Cardiac Thoracic- EKG interpretation


Webster Cardiac thoracic
Carly Pruemer
Flashcards by Carly Pruemer, updated more than 1 year ago
Carly Pruemer
Created by Carly Pruemer over 5 years ago

Resource summary

Question Answer
AVR lead should always be positive or negative negative
What is the hearts dominate pacemaker? SA Node
Automaticity is? Ability to generate pacemaking stimuli
Name the internodal tracks and where are they located Anterior internodal Middle internodal Posterior internodal Located: right atrium
What is the conduction tract to the LA called? Bachmann Bundle
The atrial conduction system is composed of what tracks? Internodal tracks: SA to AV node Bachmann bundle: SA and depolarizes LA
What cation slows the AV node Depolarization Calcium (this insures proper filling time for isometric volume contraction) Frank stalling effect
Where does the ventricular conduction originate? Bundle of HIS
After 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
For a right BBB what side is depolarized first? Left or right Left
For a left BBB what side is depolarized first? Left or right Right
SA node pacemaker rate 60-100 bpm
atrial cell pacemaker rate 55-60
AV node pacemaker rate 40-50
HIS bundle pacemaker rate 45-60
Bundle Branches pacemaker rate 40-45
Purkinje fiber pacemaker rate 35-40
Ventricular cell pacemaker rate 30-35
P wave is atrial depolarization and contraction
PR interval is time between atrial contraction and ventricular contraction
QRS complex is ventricular depolarization and contraction
T- wave is Ventricular repolarization
QT interval Duration of ventricular systole/contraction (less than 1/2 R to R ratio)
EKG paper- one small box is..? 0.04 seconds 0.1 mV
EKG paper- 5 small boxes (one large square).? 0.2 seconds 0.5 mV
EKG paper- 5 large boxes 1 sec
Chest leads I II III AVR AVL AVF
Limb Leads V1 V2 V3 V4 V5 V6
Bipoar limb leads I II III
unipolar limb leads AVF AVR AVL
AVF augmented/amplified, voltage, left foot left foot + Combination of leads II and III
AVR right arm electrode positve
AVL left arm electrode positve
lateral leads I AVL
Inferior leads II III AVF
Chest leads are all positive or negative positive oriented through AV node and projects through the patients back
EKG Interpretation: quality rate rhythm axis hypertrophy infarction
Automaticity Foci (eptopic foci) focal areas of automaticity of the heart pacemakers (atria 60-80, ventricle 40-60, AV junction 20-40)
Rhythm Regularity P before QRS QRS after each P PR interval (AV Block) QRS interal (BBB_
Normal PR Interval 0.12-0.20 seconds
Normal QRS 0.004-0.12
Bundle Branch Blocks Wide QRS (3 sm squares or 0.12 sec) Wide QRS in other leads you look for block
Right Bundle branch R and R' in V1/V2
Left bundle branch block R and R' in V5/V6
Causes of axis deviation Change in position of the heart obesity hypertrophy MI BBB
Normal axis Positive electrodes in I and AVF
Right axis deviation Lead I = neg AVF= postive
left axis deviation lead one= positive AVF= neg
Extreme right axis deviation lead I- neg AVF- neg
atrial hypertrophy p-wave
right ventricular hypertrophy R wave
left ventricular hypertrophy S-wave depth V1 R wave height V5 (exaggerated)
right atrial hypertrophy large diphasic p-wave V1 with initial tall component
Left atrial hypertrophy large diphasic with wide terminal component in V1 (MVS and HTN)
Right ventricular hypertrophy R-wave get progressively smaller V1-V6
Left Ventricular hypertrophy Exaggerated amplitude of QRS in V1-V6 Large R V5 Inverted T wave V5-V6 mmS V1 + mmR in V5= >35mm LVH
Coronary blood flow Right and left coronary artery Left: left anterior descending (anterior) Circumflex (lateral) Right: SA node, AV node, Bundle of HIS (Posterior portion of heart)
Types of infarction Ischemia- CP Injury- Decreased flow Necrosis- perm injury
Ischemia Decreased blood supply Angina Transient inverted T-waves
Injury Acute infarct ST elevation- > 1mm Earliest EKG sign of MI
prinzmental angina transient ST elevation at rest in absence of an infartion
Persistent ST depression can represent.. Compromised coronary blood flow Subendocardial infarct Angina Positive stress test Digitalis
Necrosis Dead tissue Diagnostic Q wave (one mm wide 0.04/1/3 amp of QRS)
Infarct Review 1. Q waves 2. Inverted T waves 3. ST seg elevation or depression 4. location of occluded coronary artery
Posterior leads and artery V1/V2 right coronary artery
inferior leads and artery II/III/aVF right or left coronary artery
Lateral leads and artery I, AVL, V5, V6 Left circumflex
Anterior leads and artery V1-V4 left anterior descending
Anterior infarction V1-V4
Antero-septal infarction V1-V2
Antero-lateral V3-V4
Lateral infarction I AVL
inferior infarction II III AVF
Posterior infarction V1/V2
Dominate coronary artery LV receives blood from the dominate coronary artery Primary- right, but can be left also
COPD and EKG low voltage amp in all leads multifocal atrial tachycardia
Pulmonary Embolism and EKG Wide 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
Hyperkalemia and EKG P-wave flatten qrs- widen T-wave peaked
Hypokalemia and EKG flatten/inverted T-waves U-wave can lead to torsades and vtach
hypercalcemia QT shorten
Hypocalcemia QT prolongs
Show full summary Hide full summary


Axis Deviation
Megan Daniel
Clinical Cardiology Multiple Choice Questions
Elle Ashe
Cardiac Cycle
Hannah Tribe
The Cardiac Cycle
CPE Anesthesia
Inhalational anesthetics
Mike Ru
Cardiovascular system-response and adaptations to exercise
Camilla Donaldson
EKG Basics
Elizabeth McKinley
CPE Anesthesia Part 2
Heart Sounds: An Overview
Chris Mulryan
CPE Anesthesia Part 1