Cardiac Rhythm and Exercise Quiz

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Questions and Answers

What is the characteristic QRS pattern in Ventricular Tachycardia?

Narrow and regular

Wide and bizarre (correct)

Normal and consistent

Absent

What happens to the P-wave during Atrial Fibrillation?

It is present and regular

It is merged with the T-wave

It is absent or erratic (correct)

It appears as a sawtooth pattern

What is a common rate range for Atrial Flutter?

250-350 bpm (correct)

100-150 bpm

150-250 bpm

600-800 bpm

What is the risk associated with Ventricular Fibrillation?

It requires immediate electrical defibrillation Signup and view all the answers

What type of tachycardia involves at least three different forms of P-waves?

Multifocal Atrial Tachycardia Signup and view all the answers

What is the primary focus of the goals during the rehabilitation phase mentioned?

Enhancing endurance to improve quality of life Signup and view all the answers

Which of the following indicates a patient has successfully completed Phase IV of their exercise program?

The patient can monitor themselves during exercise and at rest Signup and view all the answers

How often should patients aim to exercise to improve cardiac muscle function?

Three times a week or five times a week for improvement Signup and view all the answers

What is required for a patient to effectively monitor their own exercise intensity?

The ability to recognize and manage their vital signs autonomously Signup and view all the answers

What condition may indicate a need for improvement in a patient's exercise program?

The patient cannot tolerate the needed workload or stress level Signup and view all the answers

What percentage of the total lung volume is made up by Functional Residual Capacity?

75% Signup and view all the answers

Which breathing pattern is characterized by repeated cycles of deep breathing followed by shallow breaths or cessation of breathing?

Cheyne-Stokes respiration Signup and view all the answers

What defines obstructive impairment according to the FEV1/FVC ratio?

FEV1/FVC ratio < 70% Signup and view all the answers

Which of the following best describes hyperventilation?

Abnormally prolonged and deep breathing Signup and view all the answers

What is indicative of lateral-costal breathing?

Minimal upper chest expansion with lower rib cage flaring Signup and view all the answers

Which condition is associated with crackles heard during auscultation?

Congestive heart failure Signup and view all the answers

What describes paradoxical breathing?

Chest wall falls in during inspiration and abdomen expands during exhalation Signup and view all the answers

What is the combined total volume of the lungs during a maximum inspiratory effort known as?

Total Lung Capacity Signup and view all the answers

What is the primary muscle involved in normal inspiration during breathing?

Diaphragm Signup and view all the answers

How do the upper ribs contribute to chest expansion during breathing?

Pump handle motion, moving upward and forward Signup and view all the answers

What characterizes a first-degree AV block?

PR interval lengthened to more than 0.20 seconds Signup and view all the answers

During passive expiration, which mechanism primarily allows the lungs to return to their resting position?

Elastic recoil of lung parenchyma Signup and view all the answers

What is commonly associated with Type I second-degree AV block?

Long PR intervals leading to dropped QRS complexes Signup and view all the answers

In abnormal breathing conditions, which accessory muscles are primarily engaged for increased inhalation?

Scalenes and sternocleidomastoid Signup and view all the answers

Which statement about third-degree AV block is true?

It can lead to life-threatening complications Signup and view all the answers

Which statement correctly describes the effect of body position on diaphragm function?

Supine positions lower the diaphragm and decrease inspiratory capacity. Signup and view all the answers

What is the role of gravity in pulmonary perfusion?

More pulmonary blood is found at the base of the lung in an upright position. Signup and view all the answers

A patient exhibiting rapid progression to complete heart block is likely suffering from which type of AV block?

Type II second-degree AV block Signup and view all the answers

Which symptom is most likely associated with complete heart block?

Fatigue Signup and view all the answers

What happens to the abdominal wall during normal inspiration?

It protrudes forwards. Signup and view all the answers

Which of the following leads is correctly placed at the left sternal border?

Lead 4 Signup and view all the answers

Which mechanism is used for quick or full expiration during exercise or disease?

Abdominal muscles and intercostals Signup and view all the answers

What does a steady P-R interval followed by occasional dropped QRS complexes indicate?

Type II second-degree AV block Signup and view all the answers

What factor could contribute to first-degree AV block in athletes?

Enhanced vagal tone Signup and view all the answers

What is the most common cause of pulmonary fibrosis?

Idiopathic reasons Signup and view all the answers

What effect does pulmonary hypertension have on blood vessels?

Vasoconstriction of blood vessels Signup and view all the answers

Which statement about sarcoidosis is false?

Most patients require immediate treatment Signup and view all the answers

What is a primary characteristic that differentiates obstructive pulmonary disease from restrictive pulmonary disease?

Airflow limitation that is not fully reversible Signup and view all the answers

What is a common treatment for tuberculosis?

Antibiotics Signup and view all the answers

Which of the following is NOT a contributing factor to pulmonary fibrosis?

Viral infections Signup and view all the answers

What condition results from granulomas forming in the lungs, lymph, and skin?

Sarcoidosis Signup and view all the answers

In patients with pulmonary hypertension, what is generally expected regarding their prognosis?

Prognosis is good with treatment Signup and view all the answers

Study Notes

Cardiovascular, Pulmonary & Lymphatic Systems

The cardiovascular system comprises the heart, blood vessels, and blood, responsible for transporting oxygen and nutrients throughout the body.
The pulmonary system is responsible for gas exchange (oxygen uptake and carbon dioxide removal) within the lungs.
The lymphatic system plays a crucial role in collecting waste products, cellular debris, and proteins, and is part of the overall immune response of the body.

Anatomy and Topology

Pericardium: A fibrous sac surrounding the heart.
Epicardium: Inner layer of the pericardium.
Myocardium: The heart muscle, the main component.
Endocardium: Smooth lining of the heart chambers.
Apex: The pointed end of the heart, situated in the left ventricle.
Base: The broader upper portion of the heart.

Cardiac Valves

Atrioventricular valves (tricuspid and mitral) prevent backflow into the atria during ventricular contraction.
Semilunar valves (pulmonary and aortic) prevent backflow into the ventricles during ventricular diastole.

Cardiac Chambers

Right atrium: Receives deoxygenated blood from the body.
Right ventricle: Pumps blood to the lungs via the pulmonary arteries.
Left atrium: Receives oxygenated blood from the lungs.
Left ventricle: Pumps oxygenated blood to the body via the aorta.

Cardiac Vessels

Aorta: Carries oxygenated blood to the body.
Vena cava: Carries deoxygenated blood to the heart.

Cardiac Cycle

Atrial systole: Contraction of atria, pushing blood into ventricles.
Atrial diastole: Relaxation of atria, allowing filling.
Ventricular systole: Contraction of ventricles, pumping blood into pulmonary artery/aorta.
Ventricular diastole: Relaxation of ventricles, allowing filling.

Normal and Abnormal Heart Rhythms

Ventricular tachycardia (PVC): Abnormally fast heart rate originating in the ventricles.
Ventricular fibrillation: Irregular, disorganized heart rhythm originating in the ventricles; life-threatening emergency.
Atrial fibrillation: Irregular, disorganized heart rhythm originating in the atria.
Atrial flutter: Abnormally fast heart rate originating in the atria in particular repeating pattern.

Pacemakers (Biological and Artificial)

SA node: Primary pacemaker of the heart; initiates electrical impulses.
AV node: Delays impulse transmission to allow atria to empty completely before ventricle contraction.
Purkinje fibers: Specialized conductive fibers carrying impulses through ventricles enabling synchronized contraction.
Artificial pacemakers: Medical devices used when natural pacemakers fail.

Normal/Abnormal Heart Enzymes

CK-MB (Creatine Kinase - MB): Enzyme marker for myocardial infarction. Typically elevated within 2-4 hours after onset, peaking at 12-24 hours, and returning to normal in 2-3 days.
Troponin: Marker for myocardial damage; elevated after myocardial infarction and remains elevated longer than CK-MB.
SGOT/AST (Serum glutamic-oxaloacetic transaminase/Aspartate aminotransferase): Marker for myocardial damage; rise within 6-12 hours post-MI and returns to normal in 2-3 days or a longer period.
LDH (Lactate Dehydrogenase): rises 18 hours post-MI and takes approximately 7 days for it to return to normal.

Normal Blood Gases

PaO2 (partial pressure of oxygen): >80 mmHg
PaCO2 (partial pressure of carbon dioxide): 35-45 mmHg
pH: 7.35-7.45
HCO3 (bicarbonate): 22-26 mEq/L
O2Sat (oxygen saturation): 95%-100%

Hemostasis (Clotting/Bleeding)

Prothrombin time (PT): 11-15 seconds
Partial thromboplastin time (PTT): 25-40 seconds
INR (International Normalized Ratio): 0.9-1.1 seconds

Complete Blood Count (adult)

WBCs (White Blood Cells): 4,300-10,800 cells/mm³
RBCs (Red Blood Cells): Male: 4.6-6.2 x 10⁶/µL, Female: 4.2-5.9 x 10⁶/µL
ESR (Erythrocyte Sedimentation Rate): Male: <15 mm/hr, Female: <20 mm/hr
Hematocrit: Male: 45-52%, Female: 37-48%
Hemoglobin: Male: 13-18 g/dL, Female: 12-16 g/dL
Platelet count: 150,000-450,000 cells/mm³

Heart Rate Controls

Nervous system: Controls involuntary adjustments to heart function.
Endocrine system: Maintains heart rate during relaxed situations.
Hormones: Epinephrine and norepinephrine (sympathetic) increase heart rate; acetylcholine (parasympathetic) slows it.
Baroreceptors: Respond to blood pressure changes.
Chemoreceptors: Respond to blood gas changes.

Preload: Tension in the ventricle at the end of diastole (reflecting venous return).
Afterload: Resistance the heart faces when pumping blood.
Stroke volume (SV): Amount of blood pumped per contraction of the left ventricle (60-80 mL).
Cardiac output (CO): Cardiac output and venous return are similar in amount in a closed loop system.

Common Surgical Interventions

Heart transplant: For end-stage heart disease.
Balloon angioplasty: Used to open blocked blood vessels.
Coronary bypass surgery: Replace diseased coronary arteries with grafts.

Cardiovascular Tests and Measures

Heart auscultation: Listening to heart sounds.
ECG (Electrocardiogram): Recording of electrical activity of the heart.
Stress tests: Evaluating heart function during exercise.
Normal Blood Values: Include measurement of specific enzymes and markers for diagnosing cardiac damage.
Hemostasis: Measuring the blood's clotting time. This is used to screen for disorders related to clotting or bleeding.

Physical Signs and Characteristics

Palpable pulse: Can give clues to heart function, and blood circulation; this is where assessment of the artery pulse will give indication or conditions with heart.

Anatomy of the Pulmonary System

Mediastinum: Area between lungs, containing heart, blood vessels, trachea, esophagus.
Pleural cavity: Fluid-filled space between visceral and parietal pleurae.
Apex: Top point of a lung, approximately one inch above the middle third of the clavicle.
Base: Base is the bottom of the lung, resting on the diaphragm.

Bronchi/Bronchioles and Alveoli

Bronchi: Branches from the trachea, directing air to the lobes.
Bronchioles: Smaller branches within the lungs, regulating airflow.
Alveoli: Tiny air sacs in the lungs where the exchange of oxygen and carbon dioxide takes place.

Upper Respiratory Tract

Nose: Airway warms, humidifies, and filters.
Pharynx: Passageway for air and food.

Lower Respiratory Tract

Larynx (voice box): Contains vocal cords.
Trachea: Main airway.
Bronchi: Branches of trachea within the lungs.
Lungs: Paired organs performing gas exchange.
Bronchioles: Branches of bronchi, ultimately ending in alveolar sacs.
Alveoli: Tiny air sacs; site of gas exchange.
Diaphragm: Primary muscle of breathing.
Intercostal muscles: Aid breathing.

Pulmonary Function Tests

Lung volume measures (TLC, VC, FVC, FEV): Testing for obstructive or restrictive pulmonary abnormalities.
Respiration Rates: Measure of the respiratory system's function, and is typically 12-20 breaths per minute in adults at rest.

Breathing Patterns and Sounds

Apneustic breathing: Prolonged inhalation and short expiration.
Biot's respiration: Irregular periods of shallow or deep breaths interspersed with apneas; associated with brain injury.
Cheyne-Strokes respiration: Pattern of periods of increasing and decreasing breathing rates interspersed with apnea; a sign of heart or brain dysfunction.
Kussmaul's breathing: Deep, rapid breathing; seen in diabetic ketoacidosis.
Hypoventilation: Slow, shallow breathing.
Hyperventilation: Rapid, deep breathing.

Signs and Symptoms of Pulmonary Distress

Tachypnea: Rapid, shallow breathing.
Dyspnea: Shortness of breath.
Wheezing: Musical sound during breathing.
Cough: Expulsion of air from the airways.
Cyanosis: Bluish discoloration of the skin.

Lymphatic System

Lymph: Fluid containing proteins, fats, and cellular debris.
Lymph nodes: Filter lymph, containing lymphocytes.

Lymphatic Diseases and Conditions

Lymphedema: Swelling of an arm or leg due to lymphatic system blockage.
Lymphoma: Cancer of the lymphatic system.
Lymphocytosis: High lymphocyte count in the blood; typically a result of an infection.

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Description

Test your knowledge on cardiac rhythms and rehabilitation goals with this quiz. Questions cover Ventricular Tachycardia, Atrial Fibrillation, Atrial Flutter, and exercise protocols for improving cardiac health. Perfect for students and professionals in the medical field.