Coronary Anatomy and Function Quiz

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Questions and Answers

During the QRS complex, the impulse travels from the AV node to the ____________.

SA node

Purkinje fibers

ventricles (correct)

atria

What is the expected amplitude of the QRS complex in small boxes on the ECG paper?

1-2 small boxes

3-5 small boxes

20-30 small boxes

5-25 small boxes (correct)

What does a narrow (normal) QRS complex with no P-wave indicate?

Complete heart block

Supraventricular initiation (correct)

Ventricular fibrillation

Atrial flutter

What does the ST segment on the ECG represent?

Interval between ventricular depolarization and repolarization Signup and view all the answers

Which condition is typically associated with ST segment elevation where there is no return to the isoelectric line?

Myocardial infarction Signup and view all the answers

ST segment depression is typically seen in ____________.

Myocardial ischemia Signup and view all the answers

What does the T wave represent on an ECG?

Ventricular repolarization Signup and view all the answers

Which of the following is NOT a characteristic of a normal QRS complex?

Duration exceeding 0.12 seconds Signup and view all the answers

Which artery arises from the right anterolateral surface of the aorta?

Right coronary artery Signup and view all the answers

What distinguishes the left coronary artery from the right coronary artery?

It arises from the left anterolateral aspect of the aorta. Signup and view all the answers

Which structure separates the atria from the ventricles?

Coronary sulcus Signup and view all the answers

During which phase of heart contraction does coronary circulation and perfusion primarily occur?

Diastole Signup and view all the answers

Which system is responsible for vasodilating the coronary arteries?

Parasympathetic nervous system Signup and view all the answers

What primarily determines coronary pressure?

Diastolic pressure Signup and view all the answers

Which valve is situated between the left atrium and the left ventricle?

Mitral valve Signup and view all the answers

What does the aortic valve prevent?

Blood from flowing back into the left ventricle Signup and view all the answers

What is the target O2 saturation goal for phase 1 of cardiac rehabilitation?

Greater than 95% Signup and view all the answers

In which phase of cardiac rehabilitation is the Karvonen's formula first used to determine exercise intensity?

Phase 2 Signup and view all the answers

What is the formula to calculate maximum heart rate using the Tanaka method?

208 - 0.7 × Age Signup and view all the answers

What are the two primary goals of phase 2 of cardiac rehabilitation?

Assess cardiovascular responses and ensure continuity of exercise at home Signup and view all the answers

What are the sternal precautions referred to as that restrict upper extremity movement?

Move in the Tube precautions Signup and view all the answers

Which of the following is NOT a possible location for phase 2 of cardiac rehabilitation?

Intensive care unit (ICU) Signup and view all the answers

What is the formula for calculating target heart rate according to the Karvonen method?

Target Heart Rate = ((Max HR - Resting HR) × %Intensity) + Resting HR Signup and view all the answers

What feature is characteristic of phase 1 of cardiac rehabilitation?

Continuous supervised ECG monitoring Signup and view all the answers

What is the recommended intensity for exercise at the start of phase 1 cardiac rehab?

2-3 METS Signup and view all the answers

What is one of the primary goals for phase 1 of cardiac rehab?

Assure a safe discharge location Signup and view all the answers

How many days is the typical length of stay in the ICU for phase 1 cardiac rehab?

3-5 days Signup and view all the answers

Which of the following is NOT an appropriate adjunct therapy in phase 1 cardiac rehab?

Strength training Signup and view all the answers

What type of respiratory splinting is performed using a pillow?

Pillow splinting Signup and view all the answers

What is the purpose of assessing cardiovascular response to ADLs in phase 1 cardiac rehab?

To inform discharge location Signup and view all the answers

During days 1-3 of phase 1 cardiac rehab, patients should exercise how many times daily?

Twice daily Signup and view all the answers

Which of the following exercises is appropriate for a patient in phase 1 cardiac rehab?

Gait training Signup and view all the answers

What is the primary purpose of a percutaneous coronary intervention (PCI)?

To open a blocked coronary artery Signup and view all the answers

Which procedure is used to study the electrical activity of the heart by inducing specific dysrhythmias?

Electrophysiological studies Signup and view all the answers

What are the indications for performing electrophysiological studies?

Dysrhythmias and heart blocks Signup and view all the answers

What is the main goal of a coronary artery bypass graft (CABG)?

To reroute blood around blocked arteries Signup and view all the answers

What are the vessels commonly harvested for a coronary artery bypass graft?

Saphenous vein and internal mammary artery Signup and view all the answers

Which type of incision is used during a traditional CABG?

Median sternotomy Signup and view all the answers

What distinguishes traditional CABG from mid CAB?

Uses a median sternotomy incision Signup and view all the answers

Which component is essential for traditional CABG procedures?

Harvesting of saphenous veins Signup and view all the answers

Study Notes

Coronary Arteries

Right coronary artery arises from the right, anterolateral surface of the aorta.
Right coronary artery supplies the right atrium, right ventricle, SA node, and AV node.
Left coronary artery arises from the left, anterolateral aspect of the aorta.
Left coronary artery gives off the left anterior descending (interventricular) and the left circumflex artery.
Left coronary artery supplies the left atrium, left ventricle, and interventricular septum.

Coronary Circulation

Sympathetic nervous system vasodilates coronary arteries.
Coronary circulation occurs during diastole.
Coronary pressure is primarily determined by diastolic pressure.

Heart Valves

Mitral valve is between the left atrium and left ventricle.
Aortic valve is the semilunar valve that separates the aorta from the left ventricle.

ECG Interpretation

QRS complex represents ventricular depolarization.
Impulse travels from the AV node to the Purkinje fibers.
Amplitude of the QRS complex should be 5-25 small boxes.
Horizontal distance of the QRS complex should be 2 boxes.
A narrow QRS complex with no P-wave indicates impulse initiated above the ventricles but NOT in the SA node (supraventricular initiation).
ST segment represents the interval between ventricular depolarization and repolarization.
ST segment elevation is seen in myocardial infarct and hypothermia.
ST segment depression is seen in ischemia.
T-wave represents ventricular repolarization.

Cardiac Rehab Phase 1

Typically lasts 3-5 days.
Primary goals are early mobilization and assessment of cardiovascular response to ADLs.
Exercise intensity begins at 2-3 METs and progresses to 4-5 METs when appropriate.
Types of therapy: Incentive spirometry, ventilation training, coughing techniques, and pillow splinting.
Types of appropriate exercises: Gait, transfers, out-of-bed activities, AROM with LEs, and stair training (if indicated).
Exercise frequency: 4 times daily for days 1-3, twice daily for days 4-7.
Patient education: Sternal precautions, "move in the tube" precautions, and therapy progression timeline.
O2 saturation goal: greater than 95%.

Cardiac Rehab Phase 2

O2 saturation goal: greater than 92%.
Karvonen's formula is first introduced to determine appropriate exercise intensity.
Tanaka formula can be used as a substitute for Karvonen's formula in healthier patients.
Two primary goals: Continuity of exercise at home and assessing CV responses to exercise.
Potential locations for phase 2 rehab: Transitional rehab or home health.

Cardiac Catheterization

Percutaneous coronary intervention (PCI) is a type of cardiac catheterization.
A balloon-tipped catheter is inserted into a coronary artery to open the artery; stents are put in place.

Electrophysiological Studies

These studies are invasive measures of electrical activity.
They can induce specific dysrhythmias to determine the pathways through the heart.
Indications for electrophysiological studies: sudden death episodes with revival, ventricular tachycardia, Wolff-Parkinson-White syndrome, heart blocks.

Coronary Artery Bypass Graft (CABG)

Bypasses blocked coronary arteries to improve blood supply to the heart.
Requires harvest of saphenous vein or internal mammary artery.
Types of bypass procedure: traditional CABG or mid CAB.
Traditional CABG requires a median sternotomy, use of a heart-lung machine, and harvesting of saphenous veins.

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Description

Test your knowledge on the structure and function of coronary arteries, their regulation during diastole, and the essential heart valves involved in circulation. This quiz will also cover ECG interpretation related to cardiac depolarization. Perfect for students studying cardiovascular physiology!