Electrocardiograph
Instrument used for recording [blank_start]electrical[blank_end] activity of heart
One millivolt produces a [blank_start]10[blank_end] mm vertical deflection on paper
Proper speed on ECG recorder is [blank_start]25[blank_end]mm/sec
During exercise testing: record during rest, exercise and recovery
Used for monitoring during [blank_start]stress[blank_end] test
Electrode is placed on the skin to conduct [blank_start]electric[blank_end] current from body to measuring device
Leads display movement of electricity from one electrode to another
[blank_start]12[blank_end] lead EKG uses [blank_start]10[blank_end] electrodes
Limb leads should be placed on [blank_start]upper[blank_end] body for stability during exercise
Ensure electrode stability
1. [blank_start]clean[blank_end] and shave site
2. use [blank_start]conductive[blank_end] electrode jelly
3. Secure with [blank_start]elastic[blank_end] bandage
4. Use low [blank_start]impedance[blank_end] / high stickiness electrodes
Answer
electrical
10
25
stress
electric
12
10
upper
clean
conductive
elastic
impedance
Question 2
Question
Oscilloscope
Provides [blank_start]visual[blank_end] image of electrical activity of the heart
Usually shows [blank_start]lead II[blank_end]
Disinfect electrodes with [blank_start]alcohol[blank_end]
Answer
visual
lead II
alcohol
Question 3
Question
Electrodes
[blank_start]V1[blank_end] – 4th intercostal space on right side of sternum. Looks at the right heart
[blank_start]V2[blank_end] – 4th intercostal space on the left side of the sternum. Looks at [blank_start]right[blank_end] heart
V3 – Between [blank_start]V2[blank_end] and V4 on left side. Looks at [blank_start]ventricular[blank_end] spetum
V4 – [blank_start]5th[blank_end] intercostal space, left mid-clavicular line. Looks at [blank_start]ventricular[blank_end] septum
V5 – Between [blank_start]V4[blank_end] and V6 on left side. Looks at [blank_start]left[blank_end] heart.
V6 – intercostal space, left mid [blank_start]axillary[blank_end] line. Looks at [blank_start]left[blank_end] heart.
Answer
V1
V2
V2
5th
ventricular
ventricular
right
V4
axillary
left
left
Question 4
Question
Leads
[blank_start]AVF[blank_end]: [blank_start]Left[blank_end] Leg or foot +, everything else –
[blank_start]AVL[blank_end]: Left arm +, everything else –
[blank_start]AVR[blank_end]: Right arm +, everything else –
Lead [blank_start]III[blank_end]: Left leg +, L arm –
Lead [blank_start]II[blank_end]: Left leg +, R arm –
Lead [blank_start]I[blank_end]: Left Arm +, Right arm –
Answer
AVF
Left
AVL
AVR
III
II
I
Question 5
Question
Exercise Equipment
Ergometers
[blank_start]Arm[blank_end] Ergometer
Use if pt cannot perform leg exercise
Smaller Muscle mass in upper body stresses cardio and respiratory systems [blank_start]less[blank_end]
Leg Ergometer (Bike)
Good for patients with difficulty [blank_start]walking[blank_end]
Increase workload by increasing pedaling [blank_start]frequency[blank_end] or increasing [blank_start]resistance[blank_end]
Advantages: Less expensive, lighter, portable. Less fall risk, pt can stop exercising by choice, easier vitals, results are independent of bodyweight.
Disadvantages: uncomfortable, exercise is limited more by [blank_start]muscle[blank_end] fatigue in legs
Use [blank_start]metronome[blank_end] to keep pace
Workload is independent of pt weight.
Treadmill
Vary the workload by [blank_start]speed[blank_end] and [blank_start]grade[blank_end]
Speed = belt length x RPM
Pt should take long strides. Don’t [blank_start]lean[blank_end] and don’t talk
Douglass bag and Tissot spirometer used to measure ventilation and expired gas concentration.
Have recording device that can plot volume, flow and time.
Emergency equipment should be available – Cardiac monitor and defribrillator should be present esp with pt with heart disease.
Advantage: Walking is natural, 75% of stress tests are done on treadmill
Disadvantage: Fall Rish, patient cannot stop on their own, difficult to obtain vitals, body weight is a factor
Calibrate by multiplying belt length by RPM
Step Method
Vary the workload by step height and ste0p rate
Simple to do
Difficult to determine [blank_start]specific[blank_end] workload