ECG QUIZZES- PART II PRACTICE EXAM QUESTIONS WITH CORRECT DETAILED ANSWERS | ALREADY GRADED A+RECENT VERSION

ECG QUIZZES- PART II PRACTICE EXAM QUESTIONS WITH CORRECT DETAILED ANSWERS | ALREADY GRADED A+RECENT VERSION 1) A multi-lead interpretation using a 12 lead ecg allows for - answer anatomic localization of ischemia/infarction & interpretation of axis, chamber enlargement, etc 2) What is included in a 12 lead ecg? - answer 6 limb leads + 6 chest leads (i, ii, iii, avr, avl, avf, v1-v6) 3) Where should v1 be placed? - answer 4th intercostal space to the right of the sternum 4) Where should v2 be placed? - answer 4th intercostal space to the left of the sternum 5) Where should v3 be placed? - answer midway between v2 and v4 6) Where should v4 be placed? - answer 5th intercostal space, midclavicular line on the left 7) Where should v5 be placed? - answer left anterior axillary line, level with v4 8) Where should v6 be placed? - answer left side of the chest, fifth intercostal space, mid-axillary line, level with v5 9) The anterior wall and septum often infarct together because both are - answer supplied by the lad, so antero-septal mi would show in leads v1-v4 10) What does cardiac axis represent? - answer the general direction of depolarization from one point to another in the heart 11) The normal axis on an ecg is between - answer 1. -30 degrees and +90 degrees 2. Positive lead i 3. Positive lead avf 12) Depolarization waves move from the - answer right atrium to left ventricle 13) Left axis deviation on an ecg = - answer 1. Qrs axis less than -30 degrees 2. Positive lead i 3. Negative lead avf 4. Negative lead ii 14) Right axis deviation on an ecg = - answer 1. Qrs axis greater than +90 degrees 2. Negative in lead i 3. Positive in avf 15) Extreme axis deviation on ecg = - answer 1. Qrs axis between -90 degrees and +180 degrees (aka northwest axis) 2. Negative lead i 3. Negative avf 16) The most effective way to look at axis is by looking at leads - answer i and avf 17) If there is a possible lad, you need to look at lead - answer ii 18) What can extreme axis deviation caused by? - answer ventricular rhythms (vt, ivr, ventricular ectopy), hyperkalemia, severe rvh 19) What can indicate atrial enlargement? - answer abnormal p wave morphology 20) Right atrial enlargement = - answer p pulmonale 21) Right atrial enlargement is primary caused by - answer pulmonary htn 22) Left atrial enlargement = - answer p mitrale 23) What can left atrial enlargement indicate if seen in isolation? - answer mitral stenosis 24) What can left atrial enlargement indicate if seen with lvh? - answer systemic htn and/or aortic stenosis 25) In which leads should you look for rae and lae? - answer lead ii, lead v1 26) What is a bifid p wave in lead ii? - answer left atrial enlargement (p waves appears notched) 27) What does right atrial enlargement look like on ecg - draw it out. - answer 28) What does left atrial enlargement look like on ecg - draw it out. - answer 29) What is the ventricular enlargement diagnostic criteria called - answer sokolov-lyon criteria 30) Left ventricular enlargement (lvh) diagnostic criteria - answer 1. S wave depth in v1 + tallest r wave height in v5-v6 has to be 35mm to be considered lvh 2. Voltage criteria must be accompanied by non-voltage criteria to be considered diagnostic of lvh 31) Right ventricular hypertrophy (rvh) diagnostic criteria - answer 1. Right axis deviation of +110 degrees or more 2. Dominant r wave in v1 (7mm tall or r/s ratio 1) 3. Dominant s wave in v5 or v6 (7mm deep or r/s ratio 1) 4. Qrs duration 120 ms 32) What is r wave progression? - answer the progression of the qrs amplitude from mostly negative (predominate s wave) to mostly positive (predominately r wave) through the precordial leads v1-v6 33) R wave progression should transition in - answer v3 34) Poor r wave progression is suggestive of - answer prior antero-septal mi (or lvh/rvh, dilated cardiomyopathy, inaccurate electrode placement) 35) ________ refers to the direction of the depolarization of the wave as it spreads throughout the myocardium answer Axis 36) General direction (average) of depolarization path is known as a "________" answer "vector" (vector may be shown as an arrow in general direction of route of depolarization) 37) Ventricular depolarization (qrs) begins in the ________ and proceeds ________ through the ________ answer 1. Endocardium 2. Outward 3. Ventricular walls 38) The ventricular septum depolarizes from ________ to ________ answer Left to right 39) If all vectors are taken into consideration and averaged, one mean (average) vector can be attained, representing the "________" ________ of the ventricular depolarization (qrs) wave answer "general" direction 40) The mean qrs vector is usually ________ and to the ________ answer Downward and to the left 41) The origin of the qrs vector is considered to be the ________ answer Av node 42) The mean qrs vector may be plotted on the chest by drawing a circle (with the av node as the center and labeling the top half ____ to ____ from right to left, and labeling the bottom half ____ to ____ from right to left answer Top: 0 to -180° bottom: 0 to +180° 43) The mean qrs vector normally points within _____ to ____° answer 0 to 90°