第四节-器械检查-第一讲-心电图-(

第四篇器械检查第一章心电图 Electrocardiogram 吕卓人 第一节临床心电学的基本知识第二节心电图的测量和正常值1 了解心电图产生的原理2 熟悉常用导联 正常心电图各波的图像 正常参考值3 熟悉有关心电图诊断的常用英语词汇 QuestionsWhyECGcouldbeservedforthediagnosisofsomediseases HowdoesECGwork WhatisECG WhatisnormalECG Arealcasewithchestpaindiagnosis A BasicknowledgeofECG 1 DepolarizationandrepolarizationSinglemyocardialcellAmusclestrip2 Vectorandresultantvector 3 Pacingandconductingsystemoftheheart Sinusnode Internodaltracts AVnode rightbundlebranch RBB PurkinjefibersBundleofHisanteriorfascicleleftbundlebranch LBB Purkinjefibersposteriorfascicle 4 Leadsystem Limbleads Standardleads I II III Limbleads aVR aVL aVFHexaxialsystemChestleads V1 V2 V3 V4 V5 V6 V7 V8 V9 B NormalECG PwavePRintervalQRScomplexSTsegmentTwaveQTintervalUwave 1 MeasurementofECGwavesandintervals ECGpaper Measuringheartrate HR 60 R R bpm regularorirregularrhythm Amplitudeofwavesorsegment P QRS S T T U Widthordurationofwaves P QRS T U Durationofintervals P R Q T Shapeofwaves P QRS T 2 MeanQRSaxis lnormalcardiacaxisrangefrom 30 90 lsignificantleftdeviation 30 90 Lrightdeviation 90 180 Lsignificantrightdeviation 180 90 3 ClockwiseandcounterclockwiserotationlClockwiserotation Counterclockwiserotation 4 NormalECG 1 Pwave atrialdepolarizationlAmplitude 0 20mvlDuration 0 11seclPositiveinI II aVF V4 V6 NegativeinaVR 2 PRinterval thetimeforintraatrial AVnodal andHis Purkinjeconduction Duration 0 12 0 20sec 3 QRScomplex ventriculardepolarization lThewidth 0 06 0 10sec 0 11sec lFromV1toV6 theRwavesgetsbiggerandbigger theSwavesgetssmallerandsmaller lR SlinV5lRinV5andV6 2 5mv RinV1 1 0mvlRinaVR 0 5mv lRinaVL 1 2mvandRinaVF 2 0mvlRinI 1 5mvlQ 0 04secinwidth 1 4Rinthesamelead 4 STsegment itreflectsPhase2oftheactionpotential lSTelevation1 10Rinthesamelead maybe 1 2 1 5mVintheprecordialleads 6 QTinterval thedurationofdepolarizationandrepolarizaionofventricles Thenormalrangeis0 32 0 44sec 7 Uwave thewavefollowingtheTwaveandisusuallyverysmall Itscauseisnotcompletelyunderstood ElevatedUwave lowK inplasma C Summary WhyECGcouldbeservedforthediagnosisofsomediseases HowdoesECGwork WhatisECG WhatisnormalECG 1 BasicknowledgeofECG electrocardiogram Depolarizationandrepolarization VectorandresultantvectorPacingandconductingsystemoftheheartLeadsystem Limbleads I II III aVR aVL aVF Chestleads V1 V2 V3 V4 V5 2 NormalECG Pwave QRScomplex Twave Uwave PRinterval QTinterval STsegment R R P P MeanQRSaxisClockwiseandcounterclockwiserotationNormalvalueandshape lAmplitudeofwavesorsegment P QRS T UandS TlWidthordurationofwaves P QRS T UlDurationofintervals P R Q TlShapeofwaves QRS TClinicalsignificancesofabnormalECG TESTinclassroom PleasetranslatethefollowingwordsintoChinese PRACTICE MakeanECGbyyourselffirst ReadandmeasureyourECGwithco