ECG Traces and Leads, Cardiac Cycle, Heart Sounds Diagram - Quizlet

ECG traces and Leads, Cardiac Cycle, Heart sounds Diagram | Quizlet 2023-11-14, 12:11 AM
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Terms in this set (52)
The ECG: electrocardiogram ...
- NOT A DIRECT RECORD of changes in membrane

potential across individual cardiac muscle cells!!!
ECG measures? - Measure of the current generated in the EXTRACELLULAR

FLUID
- by changes occurring simultaneously in MANY cardiac
cells
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Changes in membrane potential
across individual myocardial cell Print
appears as:
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ECG normal trace:
• P wave = atrial depolarisation
Trace definitions: • PR interval = time taken for atrial depolarisation and

electrical activation to get through AV node
• P wave
• PR interval • QRS complex = ventricular depolarisation
• QRS complex
• ST segment • ST segment = interval between depolarisation and
• T wave repolarisation
• T wave = ventricular repolarisation
P wave - seen in which leads? ALL leads apart from aVR
QRS complex - always called this with Yes - still called 'QRS' complex, even if Q and/or S are
different leads? missing (depending on what lead you are looking at)
Conditions: • Increased heart rate

• Tachycardia • Decreased heart rate
• Bradycardia • Heart on right side of chest rather than left
• Dextrocardia
• ST segments raised in anterior (V3, V4) and lateral leads

• ST segments raised in anterior (V3, V4) and lateral leads

MI and ecg trace:
(V5, V6)
• Acute anterolateral MI
• Actute inferior MI
• ST segments raised in inferior leads (II, III, aVF)
Note: atrial repolarisation not evident Occurs at same time as QRS complex - so is hidden
in ecg. Why?
Electrical impulses in heart move in 3 - in 1 dimension

dimensions! - looks big
- looks small or negative
- But ECG only measures...
- Impulse toward electrode looks.. - atria smaller than ventricles
- Impulse away from electrode looks.. - thus less myocytes
- Why is impulse from atria smaller?
LEAD POSITIONS ...
1. Standard limb leads (I, II, III)
3 forms of ecg leads: 2. Augmented leads (aVR, aVL, aVF)
3. Precordial leads (V₁-V₆)
I, II, III
I, II, III
• Form triangle between electrodes on wrist and left leg

(right leg is a ground electrode)
• Negative electrodes = REFERENCE electrodes
• Positive electrodes = RECORDING electrodes
Lead I:
Right arm (-) to left arm (+)
Standard Limb Leads
Lead II:
Right arm (-) to left leg (+)
Lead III:
Left arm (-) to left leg (+)
aVR, aVL, aVF
• Bisect (cut into two) the angles of the limb-lead triangle
• By combining 2 electrodes as reference (-)
Augmented Leads e.g. aVL:

Negative pole is formed by combining right wrist and left
foot. This reference electrode points towards left wrist.
V₁-V₆
V₁-V₆
• Recording electrodes placed on chest
• V₁-V₂ = septal leads
• V₃-V₄ = anterior leads
• V₅-V₆ = lateral leads
Precordial leads (chest leads)

may not need to know↓??
V₁, V₂ = where 4th interc. space meets sternum, on either

side
V₃ = between V₂ and V₄
V₄ = mid-clavicular line, 5th interc. space
V₅ = anterior-axillary line
V₆ = mid-axillary line
- change in VOLTAGE over TIME
Reading an ECG:
1 small square → 0.04s / 40ms
1 large square → 0.2s
- graph shows change in __ over __
- small and large squares across
represent?
• 0.08-0.1s
• 0.08-0.1s
• 0.12-0.2s
Time taken for:
- Atrial depolarisation
• 0.06-0.1s
- AV node delay (PR interval)
- Ventricular depolarisation (QRS)
In a normal ECG: - P-waves are POSITIVE in EVERY LEAD (except aVR)
- P-waves - T-waves are POSITIVE in EVERY LEAD (apart from aVR

- T-waves and sometimes V₁ and V₂ depending on trace)
Upward deflection (positive deflection) is recorded
A wave of depolarisation is a
progressive wave of +ve charges
passing through myocardial cells. http://www.cvphysiology.com/Arrhythmias/A016 - for
more help
When the depolarisation moves
towards a +ve electrode...
-30° to +90°
(= mean electrical axis, sum of all of the mean electrical

vectors occurring during ventricular depolarization)
Cardiac axis normally lies?
The last cells to depolarize in the ventricles are the first to

The last cells to depolarize in the ventricles are the first to

repolarize.
Last cells to depolarize = in subepicardial region of the

ventricles and these cells have shorter action potentials
than found in the subendocardial regions of the
ventricular wall.
So, although the depolarization of the subepicardial cells

occurs after the subendocardial cells; the subepicardial
cells undergo phase 3 repolarization before the
P-wave & QRS complex = positive subendocardial cells.
deflections.
Repolarization waves generally are oriented opposite of
Extra: why T wave also positive wave; depolarization waves (green vs. red arrows), and
even though it represents repolarization waves moving away from a postive
REPOLARISATION? recording electrode produce a positive voltage.
So positive deflections may be:

- depolarisation wave moving towards positive electrode
OR
- repolarisation wave moving away from positive
electrode!
CARDIAC CYCLE ...
Cycle of systole and diastole Systole:

Ventricular contraction & blood ejection - 0.3s
Systole? Lasts?
Diastole:
Diastole? Lasts? Ventricular relaxation & blood filling - 0.5s
1. Isovolumetric contraction
1. Isovolumetric contraction
2. Ejection
Systole:
2 stages?
- ventricular contraction
- increase in pressure
- no change in volume (as all valves remain closed -mitral
and aortic)
Isovolumetric contraction (systole 1)
- ventricular pressure exceeds aortic & pulmonary trunk

pressures
- aortic & pulmonary valves open
- maximal ejection from ventricles→arteries
Ejection (systole 2) - ventricles DO NOT COMPLETELY EMPTY during

contraction!!!
1. Reduced ejection
2. Isovolumetric relaxation
3. Rapid ventricular filling + ventricular suction
4. Slow V filling
Diastole:
5. Atrial booster
5 stages?
Reduced ejection (diastole 1)
- ventricles relax
- ventricular pressure drops below aortic/pulmonary
- aortic & pulmonary valves close and AV valves remain
closed
- thus no blood is entering/leaving the ventricles
Isovolumetric relaxation (diastole 2)
- volume remains same but pressure decreasing
- blood in atria slightly pressurised due to venous return

(SVC, IVC and PV)
- pressure is enough to open mitral and tricuspid valves
- also ventricular pressure has dropped below LA pressure
so opens valves
- lower pressure in ventricles, blood rushes down

Rapid Left Ventricular Filling and
pressure gradient (e#ectively 'sucked' in)
ventricle suction (diastole 3)
- ventricular suction
- responsible for 80% of ventricular filling before atrial
contraction
= DIASTASIS
= DIASTASIS
- blood is continuously flowing from veins into atria

- so pressure between atria and ventricles is equalising
- thus slows filling
- pressure equalisation is called 'diastasis'

Slow Ventricular Filling (diastole 4) - little/no net movement of blood
- AVN is, at this point, delaying stimuli from SAN, to allow

full ventricular filling
- atrial contraction
- sudden pressure increase
- allows ventricles to be actively filled
- squeezes remaining blood from atria
Atrial booster (diastole 5)
Only times when ALL valves in heart Isovolumetric contraction and relaxation
are closed?
TERM LOCATION
Mitral valve closes
TERM LOCATION
Aortic valve opens
TERM LOCATION
EJECTION
TERM LOCATION
ISOVOLUMETRIC CONTRACTION
TERM LOCATION
ISOVOLUMETRIC RELAXATION
TERM LOCATION
Aortic valve closes
TERM LOCATION
Mitral valve opens
TERM LOCATION
RAPID INFLOW/FILLING
TERM LOCATION
DIASTASIS
TERM LOCATION
ATRIAL SYSTOLE
TERM DEFINITION LOCATION
Wigger & Lewis Diagram
Name of diagram
Wigger & Lewis Diagram: - 72 bpm

- 0.8s
For a normal heart, with heart rate of - 0.3s systole
___beats/min, each cardiac cycle lasts - 0.5s diastole
___ - PP interval, from start of one P wave to next
With ___ in systole and ___ in diastole
One cardiac cycle on ECG is shown as

___interval
HEART SOUNDS ...
3
S₁ = "LUB"
How many heart sounds?
Sounds?
S₂ = "DUB"
Third = blood rushing into left ventricle
'lub'
S₁ - AV valve closure
- Soft
- Low pitched
'dub'
S₂
- Aortic and pulmonary valve closure
- Louder
Abnormal, extra sounds
S₃ and S₄
S₃ - Rare. Should not be heard. In older people indicates
heart failure.

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ECG traces and Leads, Cardiac Cycle, Heart sounds Diagram | Quizlet 2023-11-14, 12:11 AM

Try the fastest way to create flashcards

ECG traces and Leads, Cardiac Cycle, Heart sounds

Try Magic Notes and save time

Students also viewed

hypertension drugs: classes The heart(inside) L12 Mechanical Cycle

69 terms 12 terms 7 terms

havrilak Preview zoeyimmordino315 Preview Alexia_Contreras3

Terms in this set (52)

The ECG: electrocardiogram ...

- NOT A DIRECT RECORD of changes in membrane

ECG measures? - Measure of the current generated in the EXTRACELLULAR

Add to class or folder

• P wave = atrial depolarisation

Trace definitions: • PR interval = time taken for atrial depolarisation and

• T wave = ventricular repolarisation

P wave - seen in which leads? ALL leads apart from aVR

Conditions: • Increased heart rate

• ST segments raised in anterior (V3, V4) and lateral leads

• ST segments raised in anterior (V3, V4) and lateral leads

Electrical impulses in heart move in 3 - in 1 dimension

- Why is impulse from atria smaller?

LEAD POSITIONS ...

1. Standard limb leads (I, II, III)

3 forms of ecg leads: 2. Augmented leads (aVR, aVL, aVF)

3. Precordial leads (V₁-V₆)

• Form triangle between electrodes on wrist and left leg

aVR, aVL, aVF

• Bisect (cut into two) the angles of the limb-lead triangle

• By combining 2 electrodes as reference (-)

Augmented Leads e.g. aVL:

• Recording electrodes placed on chest

• V₁-V₂ = septal leads

• V₃-V₄ = anterior leads

• V₅-V₆ = lateral leads

Precordial leads (chest leads)

V₁, V₂ = where 4th interc. space meets sternum, on either

- change in VOLTAGE over TIME

In a normal ECG: - P-waves are POSITIVE in EVERY LEAD (except aVR)

- P-waves - T-waves are POSITIVE in EVERY LEAD (apart from aVR

Upward deflection (positive deflection) is recorded

(= mean electrical axis, sum of all of the mean electrical

The last cells to depolarize in the ventricles are the first to

The last cells to depolarize in the ventricles are the first to

Last cells to depolarize = in subepicardial region of the

So, although the depolarization of the subepicardial cells

So positive deflections may be:

CARDIAC CYCLE ...

Cycle of systole and diastole Systole:

- ventricular pressure exceeds aortic & pulmonary trunk

Ejection (systole 2) - ventricles DO NOT COMPLETELY EMPTY during

Reduced ejection (diastole 1)

- blood in atria slightly pressurised due to venous return

- lower pressure in ventricles, blood rushes down

- blood is continuously flowing from veins into atria

- pressure equalisation is called 'diastasis'

- AVN is, at this point, delaying stimuli from SAN, to allow

Mitral valve closes

Aortic valve opens

Aortic valve closes

Mitral valve opens

TERM DEFINITION LOCATION

Wigger & Lewis Diagram

With _ in systole and _ in diastole