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87 terms

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