Chapter 13
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CHAPTER 13. The Standard 12-ECG System. Standard 12-ECG System. Consists of four limb electrodes and six chest electrodes Collectively, view the heart from 12 different positions Six standard limb leads Six precordial (chest) leads. ECG Lead Systems. Standard 12-ECG System. Each lead:

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CHAPTER 13

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Chapter 13

CHAPTER 13

The Standard 12-ECG System


Standard 12 ecg system

Standard 12-ECG System

  • Consists of four limb electrodes and six chest electrodes

  • Collectively, view the heart from 12 different positions

    • Six standard limb leads

    • Six precordial (chest) leads


Ecg lead systems

ECG Lead Systems


Standard 12 ecg system1

Standard 12-ECG System

  • Each lead:

    • Views the electrical activity of the heart from a different angle

    • Has a positive and negative component

    • Monitors specific portions of the heart from the point of view of the positive electrode in that lead


Chapter 13

STANDARD LIMB LEADS


Standard limb leads

Standard Limb Leads

  • Fig. 13-1. The standard limb leads—leads I, II, III, aVR, aVL, and aVF. Each of the standard limb electrodes can function as either a positive or negative electrode.


Einthoven s triangle

Einthoven’s Triangle

  • Fig. 13-2. Leads I, II, and III axes form Einthoven’s triangle.


Einthoven s triangle around the heart

Einthoven’s Triangle Around the Heart

  • Fig. 13-3. Einthoven’s triangle around the heart.


Einthoven s triangle around the heart1

Einthoven’s Triangle Around the Heart

  • Fig. 13-4. In the normal heart, the dominant electrical current in the heart flows from the base to the apex in a right to left direction.


Frontal plane and limb leads

Frontal Plane and Limb Leads

  • Fig. 13-5. The frontal plane and the limb leads.


Chapter 13

PRECORDIAL(CHEST) LEADS


Electrodes and precordial leads

Electrodes and Precordial Leads

  • Fig. 13-6. (A) The position of the electrodes on the rib thorax, and (B) the precordial leads as they reflect the surface of the myocardium.


Axis of six precordial leads

Axis of Six Precordial Leads

  • Fig. 13-7. The axis of the six precordial leads.


Horizontal plane and its leads

Horizontal Plane and Its Leads

  • Fig. 13-8. The horizontal plane and its leads.


Electrodes for the monitoring system mcl

Electrodes for the Monitoring System MCL

  • Fig. 13-9. The position of the electrodes for the monitoring system MCL.


Chapter 13

THE ECG PAPER


Ecg monitoring paper

ECG Monitoring Paper

  • Fig. 13-10. The ECG monitoring paper, with the blocks enlarged to illustrate the minimum units of measurement.


Ecg paper

ECG Paper

  • Small square = 0.04 sec.

  • Large square = 5 sm. Sq. = 0.20 sec.

  • Speed = 5 lg. Sq./sec.

  • Vertical portion of sm. Sq. =

    • Amplitude (voltage) of 0.1 millivolt (mV)

    • 1 millimeter (1mm) in distance


Ecg monitoring paper1

ECG Monitoring Paper

  • Fig. 13-10. The ECG monitoring paper, with the blocks enlarged to illustrate the minimum units of measurement.


Ecg monitoring paper2

ECG Monitoring Paper

  • Fig. 13-11. ECG monitoring paper showing markers indicating 3- and 6-second intervals. There are 15 blocks in 3 seconds and 30 blocks in 6 seconds.


Normal ecg configurations

Normal ECG Configurations

  • Fig. 13-12. Normal ECG configurations.


Ecg configuration

ECG Configuration

  • Fig. 13-13. The duration of the normal ECG configuration.


The p wave

The P Wave

  • Represents atrial depolarization

  • Usually symmetrical and upright


The pr interval

The PR Interval

  • Represents the total atrial electrical activity


The qrs complex

The QRS Complex

  • Represents the ventricular depolarization


The qrs complex1

The QRS Complex

  • Fig. 13-14. (A) Q waveform of the QRS. (B) R waveform of the QRS complex. (C) S waveform of the QRS complex.


The st segment

The ST Segment

  • Represents the time between ventricular depolarization and repolarization


St segment highlighted within cardiac complex

ST Segment Highlighted within Cardiac Complex

  • Fig. 13-15. (A) The ST segment highlighted within cardiac complex. Note variation. (B) ST above the baseline. (C) Shows 3 mm ST segment increase. (D) shows 3 mm ST segment decrease.


The t wave

The T Wave

  • Represents ventricular repolarization, rest, and recovery


The t wave1

The T Wave

  • Fig. 13-16. (A) T wave shows ventricular depolarization. (B) The T wave with ST segment elevation. (C) Measuring an inverted T wave and with ST segment depression.


The u wave

The U Wave

  • Its origin and mechanism are not known

  • Often prominent in certain

    • Electrolyte disturbances

    • Medications

    • Heart diseases


The u wave1

The U Wave

  • Fig. 13-17. The U wave highlighted (arrow) within the cardiac complex.


Summary of normal ecg configurations and heart activity

Summary of Normal ECG Configurations and Heart Activity


Summary of normal ecg configurations and heart activity1

Summary of Normal ECG Configurations and Heart Activity

Table 13-2


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