APK4125C - Lab 2 Quiz

diagnose; heart

Purpose of ECG Testing:

An ECG is often used (often in conjunction with other tests) to help _____ and monitor conditions affecting the _____

chest; palpitations; shortness

Purpose of ECG Testing:

It can be used to investigate symptoms of possible heart problems such as _____ pain, _____, dizziness, and _____ of breath

Arrhythmias; ischemia

Purpose of ECG Testing:

ECG can help detect

- _______

- Coronary Heart Disease

- Heart _____ (heart attacks)

- Cardiomyopathy

action potentials

ECG is an accumulation of _____

12; 2; 3; 6

A _____-lead ECG is most often used in the health field, however a ___-lead, ___-lead, ____-lead and many other variations can be used.

conductive pad; electrical

An ECG electrode is simply a ______ that is attached to the skin to record changes in _____ activity

electrical potential difference

Any pair of electrodes can measure the _____ between the two corresponding locations of attachment

bipolar lead

an ECG lead that consists of two surface electrodes of opposite polarity (one positive and one negative)

unipolar lead

an ECG lead that consists of one positive surface electrode and a reference point

electrical

Each lead gives an opportunity to look at the heart from a different ______ position

10

For the common 12-lead ECG, ______ electrodes are positioned on the body

positive

depolarization of the heart towards the positive electrode produces a ______ deflection

negative

depolarization of the heart away from the positive electrode produces a _____ deflection

towards

repolarization of the heart ______ the positive electrode produces a negative deflection

away

repolarization of the heart _____ from the positive electrode produces a positive deflection

0.04

Reading amplitude and time on ECG:

On the x-axis, the small box is _____ seconds

right arm to left arm

Lead I

right arm to left leg

Lead 2

left arm to left leg

Lead 3

left arm

the _____ lead can be positive or negative

right arm

the _____ is negative

left leg

the _____ is positive

true

T/F: electrodes go from negative to positive

II, III, aVF

Which leads look at the inferior wall of the heart?

V1, V2

Which leads look at the septum of the heart?

V3, V4

Which leads look at the anterior wall of the heart?

I, aVL, V5, V6

Which leads look at the lateral wall of the heart?

I, aVL, V5, V6

Which leads align with the left circumflex artery (Circ)?

II, III, aVF

Which leads align with the right coronary artery (RCA)?

V1, V2, V3, V4

Which leads align with left anterior descending artery (LAD)?

aVR

____ doesn't line up with anything

infraclavicular; medial; below

Electrode Placement for 12-Lead ECG:

Right arm

Right _____ fossae, _____ to the deltoid muscle, roughly 2cm ____ border of clavicle

fossae; deltoid; clavicle

Electrode Placement for 12-Lead ECG:

Left arm

Left infraclavicular ____, medial to the _____ muscle, roughly 2cm below border of _____

anterior axillary; costal

Electrode Placement for 12-Lead ECG:

Left Leg

In line with left _____ line, halfway between ____ margin and iliac crest

halfway; iliac crest

Electrode Placement for 12-Lead ECG:

Right Leg

In line with right anterior axillary line _____ between costal margin and ______

4th; right

Electrode Placement for 12-Lead ECG:

V1

_____ intercostal space ____ sternal edge

4th; left

Electrode Placement for 12-Lead ECG:

V2

_____ intercostal space ____ sternal edge

V2; V4

Electrode Placement for 12-Lead ECG:

V3

Midway between ____ and _____

5th; clavicular

Electrode Placement for 12-Lead ECG:

V4

_____ Intercostal space, mid-_____ line

Anterior axillary; V4

Electrode Placement for 12-Lead ECG:

V5

______ line in straight line with ____

Mid; V4; V5

Electrode Placement for 12-Lead ECG:

V6

_____-axillary line in straight light with _____ and _____

V4; V5; V6

Electrode Placement for 12-Lead ECG:

_____, ____ and ____ may need to be altered in female patients due to breast tissue, place electrode as close as possible to anatomical location directly under breast)

inferior; rightward

Electrode Placement for 12-Lead ECG:

Because of the altered location of the limb electrodes, Q waves in the _____ leads may be mased and there is mild _____ shift in the QRS axis.

Locate; hair; clean; water; abrasive; Explain; before; center; air

ECG Electrode Placement Protocol:

- _____ anatomical areas that will be used.

- Prepare skin by removing any excessive _____

- If possible _____ each site thoroughly with soap and ____ (preferable to alcohol wipe; alcohol dries the skin and can diminish electrical flow)

- Use ECG skin prep pad, paper or _____ tape (removes the stratum corneum to allow better electrical signals and scratches stratum granulosum to reduce motion artifact)

- ______ the electrode application procedure to the patient to decrease anxiety

- When only one patient is present, attach the lead wire to the electrode _____ placement

- Apply the electrode by pressing around the entire edge of the electrode _____ since it spreads the gel out and may create _____ pockets that contribute noise.

atrial depolarization

P wave represents ______

P-wave; Q-wave; atrial depolarization; ventricular activation

PR interval is actually the PQ interval. Measured from the start of the _____ to the beginning of the _____. So PR is actually a misnomer. Measures from the start of _____ to start of ______.

end; QRS; atrial; ventricular

PR segment is from the ____ of the P wave to the beginning of the _____ segment. It represents the the time delay between _____ and _____ activation.

ventricular depolarization; larger

QRS complex represents ______. Much _____ than the P wave because of the amount of muscle mass in the ventricle.

absolute refractory period; onset

ST segment represents the _______ (plateau of the action potential) of the ventricular contractile cells. Measures from J point to the _____ of T-wave. (Elevation or depression of ST is based off of PR segment)

ventricular repolarization

T Wave represents ______

depolarization; repolarization; arrhythmias

QT Interval represents the complete _____ and _____ on the ventricular tissue. A prolonged repolarization can lead to life-threatening ______.

upright; Q; 60-100

Sinus Rhythm:

- The P wave is _____ in leads I and II

- Each P wave is followed by a _____

- The heart rate is _____ beats/min

Tachyarrhythmia

______ is defined as an abnormal rhythm with a ventricular heart rate over 100bpm

Supraventricular

______ Tachycardia: Arrhythmia originating from above the AV node

- Atrial Fibrillation

- Atrial Flutter

- Atrial tachycardia

Ventricular

______ Tachycardia

- ventricular fibrillation

- ventricular tachycardia

Bradyarrhythmia

_____ is defined as a heart rate below 60 beats and comprises multiple disorders

- Sinus bradycardia

- First degree AV Block

- Second Degree AV Block

- Third Degree AV Block

- SA Node Exit Block

isoelectric

Normal ST segment is flat and ______.

height; baseline

ST segment deviation (elevation or depression) is measured as the _____ difference between the J point and the _____ (PR segment).

5

ST segment depression _____ mm or more is considered pathological.

Upsloping

_______ ST segment depression naturally occurs during exercise and should be considered normal

ischemia

Downsloping or horizontal ST segment depression is typical of _____.

elevation

ST segment _____ can be indication of ischemia as well