Chapter 1,2,3 Flashcards by Terri Shappley

The apex of the heart is formed by the _____.

a. tip of the left ventricle
b. tip of the right atrium
c. right atrium and right ventricle
d. left atrium and left ventricle

tip of the left ventricle

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The left atrium receives blood from the _____.

a. pulmonary veins
b. aorta
c. pulmonary arteries
d. inferior vena cava

pulmonary veins

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The anterior surface of the heart consists primarily of the _____.

a. left atrium
b. right atrium
c. left ventricle
d. right ventricle

right ventricle

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Blood pressure is determined by _____ multiplied by _____.

a. stroke volume; heart rate
b. heart rate; cardiac output
c. cardiac output; peripheral vascular resistance
d. stroke volume; peripheral vascular resistance

cardiac output; peripheral vascular resistance

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The right atrium receives venous blood from the head, neck, and thorax via the _____, from the remainder of the body via the _____, and from the heart via the _____.

a. coronary sinus; superior vena cava; inferior vena cava
b. superior vena cava; coronary sinus; inferior vena cava
c. inferior vena cava; superior vena cava; coronary sinus
d. superior vena cava; inferior vena cava; coronary sinus

superior vena cava; inferior vena cava; coronary sinus

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The heart is divided into _____ chambers but functions as a _____-sided pump.

a. two; four
b. three; two
c. four; two
d. four; three

four; two

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Stimulation of alpha1 receptors results in _____.

a. increased heart rate
b. peripheral vasoconstriction
c. constriction of bronchial smooth muscle
d. increased force of myocardial contraction

peripheral vasoconstriction

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Which side of the heart is a low-pressure system that pumps venous blood to the lungs?

a. Left
b. Right

Right

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Which side of the heart is a high-pressure system that pumps arterial blood to the systemic circulation?

a. Left
b. Right

Left

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The thick, muscular middle layer of the heart wall that contains the atrial and ventricular muscle fibers necessary for contraction is the _____.

a. epicardium
b. pericardium
c. myocardium
d. endocardium

myocardium

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Blood flows from the right atrium through the _____ valve into the right ventricle.

a. mitral
b. aortic
c. pulmonic
d. tricuspid

tricuspid

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Rapid ejection of blood from the ventricular chambers of the heart occurs because the _____ and _____ valves open.

a. pulmonic; aortic
b. tricuspid; mitral
c. pulmonic; mitral
d. tricuspid; aortic

pulmonic; aortic

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The base of the heart is found at approximately the level of the _____ rib(s).

a. first
b. second
c. fourth
d. fifth and sixth

second

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Which of the following are semilunar valves?

a. Aortic and pulmonic
b. Aortic and tricuspid
c. Pulmonic and mitral
d. Tricuspid and mitral

Aortic and pulmonic

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Blood leaves the left ventricle through the _____ valve to the aorta and its branches and is distributed throughout the body.

a. mitral
b. aortic
c. pulmonic
d. tricuspid

aortic

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Blood flows from the left atrium through the _____ valve into the left ventricle.

a. mitral
b. aortic
c. pulmonic
d. tricuspid

mitral

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The right ventricle expels blood through the _____ valve into the pulmonary trunk.

a. mitral
b. aortic
c. pulmonic
d. tricuspid

pulmonic

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The primary neurotransmitters of the sympathetic division of the autonomic nervous system are _____.

a. dopamine and acetylcholine
b. muscarine and norepinephrine
c. acetylcholine and epinephrine
d. norepinephrine and epinephrine

norepinephrine and epinephrine

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Complete occlusion of the _____ coronary artery, also referred to as the widow maker, usually results in sudden death.

a. right
b. left main
c. circumflex
d. left anterior descending

left main

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Stimulation of beta2 receptor sites results in _____.

a. increased heart rate
b. peripheral vasoconstriction
c. constriction of renal blood vessels
d. dilation of bronchial smooth muscle

dilation of bronchial smooth muscle

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Chronotropy refers to an effect on _____.

a. heart rate
b. force of contraction
c. bronchial smooth muscle
d. speed of conduction through the atrioventricular node

heart rate

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The left main coronary artery divides into the _____ branches.

a. marginal and circumflex
b. marginal and anterior descending
c. anterior and posterior descending
d. anterior interventricular artery descending and circumflex

d. anterior interventricular artery descending and circumflex

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The primary neurotransmitter of the parasympathetic division of the autonomic nervous system is _____.

a. dopamine
b. muscarine
c. acetylcholine
d. norepinephrine

acetylcholine

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The _____ artery supplies the right atrium and ventricle with blood.

a. right coronary
b. left main coronary
c. left circumflex
d. left anterior descending

right coronary

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The tricuspid valve is _____. a. a semilunar valve b. located between the left ventricle and aorta c. located between the right atrium and right ventricle d. located between the right ventricle and pulmonary artery

c. located between the right atrium and right ventricle

When the left ventricle contracts, freshly oxygenated blood flows through the _____ valve into the _____. a. aortic; aorta b. mitral; right atrium c. tricuspid; right ventricle d. pulmonic; pulmonary arteries

aortic; aorta

Thin strands of fibrous connective tissue extend from the atrioventricular (AV) valves to the papillary muscles and prevent the AV valves from bulging back into the atria during ventricular systole. These strands are called _____. a. cardiac cilia b. Purkinje fibers c. papillary muscles d. chordae tendineae

chordae tendineae

__________ is the period during which a heart chamber is contracting and blood is being ejected.

Systole

The thick, muscular middle layer of the heart wall that contains the atrial and ventricular muscle fibers necessary for contraction is the __________.

myocardium

The ______ chambers receive blood from the vena cava and coronary sinus.

right atrium

The inferior outer surface of the heart is also called the _____ surface.

diaphragmatic

The _____ are the heart chambers that pump blood.

ventricles

_____ is the period of relaxation during which a heart chamber is filling.

Diastole

Stimulation of beta-adrenergic receptor sites will result in peripheral vasoconstriction.

Blood pressure is the result of cardiac output and peripheral vascular resistance.

In most patients, the sinoatrial (SA) and atrioventricular (AV) nodes are supplied by the _____ coronary artery. a. right b. left main c. circumflex d. left anterior descending

right

The intrinsic rate of the atrioventricular (AV) bundle is _____ beats/min. a. 20 to 40 b. 40 to 60 c. 60 to 80 d. 80 to 100

40 to 60

How do you determine whether the atrial rhythm on an ECG tracing is regular or irregular? a. Compare QT intervals. b. Compare PR intervals. c. Compare R to R intervals. d. Compare P to P intervals.

Compare P to P intervals

_____ is the ability of cardiac pacemaker cells to spontaneously initiate an electrical impulse without being stimulated from another source, such as a nerve. a. Excitability b. Conductivity c. Automaticity d. Contractility

Automaticity

In the heart’s conduction system, the _____ receive(s) an electrical impulse from the bundle of His and relay(s) it to the Purkinje fibers in the ventricular myocardium. a. atrioventricular (AV) node b. atria c. sinoatrial (SA) node d. right and left bundle branches

d. right and left bundle branches

In the heart’s conduction system, the _____ receive(s) an electrical impulse from the right and left bundle branches and relay(s) it to the ventricular myocardium. a. AV node b. SA node c. Purkinje fibers d. atrial pacemaker cells

Purkinje fibers

What does the QRS complex represent? a. Atrial depolarization b. Ventricular contraction c. Ventricular repolarization d. Ventricular depolarization

Ventricular depolarization

The normal pacemaker of the heart is the _____ node, which is found in the _____ atrium, and has an intrinsic firing rate of _____ beats/min. a. sinoatrial; left; 40 to 60 b. sinoatrial; right; 60 to 100 c. atrioventricular; left; 20 to 40 d. atrioventricular; right; 100 to 180

sinoatrial; right; 60 to 100

On an ECG, what is the first negative deflection seen after the P wave? a. Q wave b. R wave c. S wave d. T wave

Q wave

Lead II records the difference in electrical potential between the _____ leg and _____ arm. a. left; left b. left; right c. right; left d. right; right

left; right

Leads II, III, and aVF view the _____ surface of the left ventricle. a. anterior b. inferior c. septal d. lateral

inferior

The period during the cardiac cycle when cells cannot respond to a stimulus, no matter how strong, is called the _____ period. a. depolarized b. supranormal c. relative refractory d. absolute refractory

absolute refractory

Leads I, aVL, V5, and V6 view the _____ surface of the left ventricle. a. anterior b. septal c. inferior d. lateral

lateral

The absolute refractory period begins with the onset of the _____ and terminates _____. a. P wave; with the end of the QRS complex b. QRS complex; at approximately the apex of the T wave c. QRS complex; with the end of the T wave d. P wave; with the beginning of the QRS complex

QRS complex; at approximately the apex of the T wave

The QT interval is measured from the beginning of the _____. a. QRS complex to the end of the T wave b. P wave to the end of the QRS complex c. QRS complex to the beginning of the T wave d. P wave to the beginning of the QRS complex

QRS complex to the end of the T wave

In an adult, the normal duration of the QRS complex is _____. a. 0.12 to 0.20 second b. 0.10 second or less c. 0.04 to 0.14 second d. 0.20 second or less

0.10 second or less

The intrinsic rate of the Purkinje fibers is _____ beats/min. a. 20 to 40 b. 40 to 60 c. 60 to 100 d. 100 to 180

20 to 40

The intrinsic rate of the SA node is _____ beats/min. a. 40 to 60 b. 60 to 100 c. 100 to 180 d. 200 to 260

60 to 100

On the ECG, the T wave represents _____. a. atrial contraction b. atrial repolarization c. ventricular contraction d. ventricular repolarization

ventricular repolarization

On the ECG, the time necessary for the spread of an electrical impulse through the AV node, bundle of His, right and left bundle branches, and the Purkinje fibers is reflected by the _____. a. TP segment b. PR segment c. QT interval d. QRS duration

PR segment

The portion of the ECG tracing between the QRS complex and the T wave is called the ____. a. PR segment b. ST segment c. TP segment d. QT interval

ST segment

Which of the following is the first positive deflection seen on the ECG after the P wave? a. Q wave b. R wave c. S wave d. T wave

R wave

_____ cells are working cells of the heart that contain contractile filaments and form the muscular layer of the atrial walls and the thicker muscular layer of the ventricular walls. a. Pacemaker b. Myocardial c. Specialized d. Electrical

Myocardial

When the cardiac muscle cell is stimulated, the cell is said to _____. a. polarize b. recover c. depolarize d. repolarize

depolarize

On the ECG, the P wave represents atrial _____ and the QRS complex represents ventricular _____. a. depolarization; depolarization b. repolarization; repolarization c. repolarization; depolarization d. depolarization; repolarization

depolarization; depolarization

_____ is a term used to describe the period of recovery that cells need after being discharged before they are able to respond to a stimulus. a. Irritability b. Conductivity c. Polarization d. Refractoriness

Refractoriness

Tall, peaked T waves observed on the ECG are most commonly seen in patients with _____. a. hypokalemia b. hyperkalemia c. hyponatremia d. hypernatremia

hyperkalemia

Which part of the conduction system receives an impulse from the bundle of His and relays it to the Purkinje fibers? a. SA node b. AV node c. Right and left atria d. Right and left bundle branches

Right and left bundle branches

Which of the following correctly reflects examples of ectopic (latent) pacemakers? a. The SA node and AV junction b. The AV junction and ventricles c. The SA node and right bundle branch d. The AV junction and left bundle branch

The AV junction and ventricles

The PR interval is considered prolonged if it is more than _____ seconds in duration. a. 0.06 b. 0.12 c. 0.18 d. 0.20

0.20

_____ is the ability of cardiac cells to spontaneously initiate an electrical impulse without being stimulated from another source.

Automaticity

An ECG lead that has a positive and negative electrode is called a(n) _____ lead.

bipolar

The appearance of coved (“frowny face”) ST-segment elevation is called a(n) _______________.

acute injury pattern

A line between waveforms is called a(n) _____.

segment

The cells of the heart that contain contractile filaments are called _____ cells.

myocardial

Name the first positive deflection seen after the P wave on the ECG.

R wave

A conduction problem above the level of the bundle branches will largely affect the P wave and PR interval

The period of time during the cardiac cycle when cells cannot respond to a stimulus, no matter how strong, is the relative refractory period.

Depolarization is the same as contraction

In most ECG leads, a normal Q wave is less than 0.04 second in duration and less than one third the amplitude of the R wave in that lead.

The point where the QRS complex and the ST segment meet is called the ST junction or J-point.

If the wave of depolarization (electrical impulse) moves toward the positive electrode, the waveform recorded on ECG graph paper will be upright (positive deflection).

In the limb leads, the ST segment is normally isoelectric, or less than 1 mm above or below the isoelectric line.

ECG changes observed in leads opposite the affected area of the heart; also called mirror image changes

Reciprocal changes

The QRS complex represents _____ depolarization

Ventricular

Each electrode placed in a “V” position is a(n) _____ electrode

Positive

Element or compound that breaks into charged particles (ions) when melted or dissolved in water or another solvent

Electrolyte

An ECG machine is a sophisticated _____.

Voltmeter

ECG changes observed in leads that look directly at the affected area of the heart

Indicative changes

The T wave represents ventricular _____.

repolarization

The a in aVR, aVL, and aVF

augmented

Impulse(s) originating from a source other than the SA node

ectopic

The spread of an impulse through tissue already stimulated by that same impulse

re entry

Height (voltage) of a waveform on the ECG

amplitude

The P wave represents _____ depolarization

atrial

During this period, a weaker than normal stimulus can cause depolarization of cardiac cells.

Supranormal

Sensors in the internal carotid arteries and aortic arch that detect changes in the concentration of hydrogen ions (pH), oxygen, and carbon dioxide in the blood

Chemoreceptors

Space between the lungs that contains the heart, great vessels, trachea, and esophagus, among other structures

Mediastinum

Specialized nerve tissue located in the internal carotid arteries and the aortic arch that detect changes in blood pressure

Barorecptors

Electrolyte very important in cardiac muscle contraction

calcium

Amount of blood flowing into the right atrium each minute from the systemic circulation

Venous return

Term used to refer to distinct conditions caused by a similar sequence of pathologic events—a temporary or permanent blockage of a coronary artery

Acute coronary syndrome

Typically results when the heart’s demand for oxygen exceeds its supply from the coronary circulation

Myocardial ischemia

A negative _____ effect refers to a decrease in heart rate

Chronotropic

A buildup of excess blood or fluid in the pericardial space can cause cardiac _____.

tamponade

In sinus arrhythmia, a gradual increasing of the heart rate is usually associated with _____. a. expiration b. inspiration c. excessive caffeine intake d. early signs of heart failure

inspiration

The rate of sinus tachycardia is _____ beats/min. a. slower than 60 b. 40 to 80 c. 60 to 100 d. faster than 100

faster than 100

An ECG rhythm strip shows a ventricular rate of 46 beats/min, a regular rhythm, a PR interval of 0.14 second, a QRS duration of 0.06 second, and one upright P wave before each QRS. This rhythm is _____. a. sinus rhythm b. sinus bradycardia c. sinus arrest d. sinoatrial block

sinus bradycardia

An ECG rhythm strip shows a ventricular rate of 128 beats/min, a regular rhythm, a PR interval of 0.16 second, a QRS duration of 0.08 second, and one upright P wave before each QRS. This rhythm is sinus _____. a. arrhythmia b. bradycardia c. rhythm d. tachycardia

tachycardia

Which of the following are possible causes of sinus tachycardia? a. Hypothermia, hypovolemia b. Hypoxia, calcium channel blocker overdose c. Fever, pain, anxiety d. Vomiting, vagal maneuvers

Fever, pain, anxiety

Which of the following are possible causes of sinus bradycardia? a. Elevated temperature, pain b. Increased intracranial pressure, beta-blocker overdose c. Hypoxia, fright, caffeine-containing beverages d. Hypovolemia, administration of sympathomimetics

Increased intracranial pressure, beta-blocker overdose

The rate of a sinus rhythm is ____ beats/min. a. slower than 60 b. 60 to 100 c. 80 to 120 d. faster than 100

60 to 100

Which of the following may cause a sinus bradycardia? a. Stress or anxiety b. Increased sympathetic tone c. Fever d. Hypothermia

Hypothermia

Which of the following correctly reflects the ECG criteria for a sinus rhythm? a. More P waves than QRS complexes b. P waves that look alike and upright in lead II, one before each QRS complex c. Irregular atrial and ventricular rhythm d. PR interval exceeding 0.20 second

P waves that look alike and upright in lead II, one before each QRS complex

Management of a patient with a sinus tachycardia might include _____. a. identification and treatment of the underlying cause b. administration of atropine c. use of a pacemaker d. vagal maneuvers, such as carotid sinus pressure

identification and treatment of the underlying cause

The rate of a sinus bradycardia is _____ beats/min. a. slower than 60 b. 60 to 100 c. 80 to 120 d. faster than 100

slower than 60