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Practical > phy > Flashcards

phy Flashcards

1
Q

1) 1 is the ___ it represents_____, it is positive in leads:___

2) 2 is the ____it represents______. It’s duration is normally __ and it is prolonged in _____

3) 2 is the _____, it represents _____, it is positive in leads:___

4) 4 is the ______, it coincides with ____of the ventricular action potential, it is normally isoelectric but elevated it suggest ______

5) 5 is the _____, it represents _________

6) 6 is the _____, it represents _______. It is positive because _____

7) 7 is the _____, it represents ______

A

1) P wave; atrial depolarization, all except AVR

2) PR interval; conduction from SA node to ventricle; 0.12 s; heart blocks

3) QRS; ventricular depolarization; all except AVR

4) ST segment; plateau; Myocardial infarction

5) QT interval; ventricular electricity

6) T wave; ventricular repolarization; last point to be depolarized is the 1st point to be repolarized

7) RR interval; one cardiac cycle

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2
Q

1) 1 is the ____, it represents ________

2) 2 is the _____, it represents _______

3) the duration of 2 is normally ______, it is prolonged in _____

4) 3 is the _____; it represents ________

5) 4 is the _____; it coincides with the _____of the ventricular action potential, it is normally isoelectric but if elevated suggests _______

6) 6 is the _____, it represents ______. It is positive because ____________________

A

1) P-wave; atrial depolarization

2) P-R interval; time needed for impulse to reach the ventricle.

3) 3-5 small squares; heart block

4) QRS complex; ventricular depolarization

5) S-T segment; plateau; myocardial infarction

6) T-wave; ventricular repolarization; the 1st part that depolarize in the ventricle is the last part to repolarize

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3
Q

Name each segment and describe it [represents what? Normal duration? importance]

A

1) P-wave. atrial depolarization. 0.08 seconds. negative in AVR and positive in all chest leads

2) P-R interval. Atrial depolarization and AV conduction. 0.2 seconds. Prolonged in 1st degree heart block.

3) QRS wave. Ventricular depolarization. 0.08 seconds. wide, bizarre in ventricular extra systole.

4) S-T segment. represents plateau in ventricular action potential, 0.16 seconds, elevated in myocardial infarction

5) Q-T interval. Ventricular depolarization and repolarization. 0.4 seconds

6) T wave. ventricular repolarization. 0.16. tall peak in hyperkalemia.

7) V-wave. Papillary muscle repolarization. Not constant in time.

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4
Q

What is the abnormality in the ECG drawing below? calculate the heart rate.

A

Sinus tachycardia. 1500/12=125 beats/min

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5
Q

1) in the above ECG drawing the R-R equals:

2) The heart rate of this person is

A

37 small squares

1500/37=40 beats/min

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6
Q

1) 1 is the _____, it represents ______

2) 2 is the _____, it represents ______, its duration is normally____, it is prolonged in ______

3) 3 is the ____, it represents _____

4) 4 is the _____, it coincides with the ______or the ventricular action potential, it is normally isoelectric but if elevated it suggest_______

5) 6 is the ______, it represents_______. This wave is positive because: _______________

A

1) Pwave; atrial depolarization

2) PR interval; conduction of electricity from SA node to AV node; 0.12 seconds; heart block

3) QRS; ventricular depolarization

4) ST; plateau; myocardial infarction

5) T wave; ventricular repolarization; last part to depolarize is the 1st part to repolarize

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7
Q

(1) match each of the following statements with the correct lettered points on the ECG.

a) The atria are depolarization:_____
b) Th ventricles are depolarizing:____
c)Both atria and ventricle are completely repolarized:______

(2) Calculate:

a)HR:__
b)P-R interval: _____
c) QT interval: _____

(3) What does the P-R interval on ECG represent? What is the normal value?

(4) How is the P-R interval affected in the above tracing?

(5) How does conduction velocity in the AV node compare conduction velocity in other portions in the heart? What is the physiological significance of the difference?

A

(1)
a) P b) QRS c) TP

(2)
a)HR: 1500/30=50/min
b) P-R interval: 9x0.04=0.36 seconds
c) QT interval: 10x 0.04= 0.4 seconds

(3) atrial depolarization + delay in AVN. Normal is 0.12

(4) Prolonged in 1st degree HB

(5) slow conduction in AVN. Enough time for ventricular filling before contractility.

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8
Q

In the figure below determine the auscultatory areas for the first heart sound. What is the causes and timing during cardiac cycle?

A

near the apex and at the xiphosternal junction

Closure of mitral and tricuspid valves

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9
Q

3 is the ____, it represents:
a)
b)
c)

A

QRS
a) septal depolarization
b) ventricular wall depolarization
c) depolarization of the base

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10
Q

Lead I of the standard limb leads measures the potential difference between ______and________with the positive electrode at the ______

A

Right arm
Left arm
Left arm

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11
Q

In the figure below the ECG abnormality is: ____. It indicates: ___________

A

ST elevation

Myocardial infarction

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12
Q

In the figure below the ECG abnormality is

A

Irregular rhythm

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13
Q

The normal range of the electrical axis of the heart is from _____to ______

A

-30 to +90

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14
Q

Compare Rt and Lt axis deviation in range, occurs physiologically in and occurs pathologically in

A

Right axis deviation: more than +90, long stature and thin person, right ventricular enlargement

Left axis deviation: Less than -30, short stature obese or pregnant person, left ventricular enlargement

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15
Q

What is the auscultatory areas for the SECOND heart sound? Mention the cause and timing during cardiac cycle of the 2nd heart sound

A

Cause: closure of semilunar valves

Timing: isovolumetric relaxation

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16
Q

Describe the four heart sounds in site and sound heard

A

First: 2nd right intercostal space and aortic component of S2

Second: 2nd left intercostal space and pulmonary component of S2

Third: left lower parasternal and Tricuspid component of S1

Fourth: 5th left intercostal space and mitral component of S1

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17
Q

Compare first and second heart sounds in causes, site in cardiac cycle, duration and character (pitch)

A

First: closure of AV valves, isovolumetric contraction, 0.15 seconds and low pitch.

Second: closure of semilunar valves, isovolumetric relaxation, 0.12 sec and high pitch

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18
Q

What are murmurs? give an example

A

abnormal sound due to turbulent blood flow. Example is valve regurge

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19
Q

The a wave is
The c wave is
The v wave is
The x wave is
The y wave is

3-what is the clinical significance of the JVP tracing

4-What are the causes of:
a) Prominent a wave?
b) The absence of a wave

A

atrial systole
Bulging of cusps in atria
accumulation of venous return
Pulling of cups down
Blood leaves atria into the ventricle

3-denotes Right atrial pressure

4
a) right sided of heart failure
b) atrial fibrillation

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20
Q

What is the cause of the anacrotic limb, dicrotic notch and dicrotic wave.

A

Causes of: anacrotic limb –> aortic pressure increases to its maximum value

catacrotic limb –> aortic pressure decreases to its minimum value

dicrotic notch –> sharp drop of pressure ending with closure of aortic valve

dicrotic wave –> bouncing up of backwardly moving blood against the closed elastic aortic valve

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21
Q

Define Mean arterial blood pressure and state the formula

A

def: Mean pressure in large arteries during whole cardiac cycle

MAP= DBP + 1/3 pulse pressure

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22
Q

What is the mean BP in an artery 50 cm below the level of the heart while standing

A

50 x 0.77= 38.5

MAP+38.5=120+38.5= 158.5 mmHg

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23
Q

The palpatory method measure the _____pressure only

A

systolic

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24
Q

In the auscultatory method the systolic pressure is when the sound ______while the diastolic is when the sound ______

A

1st appear; disappears

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25
Q

Define systole distole and pulse pressure

A

systolic BP –> max. pressure in arteries during systole

diastolic BP –> minimum pressure in arteries during diastole

pulse pressure= SBP - DBP

MAP= DBP+ 1/3 Pulse pressure

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26
Q

state formula for preipheral resistance

A

peripheral resistance = TPR

MAP= TPRxCO

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27
Q

Why is the brachial artery selected for B.P measurement? What is the mean BP in anartery 50 cm above the level of the heart while standing?

A

Large artery, at the level of heart and close to aorta
50 x 0.77= 38.5 mmHg
MAP = 126- 38.5 = 87.5 mmHg

28
Q

why is the blood flow in the arteries normally soundless

A

cause laminar blood flow

29
Q

Explain why should you measure the blood pressure using both the palpatory and auscultatory methods

A

to avoid auscultatory gap

30
Q

What is meant by Korotkoff sounds

A

sounds that produced due to turbulence of blood flow while deflating the cuff.

31
Q
A

irregular

32
Q
A

HR= 1500/10= 150 beat/min,
rhythm: regular
Causes: emtions, stress, exercise, hyperthyroidism

33
Q
A

HR: 1500/35= 42.5 beat/min

Rhythm: regular

Causes: vegal stimulation

34
Q
A

(left axis deviation)

explain: as QRS in lead I is upward and QRS IN aVF is downward

Causes: obese

35
Q
A

(irregular rhythm,

(2nd degree Heart block)

36
Q
A

regular rhythm with atrial flutter

37
Q
A

High voltage QRS e.g. ventricular hypertrophy

38
Q
A

low voltage ECG e.g. obesity

39
Q
A

elevated: acute Myocardial Infarction (MI)

40
Q

comment on ST segment suggest a cause

A

depressed

Ischemia

41
Q

1) 1 is ___, it’s value _____

2) 2 is _____, it is value ______

3) 4 is ______ its components are ________, it’s value is _____

4) Mention 2 lung diseases that decreases 4:
a-_______
b-_______

5) 6 is _____, its value ______. It is decreased in _______

6) 7 is _______. Its importance is _______

7- 5 is _________, it s components are _________

8) Can you measure 8 by spirometer

A

1) Tidal volume, 500 ml

2) IRV, 300 ml

3) Vital capacity; ERV + IVR + TV; 4600

4) a- Bronchial asthma b- pulmonary fibrosis

5) ERV; 1100 ml; emphysema

6) Residual volume; to minimize the changes of blood PCO2 between breaths

7) FRC; RV and ERV

8) No

42
Q

Inspiration is _____, expiration is _____ and their location is normally ________

A

long; short

All over the chest

43
Q

Forced expiratory ration is ______in restrictive lung disease. And _______ in obstructive lung disease. FVC and FEV1 is ______in restrictive lung disease.

A

increase
Decreased
decreased

44
Q

Vital capicty is ___________. Its equal to ____ and its normally ______. Its decreased in ______

A

max volume of air expired after max inspiration

IRV + TV + ERV

4600 ml

obesity

45
Q

Residual volumes usually equals ____ and it is measured by ____. Its importance is ________

A

1200 ml

Helium dilution method

Aerated blood between breaths and prevents marked changes in PO2 and PCO2

46
Q

What is functional residual volume

It equals and is usually

A

Volume of air remain in lungs after normal expiration

ERv+RV

2300

47
Q

Vital capacity is _____ and is increased in

A

IRV+TV+ERV=4600 ml

males and athletes

48
Q

When does residual volume increase

A

emphysema and asthma

49
Q

Type of disease, reason and mention one condition

A

Restrictive lung diseases, FEV1/FVC > 80%
lung collapse

50
Q

Name the three lungs volumes that can be measured by the micro spirometer

A

Tidal volume

Inspiratory reserve volume

Expiratory reserve volume

51
Q

Describe how the Measurement of maximal voluntary ventilation (MMV) is
performed?

A

The goal of the measurement is to get the amount of air the subject can respire in 1 minute. The subject
should be instructed to perform the following maneuvers: i) Put on the nasal clip, to prevent nasal breathing,
ii) Start breathing moving as much air as possible.

52
Q

Why the test is done for 15 seconds?

A

To prevent hypocapnia and alkalosis,

53
Q

In which respiratory values did you observe differences between short and tall subjects? How can
these be explained?

A

IRV; VC and TLC: free descent of diaphragm affecting the vertical diameter

54
Q

If somebody has chronic inflammation of the lungs (pneumonia), which respiratory volume will be
affected in the diseased person

A

IRV; IC, VC; TLC will be decreased (restricted expansion

55
Q

Name the disorder and give causes

A

Obstructive lung disease

decrease air flow due to increase of airway resistance

56
Q

name the disease and causes

A

Restrictive lung disease

Decrease of ling volume

Decrease compliance of lung

57
Q

What is the name of the drawn curve

This curve is suggestive of and example is

What do yo expect about FEV1/FVC%

Can bronchodilator be used in this case and why

A

Flow volume loop

Obstructive lung disease and ephysema

Decrease it is less than 80%, decrease airflow due to marked resistance to air flow

58
Q

Compare bronchial, vesicular and bronchiovesicular breathing sounds in Pitch (intensity), quality, duration and site

A

Bronchial: high, harsh, expiratory>inspiratory, Trachea and larynx

Vesicular: Low, breezy, inspiratory>expiratory, most of chest field

BV: Moderate, mixed, expiratory=inspiratory, main bronchi; between scapulae

59
Q

Auscultation areas

A

Apex of the lung above middle 1/3 of clavicle

2nd space mid clavicular line

4th space mid clavicular line

6th space mid axillary line

60
Q

HR variation during inspiration procedure and probable explanation and significance

A

Procedure: connect ECG electrode to person. Ask subject to breath deeply at a rate of 6 breaths/min for 3 cycles and record

Probable explanation:

Bainbridge reflex

Respiratory center influences vagal control of HR

Pulmonary stretch receptor influence vagal control of HR

Significance:

Index of cardiac vagal control

Reflects respiratory-circulatory interactions

Improve pulmonary gas exchange.

61
Q

HR response during standing procedure and significance

A

Procedure: monitor HR for 30 sec before and 60 seconds after standing.

Normally reflex increases HR in 15 seconds after standing and gradually returns to normal. Failure of this happening is an indicator of autonomic disfunction.

62
Q

Valsalva maneuver and explain in autonomic dysfunction.

A

Phase I [start strain]++ BP and – HR

Phase II [continued strain] – BP and ++ HR

Phase III [release] – BP and ++ HR

Phase IV [recovery] ++BP and –HR

In autonomic dysfunction there is progressive decrease in BP and no increase in HR

63
Q

What is the apparatus?

What is it used for

What is the role of HCl

Normal values for males and females?

Why is Hb level lower in females than males?

Hb content above physiological levels is called?

If the results of the test is 16% what is the O2 carrying capacity

Name two precautions of this test

A

Sahli

HCl ruptures RBC which release Hb which react with HCl and form acid hematin

15, 13

males have androgen which increases erythropeitn

polycythemia

16 x 1.33 = 21.3

Compare against light and don’t squeeze body fluid

64
Q

What is MCV formula and normal range

A

MCV=PCV/RBCs count x10

normal range=80-95 micrometers

65
Q

What is MCH? state the formula and normal range

A

It is the average hemoglobin content in a single RBC

MCH=Hb content/ RBC count x10

normal: 25-32 pg

66
Q

What is MCHC? state the formula and normal range

A

It is the average hemoglobin content in 100 ml RBCs

MCHC= Hb content/hematocrit value x 100

normal range: 32-38 gm/dl

67
Q

Define PCV and give the normal values for male and female and where it increases

A

ration of RBC volume to total blood

male: 46% Female: 42%

PCV increase in dehydration and polycythemia

Practical (13 decks)

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