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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

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



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



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.


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.



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.




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