Chapter 1,2,3 Flashcards
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
The left atrium receives blood from the _____.
a. pulmonary veins
b. aorta
c. pulmonary arteries
d. inferior vena cava
pulmonary veins
The anterior surface of the heart consists primarily of the _____.
a. left atrium
b. right atrium
c. left ventricle
d. right ventricle
right ventricle
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
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
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
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
Which side of the heart is a low-pressure system that pumps venous blood to the lungs?
a. Left
b. Right
Right
Which side of the heart is a high-pressure system that pumps arterial blood to the systemic circulation?
a. Left
b. Right
Left
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
Blood flows from the right atrium through the _____ valve into the right ventricle.
a. mitral
b. aortic
c. pulmonic
d. tricuspid
tricuspid
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
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
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
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
Blood flows from the left atrium through the _____ valve into the left ventricle.
a. mitral
b. aortic
c. pulmonic
d. tricuspid
mitral
The right ventricle expels blood through the _____ valve into the pulmonary trunk.
a. mitral
b. aortic
c. pulmonic
d. tricuspid
pulmonic
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
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
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
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
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
The primary neurotransmitter of the parasympathetic division of the autonomic nervous system is _____.
a. dopamine
b. muscarine
c. acetylcholine
d. norepinephrine
acetylcholine
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
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.
F
Blood pressure is the result of cardiac output and peripheral vascular resistance.
T
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
T
The period of time during the cardiac cycle when cells cannot respond to a stimulus, no matter how strong, is the relative refractory period.
F
Depolarization is the same as contraction
F
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.
T
The point where the QRS complex and the ST segment meet is called the ST junction or J-point.
T
If the wave of depolarization (electrical impulse) moves toward the positive electrode, the waveform recorded on ECG graph paper will be upright (positive deflection).
T
In the limb leads, the ST segment is normally isoelectric, or less than 1 mm above or below the isoelectric line.
T
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
