Heart Anatomy and EKG Class
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Questions and Answers

What indicates a normal sinus rhythm?

  • Heart rate between 60-100 bpm with regular rhythm (correct)
  • Heart rate below 60 bpm
  • Heart rate above 100 bpm with multiple P wave morphologies
  • Irregular rhythm without P waves

    • Which condition is characterized by a heart rate exceeding 300 bpm with an irregular rhythm?

  • PSVT
  • Atrial fibrillation
  • Ventricular fibrillation (correct)
  • Atrial flutter

    • What is the characteristic finding in Mobitz type I heart block?

  • Progressively longer PR intervals before dropped QRS (correct)
  • Prolonged but stable PR intervals
  • Consistent PR intervals with dropped QRS
  • Complete dissociation of P waves and QRS complexes

    • Which electrical axis deviation indicates negative lead I and positive AVF?

    <p>Right axis deviation</p> Signup and view all the answers

    What is the treatment indicated for Torsades de pointes?

    <p>Magnesium sulfate</p> Signup and view all the answers

    What does a heart rate of 50 bpm typically indicate?

    <p>Sinus bradycardia</p> Signup and view all the answers

    What is an initial change seen in acute myocardial infarction?

    <p>Tall positive T waves</p> Signup and view all the answers

    What distinguishes PVCs from PACs?

    <p>PVCs show no P wave and have a compensatory pause</p> Signup and view all the answers

    Which is a common risk factor for myocardial infarction?

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

    What is the recommended time frame for door-to-drug or door-to-balloon for MI treatment?

    <p>Within 90 minutes</p> Signup and view all the answers

    What is the role of the pulmonary artery in the circulatory system?

    <p>It carries deoxygenated blood from the heart to the lungs.</p> Signup and view all the answers

    Which valve prevents the backflow of blood into the right atrium?

    <p>Tricuspid valve</p> Signup and view all the answers

    Which EKG lead reflects the strongest electrical impulse from the heart's pathway?

    <p>Lead 2</p> Signup and view all the answers

    What does the T wave in an EKG represent?

    <p>Ventricular repolarization</p> Signup and view all the answers

    Which artery supplies blood to the left atrium and posterior left/lateral wall of the heart?

    <p>Circumflex artery</p> Signup and view all the answers

    What initiates the cardiac conduction system?

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

    Which EKG change is indicative of hyperkalemia?

    <p>Peaked T waves</p> Signup and view all the answers

    Which valves are involved in the pathway of blood from the left atrium to the aorta?

    <p>Bicuspid (mitral) valve and aortic semilunar valve</p> Signup and view all the answers

    Which part of the heart is supplied by the left anterior descending artery?

    <p>Anterior left ventricle</p> Signup and view all the answers

    What is the normal rate at which the SA node fires impulses?

    <p>60-100 beats/minute</p> Signup and view all the answers

    What is the role of the pulmonary veins in the circulatory system?

    <p>To carry oxygenated blood from the lungs to the heart</p> Signup and view all the answers

    Which valve does blood pass through immediately after leaving the right atrium?

    <p>Tricuspid valve</p> Signup and view all the answers

    Which leads provide information about the right coronary artery?

    <p>2, 3, AVF, AVR</p> Signup and view all the answers

    What does the QRS complex represent in an EKG?

    <p>Ventricular depolarization</p> Signup and view all the answers

    What is the function of the bicuspid (mitral) valve in the heart?

    <p>To prevent backflow from the left ventricle to the left atrium</p> Signup and view all the answers

    Which structure initiates the cardiac conduction system?

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

    What is the typical firing rate of the AV node?

    <p>40-60 beats per minute</p> Signup and view all the answers

    Which artery is known as the 'widow maker' due to its critical supply area?

    <p>Left anterior descending artery</p> Signup and view all the answers

    What does hyperkalemia typically show on an EKG?

    <p>Peaked T waves</p> Signup and view all the answers

    Which gas exchange area is indicated by the color purple in the heart diagram?

    <p>Both oxygenated and deoxygenated blood areas</p> Signup and view all the answers

    What does a heart rate below 60 bpm indicate in a patient with a regular rhythm?

    <p>Sinus bradycardia</p> Signup and view all the answers

    Which arrhythmia is characterized by an irregular rhythm without P waves?

    <p>Atrial fibrillation</p> Signup and view all the answers

    In what scenario would you observe no treatment necessary for a heart block?

    <p>First-degree heart block</p> Signup and view all the answers

    What rhythm is identified by ventricular contractions exceeding 100 bpm without P waves and long QRS complexes?

    <p>Ventricular tachycardia</p> Signup and view all the answers

    What is the typical heart rate range for normal sinus rhythm?

    <p>60-100 bpm</p> Signup and view all the answers

    A patient is diagnosed with Mobitz type II heart block. What is the significant concern related to this condition?

    <p>Has a risk of progressing to third-degree heart block</p> Signup and view all the answers

    Which of the following findings is indicative of extreme axis deviation?

    <p>Negative lead I, negative AVF</p> Signup and view all the answers

    What is a hallmark symptom of myocardial infarction?

    <p>Severe retrosternal pressure lasting &gt;30 minutes</p> Signup and view all the answers

    What specific feature differentiates atrial flutter from atrial fibrillation?

    <p>Negative sawtooth patterns</p> Signup and view all the answers

    Which type of myocardial infarction is characterized by ST depression?

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

    What does right axis deviation indicate about the lead readings?

    <p>Negative lead I and positive AVF</p> Signup and view all the answers

    Which arrhythmia is recognized for having varying P wave morphologies?

    <p>Multifocal atrial tachycardia</p> Signup and view all the answers

    What distinguishes Mobitz type II from Mobitz type I heart block?

    <p>Consistent PR intervals with occasional dropped QRS</p> Signup and view all the answers

    What is the proper treatment for ventricular fibrillation?

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

    In acute myocardial infarction, which change is observed within the first hour?

    <p>ST elevation</p> Signup and view all the answers

    What is the significance of QRS complexes during irregular rhythms?

    <p>They help estimate heart rhythm rate</p> Signup and view all the answers

    Which condition requires a pacemaker due to alternating rhythms?

    <p>Sick sinus syndrome</p> Signup and view all the answers

    What heart rate is classified as sinus bradycardia?

    <p>50 bpm or less</p> Signup and view all the answers

    Which of the following is a common symptom of myocardial infarction?

    <p>Severe retrosternal pressure lasting &gt;30 minutes</p> Signup and view all the answers

    What does the heart block algorithm begin with?

    <p>Checking if there is a P for every QRS</p> Signup and view all the answers

    Which valve prevents backflow into the right ventricle?

    <p>Pulmonary semilunar valve</p> Signup and view all the answers

    What is the function of the bicuspid (mitral) valve?

    <p>Allows blood to flow from the left atrium to the aorta</p> Signup and view all the answers

    Which artery is the only one that carries deoxygenated blood?

    <p>Pulmonary artery</p> Signup and view all the answers

    Which leads provide information about the left anterior descending artery?

    <p>Leads V1, V2, V3, V4</p> Signup and view all the answers

    What is the primary role of the SA node in the cardiac conduction system?

    <p>Sets the heart rate</p> Signup and view all the answers

    What does a peaked T wave typically indicate on an EKG?

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

    Where does blood go immediately after passing through the pulmonary veins?

    <p>Left atrium</p> Signup and view all the answers

    Which structure transmits impulses after the AV node in the cardiac conduction system?

    <p>Bundle of His</p> Signup and view all the answers

    In which leads can right coronary circulation be observed?

    <p>Leads 2, 3, AVF</p> Signup and view all the answers

    Which condition is characterized by a heart rate that can range between 120-250 bpm?

    <p>Atrial tachycardia</p> Signup and view all the answers

    In which heart block condition does the PR interval gradually lengthen before a dropped QRS complex occurs?

    <p>Mobitz type I</p> Signup and view all the answers

    What is the expected characteristic of right axis deviation?

    <p>Negative lead I and positive AVF</p> Signup and view all the answers

    Which of the following symptoms is commonly associated with myocardial infarction?

    <p>Severe retrosternal pressure lasting more than 30 minutes</p> Signup and view all the answers

    Which arrhythmia is characterized by early beats and a 1:1 P-QRS ratio?

    <p>PACs (premature atrial contractions)</p> Signup and view all the answers

    In what scenario does a patient require immediate defibrillation due to a heart rhythm issue?

    <p>Ventricular fibrillation</p> Signup and view all the answers

    What is the treatment indicated for symptomatic Mobitz type II heart block?

    <p>Pacemaker placement</p> Signup and view all the answers

    What indicates extreme axis deviation on an ECG?

    <p>Negative lead I and negative AVF</p> Signup and view all the answers

    Which arrhythmia exhibits multiple different P wave morphologies?

    <p>MAT (multifocal atrial tachycardia)</p> Signup and view all the answers

    Within what time frame should beta blockers or calcium channel blockers be administered following myocardial infarction?

    <p>Within 24 hours</p> Signup and view all the answers

    What role does the pulmonary artery play in the circulatory system?

    <p>Carries deoxygenated blood away from the heart</p> Signup and view all the answers

    Which valve allows blood to flow from the right atrium to the right ventricle?

    <p>Tricuspid valve</p> Signup and view all the answers

    Which part of the heart is supplied by the circumflex artery?

    <p>Posterior left/lateral wall</p> Signup and view all the answers

    What is the firing rate of the AV node within the cardiac conduction system?

    <p>45-60 beats/minute</p> Signup and view all the answers

    What does the QRS complex in an EKG represent?

    <p>Ventricular depolarization</p> Signup and view all the answers

    Where is the strongest electrical impulse from the heart's pathway detected?

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

    What does the T wave indicate in an EKG?

    <p>Ventricular repolarization</p> Signup and view all the answers

    What is the characteristic finding in an EKG for hyperkalemia?

    <p>Peaked T waves</p> Signup and view all the answers

    Which structure in the cardiac conduction system follows the SA node?

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

    Which area of the heart corresponds with leads V1 and V2?

    <p>Septal wall</p> Signup and view all the answers

    Which leads are primarily used to reflect the inferior wall of the heart?

    <p>II, III, AVF</p> Signup and view all the answers

    What does a U wave typically indicate on an EKG?

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

    Which artery is known as the 'widow maker' and what does it primarily supply?

    <p>Left anterior descending artery; electrical pathway and intraventricular septum</p> Signup and view all the answers

    Which EKG leads correspond to the circumflex artery supply?

    <p>I, AVL, V5, V6</p> Signup and view all the answers

    In which leads can the septal wall be primarily seen?

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

    How does hyperkalemia visually manifest on an EKG?

    <p>Peaked T waves</p> Signup and view all the answers

    Which part of the cardiac conduction system follows the SA node?

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

    What does a thick line on the electrocardiogram represent in terms of estimated heart rate?

    <p>150 bpm</p> Signup and view all the answers

    What axis deviation is characterized by positive readings in lead 1 and negative readings in AVF?

    <p>Left axis deviation</p> Signup and view all the answers

    What does the T wave signify in an electrocardiogram?

    <p>Ventricular repolarization</p> Signup and view all the answers

    How is the normal axis visually represented in an electrocardiogram?

    <p>Lead 1 and AVF are positive</p> Signup and view all the answers

    Which heart rate is associated with the AV node's firing rate?

    <p>45-60 beats/minute</p> Signup and view all the answers

    What is indicated by lead I being positive and AVF being negative?

    <p>Left axis deviation</p> Signup and view all the answers

    How can regular rhythm rates be estimated using ECG lines?

    <p>Four lines = 60 bpm</p> Signup and view all the answers

    What indicates an irregular rhythm when counting QRS complexes?

    <p>Count and multiply by 6 seconds</p> Signup and view all the answers

    What is a characteristic finding of atrial fibrillation?

    <p>Irregular rhythm without P waves</p> Signup and view all the answers

    Which of the following best describes multifocal atrial tachycardia?

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

    How is atrial flutter typically characterized?

    <p>Sawtooth pattern at a rate of 250-350 bpm</p> Signup and view all the answers

    What is true about sick sinus syndrome?

    <p>Shows varying fast and slow rhythms</p> Signup and view all the answers

    What is a characteristic of atrial flutter?

    <p>Negative sawtooth pattern with rates of 250-350 bpm</p> Signup and view all the answers

    Which condition indicates that a patient may require a pacemaker?

    <p>Sick sinus syndrome</p> Signup and view all the answers

    What distinguishes SVT from atrial tachycardia?

    <p>Episodic nature and heart rate of 150-250 bpm</p> Signup and view all the answers

    In patients with atrial fibrillation, which characteristic is typically observed?

    <p>Irregular rhythm with no identifiable P waves</p> Signup and view all the answers

    Which of the following conditions typically shows a heart rate below 60 bpm?

    <p>Sinus bradycardia</p> Signup and view all the answers

    Which characteristic finding is associated with Wolff-Parkinson-White syndrome?

    <p>Delta waves and genetic accessory pathways</p> Signup and view all the answers

    What is a definitive treatment requirement for Torsades de pointes?

    <p>Magnesium sulfate</p> Signup and view all the answers

    Which of the following is true about bundle branch block?

    <p>Causes a loss of synchrony in ventricular impulses</p> Signup and view all the answers

    What distinguishes ventricular fibrillation from other arrhythmias?

    <blockquote> <p>300 bpm irregular rhythm requiring immediate defibrillation</p> </blockquote> Signup and view all the answers

    Which condition is characterized by a flat line in two perpendicular leads?

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

    Which condition is characterized by an absence of P waves and shows a heart rate exceeding 100 bpm with prolonged QRS complexes?

    <p>Ventricular tachycardia</p> Signup and view all the answers

    What is the essential treatment for Torsades de pointes?

    <p>Magnesium sulfate</p> Signup and view all the answers

    Which of the following arrhythmias is associated with an irregular rhythm exceeding 300 bpm?

    <p>Ventricular fibrillation</p> Signup and view all the answers

    What distinguishing feature is noted in premature atrial contractions (PACs)?

    <p>Early beats with a 1:1 P-QRS ratio</p> Signup and view all the answers

    Which type of heart block necessitates monitoring without immediate treatment?

    <p>Right bundle branch block</p> Signup and view all the answers

    What EKG finding typically indicates a STEMI?

    <p>ST elevation &gt;1mm in two contiguous leads</p> Signup and view all the answers

    Which of the following symptoms is indicative of a myocardial infarction?

    <p>Chest pain lasting &gt;30 minutes and radiating to the arm</p> Signup and view all the answers

    In which time frame does troponin usually peak after a myocardial infarction?

    <p>1-2 days post-MI</p> Signup and view all the answers

    What distinguishes second-degree Mobitz type I from Mobitz type II heart block?

    <p>Gradually lengthening PR intervals</p> Signup and view all the answers

    What is a characteristic electrocardiogram (ECG) finding for STEMI?

    <p>ST elevation &gt;1mm in two contiguous leads</p> Signup and view all the answers

    When do troponin levels typically peak after a myocardial infarction?

    <p>1-2 days post-MI</p> Signup and view all the answers

    Which heart block is characterized by a prolonged PR interval greater than 200ms?

    <p>First-degree heart block</p> Signup and view all the answers

    What distinguishes NSTEMI from STEMI in terms of ECG findings?

    <p>ST depression noted in the leads</p> Signup and view all the answers

    What characterizes third-degree heart block?

    <p>Complete dissociation of P waves and QRS</p> Signup and view all the answers

    Which treatment is recommended for myocardial infarction within the first 24 hours?

    <p>Calcium channel blockers or beta blockers</p> Signup and view all the answers

    What is a common cause of heart blocks?

    <p>Increased vagal tone</p> Signup and view all the answers

    How does Mobitz type I heart block present on an ECG?

    <p>Progressively longer PR intervals before a drop</p> Signup and view all the answers

    What is the significance of door-to-drug or door-to-balloon time in myocardial infarction treatment?

    <p>Should be within 90 minutes</p> Signup and view all the answers

    Which heart block presents with complete dissociation between P waves and QRS complexes?

    <p>Third-degree heart block</p> Signup and view all the answers

    What is a common treatment option administered immediately during a myocardial infarction?

    <p>Aspirin and antiplatelet medication</p> Signup and view all the answers

    Which type of heart block is indicated by progressively longer PR intervals before a dropped QRS complex?

    <p>Mobitz type I (Wenckebach)</p> Signup and view all the answers

    What is the maximum recommended door-to-drug or door-to-balloon time for effective myocardial infarction treatment?

    <p>90 minutes</p> Signup and view all the answers

    In which heart block does the condition require a pacemaker due to the risk of progressing to complete heart block?

    <p>Mobitz type II</p> Signup and view all the answers

    What symptoms are commonly associated with third-degree heart block?

    <p>Syncope, angina, respiratory distress</p> Signup and view all the answers

    Which heart block type is typically managed without treatment?

    <p>First-degree heart block</p> Signup and view all the answers

    What monitoring is necessary for managing Mobitz type II heart block?

    <p>Regular QRS monitoring and cardiologist observation</p> Signup and view all the answers

    The long-term prognosis for heart block largely depends on which factor?

    <p>Underlying cause and treatment compliance</p> Signup and view all the answers

    Which treatment is commonly justified for severe heart block cases?

    <p>Pacemaker implantation</p> Signup and view all the answers

    What is a common symptom of third-degree heart block?

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

    Which type of heart block requires regular QRS monitoring and observation by a cardiologist?

    <p>Mobitz type II</p> Signup and view all the answers

    In which situation is no treatment necessary for a heart block?

    <p>First-degree heart block</p> Signup and view all the answers

    What is a key factor in determining the long-term prognosis of heart block?

    <p>Underlying cause</p> Signup and view all the answers

    What is the treatment approach for second-degree heart block types other than Mobitz type II?

    <p>Pacemaker implantation</p> Signup and view all the answers

    Study Notes

    Heart Anatomy and Function

    • Blood flow begins in venules, veins, and vena cava, entering the right atrium.
    • Blood passes through the tricuspid (atrioventricular) valve to the right ventricle.
    • The tricuspid valve is located on the right side.
    • Blood flows through the tricuspid AV valve, right ventricle, and pulmonary semilunar valve.
    • The pulmonary artery carries deoxygenated blood to the lungs for oxygen pickup. It is the only artery carrying deoxygenated blood.
    • The pulmonary vein returns oxygenated blood to the left atrium.
    • Blood passes through the bicuspid (mitral) valve, left ventricle, aortic semilunar valve, and aorta.
    • Blood travels through arteries and arterioles to capillaries for gas exchange.
    • Deoxygenated blood is shown in blue, oxygenated blood in red, and gas exchange areas in purple.

    EKG Leads and Coronary Arteries

    • EKG leads are positioned: AVL, AVR, then 2, 3, AVF inferiorly, and V1-V6 circumferentially around the heart.
    • Lead 2 reflects the strongest electrical impulse from the heart's pathway, commonly used for teaching EKG interpretation.
    • The left main coronary artery branches into the circumflex and left anterior descending (LAD) arteries.
    • The circumflex artery supplies the left atrium and posterior/lateral walls; it correlates with leads 1, AVL, V5, and V6.
    • The LAD artery (widow maker) supplies the electrical pathway and intraventricular septum.
    • The septal wall is seen in V1 and half of V2, anterior left ventricle is seen in half of V2, V3, and V4.
    • The right main coronary artery supplies the inferior wall, right chambers, SA/AV nodes, and posterior right side.
    • Right coronary artery circulation appears in leads 2, 3, AVF, and AVR.

    Cardiac Conduction System and Waves

    • The cardiac conduction system begins with the SA node (60-100 bpm), followed by the AV node (45-60 bpm).
    • The conduction pathway continues through the bundle of His, left and right bundle branches, and Purkinje fibers.
    • The P wave represents atrial depolarization.
    • The QRS complex shows ventricular depolarization.
    • The T wave indicates ventricular repolarization.
    • Regular rhythm rates are estimated with lines: no lines = 300 bpm, one line = 150 bpm, two lines = 100 bpm, three lines = 75 bpm, four lines = 60 bpm, five lines = 50 bpm
    • Irregular rhythms are assessed by counting QRS complexes within 3 or 6 seconds and multiplying accordingly.
    • Normal heart axis ranges from +90 to -30 degrees.

    Electrolyte Abnormalities

    • Hyperkalemia results in peaked T waves throughout the EKG.
    • Hypokalemia is indicated by U waves.

    Heart Arrhythmias

    • Normal sinus rhythm (NSR) has a rate of 60-100 bpm with regular rhythm and a 1:1 P-QRS ratio.
    • Sinus bradycardia is a heart rate less than 60 bpm with regular rhythm, sometimes normal in athletes. It may require treatment with atropine or pacemaker if severe.
    • Sick sinus syndrome alternates between fast and slow rhythms and requires a pacemaker.
    • Atrial tachycardia involves the SA node firing too rapidly (120-250 bpm).
    • Atrial fibrillation is the most common arrhythmia, showing irregular rhythm without P waves.
    • Atrial flutter demonstrates irregular rhythm with a negative sawtooth pattern at 250-350 bpm.
    • Paroxysmal supraventricular tachycardia (PSVT) is sudden and fast (150-250 bpm).
    • Multifocal atrial tachycardia (MAT) has varying P wave morphologies.
    • Wolff-Parkinson-White syndrome shows delta waves and genetic accessory pathways.
    • Ventricular tachycardia has no P waves, >100 bpm, and wide QRS complexes.
    • Torsades de pointes is a polymorphic ventricular tachycardia requiring magnesium sulfate.
    • Ventricular fibrillation is a rapid, irregular rhythm (>300 bpm) requiring immediate defibrillation.
    • Asystole shows a flat line on the EKG in two perpendicular leads.
    • Premature atrial contractions (PACs) show early beats with a 1:1 P-QRS ratio.
    • Premature ventricular contractions (PVCs) show no P wave with a compensatory pause.
    • Bundle branch block shows slowed impulse across the ventricles causing loss of synchrony.
    • Left bundle branch block requires pacemaker treatment.
    • Right bundle branch block requires observation only.

    Heart Blocks

    • First-degree heart block consistently has a prolonged PR interval >200ms.
    • Mobitz type I (Wenckebach) progressively prolongs the PR interval before a dropped QRS complex.
    • Mobitz type II shows a constant PR interval with intermittent dropped QRS complexes and may progress to third-degree.
    • Third-degree heart block completely dissociates P waves and QRS complexes, requiring a pacemaker. Symptoms include syncope, angina, and respiratory distress. Common causes include increased vagal tone, MI, myocarditis, and electrolyte imbalances.
    • First-degree heart block needs no treatment. Other types may require pacemakers.
    • Regular QRS monitoring and cardiologist observation are needed for Mobitz type II.
    • Long-term prognosis depends on the underlying cause and treatment compliance.

    Myocardial Infarction (MI)

    • MI symptoms include severe retrosternal pressure lasting over 30 minutes.
    • MI risk factors include smoking, diabetes, hypertension, hyperlipidemia, and obesity.
    • Troponin peaks 1-2 days post-MI and normalizes within 2 weeks; CKMB peaks and normalizes within 2-3 days.
    • STEMI shows ST elevation >1mm in two consecutive leads.
    • NSTEMI exhibits ST depression.
    • One hour after MI, ST elevation and necrosis onset are seen.
    • 24 hours after MI, T wave inversion and ST returning to normal are expected.
    • Early MI changes include elevated positive T wave.
    • Treatment for MI includes immediate aspirin and antiplatelet medication; door-to-drug or balloon time should be within 90 minutes.
    • Beta blockers or calcium channel blockers should be administered within 24 hours.
    • Long-term treatment with ACE inhibitors and statins.

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    This quiz covers the essential anatomy of the heart and the corresponding pathways of blood flow. It also explores EKG leads and coronary arteries vital for heart function analysis. Test your knowledge and understanding of cardiovascular physiology and EKG fundamentals.

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