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K.Sudarahan (PT) : MPT Cardio Pulmonary

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8 views22 pages

K.Sudarahan (PT) : MPT Cardio Pulmonary

Uploaded by

divya prasanna
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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K.

SUDARAHAN (PT)
MPT CARDIO PULMONARY
ECG
ECG-Electrical activity of the myocardial muscle fibres
developed during each heart beat recorded from the
surface of the body.
 Simple test and fastest test used to evaluate the hearts
rhythm and electrical activity.

BIOPHYSICAL BASIS: The electrical events of the heart rate are


conducted throughout the body in all directions .
 Body fluids act as a volume conductor.
 These electrical events can be picked by placing
appropriate electrodes over the surface of the body
 Action potentials decreases by the time they reach
surface (at the heart 100-110mv and at the skin 3mv)
 The recording obtained is an algebraic
sum of action potentials occurring .
 The individual potentials cannot be
recorded from the surface.
 The potentials are not interfered by the
brain and muscle potentials as they are in
microvolts.
ECG LEADS
 A lead is connection between any 2 selected points on
the surface of the body and electro cardiograph.
 There are 12 different leads are used, divided into two
types
1.Bipolar leads: There are 3 different leads.
These are L I ,L II, and L III each lead consists of 2
electrodes one +ve and other –ve.
 Lead I measures the potential difference between right
–ve and left +ve arms.
 Lead II measures the PD between Lt .foot +ve and
right arm-ve.
 Lead III measure PD between the left foot +ve left arm
-ve
Unipolar leads: Unipolar leads are of two types
UNIPOLAR CHEST LEADS
V1 and V2 –Mainly right ventricular
activity is recorded

V3 and V4- Mainly inter ventricular


septal activity is recorded

V5 and V6-Mainly left ventricular activity


is recorded.
UNIPOLAR LEADS

They are of two types 1)Augumented limb leads


These are 1)aVR,
2)aVL and
3)aVF
 aVR =PD between rt arm and lt arm+lt foot
 aVL =PD between lt arm and rt arm+lt foot
 aVF =PD between lt foot and rt arm+lt arm
AUGUMENTED LIMB LEADS
Enithovens law: States that sum of
electrical potentials at three peripheral
points of an equilateral triangle with the
current source in the centre is zero.

For example: If you had an ECG in which the Lead I R


wave has 7mm tall and S wave 2mm tall ,subtract the S from
the R, and you would have 5mm
 On the corresponding complex in lead III the R wave
measures 1mm and the S has negative deflection of 16mm
 subtracting R from the S gives -15mm
 In Lead II using the method as before ,you get a
measurement of -10mm
 Using these measurements with Einthovens law you get
 II=5+-15=-10
So these leads are electrically equilateral. Hence
LI+LIII=LII or
LI+LIII-LII=0
ECG PAPER

 It is milli meter graph paper. In every 5mm there


is thick line .
 Y axis represents voltage 1 mv =10mm.
 X axis represents the time 1 mm =0.04 sec.
 Normal speed of the paper movement is
25mm/sec.
 Each beat of the heart will result in a complex of
waves called PQRST complex.
 The base line is called isoelectric line or
isopotential line.
 P wave is the first positive wave above the
isoelectric line
 Q wave is the small –ve wave and first negative
wave
 R wave is the +ve wave after P wave S wave is
the –ve deflection after R.
 T wave is positve wave after S .wave
P wave
 It represents atrial depolarization.
 Normal duration is 0.08 to 0.12 sec.
 Normal voltage is 0.1 to 0.3 mv
 It undergoes changes with the diseases of the
atria.

Atrial hypertrophy-P wave becomes larger or


Atrial flutter -abnormal p wave called F wave
Atrial fibrillation - “ “ f wave
Atrial tachycardia – inverted p wave
QRS COPLEX

 This represents ventricular depolarization.


 Normal duration is 0.08 to 0.12 seconds.
 Normal voltage is 1 to 3 mv
 Q wave – it represents septal depolarization. This is present in
all bipolar leads
 R wave- it is due to potential travelling to the apex of the
ventricle.
 S wave- it is due to potential travelling to the base of the
ventricles.
 QRS Abnormalities-1)ventricular hypertrophy
2) myocardial infarction
3)complete av block
4)bundle branch block
5)ventricular ectopics
T Wave

 T wave represents ventricular repolarization


 Normal duration is 0.27 seconds
 Normal voltage is 0.2 to 1 mv
 It is normally positive wave except in LIII.
U Wave
 It is due to delayed repolarization of intra
ventricular conduction system
 It is seen in V2 to V4 leads
Myocardial infarction
Myocardial ischaemia
Thank you.

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