Podcast
Questions and Answers
Which segment of an EKG tracing represents the time between the end of the P wave and the start of the QRS complex?
Which segment of an EKG tracing represents the time between the end of the P wave and the start of the QRS complex?
- PR segment (correct)
- ST segment
- QT interval
- PR interval
What is responsible for the various waves, segments, and intervals seen on an EKG tracing?
What is responsible for the various waves, segments, and intervals seen on an EKG tracing?
- Respiratory rate
- Cardiac output
- Electrical conduction system of the heart (correct)
- Blood pressure
In the frontal plane, how is the mean QRS vector (axis) determined?
In the frontal plane, how is the mean QRS vector (axis) determined?
- By determining the heart rate from rhythm strips
- By identifying the PR interval
- By comparing the bipolar limb leads with the augmented limb leads (correct)
- By contrasting the limb leads from the precordial leads
What is the physiological cause for upward and downward deflections on an EKG tracing?
What is the physiological cause for upward and downward deflections on an EKG tracing?
What is the heart rate range for bradycardia?
What is the heart rate range for bradycardia?
What term is used for arrhythmias originating above the ventricles?
What term is used for arrhythmias originating above the ventricles?
What is the term for a rhythm in which every other beat is premature?
What is the term for a rhythm in which every other beat is premature?
What is the heart rate range for fibrillation?
What is the heart rate range for fibrillation?
What is the term for deviation from the normal range in the electrical axis in the frontal and horizontal planes?
What is the term for deviation from the normal range in the electrical axis in the frontal and horizontal planes?
How is the mean QRS axis in the horizontal plane determined?
How is the mean QRS axis in the horizontal plane determined?
Which type of blocks have distinct characteristics in terms of QRS axis and EKG patterns?
Which type of blocks have distinct characteristics in terms of QRS axis and EKG patterns?
What are the learning objectives of the workshop related to EKG interpretation?
What are the learning objectives of the workshop related to EKG interpretation?
What is the rate range for atrial automaticity foci?
What is the rate range for atrial automaticity foci?
What does overdrive suppression refer to?
What does overdrive suppression refer to?
What is escape in the context of cardiac pacing?
What is escape in the context of cardiac pacing?
What is covered in the workshop in terms of EKG tracings?
What is covered in the workshop in terms of EKG tracings?
What is recommended reading for the workshop?
What is recommended reading for the workshop?
What does overdrive suppression refer to?
What does overdrive suppression refer to?
What does escape in the context of cardiac pacing refer to?
What does escape in the context of cardiac pacing refer to?
What is covered in the workshop in terms of EKG tracings?
What is covered in the workshop in terms of EKG tracings?
What is the clinical utility of EKG attributed to?
What is the clinical utility of EKG attributed to?
What determines myocyte contraction?
What determines myocyte contraction?
What distinguishes intervals from segments in electrocardiography nomenclature?
What distinguishes intervals from segments in electrocardiography nomenclature?
What does the QT interval include?
What does the QT interval include?
Where is the J point located on an EKG tracing?
Where is the J point located on an EKG tracing?
What causes the U wave on an EKG tracing?
What causes the U wave on an EKG tracing?
How can the heart rate be determined on a standard EKG tracing?
How can the heart rate be determined on a standard EKG tracing?
What does the mean electrical axis provide important information about?
What does the mean electrical axis provide important information about?
Who developed Electrocardiography (EKG)?
Who developed Electrocardiography (EKG)?
What is the role of the Purkinje fibers in the heart's electrical activity?
What is the role of the Purkinje fibers in the heart's electrical activity?
What is the standard 12-lead EKG used for determining?
What is the standard 12-lead EKG used for determining?
What does myocyte depolarization depend on?
What does myocyte depolarization depend on?
What is used to determine the positive electrode position for bipolar limb leads based on the abbreviation of the limbs?
What is used to determine the positive electrode position for bipolar limb leads based on the abbreviation of the limbs?
How can the QRS axis be estimated when lead I is positive and aVF is negative?
How can the QRS axis be estimated when lead I is positive and aVF is negative?
Where are chest leads V1-V6 placed to record electrical activity?
Where are chest leads V1-V6 placed to record electrical activity?
How many limb leads are there in an EKG, including both bipolar and augmented unipolar leads?
How many limb leads are there in an EKG, including both bipolar and augmented unipolar leads?
What is essential for interpreting electrocardiograms accurately?
What is essential for interpreting electrocardiograms accurately?
What is used to determine the QRS axis in the frontal plane?
What is used to determine the QRS axis in the frontal plane?
What indicates the area of electrical activity when estimating the QRS axis by looking at leads I and aVF?
What indicates the area of electrical activity when estimating the QRS axis by looking at leads I and aVF?
Why is the placement of the positive and negative electrodes in limb leads and chest leads crucial?
Why is the placement of the positive and negative electrodes in limb leads and chest leads crucial?
What is fundamental for healthcare professionals involved in cardiac monitoring and diagnosis?
What is fundamental for healthcare professionals involved in cardiac monitoring and diagnosis?
What relies on the correct placement of leads and the precise determination of the QRS axis?
What relies on the correct placement of leads and the precise determination of the QRS axis?
What does D'Amico's rule of "L"'s help determine?
What does D'Amico's rule of "L"'s help determine?
What is crucial for accurate EKG recordings?
What is crucial for accurate EKG recordings?
Which EKG finding indicates AV nodal dysfunction if the PR interval is not prolonged?
Which EKG finding indicates AV nodal dysfunction if the PR interval is not prolonged?
What is the most common cause of sinus arrhythmia?
What is the most common cause of sinus arrhythmia?
What does sinus bradycardia refer to?
What does sinus bradycardia refer to?
What is the heart rate range for sinus tachycardia?
What is the heart rate range for sinus tachycardia?
What is the key criterion for identifying sinus rhythm on an EKG?
What is the key criterion for identifying sinus rhythm on an EKG?
What does a sinus arrhythmia indicate?
What does a sinus arrhythmia indicate?
What is the effect of irritability on automaticity foci's tendency to generate electrical impulses?
What is the effect of irritability on automaticity foci's tendency to generate electrical impulses?
What is the characteristic heart rate range for sinus rhythm?
What is the characteristic heart rate range for sinus rhythm?
What is the defining feature of junctional beats on an EKG?
What is the defining feature of junctional beats on an EKG?
What does an escape beat indicate?
What does an escape beat indicate?
What is the main cause of escape rhythm?
What is the main cause of escape rhythm?
What does a completely inverted P wave in lead II indicate?
What does a completely inverted P wave in lead II indicate?
Study Notes
Electrocardiography Basics and Principles
- Electrocardiography (EKG) was developed by Dr. Willem Einthoven in 1901 and is the most frequently used cardiac diagnostic test.
- The clinical utility of EKG is attributed to its widespread availability, ease of performance, relative cost permissiveness, and lack of procedural risk or contraindications.
- Myocyte contraction depends on myocyte depolarization, which occurs as a wave traveling from one end of the myocyte to the other.
- Different directions of depolarization and repolarization cause specific up or down deflections on the EKG tracing.
- Nomenclature in electrocardiography distinguishes intervals (which include waves) from segments (which are sections of baseline between waves).
- PR interval includes the P wave but not the QRS complex, QT interval includes the QRS complex and the T wave, and ST interval includes the T wave but not the QRS complex.
- There are idiosyncratic conventions for naming intervals and segments involving the QRS complex.
- The J point is where the QRS complex and the ST segment meet.
- The U wave on an EKG tracing is caused by the slowest repolarizer, often the Purkinje fibers.
- The heart rate can be determined by the number of "big blocks" between consecutive beats on a standard EKG tracing.
- The mean electrical axis can be determined in the frontal plane and the horizontal plane using the standard 12-lead EKG with limb and precordial leads.
- The electrical axis can provide important information about the heart's function and structure.
Electrocardiography Rhythm Summary
- Escape beat: transient escape of an automaticity focus to generate one beat due to pause in pacing activity in the dominant pacemaker
- Escape rhythm: escape of an automaticity focus with subsequent pacing at its inherent rate due to cessation of pacing activity in the dominant pacemaker
- Sinus Rhythm EKG Criteria: each QRS complex preceded by a positive P wave in lead II and negative in lead aVR
- Sinus rhythm: heart rate between 60 and 100 beats per minute
- Sinus bradycardia: heart rate less than 60 beats per minute
- Sinus tachycardia: heart rate greater than 100 beats per minute
- Sinus arrhythmia: same criteria as sinus rhythm with greater than 0.16 sec difference between the shortest and longest PP intervals
- Sinus arrhythmia most common cause: respiration, heart rate increases with inspiration and decreases with expiration
- Completely inverted P wave in lead II indicates AV nodal dysfunction if PR interval is not prolonged
- Junctional beats recognized by three possible EKG patterns based on location of automaticity focus and conduction variability
- Retrograde P wave preceding ventricular depolarization confirms origin above the ventricles
- Irritability: increase in automaticity foci's tendency to generate electrical impulses due to various reasons such as hypoxia, electrolyte disturbances, and sympathetic stimulation
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Description
Test your knowledge of electrocardiography basics and principles with this quiz. Learn about EKG nomenclature, intervals, segments, and the clinical utility of EKG. Also, review EKG rhythm criteria and characteristics such as sinus rhythm, bradycardia, tachycardia, arrhythmia, escape beats, and irritability.
