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2012AHS Integrated Systems Physiology > Lab Quiz 1 > Flashcards

Lab Quiz 1 Flashcards

1
Q

How many of the ECG rhythms you are asked to look at on the simulator have the term
“Sinus” in them?

A

7

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2
Q

What formula do you use for counting HR?

A

1500/no. small boxes

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3
Q

How is the electricial acitivty of the heart conducted?

A

Through the SA node -> AV node -> bundle of HIS -> Purkinje Fibres

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4
Q

What are the segments and complexes of the Cardiac Cycle?

A

PR interval, PR Segment, QRS complex, ST segment and QR interval

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5
Q

What are the durations of key waves and intervals in normal adult heart at rest?

A

R-R interval = 1.00-0.60s

HR = 60/R-R
PR interval = 0.12-0.20s
QRS duration = <0.12s
QT interval = 0.36-0.44s

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6
Q

What is teh QT interval Formula?

A

K x (square root) of RxR interval

K = 0.37 men and 0.40 women

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7
Q

How is the P wave produced?

A

By atrial depolarisation

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8
Q

How is the QRS Complex produced?

A

by ventricular depolarisation atrial repolarisation also occurs, however its contribution is insignificant

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9
Q

How is the T wave produced?

A

by ventricular repolatisation

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10
Q

Which way do the leads provide views of electrical activity as it moves across the surface of the chest

A

from right to left

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11
Q

How do you calculate HR from 6 R waves

A
  1. no. of small boxes x 0.2 = y

2. (60s/y) X 5 =

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12
Q

How is the PR interval calculated

A

no. little boxes between P-QRS

E.g. y X 0.04 =

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13
Q

How do you calculate QRS duration?

A

y X 0.04 = 0.08s

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14
Q

What is meant by “normal sinus rhythm”?

A

NSR means the rhythm that originates from the sinus node and describes characteristics of a healthy person

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15
Q

What is Bradycardia

A

When the HR is <60

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16
Q

What is Tachycardia

A

When the HR is >100

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17
Q

If the PR interval was lengthened this would indicate

A

delayed conduction of SA node - 1st degree heart block

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18
Q

If the QRS duration was lengthened this woud indicate

A

prolonged ventricular repolarisation

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19
Q

Why might you be concerned if someone has a long QT interval?

A

Fast heart beats can cause fainting and some people with the condition can have seizures. Long QT interval can cause sudden death

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20
Q

In a deep breathing trace if the rhythm irregular in resting condition but in the ECG is otherwise normal - this is?

A

Arial fibrillation

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21
Q

Considering the front views with the 6 transverse views - an inferior view of the heart?

A

2, 3, aVF

22
Q

Considering the front views with the 6 transverse views - a left lateral view of the heart?

A

5, 6, aVL

23
Q

Considering the front views with the 6 transverse views - an anterior view of the heart?

A

1, 2, 3, 4

24
Q

What is the MEA?

A

Mean electrical Axis

gives an appropriate position of the heart estimated directly using 2 ECG leads that are perpendicular to one another

25
Q

What is the angle and lead MEA uses

A

60 degrees and lead II view

26
Q

What is the axis in MEA set by

A

The axis is set by the
direction of the mean electrical impulse as the wave of depolarization travels from the AV node
through the ventricular myocardium.

27
Q

What happens after a myocardial infarction to the heart tissue

A

after a myocardial infarction, tissue that has died will not contribute to the ECG and
therefore disrupts the mean electrical axis causing a left or right axis shift - helps determine the extent of ischaemic damage

28
Q

What is the determination of Left Ventricular Hypertrophy

A

LVH results in increased R wave amplitude in the left-sided ECG leads and
increased S wave depth in the right-sided leads. The thickened LV wall leads to
prolonged depolarisation (increased R wave peak time) and delayed repolarisation (ST and T-wave
abnormalities) in the lateral leads.

29
Q

What is Systolic pressure defined as

A

‘Systolic pressure’ is defined as the peak pressure reached during the cardiac cycle. The period during
the relaxation of the ventricles is called ‘diastole’

30
Q

What is the diastolic pressure defined as

A

The value when the arterial blood pressure is at its lowest —
immediately before the contracting ventricle pushes blood into the arteries again—is called the
‘diastolic pressure’

31
Q

What are the Blood pressure values for adults

A

<120/<80 = optimal

120-129/80-84 = Normal

130-139/85-89 = high normal

140-159/90-99 = Grade 1 hypertension

160-179/100-109 = Grade 2 hypertension

> 180/>110 = Grade 3 Hypertension

> 140/<90 = isolated systolic hypertension

32
Q

What is RPP

A

Estimated rate pressure product

  • its clinical utility is its a reliable indicator of myocardial oxygen demand
33
Q

The correct pressure for initial cuff inflation

A

160

clincially 200

34
Q

The correct rate of cuff deflation

A

2-3 mmHg/sec

35
Q

Minimum interval between successive measurements

A

1 minute

36
Q

Why do clinicians sometimes measure blood pressure

a) in both arms?

A

If measurements differ more than 10 mmHg could be warning sign of cardiovascular disease

37
Q

Why do clinicians sometimes measure blood pressure in different postures

A

Orthostatic hypotension - drop in BP when sitting to standing

38
Q

How is mean arterial blood pressure MAP measured

A

DBP + (SBP-DBP/3)

39
Q

How do you calculate estimate rate pressure product

A

HR x SBP

40
Q

What happens if you take a beta blocker

A

SLow HR and low BP

41
Q

y. Spontaneous breathing is controlled by the respiratory complex in the medulla/pons
of the brain

A

y. Spontaneous breathing is controlled by the respiratory complex in the medulla/pons
of the brain

42
Q

The respiratory complex ensures that gaseous exchange at the lung matches the
requirements of the body. In times of increased demand, the rate and depth of breathing are
increased to bring more fresh air into the lungs. The respiratory complex is stimulated by central
chemoreceptors also located in the medulla/pons that are sensitive to the partial pressure of carbon
dioxide (PCO2) in the blood acting via pH changes of the cerebrospinal fluid.

A

The respiratory complex ensures that gaseous exchange at the lung matches the
requirements of the body. In times of increased demand, the rate and depth of breathing are
increased to bring more fresh air into the lungs. The respiratory complex is stimulated by central
chemoreceptors also located in the medulla/pons that are sensitive to the partial pressure of carbon
dioxide (PCO2) in the blood acting via pH changes of the cerebrospinal fluid.

43
Q

Quiet and maximal breathing enables the measurement of 3 discrete volumes:

A 
VT = Tidal Volume
IRV = Inspiratory Reserve Volume
ERV = Expiratory Reserve Volume
44
Q

Note that a 4th volume, RV = Residual Volume, the volume of air remaining in the lungs after a full
expiration, cannot be measured by spirometry as individuals are unable to empty their lungs
completely due to the rigidity of the thorax.

A

Note that a 4th volume, RV = Residual Volume, the volume of air remaining in the lungs after a full
expiration, cannot be measured by spirometry as individuals are unable to empty their lungs
completely due to the rigidity of the thorax.

45
Q

Clinically, it is usual to report these as combinations of volumes since this provides a better idea of
how much air is in the lungs at different points of the respiratory cycle (quiet and maximal). These
combined volumes are called capacities:

A 
EC = Expiratory Capacity
FRC = Functional Residual Capacity
TLC = Total Lung Capacity
VC = Vital Capacity
IC = Inspiratory Capacity
46
Q

During a single breath (in and out), a specific volume of air is drawn into and then expired from the
lungs; this is Tidal Volume (VT). Over a one minute period a number of such breaths occur; this is
the respiratory frequency (fR)

A

During a single breath (in and out), a specific volume of air is drawn into and then expired from the
lungs; this is Tidal Volume (VT). Over a one minute period a number of such breaths occur; this is
the respiratory frequency (fR)

47
Q

The product of ƒR and VT is the amount of air exhaled in one minute of breathing (V̇ E) – the correct
term for this is Pulmonary (or Minute) Ventilation. This parameter changes as fR or VT (or both)
changes – e.g. with physical activity.

A

The product of ƒR and VT is the amount of air exhaled in one minute of breathing (V̇ E) – the correct
term for this is Pulmonary (or Minute) Ventilation. This parameter changes as fR or VT (or both)
changes – e.g. with physical activity.

48
Q

VA =

A

VA = FR (VT - VD)

49
Q

VD = dead space volume

A

VD = (weight x 2.2) + 30 mL

50
Q

Estimated PaCO2 = ?

A

VCO2 = 2.8 x weight = mL/min

Therefore,
PaCO2 = VCO2 x (0.863/VA)

51
Q

Explain in principle how the %ref value on the Medikro print-out is determined

A

height, weight, ethnicity

52
Q 
What differences (if any) would you expect in the following lung function measures of an
individual with (a) an obstructive condition (eg COPD) (b) a restrictive condition
(Pulmonary Fibrosis), compared to a healthy person with the same physical characteristics.
A 
Obstructive 
FRC - up 
RV - up 
FVC - same
TLC - up 
Restricitive 
FRC - down
RV - down
RVC - down
TLC - down

2012AHS Integrated Systems Physiology (8 decks)

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