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5EKG

tiny details

QuestionAnswer
1 big box is how many seconds? .2s
1 small box is how many seconds? .04s
1 big box has how many little boxes ? 5
PR interval is how long and how many boxes? .12-.2 s and 3-5 little boxes
Name two short PR interval diseases Wolf Parkinson White (WPW) and Lang-Ganong-Levine (LGL)
What’s WPW short PR; young adult’s bundle of kent when high catecholamines; delta wave encroaches
What’s LGL? short PR; in James bundle
What is a long PR interval? AV nodal blocks
How long is the QRS interval? .4-.12 seconds
What are wide QRS pathologies? vent. Tachycardia, L/R BBB
QT interval is how long? .3-.4 s
Describe the limb leads (Einth. frontal p): angle, and degree and + vs - 1RA-LA+ 0; 2RA-RF+ 60; 3LA-LF+120
Describe Augmented leads: Unipolar leads; AVR-150,AVL -30, AVF +90 Frontal plane too
Describe V leads aka Precordial leads v1-6; horizontal plane; R wave progression
What are the anterior leads and what pathologies do they look at? V3 and V4; LAD
What are the lateral leads and what do they look at? I, V5, V6; Lcx
What are the septal leads and what do they look at? v1&V2; septal branch of LAD
What are the inferior leads and what do they do? II, III, avF; RCA
What is the normal sinus rhythm between? 60-100 bpm
Asdf asdf
Atrial Flutter has what rate and what pattern? 250-350; sawtooth
List some common atrial cell problems PAC, atrial flutter, atrial fibrillation
What are AV junctional problems? Paroxysmal supraventricular tachycardia, AV junctional (nodal blcks
What is lost in paroxysmal supraventricular tachycardia? P waves (there’s continuous firing here)
What are ventricular cell problems? PVCs, ventricular fib, ventricular tachycardia, v fib, torsades de pt.
Which ventricular cell problems fire from multiple foci? Ventricular fib, sometimes PVCS,
QT interval should be what in relation to RR interval Half of RR interval
PR interval should be what if normal? less than .2
If PR interval is greater than .2 what might this indicate? 1st degree AV block via prlonged conduction delay@ B of His
What’s 2nd AV blockI winkiblock-PR interval progressively increases and then stops: P & no QRS: AV n. delays then fails
What’s 2nd AV block II? P wave & no QRS; PR interval the same the whole time; Block in bundle of His
What’s 3rd AV block? atria and ventricles don’t communicate-need pacemaker, P wave blocked, 30-45 bpm
ST segement elevation indicates what pathology? Acute MI Q wave; transmural infarction
J point is what? junction btw S and T waves: isoelectric
Which leads are inferior? II, III, AVF
Which leads are lateral? I, avL, V4-V6
Anterior leads are? V2-V4
How do you determine posterior infarction? R >S V1, V2, V3 and ST segment depression in those leads
How low is the heart rate in RCA occlusion? less than 60bpm
What is an ST segment depression? myocardial ischemia
What’s nonST elevation MI? Non-q wave MI-subendocardial infarc. w/EKG changes w/time-ST depression=nonspecific
What is fibrosis distinguished by? ST segments and T waves go back to normal but there are still Q waves
What is a T wave inversion indicative of? And what is this called?
Time and amplitude of a normal Q wave are what? < . 04 seconds & <25% amplitude of R wave
L ventricular hypertrophy identified by? R wave in I + S in lead III> 25mm or tallest R in V5/6+deepest S in V1/2=35mm>
How is R Ven Hypertrophy ided? V1 has r-s ratio >1 or R>5mm and S<2mm
R Atrial Enlarg. is dxed how? II has P>2.5mm or V1 or V2 has a P wave of >1.5mm
PR interval should be what if normal? less than .2
If PR interval is greater than .2 what might this indicate? 1st degree AV block via prlonged conduction delay@ B of His
What’s 2nd AV blockI winkiblock-PR interval progressively increases and then stops: P & no QRS: AV n. delays then fails
What’s 2nd AV block II? P wave & no QRS; PR interval the same the whole time; Block in bundle of His
What’s 3rd AV block? atria and ventricles don’t communicate-need pacemaker, P wave blocked, 30-45 bpm
ST segement elevation indicates what pathology? Acute MI Q wave; transmural infarction
J point is what? junction btw S and T waves: isoelectric
Which leads are inferior? II, III, AVF
Which leads are lateral? I, avL, V4-V6
Anterior leads are? V2-V4
How do you determine posterior infarction? R >S V1, V2, V3 and ST segment depression in those leads
How low is the heart rate in RCA occlusion? less than 60bpm
What is an ST segment depression? myocardial ischemia
What’s nonST elevation MI? Non-q wave MI-subendocardial infarc. w/EKG changes w/time-ST depression=nonspecific
What is fibrosis distinguished by? ST segments and T waves go back to normal but there are still Q waves
What is a T wave inversion indicative of? And what is this called?
Time and amplitude of a normal Q wave are what? < . 04 seconds & <25% amplitude of R wave
L ventricular hypertrophy identified by? R wave in I + S in lead III> 25mm or tallest R in V5/6+deepest S in V1/2=35mm>
How is R Ven Hypertrophy ided? V1 has r-s ratio >1 or R>5mm and S<2mm
R Atrial Enlarg. is dxed how? II has P>2.5mm or V1 or V2 has a P wave of >1.5mm
Wandering pacemaker # SA node to atrial foci; normal rate, but irregular P waves
Multifocal atrial tachycardia #COPD patients rate >100 with irregular P waves (similar to wandering pacemaker)
Junctional Escape rhythm #series of lone QRS complexes 60-80bpm; inverted P waves
Atrial escape rhythyms P waves aren’t identical to the P wave before anymore: Paces 40-60 bpm
Ventricular escape rhythm enormous QRS complexes 20-40 bpm; pt is unconscious: stokes-adams syndrome
Escape beat transient focus escape; similar pattern
Premature beats earlier than expected;
Atrial bigeminy irregular P wave every other cycle
Atrial trigeminy irregular P wave every third cycle
Premature ventricular Contraction (PVC) have huge ventricular complex: opposite of QRS think coronary block; cocaine
V-tach three or more PVCs in rapid succession
PR interval should be what if normal? less than .2
If PR interval is greater than .2 what might this indicate? 1st degree AV block via prlonged conduction delay@ B of His
What’s 2nd AV blockI winkiblock-PR interval progressively increases and then stops: P & no QRS: AV n. delays then fails
What’s 2nd AV block II? P wave & no QRS; PR interval the same the whole time; Block in bundle of His
What’s 3rd AV block? atria and ventricles don’t communicate-need pacemaker, P wave blocked, 30-45 bpm
ST segement elevation indicates what pathology? Acute MI Q wave; transmural infarction
J point is what? junction btw S and T waves: isoelectric
Which leads are inferior? II, III, AVF
Which leads are lateral? I, avL, V4-V6
Anterior leads are? V2-V4
How do you determine posterior infarction? R >S V1, V2, V3 and ST segment depression in those leads
How low is the heart rate in RCA occlusion? less than 60bpm
What is an ST segment depression? myocardial ischemia
What’s nonST elevation MI? Non-q wave MI-subendocardial infarc. w/EKG changes w/time-ST depression=nonspecific
What is fibrosis distinguished by? ST segments and T waves go back to normal but there are still Q waves
What is a T wave inversion indicative of? And what is this called?
Time and amplitude of a normal Q wave are what? < . 04 seconds & <25% amplitude of R wave
L ventricular hypertrophy identified by? R wave in I + S in lead III> 25mm or tallest R in V5/6+deepest S in V1/2=35mm>
How is R Ven Hypertrophy ided? V1 has r-s ratio >1 or R>5mm and S<2mm
R Atrial Enlarg. is dxed how? Tall P waves in II, III, and avF; II has P>2.5mm or V1 or V2 has a P wave of >1.5mm
Causes of Right atrial enlarge Pulmonary htn; copd, RVH
L atrial enlargement Notching in II >1 box; (-) deflection of P in V1-> 1 box wide and 1 box deep
Causes of LAE? from LVH via HTN
BBB are what ? Intraventricular conduction delays which manifest as long QRS
What do BBB look like? 2 R waves R and R’bunny ears
Where are the R waves in R and L BBB? V1 R and V6 L
What form can RBBB have? RSR’ and R-R’
What is the length of complete BBB? >.12
Created by: VCOM2013