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A & P > Test 5 Study Guide > Flashcards

Test 5 Study Guide Flashcards

1
Q

a graphic recording of voltage plotted against time during
myocardial depolarization and repolarization.

A

Electrocardiogram (ECG)

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2
Q

Traced on specialized graph paper, or displayed on a LED monitoring screen

A

Electrocardiogram (ECG)

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3
Q

Cardiac Tamponade Signs and
Symptoms

A

Distended neck veins,
tachycardia,
systolic BP of 90 mmHg.
* Chest pain,
dyspnea.
* Muffled distant heart sounds,
loss of carotid artery pulse during
inspiration.

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4
Q
  • Time required for the SA node impulse to reach ventricles
A

PR interval

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5
Q

measured from the beginning of the P-wave to the next deflection, whether it is a Q or Rwave.

A

PR interval

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6
Q

The average adult PR interval

A

0.12 to 0.20 seconds

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7
Q
  • A PR interval >___ shows an abnormally slow pulse conduction from the atria to the ventricles.
A

> 0.20

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8
Q

The PR interval is _____ in fast heart rates

A

Shorter

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9
Q
  • All sinus nodal impulses are conducted to the ______
A

Ventricles

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10
Q
  • All sinus nodal impulses are conducted to the ventricles, but the conductions
    time is slowed trough the _____ _____ bundle complex
A

AV Node

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11
Q

This slowed conduction in the AV Node is marked by an increase in the P-R interval >____
seconds.

A

> 0.20

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12
Q

In a first degree AV block, All QRS complexes are ______

A

Normal

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13
Q

The spaces between waves and complexes are called ______ and _______

A

intervals and segments

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14
Q

The P-wave represents _____ ______

A

atrial depolarization

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15
Q

The QRS-complex represents ______ _______

A

ventricular depolarization

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16
Q

T-wave represents ______ ______

A

ventricular repolarization.

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17
Q

The atrial repolarization wave is obliterated by the _____ _____ and is therefore not seen on an ECG
waveform.

A

QRS Complex

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18
Q

A normal (ST-segment) is normally ___, lying on the (ECG) baseline.

A

Flat

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19
Q

ST segment may be elevated ____ mm
above the baseline or depressed ___ mm below the baseline and still be considered normal.

A

2 mm or 0.5 mm

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20
Q

An (ST-segment) depressed more than 0.5 mm indicates myocardial tissue _____

A

ischemia

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21
Q

An (ST-segment) elevated more than 2 mm
indicates myocardial tissue _____

A

Injury

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22
Q

The ST segment Extends from the ___-point to the beginning of the ___-wave and represents the early phase of
ventricular repolarization

A

J-point to the T-wave

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23
Q

At its end, the normal ST-segment curves slightly ____ into the beginning of the T-wave.

A

Upward

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24
Q

The ST-length varies according to ___ ____

A

Heart rate

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25
Q

Fast heart rates will result in ____ ST-segments

A

Shorter

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26
Q

complete absence of electrical and mechanical activity. Cardiac death

A

Cardiac standstill (asystole)

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27
Q

Cardiac output during asystole

A

0

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28
Q

During asystole, BP falls to BP falls to ___ - ___ mmHg

A

5 – 7 mmHg

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29
Q

During asystole, ECG tracing appears a ___ line and indicates severe damage to the hearts electrical conduction system.

A

Flat

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30
Q

“dying heart” have periods of disorganized electrical activity may be
generated during long periods of asystole.

A

Agonal rhythm

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31
Q

Initiated by an ectopic focus in the ventricles below the branching portion of the (bundle of
His).

A

Premature ventricular contraction (PVC)

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32
Q

An abnormally irritable focus in the ventricle discharges before the next normal (SA node) impulse arrives.

A

Premature ventricular contraction (PVC):

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33
Q

PVCs can occasionally occur in healthy people, but can also be caused by:

A

Alcohol, caffeine, or tobacco use.
* Emotional stress

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34
Q

receives deoxygenated blood from superior vena cave, inferior vena cave, and
coronary sinus.

A

Right heart

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35
Q

passively receives blood from the R atrium until the ventricles are almost full.

A

Right ventricle

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36
Q

The Right atrium contracts to complete filling of the ___ ____

A

Right ventricle

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37
Q
  • RV contraction sends ____ blood through the pulmonary arteries to the lungs.
A

Deoxygenated

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38
Q

receives oxygenated pulmonary venous blood from the lungs via the pulmonary veins. (2 from each lung)

A

Left heart

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39
Q

The LV passively receives blood from the ___ ____ until the ventricles are almost full.

A

Left atrium

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40
Q

The Left atrium contracts to complete filling of the ___ ____.

A

Left ventricle

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41
Q

LV contraction sends _____ blood through the aorta, left common carotid artery, left
subclavian artery, and the brachiocephalic trunk to the brain and body.

A

Oxygenated

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42
Q

The contraction, or period of contraction, of the heart, especially
of the ventricles, during which blood is forced into the aorta and pulmonary
artery.

A

Systole

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43
Q

The phase of the cardiac cycle in which the heart relaxes
between contractions; specifically, the period when the two ventricles are
dilated by the blood flowing into them

A

Diastole

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44
Q

Pacemaker
* Initiates electrical impulses that produce sequential
atrial and ventricular contraction

A

Sinoatrial (SA) node:

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45
Q

Prevents impulses from causing ventricles to fire
prematurely.

A

Atrioventricular (AV) node

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46
Q

Hollow muscular pump about the size of a
human fist.

A

Heart

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47
Q

The heart lies in _____ behind the sternum.

A

mediastinum

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48
Q

Apex of the heart points to the ____

A

Left

49
Q

Heart Lays on diaphragm at level of ___ intercostal space
at the midclavicular line.

A

5th

50
Q

most common congenital
defect malformation of the heart in children

A

Ventral Septal Defect (VSD)

51
Q

hole in the wall that separates the
right and left ventricles of the heart.

A

Ventral Septal Defect (VSD)

52
Q

Normally left ventricular pressure exceeds right ventricular
pressure, causing a ___ to ___ shunt

A

Left to right shunt (Small, high resistance VSD.)

53
Q

occurs in large VSDs, because of right-to-left shunting

A

Hypoxemia (Venous blood mixes with oxygen rich blood.)

54
Q

Large symptomatic VSD requires ____ ____

A

Surgical correction

55
Q

observed that the greater the preload volume of the heart the greater
the force of contraction.

A
  • Frank and starling
56
Q

This occurs even in hearts removed from the body, confirming independence from neural
mechanisms.

A

Sarcomere length-dependent activation

57
Q

A precontraction sarcomere length of ____ microns has the greatest force of contraction

A

2.2 microns

58
Q

An increase in sarcomere length causes ____ cross-bridge cycling.

A

Increased

59
Q

Pre-contraction length of the cardiac muscle fiber

A

Heart’s preload

60
Q
  • Open during diastole;
  • Ventricular relaxation
A

AV valves: tricuspid and mitral valve

61
Q
  • Closed during systole;
  • Ventricular contraction
A

AV valves: tricuspid and mitral valve;

62
Q
  • Open during systole;
  • Ventricular contraction.
A

Pulmonary and aortic semilunar valves:

63
Q

Closed during diastole;
* Ventricular relaxation.

A

Pulmonary and aortic semilunar valves:

64
Q

Heart muscle forming the bulk of
the heart wall.
* Wraps around heart chambers

A

Myocardium:

65
Q

Contraction ejects blood with
great force.

A

Myocardium:

66
Q

Responds to high BP and stretch of ventricular walls.
* Produced in ventricular walls.
* Promotes sodium loss (diuresis).

A

B-type Natriuretic Peptide (BNP) mechanism: Hormone

67
Q

Water loss causes ____ in blood volume, resulting in decreased
BP

A

Decrease

68
Q
  • In CHF, the ventricles become distended, and their walls are
    stretched, this causes a ____ in blood levels of BNP.
A

Increase

69
Q
  • Increased BNP blood levels are a diagnostic marker for ___ ____
A

Heart failure

70
Q

Differentiates pulmonary and cardiac dyspnea.

A

Increased BNP blood levels

71
Q

(increased K+) in the extracellular fluid surrounding cardiac fibers decreases the
heart rate and stroke volume.

A

Hyperkalemia

72
Q

Severe hyperkalemia causes ___ ____, or the inability of cardiac fibers conduct action potential
through the heart.

A

Heart block

73
Q

K+ is primarily responsible for generating ___, and high extracellular K+ diminishes the outward
diffusion gradient of K+.

A

RMP

74
Q

The RMP across the cell membrane is less ____ (closer to 0)

A

Negative

75
Q

The cell membrane is closer to ____ ____

A

Threshold Potential

76
Q

Makes the cell more excitable (easier to depolarize).

A

RMP

77
Q

At rest, when the heart muscle fibers are relaxed, and cell membranes impermeable to ions:

Cell interior is ______
* Cell exterior is _____

A

Cell interior is electronegative (negative pole).

  • Cell exterior is electropositive (positive pole).
78
Q

As the permeability of the cardiac fiber membrane increases, ions rush in and out of the cell
_____ the membrane.

A

Depolarizing

79
Q

initiates a series of electrochemical events responsible for heart muscle
contraction.

A

Membrane Depolarization

80
Q

Cardiac cell permeability changes _____, alternating from impermeable to completely permeable.

A

Cyclically

81
Q

The axes of precordial leads are located on a ______ plane through the chest.

A

Horizontal

82
Q

The precordial leads consist of six ____ unipolar electrodes placed on the anterior surface of
the chest

A

Positive

83
Q

Name the six precordial leads

A

V1, V2, V3, V4, V5, and V6

84
Q

Comprises three bipolar limb leads, three unipolar limb leads,
and six precordial leads.

A

12 lead ECG

85
Q

The 12 lead ECG allows the hearts ____ -vector to be viewed from 12 different electrical vantage points.

A

QRS-vector

86
Q

As soon as the ventricles ___, the pressure that accumulated in the atria during
ventricular contraction pushes the AV valves open, filling the ventricles with
blood.

A

Relax

87
Q

merely priming pumps for the ventricles, completing the
“preloading” process.

A

Atria

88
Q

Rapid filling vs. slow filling phase

A

80% passive filling (0.7 seconds).
* 20% “atrial kick”, or atrial contraction (0.1 seconds).

89
Q

The electrical charge difference between two sides of a polarized
myocardial cell membrane

A

“resting membrane potential
(RMP)

90
Q

Myocardial cell RMP

A

-85 to -90 millivolts

91
Q

The outside of the cell has ___ ground potential.

A

0

92
Q

the difference between the cell’s inside potential and zero.

A

RMP

93
Q

indicates the polarity
of the cells interior.

A

Negative sign in from the cell RMP (-90mV)

94
Q

RMP generation inside the cell:

A

K+ and large protein anions (negatively charged ions).

  • Intracellular (K+) (151 mEq/L) and extracellular (K+) (4 mEq/L).
95
Q
  • RMP generation outside the cell:
A

(Na+) and (Ca++);
* Extracellular (Na+) (144 mEq/L), (Ca++) (5 mEq/L).
* Intracellular (Na+) (7 mEq/L), (Ca++) (less than 1 mEq/L).

96
Q

occurs when the fiber RMP of -90 mV abruptly changes to 0 MV

A
  • Cardiac muscle fiber depolarization
97
Q

occurs when the RMP is reestablished at -90 mV.

A

Repolarization

98
Q

a real-time recording of the moment-to-moment changes in membrane
potential (voltage) as the cardiac fiber depolarizes and repolarizes.

A

Action potential

99
Q

All cells in the cardiac conduction system are potential _____

A

Pacemakers

100
Q

The takeover of pacemaker activity by lower order pacemakers

A

downward displacement of the pacemaker

101
Q

Atrioventricular (AV) nodal fibers fire at a rate of ___ to ___ times/min

A

40 to 60

102
Q

Purkinje fibers fire at a rate of ___ to ___times/min (30 second delay).

A

15 to 40

103
Q

Delayed ventricular takeover of the heartbeat and fainting caused by periodic blocks of atrial
impulses

A

Stokes-Adams syndrome

104
Q

control the permeability of the myocardial cell membrane to Na+
and K+

A

Voltage-gated ion channels

105
Q

Sodium and potassium channels are Formed by large _____ molecules and are specific for each ion.

A

Protein

106
Q

Voltage sensitive gating proteins open and close in response to changes in _____ _____

A

Membrane potential

107
Q

K+ and Na+
channel activation gates are closed at a RMP of ______

A

-90mV

108
Q

Some K+ and Na+ continue to diffuse through leak channels due to high ____ ____

A

Diffusion gradients

109
Q

Phase 2: Plateau, lasts how many seconds?

A

0.2 - 0.3 seconds

110
Q

During phase 2, Slow calcium channel activation gates open, allowing ____ and ____ to enter
the cell

A

Ca++ and a small amount of Na+

111
Q

Ca++ entering the myocardial fiber during the plateau phase participates in the _____ contraction coupling between actin and myosin fibers.

A

Excitation

112
Q

At the same time there is an equal outflow of K+ bringing membrane potential to near ___ mV, creating the action potentials plateau (phase 2).

A

0 mV

113
Q

a drug that increases Ca++ influx, has an inotropic effect (increased contraction force).

A

Digitalis

114
Q

When does the plateau phase end?

A

when Ca++ inactivation gates close, stopping Ca++
inflow.

115
Q

Phase 3 and 4 is _____

A

Repolarization

116
Q

During repolarization, The membrane is now highly permeable to only ____
ions, and K+ rushes out of
the cell restoring intracellular negativity.

A

K+

117
Q

During repolarization, Na+ is pumped ___ and K+ is pumped ___

A

Na+ out
K+ in

118
Q

During repolarization, The muscle fiber is ready to accept another ____ stimulus

A

depolarizing

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