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EKG Certification
Cardiology
| Question | Answer |
|---|---|
| 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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