EKG Kaiser Study Guide
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1. Cardiac Con- SA node> AV node> Bundle of His> Left and Right bundle
duction Pathway branches> Purkinjie fibers
System
2. Pacemakers of Natural: SA Node = 60-100 beats/minute
the heart Backup: AV Node = 40-60 beats/minute
Backup: Purkinje Fibers (ventricles) = 20-40 beats/minute
3. SA Node • Intrinsic Pacemaker of the heart
• Rate 60-100 beats/min
• RA (Right Atrium), close to SVC (Superior Vena Cava)
• Blood supply from RCA (Right Coronary Artery) & LCA
(Left Coronary Artery)
4. Interatrial/Intern- Transmits impulses from the SA node to the AV node
odal Tracts through the RA & LA
5. AV node • Slows conduction (40-60 beats/min)
• Physiologic delay allows atrial kick on floor of RA near
tricuspid valve
6. Bundle of His Bundle of cardiac muscle fibers that conducts the electri-
cal impulses from the AV node in the right atrium to the
, EKG Kaiser Study Guide
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septum between the ventricles and then to the left and
right ventricles.
7. bundle branches Right and Left (Left anterior & Left posterior fascicles)
8. Purkinjie Fibers Fibers from Bundle Branches imbedded into the ventricle
walls.
9. Depolarization vs Depolarization - electrical excitation of the cell membrane,
Repolarization normally followed by mechanical contraction
Repolarization - return of cell membrane to its resting
state, normally followed by mechanical relaxation
10. Electrical and The heart has two activities that are performed rhythmi-
mechanical ac- cally: electrical activity followed by mechanical activity
tivity of the heart Electrical activity always precedes mechanical activity
It is possible to have electrical activity without mechanical
response
Always check the patient - Do Not Depend on the Ma-
chine!!!
11. Measurement of A standard ECG is printed at 25mm per second or 25
the boxes in the small squares per second. Since one second divided by
ekg 25 small boxes, then each 1 mm box = 0.04 seconds. The
, EKG Kaiser Study Guide
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larger boxes indicated by the heavier lines are equal to
0.20 seconds.
Voltage is measured along the vertical axis and is ex-
pressed in millivolts (mV). The standard calibration is
that a 1 mV signal produces a 10-mm deflection (0.1
mV=1mm). Simply put 10 small squares vertically is equal
to 1 millivolt
12. EKG waveforms P wave - rounded with upright deflection in lead II, atrial
and intervals depolarization
PR interval- delay @ AV junction
• measure from beginning of P wave to beginning of QRS
• Normal duration 0.12 - 0.20 seconds •
S wave - Negative deflection following the R-wave
QRS complex - multiple components, Ventricular depolar-
ization, - 0.06 -0.11
• Q wave - first negative deflection after P wave R wave
• Positive deflection after the Q
J point - marks where the QRS complex ends and the ST
segment begins
ST segment - normally isoelectric line between QRS and
the beginning of the T wave
QT interval - beginning of the QRS complex to the end of
the T wave; changes with heart rate, usually half of the R to
R interval. beginning of vent activation through Ventricular
depolarization. 0.44 -0.48 (Rate dependent)
T wave - follows the QRS; typically, larger than the P wave
and slightly asymmetric; Ventricular repolarization
U wave - not usually seen, may be due to hypokalemia or
digitalis toxicity
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