EKG QUIZ 1

The normal standardized ECG deflection on the paper graph (amplitude) of 10 mm equates to ________. A. 1 millivolt B. 10 millivolts C. 100 millivolts D. 10 volts E. 120 volts AC F. 10 joules (watt/seconds)

A. 1 millivolt

The normal function(s) of the A-V (atrio-ventricular) junction (or node) is/are __________________________. A. A secondary pacemaker B. To (relatively slowly) shuttle atrial impulses to ventricles C. Recapture ventricular impulses to restimulate the SA node in retrograde fashion D. To beat faster than the SA node E. Select which bundle to stimulate as demand increases

A. A secondary pacemaker B. To (relatively slowly) shuttle atrial impulses to ventricles

The best technical term for cardiac muscle cell stimulation is __________________. A. Depolarized B. Excited C. Actinized D. Activated E. Argonized F. Micronized

A. Depolarized

The easiest equation for accurately calculating ECG complex rate (at a standard paper rate with a regular rhythm) is to: A. Divide 300 / the number of big horizontal boxes and fraction there-of (0.2, 0.4, 0.6 & 0.8 seconds) between two identical points of the R waves. B. Count P waves for 15 seconds and multiply by 4 C. Count complex intervals for 6 seconds (6 second strip) and multiply by 6 D. Count big boxes (0.2 second boxes) between to two T waves and E. Memorizing standard rate marks like 300, 150, 100 and so on) that correlate with standard box intervals upon which a certain ECG pattern landmark might fall.

A. Divide 300 / the number of big horizontal boxes and fraction there-of (0.2, 0.4, 0.6 & 0.8 seconds) between two identical points of the R waves.

The voltage in Lead II should equal the sum of what other leads? A. I plus III B. I plus V1 C. III minus 1, fixed signs D. None, trick question because LA only factors in to 2 of the 3 main leads E. Augmented leads

A. I plus III

This victim was found unconscious after yoga exercise class. She had major cardiac surgery as an infant. As you place the wired electrodes on her body, you should pa attention to the leads and understand what will be measured. ECG leads have two major cognitive features: orientation and ___________. A. Polarity B. Magnitude C. Time D. Speed E. Distance F. Imagination

A. Polarity

In a ventricular complex, a solitary downward deflection, following a P wave, is called a ______. A. QS wave B. D wave C. P' wave D. Missed Q wave E. late R wave

A. QS wave

In a ventricular ECG complex, a secondary upward deflection is called a __________. A. R' (r-prime) B. Q' (q-prime) C. Folding ears D. W E. w F. V' (v-prime)

A. R' (r-prime)

Augmented leads (aVR, aVL, aVF) should be considered to be ________________. A. Unipolar B. Bipolar C. Tripolar D. Direct measurements

A. Unipolar

With respect to the normal electrocardiogram, the two major electrical features of the heart are: _____ & _____ . A. Irregularity B. Conductivity C. Re-entry D. Automaticity E. Extinction F. Complete dependence upon extrinsic sympathetic activity

B. Conductivity D. Automaticity

Based on the way most ECGs are recorded these days, to estimate the rate of an irregular rhythm, one should: A. Count the number of cycle intervals over 6 seconds and multiply by 10. B. Count the number of cycle intervals over 10 seconds and multiply by 6. C. Count each complex for one minute D. Count the pulse rate instead E. Give up because irregular pulses can not nor shold not be counted.

B. Count the number of cycle intervals over 10 seconds and multiply by 6.

What is first degree heart block? A. Intentional extinction B. Delayed and complete impulse transmissions to ventricles C. Inconsistent impulse transmission D less than 0.10 seconds E. less than 0.210 seconds F. Much worse than a coronary misdemeanor G. Higher in rank than a private block

B. Delayed and complete impulse transmissions to ventricles

The QT interval may also be ABNORMALLY shortened by ____________. A. Hypocalcemia B. Digitalis C. Loss of intracellular sodium D. Slowing down the speed of paper feed E. Ethanol consumption

B. Digitalis

The QT interval can commonly be ABNORMALLY lengthened by all of the following, EXCEPT ______________. A. Drugs like quinidine B. Hypercalcemia C. Disopyramide D. Procainamide E. Hypokalemia

B. Hypercalcemia

What is the rate corrected QT interval? A. QT interval in milliseconds * HR B. QT interval in milliseconds / √RR interval C. QT interval in milliseconds * QRS interval D. QT interval in milliseconds / √QT interval E. QT interval in milliseconds / HR

B. QT interval in milliseconds / √RR interval

From another technical perspective, what is a LEAD? A. Silver fixture B. The difference in voltage (potential) between two or more electrodes C. Gold wire in antimony shielded cable D. Current flow measurement E/ An heavy English biscuit served at tea time in Leeds.

B. The difference in voltage (potential) between two or more electrodes

The QT interval primarily represents the return of stimulated ventricles to ______. A. Normal anatomical position B. Their resting electrical state C. A state ready for immediate depolarization D. A state of power E. A state of confusion F. A state when all blood flow ceases

B. Their resting electrical state

An electrocardiogragram records cardiac ____________, and specifically measures vector ____________. A. Pre-load B. electrical activity C. After-load D. voltage E. Pump function

B. electrical activity D. voltage

The PR timed interval is a measure of the time it takes for the stimuli to spread from the atria and pass through (to the) ______. A. Purkinji fibers B. Retrograde to SA node to supress early re-entry C. AV Junction (node) D. Left anterior fascicle E. Left posterior fascicle F. All of the above

C. AV Junction (node)

What is a normal, adult QTc? A. <0.11 seconds B. <0.22 seconds C. <0.33seconds D. <0.44 seconds E. <0.55seconds

D. <0.44 seconds

The vagus nerve slows SA node activity and heart rate by which of the following? A. Norepinephrine effect upon sodium channels B. Norepinehrine effect on calcium channels C. Norepinehrine effect on potassium channels D. Acetylcholine effect on potassium channels E. Acetylcholine effect on calcium channels

D. Acetylcholine effect on potassium channels

Functional pacemakers located outside the sinus node are (called) ___________________________. A. Idiopathic B. Rogue C. Lost stimulators D. Ectopic E. Rescue F. Irrelevant

D. Ectopic

An atrial electrical stimulus failing to pass through the AV junction is known as ______________________. A. Conserved B. Wasted C. Retrograde D. Heart Block E. Nodal Rhythm F. A good try!

D. Heart Block

The ST segment is normally ___________. A. Absent B. Depressed C. Elevated D. Isoelectric E. Reversed

D. Isoelectric

When the ventricles depolarize, the ECG records a ______ (best answer)___, but not necessarily in all leads. A. V wave (ventricular) B. U wave (universal) C. Q wave (quasi) D. QRS (complex) E. P wave (power) F. T wave (total) G. SUV wave (sustained universal ventricular)

D. QRS (complex)

When the heart rate decreases, what lengthens? A. P-wave B. QRS Complex C. T-wave D. QT interval E. PR-interval

D. QT interval

The ECG records two basic categories of events of which there are specific metrics. Which of the following is not recorded on the typical, normal bedside ECG? A. Ventricular Depolarization B. Ventricular Repolarization C. Atrial Depolarization D. Ventricular Pulse Pressure E. Time Between Atrial Depolarization and Ventricular Depolarization (surrogate filling time) F. Time Between Ventricular Depolarization and Ventricular Depolarization

D. Ventricular Pulse Pressure

The PR interval represents concommitant occurence of what important activity? A. Vena caval compliance B. Atrial pause C. Ventricular resitence D. Ventricular filling E. Atrial relaxation

D. Ventricular filling

In adults, the duration of the normal P-R interval is between _________ and ________ seconds. A. 2 and 4 B. 5 and 7 C. 7 and 11 D. 0.22 and 0.44 E. 0.12 and 0.2

E. 0.12 and 0.2

Lead V2 is recorded with the electrode in the _______. A. 1ST ICS just right of the sternal border B. Angle of Louis C. Left nipple D. 2nd ICS just below glenoid fossa E. 4th ICS just left of the sternal border

E. 4th ICS just left of the sternal border

A deflection that is partly upward and partly downward is __________________. A. Impossible, because opposite currents cancel each other out to zero. B. Meaningless C. Probably interference D. Isoelectric E. Biphasic

E. Biphasic

Elderly patients with severe depression of the sinus node are likely to have what ECG feature? A. Asystole B. Prolonged QT intervals C. Shortened PR intervals D. Prolonged QRS intervals E. Bradycardia

E. Bradycardia

The first phase of normal, resting "cardiac" muscle activation consists of __________________________. A. Extrinsic sympathetic stimulation B. Loss of vagal activity C. AV node repolarization D. Tricuspid valve closure E. Electrical stimulation of the right and left atria

E. Electrical stimulation of the right and left atria

The limb leads record voltages oriented in the ______. A. Airplane B. Sagital plane C. Plains of Spain D. Vanilla E. Frontal plane F. Winds comes whipping down the plain.

E. Frontal plane

Lead II is the voltage difference between measured ___ and ___ . A. RA(+) and LL(-) B. LA(+) and RA(-) C. RA(+) and LA(-) D. LL(+) and RL(-) E. LL(+) and RA(-) F. Second rate complex and a first rate complex G. A possible date to the dance after the first one turned you down

E. LL(+) and RA(-)

The width or duration of the QRS complex represents the time it takes a conducted impulse to ________. A. Close the bicuspid and tricuspid valves B. Contract all myocardium C. Supercede any myocardium contraction D. Blow through the atrial E. Spread the stimulus through the ventricles F. Directly cause blood to flow to the left anterior descending artery and RCA

E. Spread the stimulus through the ventricles

All of the following are types of ECG leads, EXCEPT A. Limb B. Augmented C. Precordial D. Transesophageal E. Transurethral F. Intraventicular

E. Transurethral

"LEADs" are states ________. A. like Maine or Virginia B. that are just across the Amarillo county line C. made antimony D. in Scotland E. of cognitive constructs F. made of silver and silver chloride G. of confusion H. made of gold

E. of cognitive constructs

T/F: An electrode is always attached on or near the right leg because of the significant danger of electrocution.

False

T/F: Bipolar leads are electrodes made with two metals, lead and zinc.

False

T/F: By convention, an upward deflection or wave graphed on and ECG strip is called negative and a downward deflection or wave is called postive.

False

T/F: Myocardial tissue depolarizes from the epicardium to the endocardium.

False

T/F: The ST segment and the T wave represent the return of the stimulated atria (mostly right side) to the resting state.

False

T/F: When the SA node depolarizes, the ECG records a P wave.

False

T/F: In a ventricular complex, a solitary upward deflection is called a R wave

True

T/F: Mycardial tissue REpolarizes from the epicardium to the endocardium.

True

T/F: Myocardial cells generally depolarize and repolarize in the same direction.

True

T/F: The ECG effectively records the electrical activity of the collective mass of cardiac cells and NOT the electrical activity of any single cell.

True

T/F: The U wave represents the last phase of ventricular replarization, thought to mostly to deal with potassium flux.

True

T/F: The composite sum of the augmented leads record voltages relative to a zero potential

True

T/F: The pre-cordial, or the so-called V leads, record voltages oriented in the horizontal plane to assess atrial activity AND ventricular activity.

True