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EKG Certification

Cardiology

QuestionAnswer
Sinoatrial (SA)Node Intrinsic Pacemaker Rate 60-100 bpm
Atrioventricular (AV) Node Intrinsic Pacemaker Rate 40-60 bpm
Bundle of His Intrinsic Pacemaker Rate 40-60 bpm
Right and Left Bundle Branches Intrinsic Pacemaker Rate 40-60 bpm
Purkinje Fibers Intrinsic Pacemaker Rate 20-40 bpm
SA Node Timelapse 0.0 seconds
AV Node Timelapse 0.03 seconds
Bundle of His Timelapse 0.04 seconds
Right and Left Bundle Branches Timelapse 0.17 seconds
Purkinje Fibers Timelapse 0.2-0.22 seconds
Receiving Chambers of the Heart Atria
Pumping Chambers of the Heart Ventricles
Arteries carry blood... Away from the Heart
Veins carry blood... Towards the Heart
Criteria for Normal Sinus Rhythm 1. Has a upright P wave for every QRS complex 2. Has a bpm of 60-100
Sinus Bradycardia 1. Has a upright P wave for every QRS complex 2. Has a bpm of less than 60
Sinus Tachycardia 1. Has a upright P wave for every QRS complex 2. Has a bpm of over 100
Depolarization Contraction
Repolarization Relaxation
What is a P wave? Atrial contraction
What is a QRS complex? Ventricular contraction
What is a T wave? Ventricular relaxation
Normal PR interval 0.12-0.2 seconds
Normal QRS interval 0.04-0.1 seconds
Normal ST segment Watch for: Ischemia (depression) Infarction (elevation)
What questions to ask when figuring out a rhythm 1. Regular or not 2. Rate 3. Does it have a P wave? 4. What is the QRS like? 5. T wave 6. Is there a U wave?
What does fibrillation look like? Jello
What does flutter look like? Shark tooth
Normal setting for sensitivity/gain 10 mV/sec
Normal setting for paper speed 25 mm/sec
If the QRS complexes are too tall... Change the sensitivity to 5 mV/sec
If the rate is too fast to read... Change paper speed to 50 mm/sec
What causes irregularity in children? Respiration
What accomodations do you make for an infant? Place limb leads on the torso to reduce artifact
What accomodations do you make for children under 8 years old? Place v1-v6 on the right
ST elevation signifies... Myocardial Infarction
ST depression signifies... Myocardial Ischemia
Lead placement of v1 right of sternum, 4th intercostal space
Lead placement of v2 left of sternum, 4th intercostal space
Lead placement of v3 between v2 and v4, 5th intercostal space
Lead placement of v4 Midclavicular line, 5th intercostal space
Lead placement of v5 Between v4 and v6, 5th intercostal space (anterior axillary)
Lead placement of v6 Midaxillary line, 5th intercostal space
Lead placement of v7 Between v6 and v8, 5th intercostal space (posterior axillary)
Lead placement of v8 Midscapular line, 5th intercostal space
Lead placement of v9 Parallel to v8, 5th intercostal space
Blood comes from body through Superior and Inferior Vena Cava to... Right Atrium
Blood comes through the tricuspid valve from the right atrium to... Right Ventricle
Blood goes through the Pulmonary Semilunar valve from the right ventricle to... Pulmonary artery
Blood goes from the pulmonary artery to... The right and left lungs
Blood comes from the lungs back to the heart through... Pulmonary veins
Blood comes from the pulmonary veins into the... Left Atrium
Blood comes from the left atrium through the bicuspid/mitral valve into... Left Ventricle
Blood goes from the left ventricle through the aortic semilunar valve to... The Aorta
The Aorta carries blood to... The entire body
The right side of the heart is... Deoxygenated
The left side of the heart is... Oxygenated
If there are inverted P waves... The rhythm is junctional
Pathologic Q waves means... Myocardial infarction
If patient is on medicine for hypertension... They could become hypotensive
If for any reason you cannot finish a stress test... Notify physician
Reasons to stop a stress test 1. Elevated or depressed ST segment 2. Lowered blood pressure 3. Lowered heart rate 4. Dizziness 5. Hyperventilation
60-cycle interferance Caused by other electronics
Somatic tremors Caused by muscle movement
Natural pacemaker of the heart SA node
Appropriate clothing for stress test Baggy clothes and tennis shoes
Rhythm: Regular Rate: 60-100 bpm P waves: 1:1 and alike PR interval: 0.12-0.20 seconds QRS interval: < or = 0.12 seconds Normal Sinus Rhythm
Rhythm: Regular Rate: <60 bpm P waves: 1:1 and alike PR interval: 0.12-0.20 seconds QRS interval: < or = 0.12 seconds Sinus Bradycardia
Rhythm: Regular Rate: >100 bpm P waves: 1:1 and alike PR interval: 0.12-0.20 seconds QRS interval: < or = 0.12 seconds Sinus Tachycardia
Rhythm: Irregular Rate: 60-100 bpm P waves: 1:1 and alike PR interval: 0.12-0.20 seconds QRS interval: < or = 0.12 seconds Sinus Arrhythmia
Rhythm: Irregular due to 1.40 second pulse Rate: Variable (can be brady) P waves: 1:1 and alike, isoelectric during pause PR interval: 0.12-0.20 seconds, isoelectric during pause QRS interval: < or = 0.12 seconds, isoelectric during pause Normal Sinus with a Sinus Arrest
Rhythm: Usually regular Rate: Variable (can be brady) P waves: 1:1 and alike PR interval: >0.20 seconds QRS interval: < or = 0.12 seconds Normal Sinus with a First Degree Heart Block
Rhythm: Irregular Rate: Variable P waves: More Ps than QRS complexes PR interval: Lengthens until P wave with dropped QRS QRS interval: < or = 0.12 seconds Wenckebach/ Second Degree Heart Block Type 1/ Mobitz 1
Rhythm: Regualar or Irregular Rate: Variable P waves: More Ps than QRS complexes PR interval: Regular QRS interval: < or= 0.12 seconds Classical/ Second Degree Heart Block Type 2/ Mobitz 2
Rhythm: Regular Rate: 20-60 bpm P waves: More Ps than QRS complexes PR interval: Different throughout QRS interval: < or = 0.12 or wide and bizarre Third Degree Heart Block/ Complete Heart Block
Rhythm: Regular Rate: >100 bpm P waves: Different or hidden in preceding T wave PR interval: If P is present, 0.12-0.20 seconds QRS interval: < or = 0.12 seconds Atrial Tachycardia
Rhythm: Regular or Irregular Rate: Variable P waves: F waves and sawtooth pattern PR interval: None QRS interval: < or = 0.12 seconds Atrial Flutter
Rhythm: Always irregular Rate: SVR<60, CVR 60-100, RVR>100 bpm P waves: Wavy baseline PR interval: None QRS interval: < or = 0.12 seconds Atrial Fibrillation
Rhythm: Regular Rate: 40-60 bpm P waves: Inverted and fall before, during or after QRS PR interval: Maybe < 0.12 seconds QRS interval: < or = 0.12 seconds Junctional
Rhythm: Regular Rate: >100 bpm P waves: Unsure PR interval: Unsure QRS interval: < or + 0.12 seconds Supraventricular Tachycardia
Rhythm: Regular interrupted by early beat Rate: Variable P waves: Different or hidden in preceding T wave PR interval: 0.12-0.20 seconds QRS interval: < or = 0.12 seconds Premature Atrial Contraction
Rhythm: Regular interrupted by early beat Rate: Variable P waves: Inverted and fall before, during or after QRS PR interval: Maybe < or = 0.12 seconds QRS interval: < or = 0.12 seconds Premature Junctional Contraction
Rhythm: Regular interrupted by early beat Rate: Variable P waves: None PR interval: None QRS interval: Wide and Bizarre Premature Ventricular Contraction
Rhythm: Regular Rate: 20-40 bpm P waves: None PR interval: None QRS interval: Wide and Bizarre Idioventricular
Rhythm: Regular Rate: >100 bpm P waves: None PR interval: None QRS interval: Wide and bizarre Ventricular Tachycardia
Rhythm: Chaotic- can't distinguish Rate: Can't distinguish P waves: Can't distinguish PR interval: Cant distinguish QRS interval: Can't distinguish Ventricular Fibrillation
Rhythm: Isoelectric line, or nearly so Rate: 0 bpm P waves: 0 PR interval: 0 QRS interval: 0 Asystole
Rhythm: Regular (on monitor) Rate: Variable P wave: 1:1 and alike PR interval: 0.12-0.20 seconds QRS interval: < or = 0.12 seconds Pulseless Electrical Activity
Heart block that looks normal, PR is greater than 0.20 seconds 1st Degree Heart Block
Heart block with dropped beats, more Ps than QRS waves, PR gets bigger until beat dropped 2nd Degree Heart Block Type 1 ( Wenckybach)
Heart block with dropped beats, more Ps than QRS complexes, Pr is 0.2< but still drops beats 2nd Degree Heart Block Type 2 (Mobitz II)
Heart block with no relationship between atria and ventricles 3rd Degree Heart Block (Complete Heart Block)
Created by: Martinafulgieri
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