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Depolarization, Cardiac Axis & EKG

Description

Cardiovascular Physiology Lecture #2
Trey W
Quiz by Trey W, updated more than 1 year ago
Trey W
Created by Trey W over 4 years ago
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Resource summary

Question 1

Question
Pacemaker cells in the SA node are located:
Answer
  • at the junction between the vena cava and right atrium
  • primarily in the right atrium
  • at the junction between the right atrium and the right ventricle
  • near the coronary sinus

Question 2

Question
The wave of depolarization in the heart moves from the SA node to the RA, interatrial septum and left atrium at a rate of 0.4 m/sec.
Answer
  • True
  • False

Question 3

Question
Which of the following is a result of atrial depolarization?
Answer
  • QRS complex
  • P wave
  • T wave
  • V wave

Question 4

Question
The rate of depolarization slows down as the wave reaches the small AV node cells.
Answer
  • True
  • False

Question 5

Question
The wave of depolarization after the AV node:
Answer
  • spreads rapidly at a rate of 2-4 m/sec
  • spreads rapidly at a rate of 3-5 m/sec
  • travels through the bundle of His and then to the bundle branches
  • is slowed at the bundle of His

Question 6

Question
The [blank_start]QRS complex[blank_end] seen in an EKG is due to depolarization of the ventricles.
Answer
  • QRS complex
  • P wave
  • PR interval

Question 7

Question
Which of the following cells is/are capable of generating spontaneous pacemaker activity?
Answer
  • AV node
  • SA node
  • Bundle cells
  • Purkinje fibers

Question 8

Question
Without any neural modulation SA node cells would fire at a rate of 100-120 bpm.
Answer
  • True
  • False

Question 9

Question
Atrial fibrillation occurs when the atrial muscle depolarizes so frequently (rates up to 500/min) that the atrial contraction is ineffective and the QRS complex is replaced by small oscillations.
Answer
  • True
  • False

Question 10

Question
Standard limb lead I compares voltage between:
Answer
  • right arm and left leg
  • right arm and left arm
  • left arm and left leg

Question 11

Question
Standard limb lead II compares voltage between the right arm and left leg.
Answer
  • True
  • False

Question 12

Question
Augmented lead aVL averages negative leads on the right arm and [blank_start]left leg[blank_end] to compare to a positive lead on the left arm.
Answer
  • left leg
  • right leg
  • 4th intercostal space
  • left arm

Question 13

Question
Augmented lead _____ has negative leads averaged between the left arm and left leg, with the positive lead on the right arm.
Answer
  • aVR
  • AVL
  • aVF

Question 14

Question
Augmented lead aVF averages negative leads on both feet and compares voltage to a positive lead on the left arm.
Answer
  • True
  • False

Question 15

Question
Which of the following are components of standard limb lead III?
Answer
  • negative lead on the left arm
  • negative lead on the right arm
  • positive lead on the left leg
  • positive lead on the right leg

Question 16

Question
What abnormality is portrayed in the EKG tracing?
Image:
Screen+Shot+2020 06 25+At+10.28.23+Pm (binary/octet-stream)
Answer
  • 1st degree heart block
  • 2nd degree heart block, Mobitz Type II
  • ST elevation
  • 2nd degree heart block, Mobitz Type I

Question 17

Question
The portrayed EKG tracing demonstrates 2nd degree, Mobitz Type II heart block.
Image:
Screen+Shot+2020 06 23+At+4.55.20+Pm (binary/octet-stream)
Answer
  • True
  • False

Question 18

Question
This EKG tracing demonstrates 3rd degree heart block. Which of the following are characteristics of this abnormality?
Image:
Screen+Shot+2020 06 23+At+5.05.51+Pm (binary/octet-stream)
Answer
  • Complete A-V disassociation (dissociated P waves)
  • consistent QRS complex
  • 3rd degree burns
  • Absent PR interval (atria & ventricles beat independently)
  • Absent P waves
  • Ventricular bradycardia

Question 19

Question
What abnormality is demonstrated by the EKG tracing?
Image:
Screen+Shot+2020 06 23+At+5.12.01+Pm (binary/octet-stream)
Answer
  • Ventricular fibrillation
  • Atrial fibrillation
  • Auricular fibrillation
  • Defibrillation

Question 20

Question
[blank_start]Ventricular tachycardia[blank_end] (as shown in this tracing) is characterized by a heart rate greater than [blank_start]100[blank_end] bpm and wide [blank_start]QRS[blank_end] interval.
Image:
Screen+Shot+2020 06 23+At+5.15.58+Pm (binary/octet-stream)
Answer
  • Ventricular tachycardia
  • 100
  • QRS

Question 21

Question
This EKG tracing demonstrates sinus bradycardia.
Image:
Screen+Shot+2020 06 23+At+5.21.40+Pm (binary/octet-stream)
Answer
  • True
  • False

Question 22

Question
What abnormality is demonstrated here?
Image:
Screen+Shot+2020 06 23+At+5.31.48+Pm (binary/octet-stream)
Answer
  • Ventricular fibrillation
  • Atrial fibrillation
  • Atrial flutter

Question 23

Question
The pictured abnormality demonstrates atrial flutter. How does this differ from atrial fibrillation?
Image:
Screen+Shot+2020 06 23+At+5.34.22+Pm (binary/octet-stream)
Answer
  • Electrical activity is coordinated in flutter, but not in fibrillation
  • Electrical activity is coordinated in fibrillation, but not in flutter
  • Characteristic "sawtooth" P waves are present
  • QRS is grossly abnormal.

Question 24

Question
This EKG tracing demonstrates which of the following?
Image:
Screen+Shot+2020 06 23+At+5.42.29+Pm (binary/octet-stream)
Answer
  • Sinus bradycardia
  • Sinus tachycardia
  • Sinus arrhythmia
  • Sinus pressure

Question 25

Question
Which is the most common cause of sudden death?
Answer
  • Abetalipoproteinemia
  • Ventricular fibrillation
  • PA students suddenly transitioning to a sedentary lifestyle and questionable dietary habits
  • Darth Proteus + a bottle of Don Julio 70
  • Atrial fibrillation

Question 26

Question
Where does standard limb lead III record differences in potential?
Answer
  • Left arm (-) and left leg (+)
  • Right arm (-) and left leg (+)
  • Right arm (+) and right leg (+)

Question 27

Question
You're performing an EKG on a patient and focusing on limb lead II. In terms of deflection, what do you expect to see on the tracing upon atrial depolarization?
Answer
  • positive (upward) deflection forming the P wave
  • negative (downward) deflection forming the P wave
  • formation of the QRS complex
  • formation of the Z wave

Question 28

Question
With respect to limb lead II, what do you expect to observe on an EKG upon the FIRST stage of ventricular depolarization?
Answer
  • a slight positive deflection at the beginning of the QRS complex
  • a slight negative deflection at the beginning of the QRS complex
  • no measurable deflection
  • a large negative deflection at the beginning of the QRS complex

Question 29

Question
With respect to aVR, you expect to see a negative (downward) deflection upon the SECOND stage of ventricular depolarization.
Answer
  • True
  • False

Question 30

Question
All of the following are terms that describe abnormal pathways of depolarization in cardiac muscle except:
Answer
  • re-entry
  • circus movement
  • reciprocating tachycardia
  • fibrillation
  • refractory repolarization

Question 31

Question
Regarding the QRS axis of the heart, if the QRS is positive (upright) in lead I and positive (upright) in lead aVF, then you have a normal axis.
Answer
  • True
  • False

Question 32

Question
If the QRS axis (vector) is negative in lead I and negative in lead aVF, then:
Answer
  • You are in the NW axis (can be seen in patients with v-tach; relatively rare)
  • This confirms a left axis deviation (LAD) usually seen with left ventricular hypertrophy or right ventricle damage
  • This confirms a right axis deviation (RAD) usually seen with right ventricular hypertrophy or left ventricle damage
  • I need to watch the video provided in the explanation to understand more

Question 33

Question
The normal QRS axis of the heart comprises a vector between +90 and -50 degrees
Answer
  • True
  • False

Question 34

Question
A normal PR interval is between
Answer
  • 0.12 and 0.2 sec
  • 0.2 - 0.3 sec
  • 0.06 - 0.1 sec
  • 0.35 - 0.4 sec

Question 35

Question
You are a 2nd year student and your internal medicine preceptor asks you the following question regarding an EKG trace: "How many seconds are represented by 1 big box?". Your answer is:
Answer
  • 1 second
  • 0.2 seconds
  • 0.5 mV
  • 0.4 seconds

Question 36

Question
The best immediate treatment for ventricular fibrillation would be blocking the
Answer
  • I (f) channel
  • TEA-type K channel
  • Na+ channel
  • None of the above

Question 37

Question
Which of the leads is depicted in this image?
Image:
Ekg (binary/octet-stream)
Answer
  • aVL
  • Limb lead II
  • Limb lead III
  • Precordial lead
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