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Tera's Clinical
LP4 Review
| Question | Answer |
|---|---|
| electrocardiograms are taken during a physical examination. What special circumstances will the physician most likely want an ekg for? | patients over 40, with a family history of cardiac disease, and those who have experienced chest pain |
| what is a ECG/EKG? | a graphic presentation of the heart's electrical activity. |
| What does a ECG/EKG measure? | the amount of the electrical activity produced by the heart and the time necessary for the electrical impulses to travel through the heart during each treatment |
| reasons for an ECG/EKG? | detect myocardial ischemia, estimate damage after heart attack, detect and evaluate cardiac arrhythmia, assess effects of cardiac medication on the heart, determine electrolyte imbalance |
| T or F: a ECG/EKG can always detect heart disease | False |
| aspects of correct ECG/EKG procedures | patient preparation, operation of the electrocardiograph, elimination of artifacts, mounting, labeling, and maintenance of the instrument |
| the heart has __ chambers | 4 |
| the heart's upper chambers are known as ___? | atria |
| the heart's lower chambers are known as ___? | ventricles |
| _______ blood enters the right atrium from the superior and inferior ____ ___. | deoxygenated, vena cavae |
| after entering the right atrium, the blood then moves through the ____ _____. | tricuspid valve |
| after passing through the tricuspid valve, the blood moves into the ____ _____. | right ventricle |
| T or F: in a healthy heart, the blood between the right and left sides cannot mix together. | True |
| after entering the right ventricle, the blood then travels to the lungs via the ____ ____. | pulmonary arteries |
| deoxygenated blood gives off the carbon dioxide and picks up oxygen in the ______ bed of the lungs | capillary |
| oxygenated blood is pumped through the pulmonary ___ into the ___ ____. | vein, left atrium |
| after entering the left atrium, blood then travels through the ___ ____. | mitral valve |
| after traveling through the mitral valve, blood then moves into the ___ ____. | left ventricle |
| after the left ventricle, oxygenated blood is then passed through the ___ ____ into the ___ and then to all the cells, tissues, and organs of the body. | aortic valve, aorta |
| on its external surface, the heart is surrounded by coronary ____ that supply the myocardium with its blood supply. | arteries |
| what are the two kinds of cardiac cells? | electrical cardiac cells, and myocardial cells |
| where are the electrical cardiac cells located? | in distinct pathways around and through the heart. |
| what are electrical cardiac cell's pathways referred to as? | the conduction system of the heart |
| the body's natural pacemaker is called ? | the sinoatrial node (SA) |
| where is the sonatrial node located? | the upper part of the right atrium |
| what is the sinoatrial node? | a bundle of specialized cardiac muscle cells that are self-excitatory or pace-maker cells. It sends out an electrical impulse that begins and regulates the heartbeat |
| what does a healthy SA node "fire"at? | 60-70 times a minute in a resting heart |
| when electrical impulses are sent along the pathways, the _____ cells contract. | myocardial |
| the contraction of the cardiac cells is called _______. | depolarization |
| the first chambers affected by the electrical discharge from the SA node are the ___. | atria |
| from the atria, the electrical impulses travel along the conduction system toward the ____. | ventricles |
| after reaching the ventricles, the electrical impulses travel to the _________ ____. | atrioventricular node (AV) |
| where is the atrioventricular node located? | at the base of the right atrium |
| if there is a suppression of the SA node, the AV node can fire intrinsically at the rate of __ to __ times per minute | 40-60 |
| after reaching the atrioventricular node, the electrical impulses are transmitted to the ____ __ ___. | bundle of His |
| the bundle of His divides into right and left bundle branches that continue the electrical impulses on to the _____ ____. | purkinje fibers |
| what do the purkinje fibers do? | disperse the electrical impulses to the right and left ventricles, causing them to contract. |
| if there is a interruption in the electrical signals from the SA or the AV node, the purkinje fibers can fire at __ to __ times per minute | 15-40 |
| the heart recovers electrically (_____) and then relaxes briefly ( ____), and then a new cycle begins. | repolarization, polarization |
| the cycle that involves electrical impulses in the heart that represents one heartbeat | cardiac cycle |
| contraction | systole |
| relaxation | diastole |
| electrical impulses are recorded on special ECG paper or displayed on an ________. | oscilloscope |
| what does MI stand for? | myocardial infarction/heart attack |
| the ____ divides into the left and right bundle branch fibers | bundle of His |
| blood that has been circulated through the body and returned to the right atrium is ____ blood. | deoxygenated |
| contraction of the ventricles is reflected in the _____ on an ECG. | QRS complex |
| the ______ detect the electrical impulses on the body surface | sensors |
| limb electrodes that record simultaneously are called ______ leads | bipolar |
| leads placed on the chest wall are known as ____ leads | precordial |
| ______ lead is placed at the fourth intercostal space at the right margin of the sternum. | V1 |
| muscle tremor is a type of artifact that is also known as _____ | somatic |
| an ECG that reflects a normal tracing in all parameters demonstrates a rhythm called: | normal sinus rhythm |
| ______ blood enters the right side of the heart | deoxygenated |
| the entire route of the electrical impulses through the heart is referred to as the _____ ____ | cardiac cycle |
| _____ refers to the height of the ECG tracing. | amplitude |
| using an AED to restore a regular heart rhythm is called ______. | defibrilation |
| the ______ is a machine used to perform the ECG procedure. | electrocardiograph |
| the _____ line is another name for the baseline on an ECG tracing. | isoelectic |
| the word for the lowest amount of pressure on the vessel during a blood pressure reading is _____. | diastole |
| Ultrasonography and ______ are noninvasive diagnostic procedures commonly used in the clinical setting. | electrocardiography |
| the study of the coronary arteries using a radiopaque medium is called a ______ ________. | cardiac catheterization |
| a _____ ______ is utilized to record heart rate and rhythm for a 24hr period. | Holter monitor |
| list five reasons why an electrocardiograph might be performed. | 1-detect myocardial ischemia 2-estimate damage from heart attack 3-detect cardiac arrhythmia 4-assess cardiac meds 5-detect electrolyte imbalance |
| Lead I records electrical activity between the ____ and the ____. | right arm, left arm |
| Lead II records electrical activity between the _____ and the ____. | right arm, left leg |
| Lead III records electrical activity between the _____ and the _______. | left arm, left leg |
| Lead I, lead II, lead III are ____ leads | bipolar |
| aVr, aVL and aVf are ____ leads | unipolar |
| the aVr records electrical activity from the _____ arm added to the ____ and the ______. | left arm, left leg, right arm |
| the aVL records electrical activity from the ____ added to the ____ and the ___. | right arm, left leg, left arm |
| the aVf records electrical activity from the ____ added to the____ and the ____. | right arm, left arm, left leg |
| the _____ leads are designated aVr, aVL, and aVf | augmented |
| V1 is placed where on the chest? | 4th intercostal space to the right of the sternum |
| V2 is placed where on the chest? | 4th intercostal space to the left of the sternum |
| V3 is placed where on the chest? | midway between V2 and V4 |
| V4 is placed where on the chest? | 5th intercostal space on the left midclavicular line |
| V5 is placed where on the chest? | horizontal to V4 at left anterior axillary line |
| V6 is placed where on the chest? | horizontal to V4 at left of midaxillary line |
| a broken patient cable or lead wire has become detached from an electrode, what type of artifact is it considered? | Interrupted baseline |
| If the patient sings to himself during the procedure, what type of artifact is it? | somatic tremor |
| If the patient uses body lotion what artifact could this cause? | wandering baseline |
| the lead wires are crossed and do not follow the patient's body contour. what type of artifact could this cause? | alternating current |
| repolarization takes place while the heart muscle ___? | relaxes |
| chest leads are also called ____ leads | precordial |
| augmented leads are also called: | unipolar |
| one millivolt of cardiac electrical activity will deflect the stylus exactly: | 10mm high |
| list some things that could cause a wandering baseline: | lotions, creams, oils |
| symptoms of syncope, fatigue, chest pain, and vertigo may indicate what condition? | cardiac arrhythmia |
| a surgical procedure that takes a portion of a vein and grafts it to a coronary artery is called what? | bypass |
| interference with the ECG tracing from other electrical sources is called? | AC interference (alternating current) |
| a life threatening arrhythmia in which the ventricles contract wildly is? | premature ventricular contractions,ventricular fibrillation, ventricular tachycardia |
| a continuous record of cardiac activity is provided by: | Holter monitor |
| Tips to improve heart health | -avoid tobacco, -eat a low fat,low cholesterol, low sodium diet, -keep weight under control, -try to reduce stress, -get enough rest, -take all meds as prescribed, -tell your doctor about anything unusual. |
| name four abnormalities that can be diagnosed using an ECG: | cardiac arrhythmias, ischemia, heart attack, enlarged heart, electrolyte imbalance |
| which limb lead is "grounded"? | the right leg |
| what is an exercise tolerance test? | a noninvasive ECG tracing taken under controlled conditions while the patient is closely monitored to help determine the patient's diagnosis. Vitals are taken during the procedure. |
| what conditions would cancel a exercise tolerance test? | pain, shortness of breath, excess fatigue |
| What patient care is given after an exercise tolerance test is performed? | patient needs to rest, refrain from taking a hot bath or shower, avoid stimulants and extreme temperature changes for several hours |
| oxygenated blood returns from the lungs and flows from the pulmonary veins into the ___ ____. | left atrium |
| tachycardia is defined as a heart rate greater than ____bpm | 100 |
| a 12-lead ECG is called such because: | it produces 12 views of the electroconduction of the heart. |
| voltage is changed into mechanical motion by the _____ in the ECG machine | galvanometer |
| because the skin is a poor conductor of electricity, an ____ substance is applied with each electrode | electrolyte |
| augmented limb leads are: | aVr, aVL, aVf |
| treatment of life-threatening arrhythmias can be delivered using a _____ to deliver countershocks | defibrillator |
| a device that is surgically implanted to provide a regular, steady heartbeat is a: | pacemaker |
| a ____ stress test is one in which the patient exercises on a treadmill after injection of a radioactive substance | thallium |
| This line is present when there is no current flowing in the heart | baseline or isoelectric |
| waves shown on a EKG are either deflecting upward, known as _____ ______ or downward, known as ______ ______. | positive deflection, negative deflection |
| the ___ wave is initiated when the SA node fires and represents atrial polarization | P |
| the P wave is recorded as a _____ deflection | positive |
| the __ __ __ _____ is initiated when the AV node fires and represents ventricular depolarization | QRS complex |
| the QRS complex is measured from the beginning of the __ ____ to the end of the ___ ____. | first wave, last wave |
| the __ wave represents ventricular repolarization and is a positive deflection. | T |
| T or F: the recovery of the atria is so slight that it is lost behind the QRS complex. | True |
| each cardiac cycle takes about ___ seconds | 0.8 |
| squares on the ECG graph paper are _mm by _mm | 5,5 |
| to calculate a heart rate, you should count the 5mm boxes between two __ waves, then divide this number into ____. | R, 300 |
| an electrocardiograph that can simultaneously record several different leads is known as a ______ electrocardiograph | multichannel |
| the most common multichannel machine used in the provider's clinic is the ____ channel machine | three |
| the ______ electrocardiograph has a built in computer program that interprets the ECG tracing while it is being recorded, allowing for faster diagnosis and treatment. | interpretive |
| because skin is a poor conductor, ____ are used in the forms of gels, lotions, pastes, presaturated pads or within adhesive sensors | electrolytes |