29 Questions
Match the following ECG components with their corresponding time intervals:
P wave = 0.08-0.1 sec QRS complex = 0.12 sec ST segment = 0.2 sec PR segment = 0.12-0.2 sec
Match the following ECG intervals with their corresponding durations:
PR interval = 0.12-0.2 sec QT interval = not > 0.45 s ST segment = 0.2 sec QRS complex = 0.12 sec
Match the following ECG segments with their corresponding descriptions:
PR segment = Atrial depolarisation ST segment = Ventricular repolarisation QRS complex = Ventricular depolarisation QT interval = Repolarisation of ventricles
Match the following ECG leads with their corresponding types:
Standard leads = Bipolar limb leads Augmented leads = Unipolar limb leads Precordial leads = Chest leads Limb leads = Arm and leg leads
Match the following heart rate conditions with their corresponding descriptions:
Sinus tachycardia = >100 beats/min (at rest) Sinus bradycardia = <60 beats/min Normocardia = 60-100 beats/min Arrhythmia = Abnormal heart rhythm
Match the following ECG calibration settings with their corresponding values:
1mm = 0.1 mV 5mm = 0.5 mV 1mV = 1cm 25mm/sec = Paper speed
Match the following ECG activities with their corresponding descriptions:
Atrial depolarisation = P wave Ventricular depolarisation = QRS complex Ventricular repolarisation = ST segment Atrial repolarisation = T wave
Match the following ECG segments with their corresponding durations:
PR segment = 0.12-0.2 sec QRS complex = 0.12 sec ST segment = 0.2 sec QT interval = not > 0.45 s
Match the following ECG waves with their corresponding descriptions:
P wave = Atrial depolarisation QRS complex = Ventricular depolarisation T wave = Ventricular repolarisation U wave = Papillary muscle repolarisation
Match the following ECG conditions with their corresponding descriptions:
STEMI = Myocardial infarction Myocardial ischemia = ST segment elevation Hypertrophy = Increased muscle mass Infarction = Myocardial necrosis
Match the following ECG components with their functions:
Electrodes = Detect electrical changes during a cardiac cycle Conducting system = Transmits electrical impulses through the heart Purkinje fibres = Initiate impulses in the cardiac cycle Bundle of His = Divides into bundle branches
Match the following ECG applications with their uses:
Diagnose & manage abnormal rhythms = ECG essential Diagnose cause of chest pain = ECG practical Assist in diagnosis of dizziness = ECG essential Early intervention in myocardial infarction = ECG practical
Match the following ECG preparation steps with their descriptions:
Prepare skin = Shave hair from electrode sites Use quality electrodes = Use only electrodes specified by the manufacturer Correct placement of electrodes = Place 10 electrodes on specific sites Insure good electrode-to-patient contact = Tightly re-seal electrodes
Match the following ECG leads with their descriptions:
Standard / Bipolar limb leads = Measures potential difference between 2 points Augmented / Unipolar limb leads = In practice, these are the same electrodes used for leads I, II and III Precordial / Chest leads = 6 leads placed on the chest 12 Leads = Comprehensive ECG recording
Match the following ECG components with their locations:
S-A node = Spontaneously initiate impulses A-V node = Transmits electrical impulses through the heart Bundle of His = Divides into bundle branches Purkinje fibres = Initiate impulses in the cardiac cycle
Match the following ECG terms with their definitions:
Lead = Electrical picture of the heart Electrode = Detects electrical changes during a cardiac cycle Rhythm = Pattern of heart beats Arrhythmia = Abnormal heart rhythm
Match the following ECG practical steps with their descriptions:
Remove skin = Remove skin prep pad or paper towel Clean sites = Soap and water Dry skin = Prepare skin for electrode placement Shave hair = Shave hair from electrode sites
Match the following ECG components with their functions:
Conducting system = Transmits electrical impulses through the heart Purkinje fibres = Initiate impulses in the cardiac cycle Bundle of His = Divides into bundle branches S-A node = Spontaneously initiate impulses
Match the following ECG lead types with their descriptions:
Right arm = Used as earth Left arm = Part of the standard/bipolar limb leads aVRA = Part of the augmented/unipolar limb leads aVLL = Part of the augmented/unipolar limb leads
Match the following ECG components with their descriptions:
ECG machine = Does the switching and rearranging of the electrodes Electrodes = Detect electrical changes during a cardiac cycle Leads = Electrical picture of the heart Conducting system = Transmits electrical impulses through the heart
Match the following ECG lead placements with their corresponding locations:
V1 = Right mid clavicle V4 = 5th ICS V6 = Left mid axillary V2 = Left mid clavicle
Match the following ECG artefacts with their causes:
Electrical interference = Cell phone Thickened baseline = Muscle tremor Muscle movement = Patient movement Rhythm strip = Electrode misplacement
Match the following ECG components with their descriptions:
P wave = Most clearly seen in Lead II Rhythm strip = Long recording of ECG 12 lead ECG = Standard ECG test ECG practical = Hands-on ECG training
Match the following ECG paper characteristics with their values:
Time (sec) = 5mm = 0.2 seconds Voltage (mV) = 1mV = 10mm Speed = 25mm/sec Standard ECG paper = 25mm = 1 second
Match the following ECG exercises with their descriptions:
Exercise ECG = Stress test for heart conditions ECG practical = Hands-on ECG training 12 lead ECG = Standard ECG test Rhythm strip = Long recording of ECG
Match the following ECG parts with their locations:
Limbs = Arms and legs Chest = Precordial / Unipolar chest leads Right = V1 lead placement Left = V6 lead placement
Match the following ECG artefact causes with their effects:
Electrical interference = Thickened baseline Muscle movement = Artifact on ECG reading Cell phone = Electrical interference Patient movement = Artifact on ECG reading
Match the following ECG procedures with their descriptions:
ECG practical = Hands-on ECG training 12 lead ECG = Standard ECG test Rhythm strip = Long recording of ECG Exercise ECG = Stress test for heart conditions
Match the following ECG components with their uses:
P wave = Measuring atrial activity Rhythm strip = Monitoring heart rhythm 12 lead ECG = Diagnosing heart conditions ECG paper = Recording ECG readings
Study Notes
Introduction to ECG
- The electrocardiograph records the electrical changes during a cardiac cycle.
- The first ECG recording was made by A. Waller in 1887.
ECG Essentials
- ECG is essential for diagnosing and managing abnormal rhythms, diagnosing the cause of chest pain, and intervening early in myocardial infarction.
- It assists in diagnosing dizziness, syncope, and breathlessness.
Conducting System
- The conducting system consists of:
- S-A node: spontaneously initiates impulses.
- A-V node.
- Bundle of His.
- Bundle branches.
- Purkinje fibres.
ECG Practical
- Clinical diagnosis depends on history and evidence to support diagnosis.
- ECG uses electrodes placed on the surface of the body to measure the sum of all cell activities.
Obtaining an ECG Recording
- Prepare the skin by shaving hair from electrode sites, removing skin oils, and cleaning with soap and water.
- Use quality electrodes, ensure good electrode-to-patient contact, and tightly re-seal electrodes to prevent drying out.
Placement of Electrodes
- Place 10 electrodes on specific sites to obtain a 12-lead ECG recording.
- The 12 leads include:
- 3 standard/bipolar limb leads.
- 3 augmented/unipolar limb leads.
- 6 precordial/chest leads.
Leads and Electrodes
- A lead refers to an electrical picture of the heart detected through electrodes.
- The 12 leads are used as an earth to measure potential differences between points.
12 Lead ECG
- The 12-lead ECG is a standard recording that includes a rhythm strip.
- Lead II is usually used to clearly display the P wave.
Artefacts
- Artefacts can be caused by:
- Cell phones.
- Electrical interference.
- Muscle tremor.
- Patient movement.
ECG Paper
-
Standard ECG paper has a voltage scale in millivolts (mV) and a time scale in seconds (sec).
-
The speed of the recording is usually 25mm/sec.### ECG Paper
-
1mm on ECG paper represents 0.04 seconds
-
5mm on ECG paper represents 0.2 seconds
-
Standard ECG paper has 1mm squares, with 1mm = 0.1mV calibration
Calibration
- Calibration signal: 1mV = 1cm
- Calibration example: 5mm = 0.5mV
Electrocardiogram - Waves
- Check calibration (1mV = 1cm)
- Check speed (25mm/sec)
- P wave: atrial depolarization (0.08-0.1sec)
- QRS complex: ventricular depolarization (0.12 sec / 3 small blocks)
- T wave: ventricular repolarization (0.2 sec)
Electrocardiogram - Activity
- Atrial depolarization (0.08-0.1sec)
- Ventricular depolarization (0.12 sec / 3 small blocks)
- Ventricular repolarization (0.2 sec)
- Conduction problems: >>>
Electrocardiogram - Segments
- PR segment: P to QRS complex
- ST segment: QRS complex to T wave
- ST elevation: Myocardial infarction (STEMI)
- Depressed ST segment: Myocardial ischemia
Electrocardiogram - Intervals
- PR interval: time from SA node to ventricular muscle (0.12-0.2 sec / 3-5 small blocks)
- QT interval: time from ventricles to depolarize and repolarize (not > 0.45 s)
12 Leads ECG
- 3 Standard/Bipolar limb leads
- 3 Augmented/Unipolar limb leads
- 6 Precordial/Chest leads
- Check calibration (1mV = 1cm)
- Check speed (25mm/sec)
Heart Rate
- Normal heart rate: 60-100 beats/min
- Sinus tachycardia: >100 beats/min (at rest)
- Sinus bradycardia: <60 beats/min
Learn about the basics of electrocardiography, including the instrument, recording, and history of the first ECG recording. Understand what an ECG measures and its significance.
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