EKG Workshops

A wave of depolarization traveling
towards a positive EKG electrode
causes a/an ________ deflection on
the EKG tracing

A wave of depolarization traveling
away from a positive EKG electrode
causes a/an ________ deflection on
the EKG tracin

A wave of repolarization traveling towards a positive EKG electrode
causes a/an ________ deflection
on the EKG tracin

A wave of repolarization traveling away from a positive EKG electrode
causes a/an ________ deflection
on the EKG tracin

this causes the p wave

this cases the QRS wavw

distance (time) from beginning of
P wave to beginning of QRS complex

distance (time) from beginning of
QRS complex to end of T wav

distance (time) from end of QRS
complex to end of T wave
(includes the T wave but not the QRS complex)

what causes the PR segment

plateu phase of evntricular repolarization

entire ventricular repolarization phase

rapid phase of ventricular repolarozation

what occurs during the QT interval?

what occurs during the U wave?

the vertical axis of an EKG represents voltage and at standard cal is ______

the horixontal axis of the EKG represents time and at standard cal is _________

equation for determining b/min on regular EKG rythms

how do you determine b/min for irregular rythmns

the 6 limb leads allow determination of axis in this plane

what are the limbleads of the frontal plane

what are the chest leads that allow deter,ination of axis in the horizontal plane

fr the limb leads, there are 3 ________ and 3 _________-

the bipolar ;limb leads have these electrodes

the augmeted unipolar limb leads have these electrodes

which of the limbs is the groundinh lomb where the grounding electrode is placed

where are the limb leads placed and wgere is the positive node placed? (bipolar)

which are the lateral leads

which are the inferior leads

how do you quickly determine QRS axis in the frontal plane (what lkeads)

A shift in the electrical axis out of
the normal range is referred to as:
 ________” in the frontal plan
"_________" in the horizontal plane

Simply stated, in determining the mean
QRS axis in the horizontal plane:
 If the R to S ratio changes from <1 to >1:
After V4 (i.e. V5, V6, or never), then this
is referred to as “______”
 At or before V2 (i.e. V1, or V2), then this
is referred to as “_______________on”
 After V2 and at or before V4, then the
axis in the horizontal plane is referred to
as “___________

horizontal plane if R to S ratio Starts < 1 and stays < 1, then this is
referred to as

horizontal plane R to S ratio starts >1 and stays > 1 then it is

horizontal plane if starts >1 ad becomes <1 by V6

QRS between -45 and -90 left axis devoation

QRS between 90 to 180 right axis deviation

Ability of specialized cells to
spontaneously generate electrical
impulses which may then spread
throughout surrounding tissue

Potential pacemakers within the heart

utomaticity foci in the heart

conduction rate atrial foci

conduction rate junctional foci

conduction rate vetricular foci

A protective mechanism whereby an automaticity focus with the next highest inherent rate begins pacing (escapesoverdrive suppression) in the event of a pause or cessation of pacing activity of the previously dominant pacemaker.

Transient escape of an automaticity focus (from overdrive suppression) to generate one beat.
 This occurs when there is a pausein pacing activity in the previously
dominant pacemaker.

Escape of an automaticity focus (from overdrive suppression) with subsequentpacing by that automaticity focus, at its inherent rate.
 This occurs when there is a cessation(or arrest) of pacing activity in the
previously dominant pacemaker.

normal rhythm of the heart

criteria of a sunus rhythm

normal sinus rhythm criteria

 Sinus rhythm with a heart rate less than 60 beats per minute

 Sinus rhythm with a heart rate
greater than 100 beats per minute

Same criteria as sinus rhythm andthere is greater than 0.16 sec.
difference between the shortest and the longest PP intervals within the same EKG tracing

what is this?

what is this?

what is this?

what is this?

what is this?

(positive in lead aVR and negative in lead II) immediately preceding (PR interval <120 msec) the QRS complex

(buried in the QRS complex or absent due to lack of retrograde AV conduction):

If the QRS complex is not prolonged (not >120 msec.), ventricular depolarization must have occurred via

 An increase in the tendency for
automaticity foci to spontaneously
generate electrical impulses

Occurs when an irritable automaticity focus spontaneously generates a single electrical impulse prior to the next
expected beat from the dominant
pacemaker

escape of an automaticity focus (from overdrive suppression) due to failure of the previously dominant pacemaker

irritability of automaticity focus

– every other beat is premature

every third beat is premature

every fourth beat is premature

sudden rhytm change

Heart rate < 60 beats per minute (bpm)

Heart rate > 100 bpm

 Rate between 250 and 350 bpm

 Rate between 350 and 450 bpm

 A “generic” term for any tachycardia originating above the ventricles

 Polymorphic ventricular tachycardia (VT) which is preceded by marked prolongation of the QT interval

bradyarrhythmias can de disorders of (x2)

Encompasses several SA nodal abnormalities:
Chronotropic incompetence
Sinus pause, arrest or exit block
Bradycardia-tachycardia syndrome:
Paroxysms of atrial tachyarrhythmias
alternating with slow atrial and ventricular
rates

what types of AV blocks can there be

what needs to be true to have a first degree AV block

what does this show?

Grouped beats
Groups or clusters of QRS complexes separated by “missed” single beats

Two P waves for every QRS complex, without groups or clusters of beats
All PR intervals will be the same (fixed/consistent)

There are more P waves than QRS complexes
All P waves that immediately precede QRS complexes have equal PR intervals
At times, there may be a fixed ratio of P waves to QRS complexes (e.g. 2-to-1*, 3-to-1, or 4-to-1, etc.)

Slowing of the previously dominant pacemaker, with subsequent junctional or ventricular escape rhythm

Acceleration of a latent pacemaker which usurps control of the ventricles

QRS duration > 120 msec.

Criteria for RBBB are not met

Criteria for LBBB are not met

how do you determine if its a left ventricular hypertrophy? (x2)

what does the T wave look like in a Left ventricular hypertrophy (left chest leads)

what 3 criteria strongly suggest rught ventricular hypertropy?

what must be present in early repolarization St elevations

clinical significance early repolarization ST elevation

what is required fir acute pericarditis ST elivation

clinical cause of acute pericarditis ST elivation

what is required for acute MI St elevation

clinical cause of acute MI St elevation

what can cause deep symmetrically inverted T waves

what can cause significant Q waves

what signifies a significant Q wave

Always order______________-sided chest
leads when there is evidence of
an acute inferior wall MI on the
standard 12-lead EKG!