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Physiology

Cardiovascular

Question 28 of 180

Regarding Einthoven's triangle, which of the following statements is CORRECT:

Answer:

The wave of depolarisation through the heart causes local currents in surrounding fluid which are detected at the body surface as small changes in voltage. This forms the basis of the ECG. The classical ECG records voltage between the left and right arm (lead I), the right arm and left leg (lead II) and the left arm and left leg (lead III). This is represented by Einthoven's triangle. The size of the voltage at any time depends on the quantity of muscle depolarisation and the direction in which the wave of depolarisation is travelling. Thus lead II normally shows the largest deflection during ventricular depolarisation, as the muscle mass is greatest and depolarisation travels from apex to base, more or less parallel to a line from the left hip to the right shoulder.

Electrocardiogram (ECG)

The wave of depolarisation through the heart causes local currents in surrounding fluid which are detected at the body surface as small changes in voltage. This forms the basis of the ECG.

The classical ECG records voltage between the right and left arm (lead I), the right arm and left leg (lead II) and the left arm and left leg (lead III). This is represented by Einthoven's triangle.

The size of the voltage at any time depends on the quantity of muscle depolarisation and the direction in which the wave of depolarisation is travelling. Thus lead II normally shows the largest deflection during ventricular depolarisation, as the muscle mass is greatest and depolarisation travels from apex to base, more or less parallel to a line from the left hip to the right shoulder.

By Npatchett (Own work) [CC BY-SA 4.0 , via Wikimedia Commons

Einthoven's Triangle. (Image by Npatchett (Own work) [CC BY-SA 4.0 , via Wikimedia Commons)

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  • Biochemistry
  • Blood Gases
  • Haematology
Biochemistry Normal Value
Sodium 135 – 145 mmol/l
Potassium 3.0 – 4.5 mmol/l
Urea 2.5 – 7.5 mmol/l
Glucose 3.5 – 5.0 mmol/l
Creatinine 35 – 135 μmol/l
Alanine Aminotransferase (ALT) 5 – 35 U/l
Gamma-glutamyl Transferase (GGT) < 65 U/l
Alkaline Phosphatase (ALP) 30 – 135 U/l
Aspartate Aminotransferase (AST) < 40 U/l
Total Protein 60 – 80 g/l
Albumin 35 – 50 g/l
Globulin 2.4 – 3.5 g/dl
Amylase < 70 U/l
Total Bilirubin 3 – 17 μmol/l
Calcium 2.1 – 2.5 mmol/l
Chloride 95 – 105 mmol/l
Phosphate 0.8 – 1.4 mmol/l
Haematology Normal Value
Haemoglobin 11.5 – 16.6 g/dl
White Blood Cells 4.0 – 11.0 x 109/l
Platelets 150 – 450 x 109/l
MCV 80 – 96 fl
MCHC 32 – 36 g/dl
Neutrophils 2.0 – 7.5 x 109/l
Lymphocytes 1.5 – 4.0 x 109/l
Monocytes 0.3 – 1.0 x 109/l
Eosinophils 0.1 – 0.5 x 109/l
Basophils < 0.2 x 109/l
Reticulocytes < 2%
Haematocrit 0.35 – 0.49
Red Cell Distribution Width 11 – 15%
Blood Gases Normal Value
pH 7.35 – 7.45
pO2 11 – 14 kPa
pCO2 4.5 – 6.0 kPa
Base Excess -2 – +2 mmol/l
Bicarbonate 24 – 30 mmol/l
Lactate < 2 mmol/l

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