Electrocardiogram

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a portable version of an EKG that is worn under the close by the patient for 24 to 48 hour.

Holter monitor

on a Holter monitor chest electrodes are connected to the monitor and cardiac TV is continually monitored when?

while the patient goes about his usual daily activities.

a Holter monitor is worn by a patient for how long?

24 to 48 hours as instructed by a physician.

the recording is scanned by an electro cardio scanner and?

a hard copy of the ECG is produced for review by the physician

Aholt about your is used to detect ECG abnormalities that may occur over?

unexpanded. The time

besides ECG abnormalities what Cao Holter monitor evaluate?

the effectiveness of any anti-arrhythmic drugs and to associate the occurrence of chest pain with stress or physical activity

what are the two types of Holter monitors?

looping and non-looping

what does a looping Holter monitor do?

it loops the activity so when the patient pushes the button to record it can record a few seconds before they push the button to a few seconds after

what does a non-looping Holter monitor do?

it only begins to record when the patient pushes the button.

the electrical impulses generated by the?

SA node

another name for the SA node?

pacemaker

the waves of depolarization move through the atria causing contraction

P-wave

the impulse is received by the AV node where is delayed for a short time

PR interval

the stimulus is then sent to the bundle of HIS and the left and right bundle branches to the Purkinje fibers. This produces the ventricle depolarization and contractions

QRS complex

a short delay after the QRS complex

ST segment

the heart re-polarizes

T wave

how long does one small horizontal square and EKG paper represent

.04 seconds

how long does one large horizontal square EKG paper represent

.20 seconds

how much voltage does 10 vertical small blocks or two vertical large blocks represent EKG paper?

1 mV

one small block of EKG paper equals what size?

1 mm

one large block of ECG paper equals what size?

5 mm

how many and where are the limb lead placed?

there are four limb leads one placed on each limb

how many chest leads are there?

six

what is the electrode?

an object place in the skin to to conduct electrical current from the body to a monitoring or measured device

what is a lead?

a positive and negative electrode that allows electrical current to flow

what adjust which electrode will be positive and which will be negative

the ECG machine

what happens when the impulse of the heart moves towards the positive electrode

an upward deflection is made on the ECG paper

what would cause a downward deflection made on the ECG paper?

the impulse of the heart moving towards the negative electrode

how many leads are used?

12

how many limb leads & precordial are there?

six each

how many electrodes are used?

10, six and the chest and one on each limb

lead 1 is?

left arm positive, right arm negative

lead 2 is?

left leg positive, right arm negative

lead 3 is?

left leg positive, left arm negative

AVR is?

right arm positive, everything else negative

AVL is?

left arm positive, everything else negative

AVF is?

left leg (foot) positive, everything else negative

are the chest leads positive or negative?

all chest leads or positive

where is V1 placed

fourth intercostal space, right side of the sternum

where is V2 placed

fourth intercostal space, left of the sternum

what part of the heart does V1 and V2 look at

right side

where is V3 placed

between V2 and V4 on the left side

where is V4 placed

fifth intercostal space, left mid-clavicle line

what part of the heart does V3 and V4 look at

ventricular septum

where is V5 placed

between V4 in V6 on the left side

where is V6 placed

fifth intercostal space, left mid auxiliary line

what part of the heart does V5 and V6 look at

left heart

what are the rates of; bradycardia, tachycardia, flutter, fib, and normal heartbeats

<60 bradycardia, >100 tachycardia, >200 flutter, fib is too fast account, 60 to 100 normal heart rate

what you waves to use to estimate the rate of in EKG

the R waves

if there are 3 to 5 large box between R waves, what is the rate

60 - 100

if the R waves are closer than three large box then what is the rate

>100 tachycardia

if the R waves are wider than five large blocks than what is the rate

<60 bradycardia

heart rate equals 300 divided by what?

large blocks between R waves

heart rate equals 1500 divided by what?

small blocks between R waves

if the P-wave goes up on the paper that means

it's a positive sinus

the treatment for normal sinus rhythm

nothing

the treatment for sinus tachycardia

oxygen

the treatment for sinus bradycardia

atropine, oxygen

the treatment for PVCs

oxygen, lidocaine

the treatment for V Tach

defibrillate if no pulse, lidocaine and cardiovert if pulses present

treatment for V fib

defibrillate

treatment for multifocal PVCs

oxygen, lidocaine

treatment for Asystole

confirm 2 leads, Epinephrine, atropine

treatment for her first-degree AV block

atropine

treatment for second-degree AV block

atropine, electrical pacemaker

treatment for third-degree AV block

electrical pacemaker

what rhythm has a rate of 60 - 100 with no skips were no extra beats

NSR or normal sinus rhythm

sinus rhythm with the rate >100

sinus tachycardia

sinus rhythm with the rate <60

sinus bradycardia

sinus rhythm with premature ventricular contractions

PVC

ventricular rhythm with the rate >100

V tach

ventricular rhythm that is completely irregular

V fib

rhythm that shows no activity

Asystole

PR interval >.20

first-degree AV block

irregular rhythm, normal P waves but the QRV complexes missing

second-degree AV block

atrial rate >60, ventricular rate <40, PR intervals cannot be determined, QRS complex will be widened

third-degree AV block

what does the axis of the ECG measure

the direction of all electricity to the heart during contraction

normally what corner does the electrical impulse of the heart begin at

upper right-hand corner at the SA node in the right atrium

what direction does the electrical impulse travel in the heart

down and across the heart to the left

normal axis direction

down into the left

what are the two factors that affect direction

hyper trophy, and infarction

what is ischemia

reduce blood flow in the tissue

what is injury

acute damage to tissue, often from ischemia

what is infarction

necrosis or death of the tissue may be recent ( acute) or old

on a ECG what represents ischemia

a depressed or inverted T wave

on a ECG what represents injury

an elevated ST segment

Anna ECG what represents infarction

significant Q waves, half the height of R wave or one small square wide

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