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Oct. 23 Lecture
Part 2
28
Nursing
Graduate
10/24/2014

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Term
DESCRIBE THE 3 BIPOLAR LEADS.
Definition
LEAD I. RIGHT ARM ELECTRODE -; LEFT ARM ELECTRODE +. LEAD II. RIGHT ARM ELECTRODE -; LEFT LEG ELECTRODE +. LEAD III. LEFT ARE ELECTRODE -; LEFT LEG ELECTRODE +.
Term
WHICH WAY DOES ATRIAL DEPOLARIZATION OCCUR?
Definition
FROM RIGHT TO LEFT. WHEN HE SET LEAD I AS NEGATIVE ON THE RIGHT ARM AND POSITIVE ON THE LEFT ARM THIS IS SET FOR THE P WAVES OT BE POSTIIVE IN LEAD I.
Term
WHICH ELECTRODE IS THE GROUND?
Definition
THE RIGHT LEG. IF THE RIGHT ELECTODE FALLS OFF YOU PICK UP A LOT OF NOISE.
Term
DESCTRIBE THE TRIAXIAL SYSTEM.
Definition
ITS A DEPICTION OF THE 3 BIPOLAR LEADS BEING REPOSITIONED ON THE HEART WHEREAS LEAD I IS 0 DEGREES, LEAD II IS 60 DEGREES, AND LEAD III IS 120 DEGREES.
Term
DESCRIBE UNIPOLAR LEADS.
Definition
AVR IS RIGHT ARM + (- SIDE IS LOCATED BETWEEN LEFT ARM AND LEFT FOOT AT LEFT SIDE OF CHEST AT LOWER RIBES)., AVL IS LEFT ARM + (- SIDE IS BETWEEN RIGHT ARM AND LEFT FOOT AT RIGHT CHEST AT THE LOWER ASPECTS OF MY RIB) AND AVF IS LEFT FOOT POSITIVE (- ELECTRODE BETWEEN RIGHT ARM AND LEFT ARM LOACTED A MANUBRIUM ABOVE THE STERNUM). AVR IS -150 DEGREES. AVL IS -30 DEGREES. AVF IS 90 DEGREES. THIS IS ANOTHER TRIAXIAL SYSTEM.
Term
IF WE WERE TO ADD THE AMPLITUDES OF AVR+AVL+AVF WHAT WOULD THEY ADD UP TO BE?
Definition
THEY WOULD NEGATE EACH OTHER AND ADD UP TO ZERO.
Term
DOES AUGMENTED LEADS HAVE A NEGATIVE ELECTRODE?
Definition
NO!
Term
DESCRIBE THE HEXAXIAL SYSTEM.
Definition
WHEN WE ADD THE 3 BIPOLAR LEADS AND THE 3 UNIPOLAR LEADS.
Term
WHAT IS LEAD I,II, AND III PERPENDICULAR TO IN RELATION TO THE UNIPOLAR LEADS?
Definition
LEAD I IS PERPENDICULAR TO AVF. LEAD II IS PERPENDICULAR TO AVL. LEAD III IS PERPENDICULAR TO AVR.
Term
IF LEAD I HAS MAXIMAL DEFLECTION WHAT IS LEAD AVF GOING TO BE?
Definition
FLAT BECAUSE IT IS PERPENDICULAR. IF LEAD I HAS THE LARGEST R WAVE, THE R WAVE IN AVF SHOULD BE FLAT AND ZERO.
Term
WHAT IS GOING TO HAPPEN IF THE WAVE OF DEPOLARIZATION IS AT 75 DEGREES?
Definition
LEAD II AND AVF WOULD BE EXACTLY EQUAL BECAUSE 75 DEGREES IS EXACTLY IN THE MIDDLE OF LEAD II AND AVF.
Term
WHAT WOULD HAPPEN IF THE WAVE OF DEPOLARIZATION WAS AT 45 DEGREES?
Definition
THE POSITIVE DEFLECTION THAT I SEE IN LEAD 2 WOULD EQUAL THE NEGATIVE DEFLECTION THAT I SEE IN AVR. SINCE IT'S MOVING AS MUCH TOWARD THE POSITIVE OF LEAD II AS IT'S MOVING TOWARD THE NEGATIVE OF AVR THE POSITIVE AMPLITUDE OF 2 EQUALS THE NEGATIVE AMPLITUDE OF AVR.
Term
HOW DOES THE HEXAXIAL SYSTEM EXIST?
Definition
IN THE FRONTAL PLANE
Term
HOW DOES THE PRECORDAL CHEST LEADS EXIST?
Definition
IN THE HORIZONTAL PLANE.
Term
WHERE ARE V1-V6 POSITIONED AT?
Definition
V1 4TH INTERCOSTAL SPACE, RIGHT OF STERNUM. V2 4TH INTERCOSTAL SPACE LEFT OF STERNUM BORDER. LEAD 3 BEWTEEN V2 AND V4. V4 5TH INTERCOSTAL SPACE MIDCLAVICULAR LINE. V5 ANTERIOR AXILLARY SPACE (BETWEEN V4 AND V6). V6 MIDAXILLARY LINE.
Term
WHAT THE PRECORDIALS DO IS THEY TAKE THE RIGHT ARM, LEFT ARM, AND LEFT LEG AND AVERAGE AL THREE OF THEM AND ST THOSE THREE AS IMAGINARY ELECTRODES THAT LANDS RIGHT WHERE?
Definition
IN THE MIDDLE OF THE HEART.
Term
WITH THE PRECORDAL LEADS WHERE ARE THE + ELECTRODES LOCATED AT?
Definition
ON THE SURFACE OF THE BODY.
Term
WHAT IS THE P WAVE AND WHAT IS IT PRECEDED BY?
Definition
P WAVE IS ATRIAL DEPOLARIZATION. IT IS PRECEDED BY THE SA NODE.
Term
DESCRIBE THE WIDTH OF THE P WAVE. WHAT CAN PROLONG IT?
Definition
TIME REQUIRED FOR WAVE OF DEPOLARIZATION TO SPREAD OVER BOTH ATRIA. MAY BE PROLONGED BY ATRIAL ENLARGEMENT OR A CONDUCTION DELAY IN BACHMANN'S BUNDLE.
Term
WHERE IS THE ELECTRICAL VECTOR DIRECTED FOR THE SA NODE?
Definition
DOWNWARD AND TO LEFT. THIS CAUSES UPWARD DEFLECTION (P WAVES) IN LEAD I AND AVF.
Term
WHY IS AVR P WAVE HAVE A NEGATIVE DEFLECTION?
Definition
BECAUSE THE WAVE OF DEPOLAIZATION IS MOVING TOWARD THE POSITIVE I ELECTRODE. IT IS MOVING AWAY FROM THE POSITIVE ELECTRODE OF AVR.
Term
THE AMPLITUDE OF DEFLECTION DEPENDS ON 2 THINGS. WHAT ARE THEY?
Definition
HOW PARALLEL OR PERPENDICULAR IT IS TO ANY GIVEN LEAD AND IT DEPENDS UPON THE MUSCLE MASS. THE LARGER THE MASS THE LARGER THE DEFLECTION.
Term
WHEN YOU ARE LOOKING AT LVH AND RVH WE CAN SEE AN INCREASED AMPLITUDE IN WHAT COMPLEX BECAUSE OF INCREASED MUSCLE MASS?
Definition
THE QRS COMPLEX. THAT IS WHY IT IS SO BIG!
Term
THE WIDTH OF THE P WAVE TELLS US WHAT?
Definition
THE AMOUNT OF TIME REQUIRED FOR THE WAVE TO SPREAD ACROSS BOTH ATRIA.
Term
DESCRTIBE THE SA NODE AND AV NODE IN RELATION TO THE P WAVE.
Definition
THE POINT IMMEDIATELY PRECEDING THE P WAVE, THIS IS WHEN THE SA NODE DEPOLARIZES. IF I LOOK AT THE WIDTH OF THE P WAVE, THAT IS THE ATRIAL MYOCYTES DEPOLARIZING. AFTER THE ATRIAL MYOCYTES IS THE AV NODE. THAT IS WHY
Term
WHAT WILL YOU SEE IF YOU HAVE ATRIAL ENLARGEMENT OR SOME TYPE OF CONDUCTIONAL DELAY?
Definition
AN INCREASED LENGTH. IF I HAVE ATRIAL ENLARGEMNT I WILL SEE AN INCREASED WIDTH AND INCREASED AMPLITUDE. IF IT'S JUST A CONDUCTION DELAY I WON'T SEE THE INCREASED AMPLITUDE, I WILL JUST SEE INCREASED LENGTH.
Term
WHEN DOES ATRIAL REPOLARIZATION OCCUR?
Definition
DURING VENTRICULAR DEPOLARIZATION.
Term
DESCRIBE THE APPEARANCE OF ATRIAL REPOLARIZATION.
Definition
ATRIAL REPOLARIZATION DOES NOT OCCUR IN A WAVELIKE PHENOMENON. IT DOESN'T GO FROM ONE DIRECTION TO THE OTHER. THEY REPOLARIZE AT THEIR OWN RATE, WHENEVER THEY WANT TO. SO IF THERE IS A WAVE OF DEPOLARIZATION, THEN AT RANDOM EACH ONE ARE GOING TO REPOLARIZE AT THEIR OWN TIME. I DO NOT HAVE A WAVE OF REPOLARIZATION. THAT IS WHY YOU DON'T SEE INVERTED P WAVES IN A PATIENT WITH AN AV BLOCK.
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