Fichas
Cardiac Thoracic- EKG interpretation
Fichas del conjunto (81)
- 1AVR lead should always be positive or negativenegative
- 2What is the hearts dominate pacemaker?SA Node
- 3Automaticity is?Ability to generate pacemaking stimuli
- 4Name the internodal tracks and where are they locatedAnterior internodal
Middle internodal
Posterior internodal
Located: right atrium - 5What is the conduction tract to the LA called?Bachmann Bundle
- 6The atrial conduction system is composed of what tracks?Internodal tracks: SA to AV node
Bachmann bundle: SA and depolarizes LA - 7What cation slows the AV node DepolarizationCalcium
(this insures proper filling time for isometric volume contraction) Frank stalling effect - 8Where does the ventricular conduction originate?Bundle of HIS
- 9After activation of the bundle of HIS what is the depolarization sequence?- It immediately bifurcates in the interventircular septum into the RBB and LBB
- The left bundle produces fine terminal filaments
- Right bundle does not
- terminal filaments purkinje fibers deplo the ventricular myocytes= ventricle contraction - 10For a right BBB what side is depolarized first? Left or rightLeft
- 11For a left BBB what side is depolarized first? Left or rightRight
- 12SA node pacemaker rate60-100 bpm
- 13atrial cell pacemaker rate55-60
- 14AV node pacemaker rate40-50
- 15HIS bundle pacemaker rate45-60
- 16Bundle Branches pacemaker rate40-45
- 17Purkinje fiber pacemaker rate35-40
- 18Ventricular cell pacemaker rate30-35
- 19P wave isatrial depolarization and contraction
- 20PR interval istime between atrial contraction and ventricular contraction
- 21QRS complex isventricular depolarization and contraction
- 22T- wave isVentricular repolarization
- 23QT intervalDuration of ventricular systole/contraction
(less than 1/2 R to R ratio) - 24EKG paper- one small box is..?0.04 seconds
0.1 mV - 25EKG paper- 5 small boxes (one large square).?0.2 seconds
0.5 mV - 26EKG paper- 5 large boxes1 sec
- 27Chest leadsI
II
III
AVR
AVL
AVF - 28Limb LeadsV1
V2
V3
V4
V5
V6 - 29Bipoar limb leadsI
II
III - 30unipolar limb leadsAVF
AVR
AVL - 31AVFaugmented/amplified, voltage, left foot
left foot +
Combination of leads II and III - 32AVRright arm electrode
positve - 33AVLleft arm electrode
positve - 34lateral leadsI
AVL - 35Inferior leadsII
III
AVF - 36Chest leads are all positive or negativepositive
oriented through AV node and projects through the patients back - 37EKG Interpretation:quality
rate
rhythm
axis
hypertrophy
infarction - 38Automaticity Foci (eptopic foci)focal areas of automaticity of the heart
pacemakers
(atria 60-80, ventricle 40-60, AV junction 20-40) - 39RhythmRegularity
P before QRS
QRS after each P
PR interval (AV Block)
QRS interal (BBB_ - 40Normal PR Interval0.12-0.20 seconds
- 41Normal QRS0.004-0.12
- 42Bundle Branch BlocksWide QRS (3 sm squares or 0.12 sec)
Wide QRS in other leads you look for block - 43Right Bundle branchR and R' in V1/V2
- 44Left bundle branch blockR and R' in V5/V6
- 45Causes of axis deviationChange in position of the heart
obesity
hypertrophy
MI
BBB - 46Normal axisPositive electrodes in I and AVF
- 47Right axis deviationLead I = neg
AVF= postive - 48left axis deviationlead one= positive
AVF= neg - 49Extreme right axis deviationlead I- neg
AVF- neg - 50atrial hypertrophyp-wave
- 51right ventricular hypertrophyR wave
- 52left ventricular hypertrophyS-wave depth V1
R wave height V5 (exaggerated) - 53right atrial hypertrophylarge diphasic p-wave V1
with initial tall component - 54Left atrial hypertrophylarge diphasic with wide terminal component in V1
(MVS and HTN) - 55Right ventricular hypertrophyR-wave get progressively smaller V1-V6
- 56Left Ventricular hypertrophyExaggerated amplitude of QRS in V1-V6
Large R V5
Inverted T wave V5-V6
mmS V1 + mmR in V5= >35mm LVH - 57Coronary blood flowRight and left coronary artery
Left: left anterior descending (anterior)
Circumflex (lateral)
Right: SA node, AV node, Bundle of HIS
(Posterior portion of heart) - 58Types of infarctionIschemia- CP
Injury- Decreased flow
Necrosis- perm injury - 59IschemiaDecreased blood supply
Angina
Transient inverted T-waves - 60InjuryAcute infarct
ST elevation- > 1mm
Earliest EKG sign of MI - 61prinzmental anginatransient ST elevation at rest in absence of an infartion
- 62Persistent ST depression can represent..Compromised coronary blood flow
Subendocardial infarct
Angina
Positive stress test
Digitalis - 63NecrosisDead tissue
Diagnostic Q wave (one mm wide 0.04/1/3 amp of QRS) - 64Infarct Review1. Q waves
2. Inverted T waves
3. ST seg elevation or depression
4. location of occluded coronary artery - 65Posterior leads and arteryV1/V2
right coronary artery - 66inferior leads and arteryII/III/aVF
right or left coronary artery - 67Lateral leads and arteryI, AVL, V5, V6
Left circumflex - 68Anterior leads and arteryV1-V4
left anterior descending - 69Anterior infarctionV1-V4
- 70Antero-septal infarctionV1-V2
- 71Antero-lateralV3-V4
- 72Lateral infarctionI
AVL - 73inferior infarctionII
III
AVF - 74Posterior infarctionV1/V2
- 75Dominate coronary arteryLV receives blood from the dominate coronary artery
Primary- right, but can be left also - 76COPD and EKGlow voltage amp in all leads
multifocal atrial tachycardia - 77Pulmonary Embolism and EKGWide S-wave Lead 1
Large Q wave lead 2
Inverted t-wave lead 3
transient RBBB
Inverted t-waves V1-V4
ST depression lead 2
S1Q3T3 - 78Hyperkalemia and EKGP-wave flatten
qrs- widen
T-wave peaked - 79Hypokalemia and EKGflatten/inverted T-waves
U-wave
can lead to torsades and vtach - 80hypercalcemiaQT shorten
- 81HypocalcemiaQT prolongs
Información
- Descripción
- Webster Cardiac thoracic
- Creado por
- Carly Pruemer
- Visitas
- 47
- Etiquetas
- Valoración