EKG Chapters 1 & 2- Study packet

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EKG Chapters 1 & 2- Study packet
2014-02-02 15:25:17

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  1. What is the body system that the left ventricle empties blood into?
    Peripheral circulatory system
  2. Which term best describes the blood pressure that is maintained actively by the amount of blood that the heart pumps out into the vascular system every minute?
    cardiac output
  3. Which part of the cardiac cycle does the largest amount of ventricular filling occur?
    Early diastole
  4. The atrioventricular septum consists of nonconductive tissue which....
    stops conduction of the electrical impulse.
  5. The slowing-down function of the AV node is known as the
    physiologic block
  6. What is the main function of the electrical conduction system of the heart?
    Create and transmit an impulse to the myocardium.
  7. What is the heart's main pacemaker which is found in the wall of the right atrium called?
    Sinoatrial Node
  8. Which of the following is NOT an intermodal pathway?
    Inter-atrial septum
  9. The difference between the charges outside and inside of the cell wall is known as its
    electrical potential
  10. The point during myocyte stimulation at which the fast sodium channels open is referred to as
    threshold potential
  11. Which ion is essential for a cell to contract?
  12. The main efferent pathway from the CNS to the heart occurs via the
    vagus nerve
  13. When a positive electrical impulse is moving away from the electrode, the ECG machine converts it into a
    negative (downward) wave
  14. Which of the following are the precordial leads?
  15. The heart lies in the space between the lungs referred to as the
  16. Which of the following is the receiving chamber of low oxygenated blood from the coronary sinus?
    Right Atrium
  17. Which layer of the heart is continuous with the inner lining of the pericardium?
  18. Cardiac muscle fibers are long branching cells that fit together tightly at junctions called
    intercalated disks
  19. Which of the following heart valves is a semilunar valve?
    Pulmonic and Aortic
  20. If the blood pressure in the body decreases, the body will attempt to compensate by
    increasing heart rate
  21. The force exerted on the walls of the ventricles at the end of diastole is
  22. When a cell is at rest which ion primarily leaks out of it?
  23. When the inside of a cell is more negative than the outside, it is
  24. Voltage can be measured and appears on an electrocardiogram as spikes or waveforms.
    (True or False)
  25. When a cell is stimulated, the cell's membrane becomes permeable to
    potassium and sodium
  26. When the inside of the cell is restored to its negative charge it is called
  27. The ability of cardiac pacemaker cells to create an electrical impulse without being stimulated from another source is called
  28. The cell will not respond to further stimulation during which period of cardiac action potential
    absolute refractory period
  29. What is the intrinsic pacemaker range for the Purkinge Fibers?
  30. The plastic devices that contain conductive media that are applied to the patient's skin are
  31. Each lead records the                current flow at specific time in a portion of the heart.
  32. Augmented limb lead may also be called a
    unipolar limb lead
  33. What does it mean when the ECG machine "augments" the amplitude of the electrical potentials?
    magnifies the amplitude
  34. The horizontal axis of ECG paper corresponds to
  35. Standard ECG paper speed is
  36. One large box on ECG paper is the width of five small boxes, a large box represents
    0.20 seconds
  37. There is a high concentration of sodium inside of the cell.
    (True or False)
  38. There is a high concentration of potassium outside the cell.
    (True or False)
  39. The electrical potential of the resting myocytes is:
    -70 mV
  40. The sodium-potassium ATPase pumps use ATP to push tow sodium ions out and bring one potassium ion into the cell. This creates a net negative charge inside the cell.
    (True or False)
  41. Actin and myosin are the protein chains that shorten the myocytes. Which ion acts like a key that allows the troponin/tropomyosin complex to clamp these two together so they can interact?
  42. The cell is polarized in the normal resting state prior to firing.
    (True or False)
  43. The cell fire when the action potential is reached. The cell is polarized during this process.
    (True or False)
  44. Which one of the following has the fastest pacemaking function?
    SA node
  45. The electrochemical activity of polarization-depolarization is measurable by the ECG.
    (True or False)
  46. The relative refractory period is also called the                period.
  47. An important electrolyte that affects cardiac function.
  48. The difference in electrical charges across the cell membrane.
    membrane potential
  49. When inside the cell is more negative than the outside it is said to be                      .
  50. The stimulus that alters the electrical charges across the cell membrane may be electrical, mechanical, or                       .
  51. Depolarization is caused by the movement of               into the cell.
  52. Element or compound that, when melted or dissolved in water or another solvent, breaks into ions.
  53. During this period, a weaker than normal stimulus can cause depolarization of cardiac cells.
  54. You can increase cardiac output by increasing
    heart rate or stroke volume
  55. The heart receives its blood supply from the
                               that start at the base of the              .
    • coronary arteries
    • heart
  56. The large flat bone in front of the heart is the
  57. The                             valve separates the left atrium from the left ventricle, and the                     valve separates the right atrium from the right ventricle.
    • mitral
    • tricuspid
  58. Starling's law states that increased                   results in increased strength of                   -up to a point.
    • stretch
    • contraction
  59. When the right ventricle is contracting, the                valve is open and the                  valve is closed.
    • pulmonic
    • tricuspid
  60. The                          controls the depolarization of the cardiac cell.
    cell membrane
  61. The                     is a group of cells that is the heart's preferred pacemaker.
    sinus node
  62. is the positive ion responsible for actually causing the muscle cell to contract.
  63.         atrial pathways transmit the signal from the sinus node to the AV node.
  64. atrial pathways transmit the signal from the sinus node to the left atrium.
  65. The                 normally holds on to the signal for a brief period of time before sending it on.
    AV node
  66. Blood pressure:
    is the force exerted by the circulating blood volume on the walls of the arteries.
  67. Peripheral resistance:
    is the resistance to the flow of blood determined by blood vessel diameter and the tone of the vascular musculature.
  68. Cardiac output:
    amount of blood the heart pumps out into the vascular system every minute.
  69. Stroke volume:
    amount of blood that the heart ejects during any one contraction.
  70. Heart rate:
    number of times the heart beat in one minute.
  71. Reload:
    the degree of ventricular filling when the heart is relaxed.
  72. Afterload:
    the pressure against which the ventricular must pump.
  73. Ejection Function:
    the percentage of blood pumped out of a ventricle with each contraction.
  74. Contractility:
    is the ability of myocardial cells to shorten, thereby causing cardiac muscle contraction in response to an electrical stimulus.
  75. Excitabiltiy:
    is the ability of cardiac muscle cells to respond to an external stimulus, such as that from a chemical, mechanical, or electrical source.
  76. Automaticity:
    the ability of specialized cardiac muscle tissue to produce its own electrical activity.
  77. Conductivity:
    is the ability of a cardiac cell to receive an electrical impulse and conduct it to an adjoining cardiac cell.
  78. Action potential:
    of a cardiac cell reflects the rapid sequence of voltage changes that occur across the cell membrane during the electrical cardiac cycle.
  79. Depolarization:
    the movement of charged particles across a cell membrane causing the inside of the cell to become positive.
  80. Repolarization:
    the movement of ions across a cell membrane that results in the cell being restored to its negative state.
  81. Threshold potential:
    is the level to which a cell must repolarized before it can depolarize again.
  82. Refractoriness:
    the period of recovery that cells need after being discharged before they are able to respond to a stimulus.
  83. Absolute Refractory period (2)
    • 1.) also called effective refractory period
    • 2.) not respond to further stimulation
  84. Relative Refractory period (2)
    • 1.) also called vulnerable period
    • 2.) some cardiac cells have repolarized to their threshold potential and can be stimulated to respond (depolarize) to a stronger than normal stimulus.
  85. Atrial kick-
    20-30% volume of blood
  86. In systole-
  87. In diastole-
  88. In systole the pressure-
  89. In diastole the pressure-
  90. Units for cardiac output?
    Normal amount in healthy adult?
    • L/min
    • 5 L/min
  91. Intrinsic rate for SA node
    60-100 bpm
  92. Intrinsic rate in AV node
    40-60 bpm
  93. Intrinsic rate in bundle branches
    30-40 bpm
  94. Intrinsic rate in Purkinje fibers
    20-40 bpm
  95. Threshold potential is located at
  96. A cardiac cycle is from
    one ventricular systole to one ventricular diastole.
  97. Blood pressure=
    cardiac output X resistance peripheral
  98. Units for stroke volume-
  99. Cardiac output=
    Stroke volume X Heart Rate
  100. What is significant about the upper small nodal region of AV node?
    contains pacemaker cells
  101. What is significant about the middle larger nodal region of the AV node?
    impulses are slowed here.
  102. What is significant about the lower nodal region of the AV node?
    they contain pacemaker cells
  103. The Left Anterior Fascicle is
    long and thin
  104. The Left Posterior Fascicle is
    short and thick
  105. Signal from the SA node to AV node takes
    0.03 seconds
  106. Signal from the AV node to bundle of His takes
    0.06 to 0.12 secs
  107. Signal from the bundle of His to the bundle branches takes
    0.03 to 0.05 seconds
  108. Signal from the bundle branches to the purkinge fibers takes
    0.10 seconds
  109. Signal from the Purkinje fibers to the myocardial fibers takes
    0.01 seconds
  110. Function of pacemaker cells
    initiate and conduct impulses
  111. Function of conductive cells
    conduct impulses from one cell to another.
  112. What is the natural tendency of a cardiac cell?
    Na+ wants to come in and K+ wants to leave.
  113. Phase 4 is called
    the resting stage
  114. Phase 0 is called
  115. Phase 1 is called
  116. Phase 2 is called
    slow plateau
  117. Phase 3 is called
  118. Is an EKG machine able to detect the activity of a single cardiac cell?
    (Yes or No)
  119. What happens in Phase 0? (3)
    • Sodium channels open.
    • Slow sodium channels open until the threshold potential is at -60mV than fast rapid sodium channels open.
    • The rapid increase causes the cell to spike or fire generating an impulse.
  120. What happens in Phase 1? (3)
    • Its peak positive charge and this opens the K+ channels and the K+ ions flow out of cell.
    • Fast sodium channels close.
    • Membrane Potential become +20mV to +30MV.
  121. What happens in Phase 2? (3)
    • K+ continues leaving.
    • Na+ enters slowly into the cell.
    • Ca++ moves slowly into cell.
  122. What phase does Ca++ enter and cause a contraction?
    Phase 2
  123. What happens in Phase 3?
    The inside of cell becomes negative because of the flow of K+ leaving the cell and there are still negative protein ions in the cell.
  124. Ca+ bridges a gap between what to cause a myocardial cell to contract?
    Actin and Myosin
  125. What happens during Diastole?
    relaxation of both atrium and ventricles to fill with blood.
  126. What happens during atrial systole?
    Atrium contract and pump blood into ventricles.
  127. What happens during ventricle systole?
    Atrium relax, ventricles contract pumping blood out of the body.
  128. The Peripheral Nervous system
    contains what two different types of nerves
    and is divided into what two divisions
    • Contains two different types of nerves
    • Afferent and Efferent

    • Is divided into what two divisions
    • Somatic Nervous System and Autonomic Nervous System.
  129. The Somatic Nervous system is
    (voluntary or involuntary)
  130. The Automatic Nervous system is
    (voluntary or involuntary)
  131. Afferent peripheral nerves function is:
    carry sensory impulses from all parts of the body to the brain.
  132. Efferent peripheral nerves function is
    carry sensory impulses from the brain to the muscles and all other organs of the body.
  133. The Autonomic Nervous System is divided into two divisions which are?
    Sympathetic and Parasympatic
  134. Sympathetic system function is: (6)
    • Speeding up things in the body.
    • Fight or Flight.
    • Speeds up rate.
    • Increases contractility.
    • Speeds conduction through the AV node.
    • (Epinephrine and Norepinephrine)
  135. Parasympathetic system function is: (6)
    • Slows things down in the body.
    • Rest and relax
    • Slowing down
    • Decrease contractility.
    • Slows conduction through the AV node.
    • (Acetylcholine)
  136. A positive chronotropic effect does what?
    increases heart rate.
  137. A positive Dromotropic effect does what?
    increases conduction velocity.
  138. A positive Inotropic effect does what?
    increases force of contraction in ventricular muscle.
  139. Chronotropicity:
    ability of cardiac cells to regulate the timing of the impulse.
  140. Dromotropicity:
    the ability to change the conduction speed (mostly having to do with the AV node).
  141. Inotropic:
    the neural influences that are said to increase the force of the contraction are known as positive and those that decrease force of contraction are negative.
  142. The Vagus Nerve does what?
    relaxes and decreases heart rate.
  143. Three types of Leads?
    • Standard limb
    • Augmented limb
    • Chest (precordial)
  144. The leads are either what two types?
    Are what is significant about each of the two?
    Bipolar: contains two electrodes (one negative and one positive)

    Unipolar: Measures electrical potential between a positive electrode and a central terminal.
  145. Leads also contain a _________ lead for what purpose?
    • Contain a ground lead.
    • Measures body and environmental movement and subtracts the electrical potential by this lead from other leads.
  146. Precordial leads
    are also called what?
    are they positive or negative?
    and are what leads labeled?
    are they unipolar or bipolar?
    where is the central terminal located?
    • chest leads
    • positive
    • V1-V6 leads
    • unipolar
    • located at the heart
  147. What type of leads
    have a central terminal (neg. pole) that measures all signals from many negative poles and averages them.
    and do not have a specific electrode for the - pole?
    Augmented limb leads.
  148. Augmented limb leads
    are labeled what?
    are they unipolar or bipolar?
    they position of positive electrode corresponds with what?
    • aVR, aVL, aVF
    • unipolar
    • corresponds to the last letter of each of the leads.
    • R= right arm
    • L= left arm
    • F=left foot
  149. Standard Limb Leads
    are labeled what?
    these leads unipolar or bipolar?
    • I, II, III
    • they are biopolar
  150. Leads placed on the right arm are always?
    Always negative
  151. Leads placed on the left leg are always?
    Always positive
  152. You should never place on electrode on what?
    On the bone.
  153. What is the standard paper speed on the EKG?
  154. What do the smallest faintest lines on the EKG paper represent?
    .04 seconds
  155. What do the bigger bolder lines on the EKG paper represent?
    .20 seconds
  156. How many boxes horizontally egual 1 second?
    5 bigger bolder boxes
  157. A positive wave on a EKG strip represents what?
  158. A negative wave on a EKG strip represents what?
  159. The P wave on a EKG strip represents what?
    atrial depolarization
  160. The QRS complex on a EKG strip represents what?
    ventricular depolarization
  161. The Ta wave on a EKG strip represents what?
    • atrial repolarization.
    • (Can be hidden because happens at the same time as the QRS)
  162. The T wave on a EKG strip represents what?
    ventricular repolarization