NREMT® Paramedic > EMT-P (2) Cardiology and Resuscitation > Electrophysiology > Flashcards

Electrophysiology Flashcards

Essential practice and understanding of the electrical activity of the heart (60 cards)

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1
Q

Where are the limb leads placed?

A
  • R leg and L leg
  • R arm and L arm
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2
Q

List ways to ensure the best ECG reading.

A
  • shave body hair
  • remove oils
  • attach to cables prior to placement
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3
Q

What are the limb leads?

A

I, II, III, aVR, aVL, aVF

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4
Q

What are the precordial leads?

A

V1 - V6

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5
Q

If you are obtaining a 12-lead ECG, how should you alter the placement of the limb leads?

A

Leads should be placed on the wrists and ankles.

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6
Q

Describe the placement of V1-V6 precordial leads.

A

V1:

  • right of sternum
  • 4th ICS

V2:

  • left of sternum
  • 4th ICS

V3:

  • midway
  • between V2 and V4

V4:

  • midclavicular
  • 5th ICS

V5:

  • anterior axillary line
  • 5th ICS

V6:

  • midaxillary line
  • 5th ICS
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7
Q

How is a posterior ECG obtained?

A
  • V7: Between V6 and V8
  • V8: Left midscapular line
  • V9: Left paraspinal line

5th ICS

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8
Q

Define:

Augmented Unipolar Leads

A

It contains one true pole, and the other end is referenced against other leads.

aVR, aVF, aVL

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9
Q

Define:

Bipolar Leads

A

Each of the leads has positive and negative poles.

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10
Q

How much time passes in one small box of ECG paper?

A

0.04 seconds

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11
Q

How many small boxes are inside one large box of ECG paper?

A

5

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12
Q

How much time passes in one large box of ECG paper?

A

0.20 seconds

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13
Q

What does the P wave represent?

A

atrial depolarization

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14
Q

What does the PR interval represent?

A

Atrial depolarization and impulse conduction through the AV node.

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15
Q

What does the QRS complex represent?

A

ventricular depolarization

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16
Q

What does the J Point represent?

A

End of depolarization and beginning of repolarization.

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17
Q

What does the ST Segment represent?

A

early ventricular repolarization

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18
Q

What does the T wave represent?

A

ventricular repolarization

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19
Q

What is the first half of the T wave?

A

absolute refractory period

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20
Q

What is the second half of the T wave?

A

relative refractory period

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21
Q

What does the QT interval represent?

A

Electrical activity of one ventricular cycle.

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22
Q

How do you use the 6 second method for calculating the HR on ECG paper?

A

Count the QRS complexes in a 6 second ECG strip and multiply by 10.

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23
Q

What is the sequence method for determining HR on ECG paper?

A

Find an R wave and count with the sequence below until you reach the next R wave for each large box.

300, 150, 100, 75, 60, 50

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24
Q

Rhythm:

A

Normal sinus

  • HR 60-100 bpm
  • P waves present
  • regular rhythm
  • narrow <120 ms QRS
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25
# Rhythm:
**Sinus Tachycardia** * HR \> 100 bpm * P waves present * regular rhythm * narrow \<120 ms QRS
26
# Rhythm:
**Sinus Bradycardia** * HR \< 60 bpm * P waves present * regular rhythm * narrow \<120 ms QRS
27
# Rhythm:
**Sinus Dysrhythmia** * HR 60-100 bpm * P waves present * regular rhythm * narrow \<120 ms QRS * Slightly irregular rhythm that varies with respiration.
28
# Rhythm:
**Sinus Arrest** * HR 60-100 bpm * P waves present * regular rhythm * narrow \<120 ms QRS * Sudden pause in rhythm to indicate cessation of sinus contraction.
29
# Rhythm:
**Atrial Flutter** * HR 60-100 bpm * P waves present; 3:1 conduction * regular rhythm * narrow \<120 ms QRS
30
# Rhythm:
**Atrial Fibrillation** * Irregular HR/QRS. * No discernible P waves. * narrow \<120 ms QRS
31
# Rhythm:
**Supraventricular Tachycardia** * HR \> 150 bpm * P waves present (sometimes blends with T wave) * regular rhythm * narrow \<120 ms QRS
32
# Rhythm: ## Footnote *Hint: Complex*
**Premature Atrial Complex** * A complex within another rhythm * P waves present * narrow \<120 ms | PAC
33
# Rhythm:
**Junctional Escape Rhythm** * HR 40-60 bpm * P waves absent * regular rhythm * narrow \<120 ms QRS
34
# Rhythm:
**Accelerated Junctional** * HR 60-100 bpm * P waves absent * regular rhythm * narrow \<120 ms QRS
35
# Rhythm:
**Junctional Tachycardia** * HR \>100 bpm * P waves absent * regular rhythm * narrow \<120 ms QRS
36
# Rhythm: ## Footnote *Hint: Complex*
**Premature Junctional Complex** * complex within a rhythm * P waves absent * QRS \<120 ms
37
# Type of heart block.
**First degree heart block** * PR Interval \>200 ms * QRS \<120 ms * regular rhythm * P waves present
38
# Type of heart block.
**Second degree type I** * QRS \<120 ms * HR 60-100 bpm * PR interval progressively lengthens until a beat is dropped. * regular rhythm
39
# Type of heart block.
**Second degree type II** * PR interval is constant; several impulses do not contract. * QRS \<120 ms * HR 60-100 bpm * regular or irregular rhythm
40
# Type of Heart block.
**Third degree** * Impulses reaching the AV node are not conducted to the ventricles; ventricles become their own pacemaker. * ventricular rate \<60 bpm * SA rate 60-100 bpm * QRS \>120 ms (but can be \<120 ms)
41
# Rhythm:
**Idioventricular** * HR 20-40 bpm * P waves absent * regular rhythm * wide \>120 ms QRS
42
# Rhythm:
**Ventricular Tachycardia** * HR \>100 bpm * P waves absent * regular rhythm * wide \>120 ms QRS
43
# Rhythm: ## Footnote *Hint: Complex*
**Premature Ventricular Complex** * Complex within a rhythm. * P wave absent * QRS \>120 ms
44
# Rhythm:
asystole ## Footnote No electrical activity is present.
45
# Rhythm:
**Ventricular Fibrillation** * The heart is quivering, and there is no contraction of the heart. * No P waves or QRS. * chaotic baseline
46
# Rhythm:
**Ventricular Pacemaker** * wide QRS * Pacer spikes present before ventricular contraction.
47
# Rhythm:
**AV Sequential Pacemaker** * Pacer spikes before P waves and ventricular contraction.
48
# Name the axis deviation. **I** is up **aVF** is up
normal axis
49
# Name the axis deviation. **I** is up **aVF** is down
left axis
50
# Name the axis deviation. **I** is down **aVF** is up
right axis
51
# What is the Axis Deviation? **I** is down **aVF** is down
extreme right axis deviation
52
What type of bundle branch block is present? ## Footnote When you have a **QRS \>120 ms** and a **terminal R wave in V1**.
right bundle branch block
53
What type of bundle branch block do you have? ## Footnote When you have a **QRS \>120 ms** and **terminal S wave in V1**.
left bundle branch block
54
How do you determine **Right Ventricular Hypertrophy** in a 12-lead?
* large R wave in V1 * R wave in lead **aVR \>5 mm**
55
How do you determine **Left Ventricular Hypertrophy** in a 12-Lead?
* tallest R wave in V5/V6 + deepest S wave in V1/V2 \>35 mm * R wave in lead **aVL \>11 mm**
56
# Fill in the blank: Q waves are **pathologic** if they are >40 ms in duration. They are considered significant if they are in \_\_\_\_\_\_ small square(s) on ECG paper.
1 ## Footnote 1 small box = 0.04 seconds = 40 ms
57
List the progression of **ischemia** to **infarction**.
1. Ischemia begins with an **inverted T wave** and leads to **elevated ST segment**. 2. Injury begins when a **Q wave starts forming**. 3. Infarction occurs after the **ST segment reaches its maximum elevation** and returns to baseline; **a pathologic Q wave remains**.
58
What are **contiguous leads**?
Leads that view similar areas of the heart. ## Footnote Eg. V1, V2 : II, III, aVF
59
# Fill in the blanks: About \_\_\_% of people having an Inferior MI also have \_\_\_\_\_\_ ventricular involvement.
40, right
60
Interpret what's being shown in this picture.
**Inferior STEMI** * Elevation in **II, III, aVF**. * Reciprocal changes in **I and aVL**. * Elevation is **\>1 mm** in two contiguous leads.
EMT-P (2) Cardiology and Resuscitation
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