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EKG Refresh and Practice Normal Sinus Rhythm P-Waves, Exams of Human Biology

EKG Refresh and Practice. Normal Sinus Rhythm . Rate: 60 - 100 beats per minute r Rhythrn: Atrial - Regular. Ventricular - Regular o Pwaves:.

Typology: Exams

2021/2022

Uploaded on 09/27/2022

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EKG
Refresh
and Practice
Normal
Sinus
Rhythm
. Rate: 60
- 100
beats
per minute
r Rhythrn: Atrial - Regular
Ventricular
- Regular
o Pwaves: Uniform in appearance
Upright
w/ normal
shape
One
Preceding
each
QRS
Nor more than
.10 second
o PR
interval: 0.12
- 0.20 second
r QRS: 0.10
second
or less
P-Waves:
Should
be
no more than
2.5 mm in height, and
no more
than .10 second
in width
PRInterval:
Includes
the
p-wave
as
it leaves
the baseline
and
ends
at the betinning
ofthe QRS
complex
QRS
Complex:
Measured
from the beginning
of the QRS
complex
(as
the first wave
leaves the
baseline)
to the end
of
the eRS complex
(when
thelast wave
begins
to level out into the ST segment).
The end of the QRS
complex
is called
the J-Point'
Normally positive in lead II
ST Segment:
Begins
with the end
of the QRS
complex
and ends
with the onset
of the T-wave. Normally flat.
Coisidered
elevated
if it is above
the baseline
and
depressed
if it is below the baseline.
An elevated
ST
segrnent
is a sign of myocardial
infarct.
T-Wave:
Begins
as the deflection
gradually
slopes
upward
from the ST segment
and
ends
when
the waveform
retums to baseline.
Should
be
positive
in a Lead
II.
Analyzing a Rhythm StriP
o What is the rate?
o Is it regular
or irregular?
o If irregular,
is there a
pattem of irregularity?
o Are there
P-waves?
...are
they all the same?
o If so,
is the P-R interval
of normal
length
and are
they all the same?
o Is there
only one
P-Wave
for every
QRS
complex?
pf3
pf4
pf5
pf8
pf9

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EKGRefreshand Practice

Normal SinusRhythm

. Rate: 60 - 100beatsperminute

r Rhythrn: Atrial - Regular

Ventricular- Regular

o Pwaves: Uniform in appearance

Upright w/ normal shape

OnePrecedingeachQRS

Nor morethan.10 second

o PR interval: 0.12- 0.20second

r QRS: 0.10secondor less

P-Waves:

Shouldbe no morethan 2.5 mm in height,andno morethan .10^ secondin width

PRInterval:

Includesthe p-waveasit leavesthe^ baselineandendsat the^ betinningofthe QRScomplex

QRSComplex:

Measuredfrom the beginningof the QRS complex(asthe first wave^ leavesthe^ baseline)to the end^ of

the eRS complex(whenthelast wave^ beginsto level out into the ST segment).The end^ of the QRS

complexis calledthe J-Point'

Normally positive^ in lead^ II

ST Segment:

Beginswith the endof the QRS complexandendswith the onsetof the T-wave. Normally flat.

Coisideredelevatedif it is abovethe baselineanddepressedif it is below the^ baseline.^ An elevatedST

segrnentis a sign^ of myocardialinfarct.

T-Wave:

Beginsasthe deflectiongraduallyslopesupwardfrom the ST segmentand^ endswhenthe waveform

retumsto baseline. Shouldbe^ positive^ in a LeadII.

Analyzing a Rhythm StriP

o What is the rate?

o Is it regularor irregular?

o If irregular,is therea pattem^ of irregularity?

o Are thereP-waves?...are they all the same?

o If so, is the P-R interval of normal length^ andarethey all the same?

o Is thereonly oneP-Wavefor everyQRS complex?

Normal Sinus Rhythm (NSR)^

Regular 60 to 100

Positive; Rounded;Normal PR Interval; One P wave for each QRS complex

Narrow

Sinus Bradvcardia Regular^ Lessthan

Positive;Rounded;Normal PR Interval; One P wave for each QRS complex

Narrow

Sinua Tachycardia Regular^100 to 170

Positive;Rounded;NormalPR Interval;OneP wavefor each QRScomplex

Narrow

SinusBlockor SinusArrest

Regular with SuddenPause^

60 to 100

Positive; Rounded;Normal PR Interval; May seeone non- conducting P before pause

Narrow

Atrial Flutter Regular or Irregular

Atrial: 250-400: Ventricular usuallv60-

Positive; Peakedor "Sawtooth" Appearanceto Baseline;Unable to measurePR Interval

Narrow

Atrial Fibrillation Irregular

Atrial: No coordinated systole; Ventricular usuallv60-

None; Wavy deflectionsaffecting baselineas atria quiver Narrow

Junctional Rhvthm Regular 40 to 60 lnverted;May occurbefore/after ORScomplexor be^ hidden^

Narrow

Accelerated Junctional Regular 60 to 100 Inverted;May occurbefore/after QRScomplexor be^ hidden^

Narrow

Junctional Tachvcardia Regular Morethan 100 Inverted; May occur before/after QRS complex^ or be hidden^

Narrow

2" AV Block, Mobitz II

Usually Regular,May be Iregular

Atrial: Varies, Ventricular: UsuallyLess Than

Positive;Rounded;PR^ Interval for conductingbeatsis always WNL; More than I P wavefor eachQRSComplex

UsuallyNarrow

3' AV Block (CompleteHeart Block)

Atrial and Ventricular Regularbut not Corresponding

Atrial: 60 to 100, Ventricular: Usuallv20-

Positive; Rounded;Unable to MeasurePR Interval; P:QRS Ratio variable; P waves may be hidden in QRS or T waves

TypicallyWidened

Bundle Branch Block

Thatof Underlying Rhvthm

That of Underlying Rhrrthm

Positive; Rounded;Normal PR Interval; One P wave for each QRS Complex

BorderlineWide:0. 0.14sec;Usually Notched(QRR'S)

Idioventricular Rhythm GVR) Regular 20 to 40^ Absent^ Wide

AcceleratedIVR Regular 40 to 100 Absent^ Wide

L

Premature Ventricular Conntraction (PVC)

Thatof Underlying Rhythmwith Isolated Anomaly

Thatof Underlying Rhythm

That of Underlying Rhythm; No P Wave PreceedinePVC

Thatof Underlying Rhythm;PVC Wide andMay Have OppositeDeflection from Underlying Rhrrthm