Electrocardiography

Question 1

What is an electrocardiograph?

Answer 1

Instrument with graph paper that moves under a stylus

Question 2

How does an EKG work?

Answer 2

Electric currents cause the stylus to move up or down as the paper unrolls beneath it

Question 3

Describe what is happening during each wave
1. P wave:
2. QRS wave:
3. T wave:

Answer 3

1. Atria contract
2. Ventricles contract
3. Muscle relaxation

Question 4

Define each. State if it’s systolic or diastolic.
1. Depolarization
2. Repolarization

Answer 4

1. Process of generating electrical impulse
   - Results from movement of cations into heart muscle cells.
   - Systolic
2. Cations are pumped out of the cell
   - Results in the outside of the cell having a more positive charge than the inside of the cell.
   - Diastolic

Question 5

Label where the three leads go on the patient

Answer 5

Question 6

Principles for Depolarization: (1/2)
If the wave of depolarization is generally moving ___ the positive sensing electrode, that electrode will record a ___ deflection above the isoelectric line on the EKG paper

Answer 6

1. Toward
2. Positive

Question 7

Principles for Depolarization: (2/2)
If the wave of depolarization is generally moving ___ the positive sensing electrode, that electrode will record a ___ deflection above the isoelectric line on the EKG paper

Answer 7

1. Away
2. Negative

Question 8

Isoelectric line is…

Answer 8

If depolarization is running perpendicular to the positive lead then the results is at the base line
(Line is red in image)

Question 9

The smallest box on the paper is ___mm.
The largest box on the paper is ___mm.

Answer 9

1. 1mm
2. 5mm

Question 10

The speed of which paper comes out of the EKG is typically ___mm per second.

Answer 10

25mm/sec

Question 11

At the speed of 25mm/sec:
A 1mm box is ___seconds
A 5mm box is ___seconds

Answer 11

1mm box = 0.04 seconds
5mm box = 0.20 seconds

Question 12

To determine a HR from an EKG strip, you must obtain a ___ second tracing, which is also ___ five mm boxes. Then you count the number of ___ waves and multiply by ___ to obtain the HR/min.

Answer 12

1. Six second
2. 30 five mm boxes
3. R waves
4. 10

Question 13

What is the HR?
25mm/sec

Answer 13

120 bpm
Work:
12 R waves x 10 = 120 bpm

Question 14

Amplitude of the deflected waves is measured in ___.
Voltage of a wave deflected thru

FINISH

Question 15

State what electrodes each lead goes between/measures:
Lead I is from…
Lead II is from…
Lead III is from…

Answer 15

Lead I: Right arm to left arm
Lead II: Right arm to left leg
Lead III: Left arm to left leg

Question 16

ECG Recording Technique (6)

Answer 16

1. Place Pt on clean floor or non-metal table
2. Attach ECG leads, moisten w/alc or electrode gel
3. Record in right lateral or standing position
4. Keep Pt still & calm as possible
5. Record lead II for 30-60sec at 25mm/sec
6. Record brief brief tracing at 50mm/sec

Question 17

ECG Pneumonic with colors
Black
Red
White
Green

Answer 17

Black & Red = Smoke over fire
White & Green = Snow over grass

Question 18

Arrhythmia is…

Answer 18

Any abnormality in the rate, rhythm, or electrical generation of the heart beat.

Question 19

Arrythmia pathology is abnormal impulse ___ & ___.

Answer 19

Formation & conduction

Question 20

Abnormal impulse Formation from arrhythmias can be due to… (4)

Answer 20

1. Low O2
2. Hypocalcemia or hypercalcemia
3. Cardiomyopathy
4. Heart tissue trauma/injury

Question 21

Abnormal impulse Conduction from arrhythmias can be due to…

Answer 21

Anatomic defect of electrical conduction system

Question 22

Pulse deficit demonstrates altered ____.

Answer 22

Hemodynamics

Question 23

Arrhythmias cause abnormal ___ in the body blood flow. Blood flow to the brain may be decreased from __% to __%

Answer 23

1. Hemodynamics
2. 8% to 80%

Question 24

Define each
1. Sinus rhythm
2. Arrhythmia
3. Bradycardia
4. Tachycardia
5. Asystole

Answer 24

1. Normal steady rhythm
2. Abnormal rhythm
3. Slow heart
4. Fast heart
5. No contraction

Question 25

In a canine, bradycardia is ___bpm and tachycardia is __bpm or ___bpm in giant breeds.

Answer 25

Bradycardia: <60bpm Tachycardia: >180bpm; giant >160bpm

Question 26

Atrial Fibrillation has no organized ___ contraction, but "quivering" muscle tissue. ___ cardiac output due to poor ventricular filling of blood.

Answer 26

1. Atrial 2. Decreased

Question 27

Atrial fibrillation Dx (2)

Answer 27

1. Auscultation - "Tennis shoes in the dryer" 2. EKG doesn't have a P wave

Question 28

Premature Ventricular Contractions is when a heart beat is ___ generated from the Bundle of His ___ of the SA node.

Answer 28

1. Spontaneously 2. Independent

Question 29

PVCs Causes (4) Dx (2)

Answer 29

Cause 1. Hypoxia or heart trauma 2. Anesthesia or toxins 3. Heart disease 4. Electrolyte abnormalities Dx Pulse deficit or EKG

Question 30

Identify this arrhythmia. Hint: Use the red circle as guidance

Answer 30

Question 31

Ventricular Tachycardia is a ___ risk rhythm and is usually fatal within ___ days if left untreated.

Answer 31

1. High risk 2. Two days

Question 32

Ventricular Tachycardia Cardiomyopathy, heart ___, myocarditis, heart ___, may cause PVCs. If a HR is ___bpm due to PVCs, ___ ___ may occur and must be treated.

Answer 32

1. Failure 2. Tumor 3. >130bpm 4. SVDDEN DEATH

Question 33

Which arrhythmia is this? PVC or Ventricular Tachycardia

Answer 33

"Ghosts holding hands"

Question 34

Ventricular Fibrillation is identified by it's electrical activity in the ____. It doesn't effectively move ___. It is a rapidly ___ rhythm. Although, it may be ___ with an ___ shock of a defibrillator.

Answer 34

1. Ventricles 2. Blood 3. Fatal 4. Reversed 5. Electrical

Question 35

Pulseless electrical activity is a common ___ animal arrhythmia (esp under ___). ECG pattern is visible, but no ___ and no ____ contraction. It is fatal within ___ if not resuscitated.

Answer 35

1. Small animal 2. Anesthesia 3. Pulse 4. Heart contraction 5. Minutes!

Question 36

Patient has no pulse and their EKG looks like this. What is this called?

Answer 36

Pulseless electrical activity

Question 37

What is this? How is it caused? How do you fix it?

Answer 37

1. Electrical interference 2. IV pump & other machines cause ECG artifacts; also called "60 cycle" 3. Solutions: - Plug ECG into different outlet - Turn off unneeded equipment - Switch to battery mode when possible

Question 38

What is this? How is it caused? How do you fix it?

Answer 38

1. Movement artifact 2. Animal or lead movement 3. Restrain to minimize movement

Question 39

What is this? How is it caused? Who is it normal in? Common in?

Answer 39

1. Sinus arrhythmia 2. Variation in rhythm associated with breathing 3. Normal in canines & humans 4. Common in young athletic animals