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EKG week 4 & 5

Waveforms & Leads

waveforms created by Dr. Einthoven credited for the first three leads Einthoven's triangle
letters of waveforms P Q R S T U
isoelectric line baseline - has no polarity - invisible
above the isoelectric line is positive
below the isoelectric line is negative
Pwave first wave mark-atrial depolarization- starts at SAnode to internodol pathways to AVnode
TAwave atrial repolarization NOT SEEN ON EKG
QRS Complex ventricular depolarization- starts after the Pwave can start + or - ends at the isoeletric line/ is one of the largest wave line.
Jpoint is where the QRS ends at the isoelectric line and ST segment begins
STwave ventricle depolarization begins at Jpoint ends at Twave sodium is exiting and potassium is entering
ST segment ending depolarization going towards repolarzation starts after Jpoint in normal EKG run w/ isoelectric line
Twave total ventricular repolarazation potassium inside and sodium outside
ST + Twave elevation + acute lack of oxygen to the myocardium
ST + Twave depressed - Ischemia shows signs of heart damage
Ischemia heart damage
Uwave Hypokalemia low patassium
waveforms movement away from the isoelecric line they can be + or -
intervals is a waveform + a segment PR interval & QT interval
segments isoelectric event between wave forms ST segment
complex several waveforms QRS complex
PR segment AV delay
PR interval from the start of the Pwave to the beginning of the QRS complex starts at SAnode to internodal pathways to AVnode
Rwave Positive waveform any positive wave in the QRS is Rwave
Qwave negative waveform BEFORE the Rwave shows damage to the heart
Swave negative waveform AFTER the Rwave
R prime R1 is a second Rwave
S prime S1 is a second Swave
QT interval ventricular depolarization ventricular repolarization begins at the beginning of the QRS ends at the end of the Twave
1 small box time is .04 seconds
1 vertical box is voltage = 1 milmeter of voltage
5 small boxes in time = .20 seconds
5 large boxes in time = 1 second
15 large boxes in time = 3 seconds
30 large boxes in time = 6 seconds
rhythm can be regular or irregular
irregular heart rate rule in 6 seconds how many QRS complexes X 10 = heart rate
regular heart rate rule 300, 150, 100, 75, 60, 50, 43 BPM
leads I, II & III also known as Einthoven's Triangle
how many leads on EKG 12 leads
lead I -R arm to +L arm bipolar is always going to have a positive QRS always on Rwave
lead II -R arm to +L leg bipolar right leg always ground green common for arrhythmia it has the most prominent Pwave
lead III -L arm to +L leg bipolar NOT use for arrhythmias placed on
augmented leads +AVR=R arm +AVL=L arm +AVF=L leg augmented voltage unipolar & positive. looking from the inside out. enlarged on the EKG not used for arrhythmias
lead V1 4th intercostal space right side of sternum percordial unipolar positive
Percordial leads V1,V2, V3, V4,V5 & V6 need to be put in the right spot EVERY SINGLE TIME! never on a bone are unipolar and positive.NOT ON BONE
lead V2 4th intercostal space on left side of sternum pericordial unipolar positive
lead V4 5th intercostal space at the mid clavicular line percordial unipolar positive
lead V3 between V2-V4 in the 5th intercostal space percordial unipolar positive
lead V6 midaxillary line in line with V4 on side percordial unipolar positive
lead V5 5th intercostal space between V4-V6 percordial unipolar postive
normal sinus rhythm NSR regular sinus rhythm RSR rhythm regular 60-100 bpm PR interval .12-.20 QRS complex .04-.11
sinus tachycardia rhythm regular 100-150 bpm PR interval .12-.20 QRS complex .04-.11
sinus bradycardia rhythm regular 60-40 bpm PR interval .12-.20 QRS complex .04-.11
sinus arrhythmia rhythm slightly irregular 60-100bpm PR interval .12-.20 QRS complex.04-.11
Created by: joanneb