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12-Lead ECG--Study Guide

Study Guide-chapter 9

1. A 12-lead ECG provide us with multiple views of the heart. Identify the different views of the heart.
2. What type of information will a 12-lead provide?
3. The standard 12-lead is composed of six________leads and six _______leads.
4. Name the two planes viewed by the 12-lead
5. Name the directions in the frontal plane
6. Which plane does Leads I, II, III, aVR, aVL, aVF view?
7. Give the directions in the Horizontal plane
8. How is it we only use 10 electrodes to do a 12-lead? Explain this conundrum.
9. Identify the standard limb leads. Bipolar or unipolar?
10. Identify the augmented limb leads. Bipolar or unipolar?
11. Where are the positive poles located for aVL, aVF, and aVR?
12. Where is the negative pole for the augmented leads?
13. Where does aVR view the heart from? What part of the heart does it view?
14. Where does aVL view the heart from and what part of the heart does it view?
15. Where does aVF view the heart from and what area of the heart does it view?
16. How are the chest leads identified?
17. Know what each chest lead views
18. What does the positive and negative electrode poles sense?
19. Define vector as used in cardiology
20. In what direction does a vector point?
21. During normal ventricular depolarization which side of the interventricular septum is stimulated first, and second?
22. Which leads form an equilateral triangle with the heart at the center?
23. In Leads I, II, and III identify the area of the heart each lead views.
Lead I ________________
Lead II _______________
Lead III_________________
24. Which areas of the heart are viewed by the augmented leads?
25. Which area of the heart does the chest leads V1-V3 view?
26. Which area of the heart is viewed by chest leads V4-V6?
27. Define Acute Coronary syndrome
28. List pathological events that may cause ACS
29. List the conditions included in ACS
30. Define Arteriosclerosis and explain how it affects the arteries
31. Compare stable plaques to unstable
32. How are clots dissolved in the arteries?
33. What causes a STEMI? or NSTEMI?
34. Identify the result of Ischemia in heart muscle. What will occur if this is allowed to progress?
35. Describe the cause of MI
36. How would you recognize an infarction on a 12-lead ECG? Explain
37. What is the primary indication of myocardial injury on a ECG?
38. When will you see ST elevation?
39. What does an abnormal Q wave indicate?
40. How long does it take them to appear after occlusion of a coronary artery?
41. Explain Indicative changes
42. Explain Reciprocal changes
43. Which area of the heart is viewed by Leads II, III, and aVF? What type of leads are these? 44. Which artery supplies blood to the area viewed by the leads in No. 43
45. Which area of the heart is viewed by Leads V3 and V4 and which artery along with its adjacent tissue is viewed by these leads?
46. Which artery is known as the "widow maker"? And, what is caused by the blockage of this artery?
47. Which area of the heart is viewed by Leads I, aVL, V5 and V6? Which artery is this area supplied by?
48. Which area of the heart is viewed by Leads V1 and V2 and which artery supplies it?
49. Describe R wave progression and poor R wave progression
50. Explain what happens when there is a delay or block in one of the bundle branches. How does this affect the depolarization of the ventricles?
51. Describe a monofascicular block
52. Describe a bifascicular block
53. Describe a trifascicular block
54. List the two criteria for identification of a right or left bundle branch block
55. Trace the route of an electrical impulse when there is a right BBB
56. Trace the route of electrical impulse when there is a left BBB
57. What part does the J-point play in determining a BBB?
58. using the J-point how do you determine a RBBB? A LBBB?
59. If the right atrium is enlarged, how will it affect the P wave? Describe the P wave as it is affected by the enlarged atrium.
60. If the Left atrium is enlarged, how will it affect the P wave? Describe the P wave in this case.
61. How does ventricular enlargement affect the ECG?
62. Know normal values for:
(a) Sodium
(b) Calcium
(c) Magnesium
(d) Potassium
63. How does the above electrolytes affect the heart in both hypo-- and hyper-- conditions?
64. Practice reading 12-Leads on pages 256-263.