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ECG Basics

QuestionAnswer
In lead 1, the left arm electrode is... positive
In lead II, the right arm electrode is... negative
In lead III, the left leg electrode is... positive
In the AVF lead, where is the + charge located? The ground? Left foot electrode is +. Right and Left arm electrodes are ground.
What are the two ground electrodes in lead AVR? The positive electrode? Ground = Left arm and left foot. Positive=Right arm
What are the ground electrodes in lead AVL? And the positive? Positive = Left arm.
What are the 6 limb leads? I, II, III, AVR, AVL, AVF
The limb leads lie in what plane? Frontal plane, on pt's chest
Which leads are the "lateral" leads? I and AVL
Which leads are the "inferior" leads? II, III, and AVF
Which leads lie in the horizontal plane? Chest leads (V1-V6)
A wave of depolarization within myocytes flows towards which electrodrode? Positive electrode
How is depolarization moving towards a positve electrode manifested on the ECG? By positive deflection
Amount of time represented b/n two heavy black lines 0.2 second
Amount of time represented b/n two fine lines .04 second
How many fine squares b/n two heavy black lines? 5
P wave: define and normal duration Atrial depolarization; no more than 2.5 mm in height & no more than .11 sec in length
QRS: define and normal duration Ventricular depolarization; 0.06 - 0.12 sec
QT interval: define and normal duration Duration of ventricular depolarization and repolarization; QTc < .45 sec (should be less than half the RR)
P-R interval: define and normal duration time from onset of atrial depolarization to onset of ventricular depolarization; 0.12 - 0.20 sec
Normal axis: -30 to -90
Inherent rate of SA node 60-100 bpm
Inherent rate of an atrial foci 60-80 bpm
Inherent rate of Junctional foci 40-60 bpm
Inherent rate of ventricular voci 20-40 bpm
Charictaristics of NSR Rate: 60-100 bpm; Rhythm: Regular; P waves: uniform, + in lead II, one precedes each QRS; PR interval: 0.12-0.20 sec and constant from beat to beat; QRS duration: 0.06 - 0.12 sec
Rate and rhythm of Sinus Arrhythmia Rate: Usually 60 - 100 bpm; Rhythm: irregular, phasic w/respiration, increase w/inspiration (sympathetic), decr w/expiration (parasymp)
Sinus Arrhythmia: char. of P, PR, QRS intervals P waves: uniform, + in lead II, one preceds each QRS, at very fast rates it may be diff to distinguish a P from T waves; PR: 0.12 - 0.20 sec and constant; QRS: 0.06 - 0.12 sec
Charictaristics of Sinus Bradycardia Rate: <60 bpm; Rhythm: Regular; P: uniform, + in lead II, one preceding each QRS; PR: 0.12 - 0.20 sec and constant; QRS: 0.06 < 0.12 sec
Characteristics of Sinus Tach Rate: 101-180 bpm; Rhythm: reg; P: uniform, + in lead II, one preceding each QRS; @ very fast rates it may be diff to distinguish P from T waves; PR: 0.12 - 0.20 and constant; QRS: 0.06 - 0.12 sec
What is an axis of depolarization the mean vector located by degrees in the frontal plane.
What is the axis if lead I is positive and aVF is negative Left axis deviation
What is the axis if lead I is negative and and aVF is positive Right axis deviation
What is the axis if lead I is negative and aVF is negative extreme right axis deviation
Dipole theory A wave of depolarization towards + electrode inscribes a + deflection; A wave of depolarization toward a - electrode inscribes a - deflection.
General characteristics of supraventricular dysrhythmias Disturbances in rhythm occurring above the ventricles; can be regular or irregular
QRS duration of supraventricular dysrhythmias the impulse will conduct down the normal ventricular conducting system -> QRS will be of normal duration
Rate and rhythm of a Wandering Atrial Pacemaker Rate: usually 60 - 100 bpm, but may be slower; Rhythm: may be irregular as the pacemaker site changes from teh SA node to ectopic foci
What do you call a wandering atrail pacemaker with a rate > than 100 bpm? Multifocal atrial tachycardia
P, PR, and QRS of a Wandering Atrial Pacemaker P: size, shape and direction may change from beat to beat, at least 3 different P morphologies needed to Dx; PR: variable; QRS: 0.06 - 0.12 sec
What rhythm am I? Rate: 400-600, ventricular rate varies; Ventricular rhythm: irregularly irregular; P waves: none identifiable, fibrillatory waves present, erratic & wavy baseline; PR: not measurable; QRS: usually <0.12 Atrial fibrillation
Rate and rhythm of SA Block Rate: usually normal but varies due to pause; Rhythm: irreg b/c of the pause - each pause is the same as (or exact multiple of) the distance b/n two other P-P intervals
P, PR, and QRS characteristics in SA block P: uniform, + in lead II, one precedes each QRS, at very fast rates it may be diff to distinguish P from T; PR: 0.12 - 0.20 and constant from beat to beat; GRS: 0.06 - 0.12 sec
Charictaristics of Sinus Arrest Rate: usually normal; Rhythm: irreg b/c or undetermined length of puase (doesn't march out); P: uniform, may be diff to distinguish P from T; PR: 0.12 - 0.20 and constant; QRS: 0.06 - 0.12
Origin of escape beat during sinus arrest An escape beat can emerge to pace the heart from another foci in the atria, junction, or ventricles.
Atrial escape P prime wave present but is not from the sinus. PR interval will be wider than a junction escape.
P prime wave Represents atrial depolarization by an automaticity focus, as opposed to normal sinus-paced P waves
Charictaristic of Junctional Escape Beats Rate: usually w/in normal range but depends on underlying rhythm; Rhythm: regular and late beats; P waves: may occur before, during, or after QRS, inverted in leads II, III, aVF; PR: if P occurs before QRS, it will usually be < or= 0.12; QRS: usully<0.12
Rate and rhythm of Junctional Escape Rhythm Rate: 40-60 bpm; Rhythm: regular
P, PR, and QRS characteristics in junctional escape rhythm P: may occur before, during, after QRS, inverted in II, III, & aVF; PR: if a P occurs before QRS it's usually < or = 0.12, if there's no P there's no PR; QRS: usually < 0.12 sec
Charictaristics of Ventricular Escape Rate: usually too slow to adequately perfuse (15-40 bpm); No P wave or atrial foci; no junctional escape mechanism; will likely see ischemic changes
Created by: ryanwight
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