Term
Axis deviation is in the frontal plane

Axis rotation is in the horizontal plane
Definition
Term
Sinus arrhythmia is is irregular rhythm varying with respiration. This will show a slight __ in heart rate during inspiration.
Definition
increase
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