Cardiac Function and ECG Basics
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Questions and Answers

Which of the following is a lateral lead on a 12-lead ECG?

  • V2
  • V6 (correct)
  • V1
  • V4

    • What is the first action to take upon observing asystole on an ECG?

  • Confirm flatline in two or more leads.
  • Administer epinephrine.
  • Immediately begin chest compressions.
  • Check for a pulse. (correct)

    • Which of the following is NOT a type of artifact discussed in the content?

  • Electrical artifact
  • Baseline artifact (correct)
  • Sixty hertz artifact
  • Muscle artifact

    • What type of epithelium predominately lines the airway?

    <p>Pseudostratified ciliated columnar</p> Signup and view all the answers

    What is the primary function of the upper airway?

    <p>Warm, moisture and humidify air</p> Signup and view all the answers

    Which medication is best for decreasing upper airway edema?

    <p>Racemic epinephrine</p> Signup and view all the answers

    A patient is experiencing bradycardia; which type of drug would be useful?

    <p>Chronotropic</p> Signup and view all the answers

    What is the partial pressure of inspired oxygen (PIO2) at sea level on room air?

    <p>160 mmHg</p> Signup and view all the answers

    What characteristic of cardiac cells enables them to spontaneously generate action potentials?

    <p>Automaticity</p> Signup and view all the answers

    An irregular heartbeat originating from an abnormal location within the heart muscle is referred to as:

    <p>Ectopic</p> Signup and view all the answers

    Which timeframe represents the duration of one large box on ECG paper?

    <p>0.20 seconds</p> Signup and view all the answers

    A P-R interval of 0.24 seconds is considered:

    <p>Prolonged from normal duration</p> Signup and view all the answers

    What wave on an ECG is representative of atrial depolarization?

    <p>P wave</p> Signup and view all the answers

    What is the heart's natural pacemaker?

    <p>SA node</p> Signup and view all the answers

    What is the term for an area of the heart muscle that is experiencing a lack of sufficient blood and oxygen?

    <p>Ischemia</p> Signup and view all the answers

    Which of the following is a location used to place an electrode for a 12-lead ECG?

    <p>Mid-clavicular line at the 4th intercostal space</p> Signup and view all the answers

    Which of these represents the timeframe for a normal QRS complex on an ECG?

    <p>0.08 - 0.10 seconds</p> Signup and view all the answers

    What does the term 'escape' refer to in the context of cardiac rhythms?

    <p>An arrhythmia that occurs when the heart's natural pacemaker fails.</p> Signup and view all the answers

    If the heart's sinoatrial (SA) node fails, which of the following areas would most likely act as a secondary pacemaker?

    <p>Atrioventricular (AV) node</p> Signup and view all the answers

    Which ECG waveform is associated with the electrical event of ventricular repolarization?

    <p>T wave</p> Signup and view all the answers

    What does the term 'foci' refer to in the context of cardiac electrophysiology?

    <p>Specific locations within the heart where electrical impulses originate.</p> Signup and view all the answers

    If a patient's P-R interval measures 0.22 seconds, this would be considered

    <p>Prolonged</p> Signup and view all the answers

    Which of the following is not a bipolar lead on a 12 lead EKG?

    <p>V1</p> Signup and view all the answers

    Which of the following is NOT an indication for an EKG?

    <p>Headache</p> Signup and view all the answers

    Which of the following is a long-acting beta agonist (LABA)?

    <p>Formoterol</p> Signup and view all the answers

    A patient with a heart condition requires a medication to increase the force of their heart contractions. Which type of drug would be most appropriate?

    <p>Inotropic</p> Signup and view all the answers

    Which of the following best describes a depolarizing neuromuscular blocking agent?

    <p>Succinylcholine</p> Signup and view all the answers

    Which of the following solutions is used to help mobilize secretions?

    <p>All of the above</p> Signup and view all the answers

    Which medication is a long-acting muscarinic antagonist (LAMA) that can be nebulized?

    <p>Revefenacin</p> Signup and view all the answers

    What is the purpose of administering a sedative alongside a neuromuscular blocking agent (NMBA)?

    <p>To reduce patient's awareness and anxiety</p> Signup and view all the answers

    What is the correct method to calculate the A-a gradient?

    <p>Subtract arterial oxygen pressure from the alveolar oxygen pressure</p> Signup and view all the answers

    A patient is experiencing a very slow heart rate (bradycardia). Which type of medication would be suitable?

    <p>Chronotropic</p> Signup and view all the answers

    What is the duration in seconds, of the normal P-R interval?

    <p>0.12 - 0.20</p> Signup and view all the answers

    If the ventricles depolarize, what event is represented on an EKG?

    <p>QRS complex</p> Signup and view all the answers

    What is the time, in seconds, that one small box represents on an EKG?

    <p>0.04</p> Signup and view all the answers

    When a patient's heart rate is between 40 and 60 bpm, which area of the heart is most likely acting as the primary pacemaker?

    <p>AV node</p> Signup and view all the answers

    Which of the following is NOT a typically described indication for performing an EKG?

    <p>Cyanosis</p> Signup and view all the answers

    Which lead is NOT one of the standard bipolar leads on a 12-lead EKG?

    <p>Lead V1</p> Signup and view all the answers

    What is the approximate duration of the QRS complex on a normal EKG tracing?

    <p>0.08 to 0.10 seconds</p> Signup and view all the answers

    When placing electrodes on a patient for a 12-lead EKG, where should the V4 electrode be positioned?

    <p>Fifth intercostal space at the midclavicular line</p> Signup and view all the answers

    Which of the following precordial leads primarily assesses the septal area of the heart?

    <p>V1 and V2</p> Signup and view all the answers

    After confirming asystole on an ECG, which step is next most critical?

    <p>Confirming a 'flat line' in multiple leads</p> Signup and view all the answers

    Which of the following is a common cause of electrical artifact seen on an ECG?

    <p>Sixty hertz electrical interference</p> Signup and view all the answers

    What is the primary physiological effect of racemic epinephrine when used to treat upper airway edema?

    <p>Causes vasoconstriction to reduce swelling</p> Signup and view all the answers

    Which of the following is classified as a long-acting beta agonist (LABA) often used in the management of airway disease?

    <p>Formoterol</p> Signup and view all the answers

    Which of the following solutions is considered hypertonic?

    <p>3.0% Sodium Chloride</p> Signup and view all the answers

    What is the primary action of an inotropic medication?

    <p>Modify the force of myocardial contractions</p> Signup and view all the answers

    When providing ventilation assistance to a patient at sea level on room air, what is the approximate partial pressure of inspired oxygen ( $\text{P}\text{I}\text{O}_2$ ) they will receive?

    <p>$160 \text{ mmHg}$</p> Signup and view all the answers

    Study Notes

    Cardiac Cell Function and Electrical Activity

    • Automaticity: Cardiac cells spontaneously generate action potentials.
    • Ectopic Beats: Irregular heartbeats originating from abnormal sites in the heart muscle, outside the normal pacemaker.
    • Escape Rhythms: Irregular heartbeats caused by the heart's natural pacemaker failing.
    • Focus (Foci): Specific locations in the heart initiating electrical impulses; acting as pacemakers.
    • Depolarization: Heart muscle contraction.
    • Repolarization: Heart muscle relaxation.
    • Sinoatrial node (SA node): The primary pacemaker of the heart.

    ECG/EKG Indications

    • Indications: Shortness of breath, palpitations, weakness, lethargy, syncope, chest pain.
    • Purpose: Assessing heart pumping and contractions.
    • Frequency: Recommended after age 40.

    EKG Timing

    • Small Box: 0.04 seconds.
    • Large Box: 0.20 seconds.

    Ischemia

    • Definition: Insufficient blood flow to a body part, causing oxygen deprivation.
    • Severity: A serious medical condition.,

    P-R Interval

    • Normal Range: 0.12 to 0.20 seconds (3 to 5 small boxes).

    QRS Complex

    • Normal Range: 0.08 to 0.10 seconds (2 to 2.5 small boxes).

    Heart Pacemakers

    • SA Node: Primary pacemaker (60-100 bpm).
    • AV Node: Secondary pacemaker (40-60 bpm).
    • Bundle Branches & Purkinje Fibers: Tertiary pacemakers (30-40 bpm).

    ECG Electrode Placement

    • Ten electrodes: Used for a twelve lead ECG.
    • Placement Details:
      • RA: Anywhere between the shoulder and lower forearm.
      • LA: Anywhere between the shoulder and lower forearm.
      • RL: Anywhere below the lower hip, above the ankle.
      • LL: Anywhere below the lower hip, above the ankle.
      • V1: Fourth intercostal space, right of the sternum.
      • V2: Fourth intercostal space, left of the sternum.
      • V3: Midway between V2 and V4.
      • V4: Fourth intercostal space, midclavicular line.
      • V5: Anterior axillary line, same level as V4.
      • V6: Midaxillary line, same level as V4 and V5.

    ECG Waveforms

    • P Wave: Atrial depolarization.
    • QRS Complex: Ventricular depolarization.
    • T Wave: Ventricular repolarization.

    ECG Leads

    • Bipolar Leads: Leads 1, 2, and 3.
    • Precordial Leads: V1 to V6.

    Asystole

    • Procedure for Asystole: Check pulse, confirm a flatline in two or more leads.

    Artifacts and EPITHELIUM

    • Artifacts: 60 Hz muscle electrical interference.
    • Epithelium: Pseudostratified ciliated columnar epithelium.

    Airway Function

    • Upper Airway Function: Warms, moistens, and humidifies inspired air.

    Medications for Upper Airway Swelling

    • Racemic Epinephrine: Used to shrink upper airway edema.

    Beta-Adrenergic Agonists

    • LABA (Long-acting): Formoterol (Foradil), Arformoterol (Brovana), Salmeterol (Serevent).
    • SABA (Short-acting): Albuterol (Ventolin, Proventil, ProAir), Levalbuterol (Xopenex), Pirbuterol (Maxair).

    Muscarinic Antagonists

    • SAMA (Short-acting): Ipratropium Bromide (Atrovent).
    • LAMA (Long-acting): Tiotropium Bromide (Spiriva), Revefenacin (Yulpelri) - only nebulizable LAMA.

    Oxygen Transport

    • Method: Oxygen carried in blood, bound to hemoglobin.

    Secretions Mobilization Solutions

    • Solutions: Hypertonic, hypotonic, and isotonic solutions.

    Ionotropic Drugs

    • Action: Modify the force of heart contractions.

    Chronotropic Anticholinergic Drugs

    • Action: Treat atrioventricular block and bradycardia.

    Neuromuscular Blocking Agents (NMBAs)

    • Depolarizing NMBA (for intubation): Succinylcholine.

    Co-administration with NMBAs

    • Companion drugs: Sedatives.

    Inspired Oxygen Partial Pressure

    • Normal PIO2 (at sea level): 160 mmHg.

    A-a Gradient

    • Calculation: PAO2 - PaO2.

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    Description

    Explore the fundamentals of cardiac cell function and the electrical activity involved in heartbeats. This quiz covers automaticity, depolarization, ECG indications, and the significance of ischemia, among other critical topics. Test your knowledge on how these elements impact heart health and function.

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