Diploma in ECG Interpretation

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Questions and Answers

What is the correct order of electrical events in the cardiac conduction system?

Ventricular depolarisation, Atrial depolarisation, Ventricular repolarisation, AV nodal depolarisation

Atrial depolarisation, AV nodal depolarisation, Ventricular depolarisation, Ventricular repolarisation (correct)

AV nodal depolarisation, Atrial depolarisation, Ventricular repolarisation, Ventricular depolarisation

Ventricular repolarisation, Atrial depolarisation, AV nodal depolarisation, Ventricular depolarisation

Which leads are considered standard limb leads?

aVR, aVL, aVF

I, II, III (correct)

I, aVF, III

V1, V2, V3

What does the right leg electrode do in an ECG setup?

Reduces interference (correct)

Records electrical activity directly

Acts as an earth electrode

Must always be placed below the knee

What is the significance of Einthoven's triangle in ECG interpretation?

It provides a framework for understanding limb leads Signup and view all the answers

What mathematical relationship exists among standard limb leads?

From any two leads, the others can be calculated Signup and view all the answers

Which waves and segments correlate with ventricular depolarisation on an ECG?

QRS complex Signup and view all the answers

How do limb leads differ in terms of detecting electrical activity?

They reflect electrical activity in the frontal plane Signup and view all the answers

What specifically characterizes augmented unipolar limb leads in ECG?

They are derived from the standard bipolar leads Signup and view all the answers

What is the position for the V1 chest electrode?

4th intercostal space, right sternal edge Signup and view all the answers

Which chest lead is located at the horizontal level with V4 at the anterior axillary line?

V5 Signup and view all the answers

What is the function of Wilson's central terminal in chest leads?

It forms the negative pole by joining limb electrodes. Signup and view all the answers

Which of the following is true regarding all chest electrodes?

They are all positive poles. Signup and view all the answers

Which lead is placed at the 5th intercostal space, mid-clavicular line?

V4 Signup and view all the answers

What is the standard position for the V3 chest electrode?

exactly midway between V2 and V4 Signup and view all the answers

Which lead records electrical activity from a point above the left leg?

aVF Signup and view all the answers

Which lead is placed at the 4th intercostal space, left sternal edge?

V2 Signup and view all the answers

Study Notes

Cardiac Conduction System

Sequence of electrical events in the heart includes: atrial depolarization, AV nodal depolarization, ventricular depolarization, and ventricular repolarization.
ECG waves representing these events: P wave (atrial depolarization), PR segment (AV nodal delay), QRS complex (ventricular depolarization), T wave (ventricular repolarization).

ECG Lead Theory

Standard limb electrodes are placed as follows:
- Red on right arm
- Yellow on left arm
- Green on left leg
- Black on right leg
Limb electrodes form an equilateral triangle (Einthoven's triangle) with the heart at its center.

Standard Limb Leads

The ‘standard’ limb leads are labeled as I, II, and III, providing essential electrical activity views of the heart.

Augmented Unipolar Limb Leads

Additional limb leads include aVR, aVL, and aVF, enhancing the electrical activity recording capabilities.

Hexaxial Reference System

Limb leads are mathematically interconnected; knowledge of any two leads allows calculation of others.
Example calculations include:
- Lead I = VLA - VRA
- Lead II = VLL - VRA

Electrical Activity Orientation

ECG appearances vary based on the lead’s orientation relative to the direction of cardiac electrical current flow.

Right Leg Electrode

Used to reduce electrical interference, not as an earth electrode, and can be placed flexibly.

Orientation of Limb and Chest Leads

Limb leads record electrical activity in the frontal plane (right/left and up/down).
Chest leads are necessary for recording in the transverse plane.

Standard Chest Electrode Positions

V1: 4th intercostal space at right sternal edge
V2: 4th intercostal space at left sternal edge
V3: Midway between V2 and V4
V4: 5th intercostal space on the mid-clavicular line
V5: Anterior axillary line, horizontal to V4
V6: Mid-axillary line, horizontal to V4

Wilson’s Central Terminal

The negative pole for chest leads is created by electrically combining the three limb electrodes.

Chest Leads Configuration

All chest electrodes serve as positive poles.
Standard chest lead arrangement involves positioning relative to other anatomical landmarks, including the sternum and spine.

12-Lead ECG Format

A typical 12-lead ECG comprises both limb leads and chest leads, crucial for comprehensive cardiac assessment and interpretation.

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Description

This quiz focuses on the essential concepts of ECG interpretation as part of the Diploma in ECG course. It covers the cardiac conduction system, the relationship between electrical events, and the components of the ECG such as the P wave, QRS complex, and T wave. Test your knowledge and understanding of these critical topics in cardiac health.