ECG Basics Quiz

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Questions and Answers

What is the duration of the PR interval in an ECG?

  • 0.20 sec (correct)
  • 0.12 sec
  • 0.08 sec
  • 0.40 sec

What does the T wave in an ECG represent?

  • Electrical silence
  • Ventricular contraction
  • Ventricular repolarization (correct)
  • Atrial contraction

How long is the normal duration for the QRS complex?

  • 0.20 sec
  • 0.08 sec (correct)
  • 0.12 sec
  • 0.40 sec

Which component of the ECG indicates electrical silence?

<p>ST segment (D)</p> Signup and view all the answers

What is the maximum acceptable height for an R wave in an ECG?

<p>15 mm (D)</p> Signup and view all the answers

What does each small square represent on the X-Axis of an ECG graph?

<p>0.04 seconds (A)</p> Signup and view all the answers

How many milliseconds is represented by one large square on the Y-Axis?

<p>0.5 mV (D)</p> Signup and view all the answers

What is the standard paper speed of an ECG recording?

<p>25 mm/sec (C)</p> Signup and view all the answers

If one minute corresponds to 300 large squares on the ECG graph, how many small squares does it correspond to?

<p>1,500 (C)</p> Signup and view all the answers

What is the voltage calibration for ECG paper represented by 10 mm?

<p>1 mV (B)</p> Signup and view all the answers

What is represented by the vertical axis on an ECG graph?

<p>Electrical potential in millivolts (B)</p> Signup and view all the answers

How many big squares on the ECG graph represent 1 second?

<p>5 (D)</p> Signup and view all the answers

Which component is NOT part of the ECG system?

<p>Data processor (D)</p> Signup and view all the answers

What is the correct position for the V1 chest lead?

<p>In the fourth intercostal space on the right sternal edge (C)</p> Signup and view all the answers

Which color represents the augmented lead aVF?

<p>GREEN (D)</p> Signup and view all the answers

Which is NOT a type of lead used in ECG?

<p>Bipolar lead (D)</p> Signup and view all the answers

What is the correct order of positioning for the chest leads V2 to V6?

<p>V1, V2, V3, V4, V5, V6 (A)</p> Signup and view all the answers

In a 12-lead ECG, what does the limb lead labeling R, L, F, and N stand for?

<p>Right, Left, Foot, Neutral (B)</p> Signup and view all the answers

Which lead is positioned in line with V4 and on the anterior axillary line?

<p>V5 (C)</p> Signup and view all the answers

What component is NOT part of an ECG setup?

<p>Ink (D)</p> Signup and view all the answers

What is crucial to ensure accurate ECG readings?

<p>Proper electrode positioning (C)</p> Signup and view all the answers

What is indicated by the P wave in an ECG?

<p>Atrial excitation (B)</p> Signup and view all the answers

What does the P-R interval signify in an ECG reading?

<p>Impulse delay at the AV junction (C)</p> Signup and view all the answers

What should be done if the ECG trace is not satisfactory?

<p>Check that all electrode dots are secure (A)</p> Signup and view all the answers

What is the role of the QRS complex in an ECG?

<p>Electrical excitation of the ventricles (C)</p> Signup and view all the answers

Which of the following conditions can lead to an abnormal ECG but may not indicate a specific diagnosis?

<p>Abnormal ECG, not characteristic of any diagnosis (A)</p> Signup and view all the answers

What is identified as a potential problem during ECG recording?

<p>Incorrect patient identity (A), Electrode positioning (D)</p> Signup and view all the answers

What action should be taken to minimize interference during an ECG recording?

<p>Have the patient relax completely (B)</p> Signup and view all the answers

What is the typical paper speed for recording an ECG?

<p>25mm/s (A)</p> Signup and view all the answers

What is a common cause of wandering baseline in an ECG recording?

<p>Excessive movements of limbs (B), Non-cooperative patient (C)</p> Signup and view all the answers

Which factor may contribute to muscle tremor during an ECG?

<p>Hairy chest interfering with lead contact (C)</p> Signup and view all the answers

What should not be done to avoid AC interference during an ECG?

<p>Utilizing a shared power outlet (C)</p> Signup and view all the answers

In the context of juvenile ECG, which T-wave abnormality is acceptable?

<p>Tall T waves (C)</p> Signup and view all the answers

Which description represents a sign of baseline disturbance in a child’s ECG?

<p>Disturbances in leads V5 and V6 (C)</p> Signup and view all the answers

Which of the following is essential for accurate ECG recordings?

<p>Proper earthing of the ECG machine (B)</p> Signup and view all the answers

What is a potential outcome of having a tense patient during ECG recording?

<p>Increased baseline fluctuations (D)</p> Signup and view all the answers

When considering sinus rhythm identification, what is the normal duration for a P-wave?

<p>&lt; 0.12 sec (D)</p> Signup and view all the answers

Which of the following abnormalities can be identified through an ECG interpretation?

<p>Myocardial ischemia and infarction (D)</p> Signup and view all the answers

What is the primary purpose of an electrocardiogram (ECG)?

<p>To represent electrical events of the cardiac cycle (D)</p> Signup and view all the answers

Which statement best reflects an early perspective on electrocardiography?

<p>It was thought to provide a record of rare cardiac anomalies. (B)</p> Signup and view all the answers

Which individual was awarded the Nobel Prize for improving ECG sensitivity?

<p>William Einthoven (D)</p> Signup and view all the answers

What are the three essential components of an ECG system?

<p>Patient, Machine, and Paper (B)</p> Signup and view all the answers

Which of the following types of ECG recorders allows for monitoring multiple channels simultaneously?

<p>Twelve channel recorder (B)</p> Signup and view all the answers

What type of tool uses ECG for stress testing?

<p>Vector electrocardiograph (D)</p> Signup and view all the answers

Electrolyte disturbances can be indicated on an ECG. Which of the following disturbances is associated with high potassium levels?

<p>Hyperkalemia (C)</p> Signup and view all the answers

Flashcards

Electrocardiogram (ECG)

Measuring the electrical activity of the heart using electrodes placed on the body.

Types of ECG Leads

An ECG can be recorded using different types of leads. 3, 5, or 12-lead ECGs

Lead

A lead records electrical activity between specific points on the body.

Limb Leads

Leads that look at the electrical activity from limbs.

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Chest Leads

Leads placed on the chest to record electrical activity from the heart.

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Standard Leads

The standard limb leads are labelled I, II, and III. These leads record activity between specific arms and legs.

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Augmented Leads

The augmented leads (aVR, aVL, and aVF) provide additional perspectives on the heart's electrical activity.

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Pericardial Leads (V1-V6)

The chest leads are labelled V1 through V6 and offer a detailed look at the heart's electrical activity.

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What is an EKG?

A graphic representation of the electrical activity of the heart, displaying the heart's electrical cycle as waveforms on a graph.

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What is an Arrhythmia?

An irregular heart rhythm. This could include problems with the rate (too fast, too slow) or the regularity (irregular).

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What is Myocardial Ischemia?

This is a condition where the heart muscle isn't receiving enough oxygen. It can be temporary, causing chest pain (angina) or lasting, causing damage to the heart muscle (heart attack).

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What is Pericarditis?

Inflammation of the pericardium, the sac surrounding the heart. It can cause chest pain and a muffled heart sound.

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What is Chamber Hypertrophy?

An EKG can show if one or more chambers of the heart are enlarged. This is often due to high blood pressure or other heart conditions.

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How are electrolyte disturbances seen on an EKG?

Electrolyte levels in the blood are crucial for heart function. Abnormal levels (too high or too low) can cause irregular heart rhythms.

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How can medications affect the EKG?

Certain medications can either slow down or speed up the heart rate, or prolong the electrical cycle of the heart. This is seen on an EKG.

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What is Pacemaker Function Assessment?

An EKG can be used to assess the function of a pacemaker, which is a device implanted in the chest to regulate the heart rate.

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What does the P wave represent on an ECG?

The P wave represents atrial depolarization, which is the electrical activation of the atria causing them to contract.

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What does the PR interval represent on an ECG?

The PR interval represents the time it takes for electrical activity to travel from the atria to the ventricles, including the delay at the AV node.

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What does the QRS complex represent on an ECG?

The QRS complex represents ventricular depolarization, which is the electrical stimulation of the ventricles causing them to contract.

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What does the T wave represent on an ECG?

The T wave reflects ventricular repolarization, the return of the ventricles to their resting state.

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What does the ST segment represent on an ECG?

The ST segment represents a period of electrical silence, as the ventricles are fully depolarized and ready to repolarize.

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ECG paper grid size

A standard ECG paper uses 1 mm squares for recording the electrical activity of the heart.

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Standard ECG Paper Speed

The standard paper speed for ECG recordings is 25 millimeters per second.

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Standard ECG Voltage calibration

The standard voltage calibration for ECG recordings is 10 millimeters per millivolt, meaning a 10 mm deflection on the paper represents 1 millivolt of electrical activity.

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Time representation on ECG paper

Each large square on the ECG paper represents 0.2 seconds (5 small squares).

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ECG graph axes

The vertical axis of an ECG graph represents voltage (millivolts) and the horizontal axis represents time (seconds).

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Time represented by a small square

Each small square on the ECG paper represents 0.04 seconds.

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Components contributing to ECG

The ECG is a recording of the electrical activity of the heart, which comes from three main components: the patient, the machine, and the paper.

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Patient factors influencing ECG

Factors like age, race, height, weight, body build, pulmonary diseases, medications, blood pressure, and clinical impression can influence the ECG recording.

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What does the PR interval indicate on an ECG?

The PR interval on an ECG measures the time it takes for the impulse to travel from the atria to the ventricles, through the AV node.

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What factors are crucial for a good ECG recording?

An ECG recording requires a relaxed patient, proper lead placement, and the right settings on the machine.

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What are ECG artefacts?

Artefacts are any disturbances in the ECG reading that aren't related to the heart's electrical activity. Common sources include muscle movement or loose electrodes.

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What is the significance of ECG results?

An electrocardiogram reading is a valuable diagnostic tool for identifying heart conditions, but it should always be interpreted with clinical context.

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Who should interpret ECG results?

ECG recordings should be thoroughly analyzed and interpreted by a qualified healthcare professional with expertise in electrocardiography.

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What is an Electrocardiogram (ECG)?

Electrical activity of the heart is measured through electrodes placed on the body, providing a visual representation of the heart's electrical cycle.

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What is Wandering Baseline on an ECG?

A common artifact caused by patient movement, especially in children, resulting in baseline fluctuations on the ECG.

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What is Muscle Tremor on an ECG?

Muscle activity caused by tremors or limb movements, resulting in fluctuations on the ECG, which can mimic heart problems.

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What is Electrical Interference (AC Interference) on an ECG?

Electrical interference from external sources, like electrical appliances or power lines, can distort the ECG.

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What is Early Repolarization on an ECG?

This refers to an ECG pattern usually seen in children, where the ST-T (J) Junction point is elevated, the T waves are tall, and the ST segment is often concave.

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What is ECG Rhythm ID?

The process of analyzing the ECG waveform, starting with the P wave (atrial rhythm) and moving to the QRS complex (ventricular rhythm).

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What is a Juvenile ECG?

The ECG pattern that is considered 'normal' for children.

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Study Notes

ECG - EKG Interpretations

  • An electrocardiogram (ECG/EKG) is a representation of the electrical events of the cardiac cycle.
  • Studying the waveforms helps understand a patient's cardiac pathophysiology.
  • EKGs can identify pathology, like arrhythmias, myocardial ischemia/infarction, pericarditis, chamber hypertrophy, electrolyte imbalances (hyperkalemia, hypokalemia), drug toxicity (digoxin, QT interval prolonging drugs), and pacemaker function.
  • An ECG has three components: the patient, the machine, and the paper.
  • ECG machines have different types, including single, three, and twelve channel recorders, vector/monitor electrocardiographs, ECG systems for stress testing, and Holter ECGs.
  • ECGs can be intermittent or continuous, with differing lead counts (3, 5, or 12 leads).
  • Leads measure the difference in electrical potential: bipolar leads detect potential between two different body points, unipolar leads detect potential between a body point and a virtual point in the heart's center.
  • Standard EKGs have 12 leads: 3 standard limb leads (I, II, III), 3 augmented limb leads (aVR, aVL, aVF), and 6 precordial leads (V1-V6).
  • Precordial lead placement is critical for accurate diagnosis. Specific locations are noted for each lead (V1-V6) relative to the patient's ribs, sternum, and clavicle, which is essential for accurate depiction of anterior, lateral and septal heart locations.
  • The ECG paper has standard dimensions with 1 mm and 5 mm squares for both time and voltage.
  • The paper speed is typically 25 mm/second.
  • ECG graphic paper has a Y-axis (voltage) and X-axis (time) for visualizing heart activity.
  • 1 mm on the Y-axis represents 0.1 mV, and 1mm on the X-axis represents 0.04 seconds.
  • The ECG paper has time and voltage units allowing doctors to assess heart rate. The paper speed is usually standardized at 25 mm per second to record events accurately.
  • The 6-second strips are fundamental for determining heart rhythm.
  • A simple recording procedure involves steps like positioning the patient, turning on the machine, calibration, attaching leads, recording, labeling, disconnecting the leads, and data analysis.
  • There are varying types and degrees of abnormalities. These range from minor changes requiring further assessment to severe conditions demanding emergency intervention.
  • Patient identity, lead placement accuracy, paper settings, and external artifacts affect ECG interpretations.
  • Misinterpretation is a more common error than faulty recording technique.
  • Different methods exist to determine the heart rate by counting the R-R intervals and calibrating it against the paper speed.
  • The cardiac axis (vector) signifies the direction of the heart's electrical activity. Determining normal axes involves checking leads (I, II, and III, aVR, aVL, aVF) and observing voltage and direction in different leads.
  • Electrophysiology explains that a positive deflection occurs when the depolarization wave spreads towards electrodes, and a negative deflection happens when it moves away.
  • Normal, borderline, and abnormal ECG tracings categorized based on normal heart activity, moderate changes needing more details, or abnormal conditions require specific diagnoses after careful study.
  • Normal variations exist, like slight left axis deviation from heart rotation, high voltage QRS, J-point depressions, and T wave inversions, which are typically considered normal in some cases.
  • Pediatric and juvenile ECGs have specific characteristics, where differences from normal adult ECGs include heart rate, T wave direction, and baseline.
  • In some cases, pseudo-normalization, where symptoms might disappear on an ECG but still exist, is important to keep in mind. The final interpretation of the ECG always requires complete evaluation of the tracing, and complete correlation with clinical findings.

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