EKG Basic Principles (Lecture 2 Part 2)

Question 1

what are the 3 components of a waveform?

Answer 1

duration (fractions of seconds)
amplitude (millivolts mV)
configuration (shape and appearance)

Question 2

what do the light lines form on the EKG paper?

Answer 2

forms small boxes 1mm x 1mm

Question 3

what does the distance across 1 small square measure horizontally (time)?

Answer 3

0.04 seconds

Question 4

what does the distance across 1 small square measure vertically (voltage)?

Answer 4

0.1 mV

Question 5

what do the dark lines form on the EKG paper?

Answer 5

5 small boxes forming 1 square 5mm x 5mm

Question 6

what does the distance across 1 large square measure horizontally (time)?

Answer 6

0.2 seconds

Question 7

what does the distance across 1 large square measure vertically (voltage)?

Answer 7

0.5 mV

Question 8

what is the EKG paper speed

Answer 8

25 mm/sec

Question 9

on the top or the bottom of the EKG paper, there will be ___ second marks

Answer 9

3

Question 10

how should P waves look on a normal EKG

Answer 10

all are uptight and appear the same

Question 11

how long should the P-R interval be on an EKG in time and in boxes?

Answer 11

0.12- 0.20 sec
3-5 small boxes

Question 12

how long should the QRS segmeent be on an EKG in time and in boxes?

Answer 12

0.05-0.11 sec
less than 3 small boxes

Question 13

what is a segment?

Answer 13

straight line connecting 2 waves (ST segment)

Question 14

what is an interval?

Answer 14

encompasses at least 1 wave and the connecting straight line (PR interval is from atrial depolarization to ventricular depolarization)

Question 15

when is P wave seen as a + deflection?

Answer 15

frontal plane:
left lateral leads I and AVL
inferior leads II and AVF

horizontal plane:
leads V5 and V6

Question 16

when is P wave seen as a - deflection?

Answer 16

frontal plane:
AVR

Question 17

when is P wave seen as a biphasic wave?

Answer 17

frontal plane:
lead III

horizontal plane:
V1

Question 18

what is the usual amplitude of the P wave in voltage and squares?

Answer 18

<0.25 mV
2.5 mm or 2.5 squares

Question 19

the origin of the QRS vector is the ___ node

Answer 19

AV

Question 20

what does the Q wave represent?

Answer 20

IV septum depolarization

Question 21

is the Q wave usually seen?

Answer 21

no

Question 22

when may the Q wave be seen?

Answer 22

in left lateral leads I, AVL, V5,V6

Question 23

if the Q wave is present and significant, it may be indicative of a ___

Answer 23

MI

Question 24

what is an abnormal Q wave as seen on EKG?

Answer 24

-more than 1 square wide
-more than 1/3 height of the R wave

Question 25

what should be the voltage of QRS in the limb and chest leads?

Answer 25

>5mm to <30mm

Question 26

when is R wave seen as tall waves?

Answer 26

left lateral and inferior leads- I, II, III, AVL, AVF V5 and V6, gets smaller as you go right

Question 27

when is S wave seen as deep waves?

Answer 27

AVR V1 and gets smaller as you go left

Question 28

the same leads that record tall R waves will generally record positive ___ waves

Answer 28

T (II, III, AVL, AVF V5 and V6)

Question 29

what should you assess on an EKG for cardiac cycle for rhythm and rate disturbances?

Answer 29

1. Evaluate the P wave. (Is it normal and upright, and is there a P wave before every QRS? Do all the P waves look alike?) 2. Evaluate the PR interval. (Normal duration is 0.12 to 0.20 second.) 3. Evaluate the QRS complex. (Do all QRS complexes look alike?) 4. Evaluate the QRS interval. (Normal duration is 0.05 to 0.11 second.) 5. Evaluate the T wave. (Is it upright and normal in appearance?) 6. Evaluate the R to R wave interval. (Is it regular?) R-R intervals exactly the same - not good, type A personality, excessive catecholamines, lose cardiac variability → sympathetically dominant 7. Evaluate the heart rate (6-second strip if regular rhythm; normal rate is 60-100 bpm). 8. Observe the patient, and evaluate any symptoms. (Do the observation, symptoms, or both correlate with the Dysrhythmia?)