1.
One small square on an EKG is equivalent to how much time ( and what distance)?
Correct Answer
C. .04 sec (1mm)
Explanation
In an EKG, the small squares on the graph paper represent a specific amount of time. The standard measurement is that one small square equals 0.04 seconds. Additionally, the small squares also represent a specific distance, with each small square measuring 1 millimeter. Therefore, the correct answer is ".04 sec (1mm)" as it accurately represents the time and distance measurement of one small square on an EKG.
2.
One large square is equal to what amount of time (and distance) on EKG?
Correct Answer
D. 0.2 sec/5mm
Explanation
The correct answer is 0.2 sec/5mm. This means that one large square on an EKG represents a time interval of 0.2 seconds and a distance of 5 millimeters. The EKG measures the electrical activity of the heart, and each square on the EKG paper represents a specific time and distance measurement. Therefore, this answer correctly identifies the time and distance represented by one large square on the EKG.
3.
What leads are considered inferior leads?
Correct Answer
A. II, III, aVF
Explanation
II, III, and aVF leads are considered inferior leads in electrocardiography. The term "inferior" refers to the anatomical location of these leads on the body. These leads are placed on the lower part of the chest and abdomen. The inferior leads are useful for detecting abnormalities in the inferior wall of the heart, including the right ventricle and the inferior part of the left ventricle. They are particularly important in diagnosing conditions such as inferior myocardial infarction.
4.
What leads are considered (left) lateral leads?
Correct Answer
B. I, aVL
Explanation
The leads I and aVL are considered (left) lateral leads because they are positioned on the left side of the heart. These leads provide a view of the lateral wall of the left ventricle and help in diagnosing conditions such as myocardial infarction or ischemia affecting this area. The other leads mentioned, aVR, V5, V6, II, and III, are not considered lateral leads as they do not provide a direct view of the lateral wall.
5.
Choose the correct placement of V1 :
Correct Answer
C. 4th right intercostal space
Explanation
The correct placement of V1 is in the 4th right intercostal space. This is a standard placement for the V1 electrode in an ECG (electrocardiogram) test. The intercostal spaces are the spaces between the ribs, and the 4th right intercostal space refers to the space on the right side of the chest, between the 4th and 5th ribs. This placement allows for accurate measurement of the electrical activity of the heart from this specific location.
6.
Name the correct placement of V2:
Correct Answer
A. 4th left intercostal space
Explanation
The correct placement of V2 is in the 4th left intercostal space. This is a specific location on the chest where the electrode for lead V2 is placed during an electrocardiogram (ECG) test. The ECG measures the electrical activity of the heart and helps diagnose various heart conditions. Placing the electrode in the correct position allows for accurate readings of the heart's electrical signals.
7.
Name the placement for V4
Correct Answer
C. 5th intercostal space, midclavicular line
Explanation
The correct answer is 5th intercostal space, midclavicular line. This is the correct placement for V4 in an ECG (electrocardiogram). V4 is typically placed in the 5th intercostal space, which is the space between the ribs, and it is positioned along the midclavicular line, which is a vertical line drawn down from the midpoint of the clavicle. This placement allows for accurate recording of the electrical activity of the heart from this specific lead.
8.
What view of the heart does V1-V4 give ?
Correct Answer
A. Anterior
Explanation
V1-V4 leads in the electrocardiogram (ECG) provide a view of the anterior surface of the heart. These leads are placed on the chest in specific positions to capture electrical activity from the front of the heart. By analyzing the ECG waveform in these leads, healthcare professionals can assess the electrical conduction and function of the anterior part of the heart, including the left ventricle and the septum.
9.
What view of the heart does V5-V6 give ?
Correct Answer
A. Left lateral view
Explanation
V5-V6 electrodes are placed on the left side of the chest, specifically on the left anterior axillary line and left midaxillary line respectively. These positions provide a left lateral view of the heart. This view allows for the visualization of the left ventricle, left atrium, and the lateral walls of the heart. The electrical activity recorded from these electrodes helps in diagnosing conditions such as left ventricular hypertrophy and myocardial infarction in the lateral wall of the heart.
10.
Normal height and length of P wave?
** < stands for less than or equal to
Correct Answer
C.
Explanation
The normal height of a P wave is usually less than or equal to 2.5 mm, and the normal length is typically less than or equal to 0.11 seconds. These measurements are used to assess the electrical activity of the atria during an electrocardiogram (ECG). Abnormalities in the height or length of the P wave can indicate various cardiac conditions, such as atrial enlargement or conduction abnormalities.
11.
In which lead is the P wave best seen?
Correct Answer
A. II
Explanation
The P wave represents atrial depolarization in an electrocardiogram (ECG). Lead II is positioned between the right arm and left leg, providing a good view of the electrical activity in the heart's inferior region. This makes it the best lead to visualize the P wave, as it captures the atrial depolarization from a more optimal angle.
12.
In which leads would you see a positive P wave?
Correct Answer
D. I, II, AVL, AVF, V4-V6
Explanation
The P wave represents atrial depolarization in an electrocardiogram (ECG). It is a small upward deflection before the QRS complex. A positive P wave indicates that the electrical activity is moving towards the positive electrode. In leads I, II, AVL, AVF, V4-V6, the positive electrode is positioned in a way that it can detect the atrial depolarization moving towards it, hence resulting in a positive P wave.
13.
In which lead would you see a BIPHASIC P wave?
Correct Answer
C. V1
Explanation
In lead V1, a BIPHASIC P wave can be seen.
14.
What is the normal length in PR interval in both seconds and mm?
Correct Answer
B. 0.12 to 0.20 seconds (3-5 mm)
Explanation
The normal length of the PR interval is 0.12 to 0.20 seconds (3-5 mm). This indicates the time it takes for the electrical signal to travel from the atria to the ventricles in the heart. A PR interval within this range suggests a normal conduction of the electrical impulses and proper coordination between the atria and ventricles.
15.
Normal duration of QRS complex?
Correct Answer
A. 0.06 to 0.10 seconds
Explanation
The normal duration of the QRS complex is 0.06 to 0.10 seconds. This represents the time it takes for the electrical impulses to travel through the ventricles of the heart, causing them to contract and pump blood. Any deviation from this range may indicate abnormalities in the conduction system of the heart, such as bundle branch blocks or ventricular hypertrophy.
16.
Regarding the QRS complex: In which leads would you see a Deep S wave ?
Correct Answer
B. V1, V2
Explanation
In leads V1 and V2, a deep S wave is typically seen in the QRS complex. This is because these leads are positioned over the right ventricle, which is responsible for generating the S wave. Leads V3, V4, V5, and V6 are positioned over the left ventricle, and therefore typically show a taller R wave rather than a deep S wave.
17.
Regarding the QRS complex: In which lead(s) would you see a TALL R wave?
Correct Answer
D. V5,V6
Explanation
The QRS complex represents the depolarization of the ventricles during a heartbeat. A tall R wave in the QRS complex indicates a strong depolarization of the ventricles. In leads V5 and V6, the electrodes are placed over the left ventricle, which is responsible for generating a large portion of the electrical activity during depolarization. Therefore, it is expected to see a tall R wave in leads V5 and V6.
18.
Regarding the QRS complex: In which lead(s) would you see a biphasic complex, reflection a "transition zone"?
Correct Answer
C. V3, V4
Explanation
In the QRS complex, a biphasic complex refers to a waveform that has both positive and negative deflections. The "transition zone" refers to the point where the QRS complex changes from predominantly negative to predominantly positive. In this case, leads V3 and V4 would show a biphasic complex with a transition zone, indicating a change in the direction of the electrical activity.
19.
In what leads do you see an "R wave progression"?
Correct Answer
A. V1 to v6
Explanation
The correct answer is v1 to v6. R wave progression refers to the gradual increase in the amplitude of R waves from lead V1 to V6 on an electrocardiogram (ECG). In a normal ECG, the R wave should progressively increase in amplitude from V1 to V6, indicating normal ventricular depolarization. This pattern can be disrupted in certain cardiac conditions such as myocardial infarction or ventricular hypertrophy. Therefore, the presence of R wave progression in leads V1 to V6 suggests a normal cardiac electrical conduction.
20.
What part of the EKG is known as the "plateau phase", and represents the initial part of ventricular repolarization?
Correct Answer
B. ST Segment
Explanation
The ST segment of the EKG is known as the "plateau phase" and represents the initial part of ventricular repolarization. During this phase, the ventricles are in a state of electrical recovery and preparing for the next heartbeat. The ST segment is important in diagnosing various cardiac conditions, such as myocardial infarction, as any deviations from the normal baseline can indicate abnormalities in the heart's electrical activity.
21.
What segment, if elevated or depressed, reveals a sign of serious pathology?
Correct Answer
A. ST
Explanation
Elevation or depression of the ST segment on an electrocardiogram (ECG) is a significant sign of serious pathology. The ST segment represents the interval between ventricular depolarization and repolarization. Any abnormality in this segment can indicate myocardial infarction, ischemia, or other cardiac conditions. Therefore, the correct answer is ST.
22.
What wave represents ventricular repolarization?
Correct Answer
D. T wave
Explanation
The T wave represents ventricular repolarization. During ventricular repolarization, the ventricles of the heart relax and reset their electrical charge in preparation for the next heartbeat. The T wave on an electrocardiogram (ECG) represents this phase of the cardiac cycle. It shows the electrical activity as the ventricles recover and return to their resting state.
23.
Which of the following best represents the normal height of the T WAVE?
Correct Answer
B. 1/3-2/3 height of corresponding R wave
Explanation
The T wave represents the repolarization of the ventricles in the heart. It is typically a positive deflection on an ECG waveform. The normal height of the T wave is usually between 1/3 and 2/3 of the height of the corresponding R wave. This means that the T wave is generally smaller in amplitude compared to the R wave.
24.
What portion of the EKG represents the duration of ventricular systole?
Correct Answer
A. QT interval
Explanation
The QT interval on an EKG represents the duration of ventricular systole. It measures the time it takes for the ventricles to contract and then relax. This interval includes the depolarization and repolarization of the ventricles, which is crucial for proper heart function. Monitoring the QT interval can help identify any abnormalities in ventricular systole, such as a prolonged QT interval which may indicate an increased risk of arrhythmias. Therefore, the correct answer is QT interval.
25.
The QT interval varies with heart rate, and thus must be corrected. This corrected QT interval is also abbreviated as (QTc). This value is considered normal when it's less than half of the _____ interval at normal rates.
Correct Answer
C. R-R
Explanation
The QT interval is a measure of the time it takes for the ventricles of the heart to contract and then recover. It is influenced by the heart rate, with shorter QT intervals at faster heart rates and longer QT intervals at slower heart rates. To account for this variability, the QT interval is corrected using the R-R interval, which represents the time between consecutive ventricular contractions. The corrected QT interval (QTc) is considered normal when it is less than half of the R-R interval at normal heart rates.
26.
An R-R interval represents what on the EKG?
Correct Answer
C. One complete cardiac cycle
Explanation
An R-R interval represents one complete cardiac cycle on an EKG. The R-R interval is the time between two consecutive R waves, which corresponds to the contraction and relaxation of the ventricles of the heart. This interval is used to measure the heart rate and assess the regularity of the heart rhythm.
27.
What does the Sympathetic system do to the heart, and what receptors are associated with it?
Correct Answer
A. Constrict arteries (alpHa 1 adrenergic receptors)
Explanation
The sympathetic system constricts arteries through the activation of alpha 1 adrenergic receptors. These receptors are responsible for causing vasoconstriction, which leads to a narrowing of the arteries. This response increases blood pressure and redirects blood flow to vital organs during times of stress or danger.
28.
What does the Parasympathetic system do to the heart, and what receptors are associated with it?
Correct Answer
D. Dilation of arteries (cholinergic receptors)
Explanation
The parasympathetic system causes dilation of arteries through the activation of cholinergic receptors. Cholinergic receptors are associated with the release of acetylcholine, which is the neurotransmitter responsible for the parasympathetic response. When these receptors are activated, they cause relaxation of smooth muscles in the arterial walls, leading to dilation of the arteries. This dilation helps to increase blood flow and decrease blood pressure.
29.
Vasovagal syncope is a reflex of ________response (dilates systemic arteries causing hypotension and slows SA node).
Correct Answer
A. Parasympathetic
Explanation
Vasovagal syncope is a reflex that occurs when the parasympathetic nervous system is activated. This activation leads to the dilation of systemic arteries, causing a drop in blood pressure (hypotension). Additionally, it slows down the SA node, which is responsible for initiating the electrical signals that regulate the heart's rhythm. Therefore, the correct answer is parasympathetic.
30.
*Neurocardiogenic syncope: paradoxical __________response to prolonged _________, causing __________and slowing of the pulse, resulting in loss of consciousness. (Tilt test that is positive confirms dx)
Correct Answer
B. Parasympathetic; standing; vasodilation
Explanation
The correct answer is parasympathetic; standing; vasodilation. Neurocardiogenic syncope is a condition characterized by a sudden drop in blood pressure and heart rate, leading to loss of consciousness. In this condition, the parasympathetic nervous system, which is responsible for rest and digestion, becomes overactive. When a person stands up, the parasympathetic response causes blood vessels to dilate, leading to a decrease in blood pressure. This decrease in blood pressure and the slowing of the heart rate result in loss of consciousness. The tilt test, which reproduces the symptoms, can confirm the diagnosis.
31.
What is the best match for the following definition: a barely detectable rate change in sinus pacing related to inspiration and expiration ?
Correct Answer
C. Sinus arrythmia
Explanation
Sinus arrhythmia is the best match for the given definition. Sinus arrhythmia refers to a barely detectable rate change in the pacing of the heart's sinus node, which is influenced by the process of inspiration and expiration. This phenomenon causes the heart rate to slightly increase during inspiration and decrease during expiration. It is a normal variation in heart rhythm and is commonly observed in healthy individuals. Atrial arrhythmia, atrioventricular arrhythmia, and ventricular arrhythmia do not specifically involve rate changes related to inspiration and expiration, making them less suitable matches for the given definition.
32.
Upon inspiration, your HR _________, and upon expiration, your HR ____________ ?
Correct Answer
A. Increases; decreases
Explanation
Just think= I for inspiration
I for increase
33.
_____________ is an irregular rhythm produced by pacemaker activity wandering from SA node.
Correct Answer
B. Wandering pacemaker
Explanation
Wandering pacemaker refers to an irregular rhythm that occurs when the pacemaker activity wanders away from the sinoatrial (SA) node, which is the normal pacemaker of the heart. In this condition, the pacemaker activity shifts between the SA node and other sites within the atria. This results in an irregularity in the heart's rhythm. Therefore, the correct answer is wandering pacemaker.
34.
True or False: ·
The wandering pacemaker has an abnormal rate range, and its cycle length varies.
Correct Answer
B. False
Explanation
The wandering pacemaker has a NORMAL rate range- it's cycle length varies
35.
What disease shows a HR > 100 bpm·and P' waves of various shape?
Correct Answer
A. Multifocal Atrial Tachycardia
Explanation
Different atrial foci firing= different p wave morphologies
36.
What is another name for an automaticity focus that escapes overdrive suppression to pace at its inherent rate?
Correct Answer
C. Escape rhythm
Explanation
An escape rhythm refers to the phenomenon where a specific area of the heart takes over the role of the natural pacemaker, pacing the heart at its inherent rate. This rhythm occurs when the normal pacemaker fails or is suppressed by overdrive, allowing another area of the heart to initiate the heartbeat. It is considered an automaticity focus because it originates from an ectopic site within the heart and escapes the suppression of the normal pacemaker.
37.
What is another name for an automaticity focus that transiently escapes overdrive suppression to emit one beat (atrial, junctional, or ventricular)?
Correct Answer
B. Escape beat
Explanation
An escape beat is another name for an automaticity focus that transiently escapes overdrive suppression to emit one beat. It refers to a single beat that occurs when the normal pacemaker fails to fire or is suppressed, and another pacemaker site takes over temporarily. This can happen in the atria, junctional area, or ventricles, resulting in an escape beat.
38.
1. a _____ escape beat produces a large QRS.
2.a _______escape beat may produce a retrograde P' before/after/buried within QRS,
3. A______escape beat is followed by P',
Correct Answer
A. 1. ventricular; 2. junctional; 3. atrial
Explanation
A ventricular escape beat produces a large QRS complex because it originates from the ventricles, which have a larger muscle mass compared to the atria. A junctional escape beat may produce a retrograde P' wave before, after, or buried within the QRS complex because it originates from the AV junction, which can cause the electrical signal to travel backwards towards the atria. An atrial escape beat is followed by a P' wave because it originates from the atria, which results in a normal atrial depolarization before the ventricles contract.
39.
Cardiac parasympathetic innervation cannot inhibit SA node/atrial foci/junctional foci, but it can inhibit ventricular foci.
Correct Answer
B. False
Explanation
ardiac parasympathetic innervation can inhibit SA node/atrial foci/junctional foci producing a pause, but it cannot inhibit ventricular foci
40.
Premature atrial beat is every other beat
Correct Answer
A. Atrial Bigeminy
Explanation
Atrial bigeminy is a cardiac arrhythmia characterized by premature atrial beats occurring every other beat. This means that after every normal beat, there is a premature beat originating from the atria. This results in a pattern of alternating normal and premature beats, hence the term "bigeminy." Atrial trigeminy, on the other hand, refers to premature atrial beats occurring every third beat. Since the given description matches atrial bigeminy, it is the correct answer.
41.
What would cause an inverted P’ immediately before premature QRS?
Correct Answer
A. Premature junctional beat causing retrograde atrial depolarization
Explanation
A premature junctional beat occurs when the electrical signals in the heart originate from the junction between the atria and the ventricles, instead of the normal site in the atria. In this case, the premature junctional beat causes an abnormal depolarization of the atria, which is conducted in a retrograde manner towards the atria. This retrograde atrial depolarization results in an inverted P' wave immediately before the premature QRS complex.
42.
3 or more PVC’s in a row is also known as what?
Use full answer, or standard abbreviation.
Correct Answer
Ventricular Tachycardia
VT
ventricular tachycardia
Explanation
When a person experiences 3 or more premature ventricular contractions (PVCs) in a row, it is referred to as Ventricular Tachycardia (VT). VT is a condition characterized by a rapid heart rate originating from the ventricles, the lower chambers of the heart. It can be potentially life-threatening and may require medical intervention. The abbreviation "VT" is commonly used to represent Ventricular Tachycardia.
43.
If a PVC falls on a ___ wave, it could lead to serious arrhythmias. This is known as ____ on ____ phenomenon.
Correct Answer
A. T; R,T
Explanation
When a PVC (premature ventricular contraction) falls on a T wave, it can cause serious arrhythmias. This phenomenon is known as "R on T" phenomenon.
44.
The rate of Paroxysmal tachycardia is typically:
Correct Answer
B. 150-250 bpm
Explanation
Paroxysmal tachycardia is a condition characterized by sudden, rapid heartbeats that start and stop abruptly. The correct answer, 150-250 bpm, indicates that the typical heart rate during an episode of paroxysmal tachycardia falls within this range. This means that during an episode, the heart rate can range from 150 beats per minute to 250 beats per minute.
45.
Match the definition below with its appropriate vocab term:
"A continuous reentry circuit in AV node or lower atria that rapidly paces atria and ventricles (can only be eliminated by catheter ablation)"
Correct Answer
D. AVNRT
Explanation
AVNRT stands for atrioventricular nodal reentrant tachycardia. It is a type of supraventricular tachycardia (SVT) characterized by a continuous reentry circuit in the atrioventricular (AV) node or lower atria. This abnormal circuit causes rapid pacing of both the atria and ventricles, leading to a fast heart rate. AVNRT can only be eliminated by a procedure called catheter ablation, which involves destroying the abnormal electrical pathway in the heart.
46.
What would you typically see on EKG if a patient had Bundle Branch Block
Correct Answer
A. Wide QRS
Explanation
A bundle branch block is a condition where there is a delay or blockage in the electrical conduction through the bundle branches of the heart. This leads to a delay in the ventricles contracting, resulting in a widened QRS complex on an EKG. The QRS complex represents the depolarization of the ventricles, and a widened QRS indicates that the electrical impulse is taking longer to travel through the ventricles. Therefore, the correct answer is "Wide QRS."
47.
What is the best lead for determining RAD?
Correct Answer
C. Lead I
Explanation
Lead I is the best lead for determining RAD because it provides a view of the electrical activity between the right and left arm electrodes. This lead is helpful in assessing the axis deviation of the heart, as it shows the electrical flow from the right arm to the left arm. By analyzing the QRS complex in Lead I, healthcare professionals can determine if there is right axis deviation present.
48.
If you see a patient with a positive QRS in lead I, and a negative QRS in lead aVF, what sort of axis do they have?
Correct Answer
A. LAD
Explanation
A patient with a positive QRS in lead I and a negative QRS in lead aVF indicates a Left Axis Deviation (LAD). In a normal axis, the QRS complex would be predominantly positive in lead I and aVF. However, in LAD, the electrical activity of the heart is shifted towards the left side. This can be caused by conditions such as left ventricular hypertrophy or conduction abnormalities.
49.
Which would you expect to see on EKG of a patient with normal axis?
Correct Answer
B. Positive QRS in lead I, positive QRS in lead AVF
Explanation
A patient with normal axis would be expected to have a positive QRS in lead I and a positive QRS in lead AVF. This is because the electrical activity of the heart is normally directed towards the left ventricle, which generates a positive deflection in lead I. Additionally, the electrical activity is also directed towards the inferior part of the heart, which generates a positive deflection in lead AVF. Therefore, a patient with normal axis would exhibit positive QRS complexes in both lead I and lead AVF.
50.
What is always the tail of the mean QRS vector?
Correct Answer
B. AV Node
Explanation
The AV node is always the tail of the mean QRS vector. The mean QRS vector represents the average direction of electrical activity during ventricular depolarization. The AV node is located at the base of the atria and is responsible for delaying the electrical impulse before it is conducted to the ventricles. Since the mean QRS vector represents ventricular depolarization, the AV node, being the last structure involved in the conduction pathway before the ventricles, is always the tail of the mean QRS vector.