Deck 34: Acquisition of the 12 Lead Ecg

Question 1

One of the first ECG changes associated with hypothermia is a shortened QT interval.

Answer 1

False

Question 2

The paper speed is critical for the analysis of the 12-lead ECG.

Answer 2

True

Question 3

Lesser branches off the LAD, called the septal perforators (SP), provide the septum with blood, including the bundle branches.

Answer 3

True

Question 4

One study suggests that serial 12-lead ECGs identified acute myocardial infarctions in 50% of patients upon whom the initial 12-lead ECG exhibited nonspecific ECG changes.

Question 5

Death from acute myocardial infarction remains a leading reason for mortality in the United States despite advances in medicine.

Question 6

Extra-cardiac pathologies, such as intracranial hemorrhage, hypothermia, and pericarditis, do not cause changes on the 12-lead ECG.

Question 7

Hypothermia affects all cellular functions and can also cause changes in the ECG.

Question 8

Calcium is needed for regular cell function.

Question 9

It has been estimated that upward of 50% of patients who will develop an acute myocardial infarction had no confirmatory electrocardiographic (ECG) findings upon the initial ECG.

Question 10

Dried electrodes can be rehydrated and used until the expiration date.

Question 11

Static electricity can also produce artifact on the ECG.

Question 12

One of the advantages of the 12-lead ECG is its ability to predict the clinical progression of the patient's disease if left unchecked.

Question 13

The circumflex coronary artery (Cx) was the first artery at the bifurcation of the left coronary artery.

Question 14

Patients with cardiac-related chest pain are at high risk for acute myocardial infarction and sudden cardiac death.

Question 15

Electrode gels depend on the body's warmth to liquefy the gel so that it can penetrate the skin.

Question 16

Arrhythmias caused by hyperkalemia are easy to treat with defibrillation.

Question 17

Electrocardiographic findings are always present in patients who are at the beginning of the event (i.e., early in the evolution of the acute myocardial infarction).

Question 18

A Q wave is always visible in every patient.

Question 19

Treatment for suspected acute myocardial infarction-specifically morphine, oxygen, nitrates, and aspirin-should be withheld if there are a lack of electrocardiographic findings.

Question 20

Osborn waves are often difficult to discern because of artifact from muscle tremors, but are seen in 50% of patients with hypothermia.

Question 21

Because Einthoven's limb leads required two leads which measured the current difference between the leads' electrodes, they were-and still are-referred to as ____ leads.

A) bipolar
B) dipolar
C) standard
D) reflective

Question 22

____ is an inflammation between the pericardium and the epicardium.

A) Pericarditis
B) Phlebitis
C) Pericardiocentesis
D) Encephalitis

Question 23

The AHA states that upon recognition of acute coronary syndrome and a suspected acute coronary event, a 12-lead ECG should be obtained as soon as possible but no later than ____ minutes upon arrival at the hospital.

A) 5
B) 10
C) 15
D) 20

Question 24

During the ____ phase, myocardial cells are deprived of oxygen and hypoxia ensues.

A) lateral
B) ischemic
C) ventricular
D) palpitation

Question 25

When two or more leads look at the same wall of the left ventricle, they are said to be ____ leads.

A) mirror
B) inverse
C) variable
D) contiguous

Question 26

____ is any time the heart's axis is not normal.

A) Linear deviation
B) Axis deviation
C) Linear polarization
D) Axis polarization

Question 27

The sum of the heart's electrical events would be the common direction of the electrical wave front called the ____.

A) median electrical vector
B) modal electrical vector
C) mean electrical vector
D) aggregate electrical vector

Question 28

If the heart and lungs are opposite and the abdominal organs are in their usual position, this is referred to as ____.

A) dextrocardia
B) sinocardia
C) retrocardia
D) laterocardia

Question 29

An acute rise in intracranial pressure secondary to subarachnoid hemorrhage, intracerebral bleed, or an epidural bleed may lead to wide and deeply inverted ____ waves in the chest leads.

A) R
B) S
C) T
D) U

Question 30

The vector of the energy of depolarization is called the heart's ____.

A) electrical axis
B) angular axis
C) electrical radius
D) polar radius

Question 31

The ____ is the start of the ST segment and is found at the juncture of the QRS and the ST segment, the point where the angle from the QRS changes.

A) QT interval
B) T wave
C) J point
D) U wave

Question 32

A normal ____ level, between 3.5 mEq/L and 4.5 mEq/L, is important for optimum cardiac cell function.

A) calcium
B) iron
C) oxygen
D) potassium

Question 33

A combination of Q waves, ST changes, and T wave abnormalities across one or more ventricular walls may be suggestive of a(n) ____ later in its evolution.

A) STEMI
B) AMI
C) ACS
D) LAD

Question 34

A ____ is a type of heart block in which the impulse fails to be conducted down the right bundle of the bundle of His.

A) right bundle branch block
B) left bundle branch block
C) right bundle branch function
D) left bundle branch function

Question 35

____ is commonly referred to as the "father of electrocardiology."

A) Albert Einstein
B) Ronald Ross
C) Willem Einthoven
D) Alphonse Laveran

Question 36

The ____ stands at the center of the decision pathway when managing patients with ischemic chest pain.

A) 10-lead ECG
B) 12-lead ECG
C) 14-lead ECG
D) 18-lead ECG

Question 37

Any time a muscle contracts, it produces an electrical current that will be detected as a(n) ____ signal by the ECG.

A) bioelectric
B) electromyographic
C) biorhythmic
D) electrocardiographic

Question 38

An additional diagnostic test available to the Paramedic if the Paramedic suspects right ventricular involvement is the ____-lead ECG.

A) 6
B) 12
C) 15
D) 18

Question 39

The use of a single positive electrode, using Wilson's central terminal, created the ____ lead.

A) bipolar
B) deflective
C) polar
D) unipolar

Question 40

To properly place the limb electrodes in the ____ modification, the right arm electrode is moved to the right infraclavicular fossa, approximately 2 cm below the clavicle.

A) Einthoven-Cooper
B) Einthoven-Likar
C) Mason-Likar
D) Mason-Cooper

Question 41

___________________ are ST-segment depressions seen on the 12-lead ECG in leads that face the wall opposite of those with ST-segment elevations.

Question 42

As a result of acute occlusion of the coronary arteries, and subsequent hypoxia, the myocardial cells go through a predictable pathway to cell necrosis and myocardial infarction called ___________________.

Question 43

Loss of right ventricular function, secondary to myocardial injury, can lead to profound ___________________.

Question 44

With the ___________________ method, the Paramedic would refer to Lead I and Lead II only.

Question 45

A(n) ___________________ lead is an QRS complex with an R wave that is equal in height to the depth of the S wave.

Question 46

___________________, which is a complete reversal of all thoracoabdominal organs, occurs in less than 1 in 10,000 patients but has been a documented medical phenomenon since 1643.

Question 47

___________________ T waves are defined as T waves greater than 5 mm in the limb leads and greater than 10 mm in the precordial leads.

Question 48

The primary mission of all Paramedics has always been to prevent sudden cardiac death from ___________________.

Question 49

The artery that serves the AV node is the ___________________ artery.

Question 50

A reverse R wave progression (RRWP) is suggestive of ___________________.