Test 4 - 10/25

Question 1

What is the tough outer layer of the pericardium?

Answer 1

Fibrous pericardium

Question 2

What is immediately under the fibrous pericardium (attached)

Answer 2

Serous pericardium, parietal layer

Question 3

Parietal pain is more ____ pain

Answer 3

tissue

Question 4

Clear, stretchy, super thin layer that sits between the serous parietal layer and the actual heart tissue

Answer 4

Serous pericardium, visceral layer.

Question 5

The serous pericardium visceral layer allows for the heart to ____

Answer 5

slide around easily within the pericardium

Question 6

In the AP’s in the heart, where would we see lots of fast Na channels?

Answer 6

1. ventricular muscle
2. purkinje fibers

Question 7

If something happens to the fast Na channels in our heart AP, what can happen?

Answer 7

it can turn out fast AP into slow AP and that can affect our HR and strength of contraction

Question 8

Action potential propogation through two cells is only via

Answer 8

gap junctions

Question 9

How are neurotransmitters used in the heart?

Answer 9

They aren’t, dumbass. its only gap junctions. this isn’t a neuron.

Question 10

What fits through gap junctions?

Answer 10

Na fits best. Ca is big and clunky.

Question 11

If we are relying on Ca to get us an AP what would we see?

Answer 11

It would still get us an AP but it is big and clunky and doesn’t move through the gap junctions very well

Question 12

Since we are using gap junctions in the heart as a synapse it can be _____

Answer 12

a bidirectional synapse

Question 13

Synaptic connections are ____

Answer 13

One way

Question 14

Why can gap junctions being bidirectional be a negative thing?

Answer 14

If a part of the heart depolarizes spontaneously it can have retrograde movement and travel backward

Question 15

What is protecting us from retrograde movement through the gap junctions

Answer 15

the absolute refractory period

Question 16

What might happen if there is retrograde movement during the relative refractory period

Answer 16

might fire an odd AP. force generation wont look great.

Question 17

What is the 3 lead EKG also called?

Answer 17

frontal or coronal plane

Question 18

What are augmented leads?

Answer 18

3 extra leads if 3 isnt enough

Question 19

What is the eyeball in terms of the EKG leads?

Answer 19

The positive lead, we can see if the AP is moving towards it (positive deflection) or away from it (negative deflection)

Question 20

If there is current moving towards the eyeball that will show up as a ______ deflection

Answer 20

positive

Question 21

For lead placement where will the negatives and positives always be?

Answer 21

L foot - 2 positives
R arm - 2 negatives
L arm - 1 positive and 1 negative

Question 22

The equilateral triangle for the lead placements is called what?

Answer 22

Einthovens Triangle (Dutch..somewhere from europe)

Question 23

Need _____ to turn the EKG signals into something that the machine can process

Answer 23

amplifier.

Question 24

What is a left axis deviation

Answer 24

anything less than 59 degrees. If the depolarization is headed more superior towards the left arm.

Heart rotated left

Question 25

If the heart is turned towards the left that would give us a _____ deviation and it would be ______ degrees

Answer 25

left axis; less than 59

Question 26

A bundle branch block might do what?

Answer 26

swing the electrical axis one way or another

Question 27

what can cause the heart to be pointed straight up and down instead of pointed towards the left foot?

Answer 27

Inflated lungs or COPD

Question 28

If we deflate the lungs the heart will be more oriented towards _____

Answer 28

L arm. kinda on its side

Question 29

If we take a really big deep breath that will turn the heart towards _____

Answer 29

the right

Question 30

anything greater than ____ degrees is considered a right axis deviation

Answer 30

59

Question 31

Anything less than _____ degrees is a left axis deviation

Answer 31

59

Question 32

The wall of the right ventricle is ______ compared to the left

Answer 32

thinner

Question 33

The main bundle branches are located in the _____

Answer 33

interventricular septum

Question 34

The atrial P wave is pointed towards _____

Answer 34

L foot.

Question 35

If we have repolarization for the atria it will be pointed towards _____ and will be a ______ deflection.

Answer 35

L foot. negative

Question 36

Where do we see the atrial repolarization on the EKG?

Answer 36

We don't, it is hidden by the QRS complex

Question 37

What do the wall size of the atria and the wall size of the ventricles have to do with the fact that we cant see the repolarization of the atria

Answer 37

The walls of the atria are super thin compared to the ventricles so its not powerful enough to obscure the QRS complex.

Question 38

Atrial depolarization and repolarization go in _______(same/opposite) direction

Answer 38

same

Question 39

If we had an atrial T wave it would be a _____ deflection

Answer 39

negative

Question 40

Which one is lead 1

Answer 40

green. 0 degrees

Question 41

which one is lead 2

Answer 41

pink. 60 degrees

Question 42

which one is lead 3. what is the axis for this lead

Answer 42

Blue. 120 degrees

Question 43

In a normal EKG if we are looking at the different readings for leads 1,2 and 3 what would we expect to see from lead 2.

Answer 43

the biggest magnitude of deflection.

Question 44

Why does lead 2 show the biggest magnitude of deflection?

Answer 44

Because everything is headed straight towards that lead (the eyeball)

Question 45

Why does lead one have a much smaller magnitude of deflection

Answer 45

Because lead one only picks up a portion of the current

Question 46

How would we figure out how much of a positive deflection we would see in lead 1?

Answer 46

Draw in the line L and the length of line A would be the positive deflection we would see in lead 1 vs lead 2. it is much smaller.

Question 47

If the heart is positioned straight up and down and the mean electrical axis is now 90 degrees, what would we expect to see from lead 1? Why?

Answer 47

Should show zero because there is no left to right movement. The vector is perpendicular to lead 1.

Question 48

If the heart is pointed towards the right foot and this is our new mean electrical axis, what would we expect to see in lead 1

Answer 48

This should show a negative deflection

Question 49

What would this show in lead one?

Answer 49

Huge negative deflection

Question 50

What would this show in lead one?

Answer 50

Huge positive deflection

Question 51

What would we use 3 vs 6 leads for?

Answer 51

3: figure out what the problem is 6: figure out where the problem is

Question 52

What is Einthovens Law?

Answer 52

Lead 1 + Lead 3 = Lead 2

Question 53

How would we calculate einthovens law?

Answer 53

lead 1 + 3 = 2 Difference in peak positive deflection minus peak negative deflection