phy Flashcards
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 ______
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
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 ____________________
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
Name each segment and describe it [represents what? Normal duration? importance]
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.
What is the abnormality in the ECG drawing below? calculate the heart rate.
Sinus tachycardia. 1500/12=125 beats/min
1) in the above ECG drawing the R-R equals:
2) The heart rate of this person is
37 small squares
1500/37=40 beats/min
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: _______________
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
(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?
(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.
In the figure below determine the auscultatory areas for the first heart sound. What is the causes and timing during cardiac cycle?
near the apex and at the xiphosternal junction
Closure of mitral and tricuspid valves
3 is the ____, it represents:
a)
b)
c)
QRS
a) septal depolarization
b) ventricular wall depolarization
c) depolarization of the base
Lead I of the standard limb leads measures the potential difference between ______and________with the positive electrode at the ______
Right arm
Left arm
Left arm
In the figure below the ECG abnormality is: ____. It indicates: ___________
ST elevation
Myocardial infarction
In the figure below the ECG abnormality is
Irregular rhythm
The normal range of the electrical axis of the heart is from _____to ______
-30 to +90
Compare Rt and Lt axis deviation in range, occurs physiologically in and occurs pathologically in
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
What is the auscultatory areas for the SECOND heart sound? Mention the cause and timing during cardiac cycle of the 2nd heart sound
Cause: closure of semilunar valves
Timing: isovolumetric relaxation
Describe the four heart sounds in site and sound heard
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
Compare first and second heart sounds in causes, site in cardiac cycle, duration and character (pitch)
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
What are murmurs? give an example
abnormal sound due to turbulent blood flow. Example is valve regurge
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
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
What is the cause of the anacrotic limb, dicrotic notch and dicrotic wave.
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
Define Mean arterial blood pressure and state the formula
def: Mean pressure in large arteries during whole cardiac cycle
MAP= DBP + 1/3 pulse pressure
What is the mean BP in an artery 50 cm below the level of the heart while standing
50 x 0.77= 38.5
MAP+38.5=120+38.5= 158.5 mmHg
The palpatory method measure the _____pressure only
systolic
In the auscultatory method the systolic pressure is when the sound ______while the diastolic is when the sound ______
1st appear; disappears
Define systole distole and pulse pressure
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
state formula for preipheral resistance
peripheral resistance = TPR
MAP= TPRxCO
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?
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
why is the blood flow in the arteries normally soundless
cause laminar blood flow
Explain why should you measure the blood pressure using both the palpatory and auscultatory methods
to avoid auscultatory gap
What is meant by Korotkoff sounds
sounds that produced due to turbulence of blood flow while deflating the cuff.
irregular
HR= 1500/10= 150 beat/min,
rhythm: regular
Causes: emtions, stress, exercise, hyperthyroidism
HR: 1500/35= 42.5 beat/min
Rhythm: regular
Causes: vegal stimulation
(left axis deviation)
explain: as QRS in lead I is upward and QRS IN aVF is downward
Causes: obese
(irregular rhythm,
(2nd degree Heart block)
regular rhythm with atrial flutter
High voltage QRS e.g. ventricular hypertrophy
low voltage ECG e.g. obesity
elevated: acute Myocardial Infarction (MI)
comment on ST segment suggest a cause
depressed
Ischemia
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
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
Inspiration is _____, expiration is _____ and their location is normally ________
long; short
All over the chest
Forced expiratory ration is ______in restrictive lung disease. And _______ in obstructive lung disease. FVC and FEV1 is ______in restrictive lung disease.
increase
Decreased
decreased
Vital capicty is ___________. Its equal to ____ and its normally ______. Its decreased in ______
max volume of air expired after max inspiration
IRV + TV + ERV
4600 ml
obesity
Residual volumes usually equals ____ and it is measured by ____. Its importance is ________
1200 ml
Helium dilution method
Aerated blood between breaths and prevents marked changes in PO2 and PCO2
What is functional residual volume
It equals and is usually
Volume of air remain in lungs after normal expiration
ERv+RV
2300
Vital capacity is _____ and is increased in
IRV+TV+ERV=4600 ml
males and athletes
When does residual volume increase
emphysema and asthma
Type of disease, reason and mention one condition
Restrictive lung diseases, FEV1/FVC > 80%
lung collapse
Name the three lungs volumes that can be measured by the micro spirometer
Tidal volume
Inspiratory reserve volume
Expiratory reserve volume
Describe how the Measurement of maximal voluntary ventilation (MMV) is
performed?
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.
Why the test is done for 15 seconds?
To prevent hypocapnia and alkalosis,
In which respiratory values did you observe differences between short and tall subjects? How can
these be explained?
IRV; VC and TLC: free descent of diaphragm affecting the vertical diameter
If somebody has chronic inflammation of the lungs (pneumonia), which respiratory volume will be
affected in the diseased person
IRV; IC, VC; TLC will be decreased (restricted expansion
Name the disorder and give causes
Obstructive lung disease
decrease air flow due to increase of airway resistance
name the disease and causes
Restrictive lung disease
Decrease of ling volume
Decrease compliance of lung
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
Flow volume loop
Obstructive lung disease and ephysema
Decrease it is less than 80%, decrease airflow due to marked resistance to air flow
Compare bronchial, vesicular and bronchiovesicular breathing sounds in Pitch (intensity), quality, duration and site
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
Auscultation areas
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
HR variation during inspiration procedure and probable explanation and significance
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.
HR response during standing procedure and significance
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.
Valsalva maneuver and explain in autonomic dysfunction.
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
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
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
What is MCV formula and normal range
MCV=PCV/RBCs count x10
normal range=80-95 micrometers
What is MCH? state the formula and normal range
It is the average hemoglobin content in a single RBC
MCH=Hb content/ RBC count x10
normal: 25-32 pg
What is MCHC? state the formula and normal range
It is the average hemoglobin content in 100 ml RBCs
MCHC= Hb content/hematocrit value x 100
normal range: 32-38 gm/dl
Define PCV and give the normal values for male and female and where it increases
ration of RBC volume to total blood
male: 46% Female: 42%
PCV increase in dehydration and polycythemia
