ECG

Question 1

physiological Q wave

Answer 1

since heart is 3D the Q waves exists b some depolarisation current is moving away from the + electrode

Question 2

S wave

Answer 2

movement away at eh end o depolarisation

-dereieves from the end of the base of the ventricles (terminal part of ventricular depolarisation)

Question 3

T

Answer 3

ventricular repolarisation

- still ^ b moving away from the positive electrode in Lead 2

Question 4

P

Answer 4

a d not the contraction

Question 5

QRS

Answer 5

V d not the contraction b follows it

Question 6

issues with lateral wall of LV

Answer 6

L1 avL

- coronary artery disease / accusation

Question 7

inferior

Answer 7

avF

gets its supply from the right coronary artery

Question 8

anterior wall conditon

Answer 8

• widow maker
• pericardial leads
  e. g

Question 9

widow maker

Answer 9

v3 v4

Question 10

prolonged pq interval

Answer 10

use

Question 11

prolonged interval of P Q

Answer 11

LONGER

Question 12

2nd degree heart. block morbid type 2

Answer 12

p qrs p qrs p no qrs

• symptomatic ; risk of complete stop ; MI
• measure intervals and make sure qrs follows the p wave

Question 13

third degree heart block

Answer 13

atrial and ventricles fire continuously but the ventricular pacemaker cells fire slowly,
- SAn and AVn slow not susceptible

• need pacemaker

Question 14

bundle branch block

Answer 14

• problem in the bundle branch of either R or L so see a wider complex
• L branch damage sign of heart damage

Question 15

arrhythmia

Answer 15

• supraventricualr; start in sinus node/ atrium cells/ AVN

- ventricular; start at the heart

Question 16

S

Answer 16

• QRS normal
• narrow complex
• rate is super super high
• most common arrhythmia ; happens d atria firing quivering ,b is still delivered to LV and rV so okay pressure, not hypotensive
• irregularly irregular

Question 17

VF

Answer 17

• ## they can go back to normal b thunking their own heart or shock them back to life

Question 18

AVF

Answer 18

• SOW <60
• ABNORMLA
• fast
• tachybrady syndrome ;
• base line
• atria isn’t working. well, so b just stays the atria wc then clots wc can embolise to the brain c stroke

Question 19

PBC

Answer 19

• ventricular
• wide complex
• premature before next qrs complex is predicted to happen
• can be asymptomatic
• if isolated no issue
• can progress to ventricular tachycardia (sustained )
• more than 3 ventricular tachycardia

Question 20

apex of heart?

Answer 20

• 5th intercostal

Question 21

what doe the bipolar allow

Answer 21

• communication since one is - and one is + so they can communicate

Question 22

types of heart Block

Answer 22

• SAn to AVn singa defectos

- brachycardia, dizziness, syncope

Question 23

1st degree

Answer 23

• 1st degree AV block

- prolonged PR intervals >0.2 seconds (<5 boxes)

Question 24

2nd

Answer 24

• WENKEBACH (mobitz 1) ;PR- longer than drop no QRS (longer longer longer drop that is a wenkebach)
• mobitz tpye2 ; say longer then drop >0.2 seconds

Question 25

3rd

Answer 25

- AV and SAN work independently so constant P and constant QRS - overlap of P and QRS b they are independent - ventricular pacemaker (myocytes) take over and they work at 20-40bpm wc is too slow to maintain bp so p urgently needs a pacemaker

Question 26

bundle branch block

Answer 26

- obstruction on one of the bundle branches - LBBBor RBBB - unaffected branch depolarises first so you get two little R peaks and its broader QRS complex b of the delayed depolarisation - >3 squares - look at leads V1 and see W look at lead V6 and see M

Question 27

Arrhythmia

Answer 27

- abnormal rhythms | - can arise supraventrocular ie ATRIA (san avn atria)

Question 28

difference bw supra ventricular and ventricular

Answer 28

``` SV = normal but narrow QRS V = wide and weird QRS ```

Question 29

SV

Answer 29

- most comon - foci in atria uncoordinated firing , only some impulses travel through the AVN so depending on how many can get through the AVN determines the symptoms; if lots = tachycardia, little; brachycardia, or sometimes tachybradycadia - b is still being delivered, - no P wave b san not firing - only some electric

Question 30

a fib types

Answer 30

- coarse | fine

Question 31

what does fib c

Answer 31

- some b in the atria is static and so it clots c embolism ; going to brain, LA, coronary arteries

Question 32

premature ventricular contration

Answer 32

- wide QRS complex - happens before next QRS - can be asympomiatic or can feel palpitates - dont c issue if random b can lead to ventricular fib - more than pvc = ventricular tachycardia

Question 33

ventricular fibrillation

Answer 33

- random ventricles myocytes firing - lethal b b is not being sent around therefor v in bp - no cardiac output and leads to death

Question 34

classification of arrhythmia

Answer 34

- hr<60 = Brady cardia can be heart block / simple bradycardia - tachycardia >100 = tachycardia <120 = narrow complex af/flutter /SVT/sinus tachycardia if <120ms = broad complex VT/VF

Question 35

ECG in ischameia

Answer 35

-look at leads at the side of the heart

Question 36

ischaemia test

Answer 36

- look at troponin it will be negative since the tissues hasn't died yet

Question 37

mi tst

Answer 37

- troponin positive

Question 38

types of inafarcrs

Answer 38

- full thickness STEMI ST segment elevation MI | - non-stemi = not full thickness of cardiac wall

Question 39

stemi

Answer 39

d occulsion of the coronary artery | -look at leads

Question 40

why do Myocardial necrosis andscar tissue lead to pathological Q wave

Answer 40

-no one knowns

Question 41

whats a Q wave and types

Answer 41

negative defelciton - pathological and non - depnds on lead their sizes but leads 3 and avR has slightly bigger - Q should never be bigger than 25% of r

Question 42

are all q waves a sign of old infarcts?

Answer 42

no PE too

Question 43

non scemi

Answer 43

- infarct only the endocardial so outside is infarcts b of coronary artery is half occluded and you can get b to the outside b closer to it but the endocardial part dies - t wave normally upright in all leads except avR and V1 where they are negative inverstion - pathological t wave >3mm deep

Question 44

how to differentiate

Answer 44

tropinon release

Question 45

hypokalaemia

Answer 45

- U wave post the | - T waves flip and get deeper

Question 46

hyporkalemia

Answer 46

- fast hypekaelima b na+ channels being inactivated so you get - tall peaked T waves , then you loose T waves b lose ventricular repolarisation - wide QRS not normal conduction