Fundamentals Test
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| The thorax is made up of ___, sternum and ___; protects heart, ___ and great ___. | ribs, vertebrae, lungs, vessels
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| ___ breath sounds - loud, high-pitched, tubular sounds caused by air moving through trachea | bronchial
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| bronchial breath sounds -___ longer duration than ___ | expiration, inspiration
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| ___ breath sounds - medium-pitched, caused by air moving through bronchi | bronchiovesicular
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| bronchiovesicular breath sounds are best heard where (anterior and posterior locations)? | over 1st and 2nd ICS (anterior) and between scapula (posterior)
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| ___ breath sounds - equal inspiratory and expiratory rates | bronchiovesicular
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| ___ breath sounds - soft, low-pitched, breezy, air moving in smaller airways make these sounds | vesicular
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| vesicular breath sounds are best heard over ___ fields | lung
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| ___ breath sounds have a lengthy inspiratory phase and a short expiratory phase | vesicular
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| wheezing, ronchi, rales are all ___ (or abnormal breath sounds) | adventitious
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| expected respiratory findings - ___ to ___ breaths per minute in adults and ___ to ___ a newborns | 12, 20, 40, 90
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| AP lateral ratio in adults | 1:2
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| AP lateral ratio in infants is equal to lateral ___ | diameter
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| COPD AP lateral ratio is ___, barrel chest | increased
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| lateral curvature of spine | scoliosis
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| excessive thoracic curvature of spine | kyphosis
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| sternal and intercostal retractions are seen in ___ or ___ ___ | hypoxia, respiratory distress
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| deviation of trachea may be caused by ___ enlargement or ___ ___ | thyroid, tension pneumothorax
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| term used for air leaking into subQ tissue, may occur around wounds, central IV, chest tubes, tracheostomy | crepitus
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| ___ chest excursion occurs with shallow breathing, restrictive clothing, airway disease | limited
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| ___ chest excursion may result from airway obstruction, pleural effusion, pneumothorax | asymmetrical
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| ___ ___ is diminished if chest wall is very thick or voice very soft, increased respiratory rate e.g. pulmonary edema, decreased or absent w/decreased air movement e.g. emphysema, asthma | tactile fremitus
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| when percussing the chest, dullness is heard when there is ___ or mass in lungs | fluid
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| air trapping that is heard with emphysema is called ___ | hyperresonance
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| normal distance of diaphragmatic excursion is 3 to __ cm | 6
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| decreased diaphragmatic excursion may indicate ___, paralysis or ___ | atelectasis, COPD
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| name the 2 main networks of blood vessels; ___ and ___ circulation | pulmonary, systemic
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| ___ circulation, oxygen depleted blood - from heart into lungs, where it is oxygenated | pulmonary
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| ___ circulation, coronary circulation, circulates blood through heart itself | systemic
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| always listen to heart in the same… | order
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| ___ is when atria contract (empty), ___ is when ventricles relax (fill) | systole, diastole
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| point of maximal impulse (PMI), is a small pulsation at the ___ ICS | 5th
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| ___ is associated with abnormal blood flow, usually has accompanying murmur | thrill
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| Aunt Polly Takes Meds | aortic, pulmonic, tricuspid, mitral
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| closure of valves between atria and ventricles; S___ | S1 (lub)
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| S1 (lub) is loudest over mitral and ___ areas | tricuspid
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| S1 (lub) marks the beginning of ___ | systole
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| closure of semilunar valves; S___ | S2 (dub)
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| S2 (dub) is loudest at aortic and ___ areas | pulmonic
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| S2 (dub) marks the beginning of ___ | diastole
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| S3 is heard directly after S2 and has a gallop rhythm of KenTUCKy, true or false? | true
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| When is S4 heard and what is the rythm? | immediately before S1 (lub), FLOrida
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| significant distention of jugular vein suggests ___-sided heart failure | right
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| normal venous pressure of jugular vein is <___cm | 3
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| carotid bruits suggest carotid ___ | stenosis
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| precordium pulsations toward axillary line may indicate left ___ ___ | ventricular hypertrophy
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| precordium pulsations toward the right of sternum may indicate ___ ___ | aortic aneurysm
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| grades of murmurs 1/6 | barely audible
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| grades of murmurs 2/6 | faint but easily audible
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| grades of murmurs 3/6, loud murmur without a ___ ___ | palpable thrill
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| murmur >3/6 is never ___ | innocent
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| grades of murmurs 4/6, loud murmur with a ___ ___ | palpable thrill
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| grades of murmurs 5/6, very loud murmur heard with stethoscope lightly on chest, true or false? | true
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| grades of murmurs ___/6, very loud murmur that can be heard without a stethoscope | 6
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| signs of pulmonary oxygenation problem are ___, ___, shininess, ___ of nails | pallor, cyanosis, clubbing
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| Allen’s test is used to asses abnormal pulse finds and ___ ___ in hands, pallor resolves in 3-5 seconds | arterial flow
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| ___-___ ___ is used to assess circulatory impairment of feet, abnormal signs are reddish-purple (signs of arterial insufficiency) | ankle-brachial index (ABI)
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| sac of connective tissue encasing heart | pericardium
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| two thin-walled ___ receive blood into heart | atria
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| purpose of ventricles is to pump blood where | out of the heart
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| broadest side of heart is called | base
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| ___ ___ ___ supplies right atrium, right ventricle and inferior surface of the I ventricle and posterior surface of I ventricle, right does 85% of I ventricle | right coronary artery
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| ___ ___ ___ ___ supplies anterior surface of I ventricle, part of lateral surface of I ventricle and most of ___ septum | left anterior descending artery, intraventricular
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| left circumflex artery, a branch of the ___ ___ ___, supplies left atrium part of lateral surface of I ventricle, inferior surface of I ventricle and the posterior surface of I ventricle, does 15% of I ventricle | left coronary artery (LCA) AKA left main coronary artery (LMCA)
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| Which blood, oxygenated or deoxygenated, enters the right atrium via the superior/inferior vena cava | deoxygenated
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| myocardial cells contain ___ ___, mechanical cells, that when electrically stimulated, slide together and myocardial cell contracts | contractile filaments
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| specialized cells of heart’s electrical system, responsible for spontaneously generating and conducting electrical impulses | pacemaker cells
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| action potential cycle has how many phases | 5
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| action potential phase 0, depolarization, rapid entry of ___ into cell, ___ moves slowly into cell, ___ leaves cell, cell depolarizes, contraction begins, represented by ___ complex | sodium, calcium, potassium, calcium, QRS
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| action potential phase 1, early repolarization, sodium channels partially close, slowing flow of sodium into cell, ___ enters, ___ leaves, results in decreased number of positive electrical charges in cell | chloride, potassium
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| action potential phase 2, plateau phase, calcium slowly enters cell, allows cardiac muscle to sustain an increased period of contraction, responsible for __ segment | ST
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| action potential phase 3, final rapid repolarization, ___ flows quickly out of cell, sodium and calcium channels close (stops entry of sodium and calcium), rapid movement causes inside to become more electrically negative, represented by ___ wave | potassium, T
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| action potential phase 4, resting ___ ___, excess sodium inside cell & excess potassium outside cell, sodium potassium pump activated to move sodium out/potassium in, heart polarized, ready for discharge, cell remains this way until activated by stimulus | membrane potential
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| Deoxygenated blood enters right atrium via ___/___ ___ ___, enters right ventricle via ___ ___, enters left pulmonary artery to left lung. | superior/inferior vena cava, tricuspid valve
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| Oxygenated blood returns to heart via right and left ___ ___ into left atrium, then goes through ___ ___ through left ventricle, then into ___, then enters ___ circulation | pulmonary veins, mitral valve, aorta, systemic
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| cell will not respond to further stimulation and corresponds with onset of QRS complex to peak of T wave during ___ ___ period | absolute refractory
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| vulnerable period, cardiac cells can be stimulated to respond, corresponds with downslope of T wave; ___ ___ period | relative refractory
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| SA node stands for | sinoatrial
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| normal heart beat is result of electrical impulse, begins in SA node that has greatest concentration of ___ cells (have intrinsic rate of 60-100 bpm) | pacemaker
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| Where is the SA node located? | upper posterior part of right atrium
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| atrioventricular junction consists of AV node and non-branching portion of ___ ___ ___ | bundle of HIS
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| rate of atrioventricular junction is ___-___ bpm | 40-60
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| AV node stands for | atrioventricular
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| group of cells located on floor of right atrium, immediately behind tricuspid valve | AV node
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| ___ node helps regulate number of impulses reaching ventricles | AV
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| after passing through AV node, electrical impulse enters Bundle of HIS, located in upper portion of ___ ___, intrinsic rate of 40-60 bpm | interventricular septum
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| Bundle of HIS conducts electrical impulse to what? | right and left bundle branches
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| RBB innervates ___ ___ | right ventricle
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| RBB and LBB | right bundle branches, left bundle branches
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| LBB spreads electrical impulse to ___ ___ and left ventricle | interventricular septum
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| right and left bundle branches (RBB & LBB) divide into smaller branches known as ___ ___ | purkinje fibers
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| purkinje fibers spread from interventricular septum into ___ ___ | papillary muscle
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| purkinje fibers have pacemaker cells capable of firing ___-___ bpm | 20-40
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| ECG records electrical activity of large mass of ___ and ___ cells as specific waveforms and complexes | atrial, ventricular
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| ECG electrodes connected to patient, cable goes from electrode to machine, tracing of electrical activity between two electrodes (recording) is called ___ | lead
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| when an ECG is properly calibrated, one millivolt (mV) equals ___mm | 10
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| ___ wave, atrial depolarization | P
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| Which waveform of cardiac cycle is first? | P wave
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| electrical impulse that originates in SA node, stimulates right atrium, reaches AV node | P wave
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| QRS complex consists of Q, R, S waves, represents spread of electrical impulse through ___ | ventricles
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| ventricular repolarization -___ wave | T
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| ___ segment represents early part of repolarization of right and left ventricles | ST
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| ___ segment - horizontal line between end of P wave and beginning of QRS complex | PR
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| PR segment represents activation of ___ ___, Bundle of HIS, ___ ___ and ___ fibers | AV node, bundle branches, purkinje
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| P wave plus PR segment - PR ___ | interval
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| PR interval reflects depolarization of right and left atria, true or false? | true
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| __ interval represents total ventricular activity (time from ventricular depolarization to repolarization) | QT
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| distortion of ECG tracing, non-cardiac in origin, must assess regularity, rhythm and rate | artifact
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| sinus rhythm - normal heart rhythm ___-100 bpm | 60
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| sinus ___ - rate slower than normal for patient age (<60 bpm) | bradycardia
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| sinus ___ - rate faster than normal for patient age (101-180 bpm) | tachycardia
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| irregular rhythm, SA node fires irregularly 60-100 bpm - sinus ___ | arrhythmia
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| failure of SA node cells to conduct impulse (atria not activated, appears as single missed beat on ECG) | sinus block
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| sinus arrest (sinus pause) - disorder of property of automaticity, see an absent ___ ___ on strip (missed beat) | PQRST complex
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| PAC (premature atrial complexes) - abnormally shaped P wave, premature heartbeats originating in atria, occur when another region of atria ___ before SA node, triggers premature heartbeat | depolarizes
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| SVT | supraventricular tachycardia
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| SVT includes rhythms that begin in ___ ___, atrial tissue or junction, <180 bpm | SA node
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| ___ ___ - ectopic atrial rhythm, irritable site fires very rapidly and regularly (looks like picket fence) | atrial flutter
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| ___ ___ occurs because of altered automaticity in one or several rapidly firing sites in atria, or reentry involving one or more circuits in atria | atrial fibrillation
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| PVC | premature ventricular contraction
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| arises from irritable site within either ventricle, premature or occurring earlier than next sinus beat | PVC (premature ventricular contraction)
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| ventricular tachycardia exists when 3 or more ___’s occur in a row at a rate of <101-250 bpm | PVC
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| chaotic rhythm, begins in ventricles, no organized depolarization of ventricles, muscle quivers - ___ ___ | ventricular fibrillation
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| total absence of ventricular electrical activity, no rhythm, no rate, no pulse, no cardiac output - ___ | asystole
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| name 3 blood oxygenation tests | pulse oximetry, capnography, arterial blood gases
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| ECG renders electrical activity of heart, not mechanical activity, and records what nerves are telling heart to do. How many nodes are placed on skin? | 3 to 5
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| purpose of cardiac monitoring is to identify patient’s baseline ___ and ___, recognize changes in ___ and recognize lethal ___ that require immediate attention. | rhythm, rate, dysrhythmias
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| Which wave represents firing of SA node, conduction of impulse through atria? | P wave
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| What represents ventricular depolarization, leads to ventricular contraction? | QRS complex
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| Which wave represents return of ventricles to electrical rest state, ventricular repolarization? | T wave
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| ___ - abnormal heart rhythms | dysrhythmias
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| tachydysrhythmias, rate | > 100 bpm
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| bradydysrhythmias rate | < 60 bpm
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| ectopy | extra beats
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| junctional – within ___ ___ | AV node
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| air moved in or out of lungs with each breath (normally 500mL) | tidal volume (VT)
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| maximum amount of air than can be inhaled above normal tidal volume (VT), ranges from 2000 to 3000 mL | inspiratory reserve volume (IRV)
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| maximum amount of air that can be forcefully exhaled after normal tidal expiration, ranges from 1000 to 1500 mL | expiratory reserve volume (ERV)
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| air remaining in lungs after forceful expiration, ranges from 1000 to 1500 mL | residual volume (RV)
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| combination of tidal volume and inspiratory reserve volume; Formula (VT) + (IRV), ranges from 2500 to 3500 mL | inspiratory capacity (IC)
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| combination of expiratory reserve volume and residual volume, Formula (ERV)+ (RV), ranges from 2000 to 3000 mL | functional residual capacity (FRC)
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| combination of inspiratory reserve volume and expiratory reserve volume, Formula (IRV)+ (ERV), ranges from 3000 to 4500 mL | vital capacity (VC)
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| contrast dye in veins, serial films taken, test patency of vessels | angiogram
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| evaluates effectiveness of gas exchange | ABG (arterial blood gases)
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| insert endoscope, examine larynx, trache, bronchial tree | bronchoscopy
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| catheter in heart, assess pressure, blood flow, size & patency of chambers | cardiac catheterization
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| anterior/posterior or lateral view of heart/lungs, shows density, evaluates size, masses, fluid | chest x-ray (CXR)
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| MB (myocardial band) isoenzyme present only in heart, high serum of MB band, used to detect MI | creatinin kinase-MB (CK-MB)
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| ultrasound, examines heart function / blood flow | echocardiogram
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| electrodes placed on extremities / chest, illustrates heart rate, rhythm, size, helps evaluate heart damage | electrocardiogram (ECG)
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| serum measurement of oxygen-carrying capacity of blood, may be measured separately or part of CBC | hemoglobin (HgB)
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| continuous ECG tracing, to correlate symptoms and cardiac activity, tracing lasts 48 hrs to 7 days | holter monitor
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| series of test to detect lung volume and capacity | pulmonary monitor
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| microscopic evaluation of sputum | sputum culture
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| Technetium-99m sestamibi injected IV, 90 - 120 min later, heart is scanned, myocardial (hot spots) - damaged areas can be viewed | Techneitium scan
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| large-bore needle through chest wall to obtain fluid specimens, instill meds, or drain accumulations | thoracentisis
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| swap of pharynx or tonsils, assess for pathogens | throat culture
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| evaluates exercise on heart and circulation during exercise using ECG and vital signs monitoring | treadmill test
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| serum protein evaluation, evaluates possible MI, levels elevate up to 7 days after MI | troponin
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| assess for pulmonary embolus, radioactive substance injected, flows to lungs for evaluation, 2nd substance inhaled, maps oxygen distribution | ventilation-perfusion scan
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| what serum measurement assesses for infection | white blood cell (WBC) count
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Created by:
BrandiLynn
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