Deck 1: Diagnostic 12 Lead Ecg

Question 1

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

A) physiologic artifact
B) electromyographic signal
C) nonphysiologic artifact
D) muscle artifact

Answer 1

electromyographic signal

Question 2

Even with the use of three limb leads, Einthoven's ECG was only able to view the frontal plane and the inferior and lateral wall of the heart.

Answer 2

True

Question 3

The elderly tend to have a lower frequency of acute myocardial infarction.

Answer 3

False

Question 4

The presence of Q waves in the face of concurrent ST elevation speaks to the evolution of the infarction and may indicate that an MI has been in progress for several hours.

Question 5

The mnemonic used for treating suspected acute myocardial infarction is MONA (Morphine, Oxygen, Nitrates, and Aspirin); this also indicates the order of treatment.

Question 6

A 12-lead ECG is printed in a standard four column format.

Question 7

Leads I, aVL, V5, and V6 have the negative electrode located on or beneath the left arm.

Question 8

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

Question 9

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

A) precordial
B) connected
C) modified
D) bipolar

Question 10

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

A) dysrhythmia
B) myocardial infarction
C) the inability to breathe
D) renal failure

Question 11

If untreated, acute coronary syndrome can lead to fatal heart attacks.

Question 12

Wilson's unipolar precordial ____ leads encircled the anterior ventricular wall from the septal wall on the right to the lateral wall on the left and permitted a complete view of the anterior myocardium.

A) V
B) exploratory
C) chest
D) limb

Question 13

The isolated appearance of a RRWP should be taken to mean that the patient is having an anterior wall MI.

Question 14

All Paramedics should obtain an initial baseline 12-lead ECG as soon as possible, and thereafter, serial 12-lead ECGs should be performed every ____ for the first two hours of patient contact.

A) 10 to 15 minutes
B) 15 to 20 minutes
C) 15 to 30 minutes
D) 20 to 25 minutes

Question 15

The early ECG machines were intended to monitor the rhythm only.

Question 16

National standards have encouraged rapid intervention, less than 60 minutes, from arrival at the emergency department to balloon inflation in a cardiac catheterization lab for patients with a suspected STEMI.

Question 17

Wilson's precordial leads measure the ECG potentials across the anterior wall of the right ventricle.

Question 18

It is important that the gel on an electrode be moist.

Question 19

The primary value of a Paramedic-obtained 12-lead ECG in the field is the identification of myocardial injury and the transportation of the patient to the definitive care center.

Question 20

The electrocardiogram is a relatively new diagnostic tool.

Question 21

A(n) ____ is a QRS complex where the R wave is equal in height to the depth of the S wave.

A) hexaxial lead
B) torsades lead
C) equiphasic lead
D) bilateral lead

Question 22

When every other ECG complex has alternating amplitude (i.e., the one QRS complex is smaller when compared to the next), then the patient may have ____.

A) LBBB
B) RBBB
C) electrical alternans
D) reciprocal ST depression

Question 23

____ ischemia occurs as the ischemia reaches a point in which it affects the entire thickness of the myocardium, from the endocardium to the epicardium.

A) Subendocardial
B) Hyperacute
C) Transmural
D) Myocardial

Question 24

To help conceptualize the heart's normal axis, and to help determine if there is any axis deviation, an artificial construct called the ____ was created.

A) hexaxial reference system
B) mean electrical vector
C) axis determination method
D) aberrant conduction curve

Question 25

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

A) idioventricular rhythm block
B) right bundle branch block
C) CVA block
D) vasospastic block

Question 26

____ is a bronchodilator but it also drives potassium into the cells.

A) Digoxin
B) Coumadin
C) Heparin
D) Albuterol

Question 27

The coronary arteries originate at the ____.

A) aortic valve
B) left ventricle valve
C) junction of vessels
D) sinus of Valsalva

Question 28

With electrode placement from the V2 position, the Paramedic should palpate the fifth intercostal space and move laterally to the midclavicular line to place the ____, the third electrode.

A) V3
B) V4
C) V5
D) V6

Question 29

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) T point
B) J point
C) S point
D) P point

Question 30

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

A) depolarization
B) depression
C) reciprocity
D) penumbra

Question 31

The sum of electrical events would be the common direction of the electrical wave front, called the mean electrical ____.

A) direction
B) axis
C) vector
D) hexaxial arc

Question 32

The major direction of the energy during depolarization is toward the apex of the heart and this common direction, or vector, of the energy of depolarization is called the heart's electrical ____.

A) node
B) axis
C) vector
D) arc

Question 33

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

A) Hyperacute T waves
B) ST segment depressions
C) ST segment elevations
D) Flattened T waves

Question 34

Ventricular tachycardia occurs most often in patients with ____ or those with a previous cardiac history.

A) acute cardiac ischemia
B) inferior wall MI
C) P waves before each QRS
D) R wave progression

Question 35

The loss of an R wave progression, sometimes called a ____, is suggestive of an anterior wall MI.

A) reverse R wave progression
B) nonspecific R wave progression
C) reciprocal R depression
D) depressed R progression

Question 36

In some cases, the ST changes are transitory but not evolutionary, and in those cases, the Paramedic merely notes that the 12-lead ECG has ____.

A) prolonged QT intervals
B) ST segment elevations
C) ST segment depression
D) nonspecific ST changes

Question 37

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

A) contiguous
B) inferolateral
C) adjacent
D) adjoining

Question 38

The cellular changes that occur during penumbra can be witnessed by the Paramedic as changes in the ECG called____.

A) ischemic patterns
B) nonspecific ST changes
C) reciprocal changes
D) penumbra

Question 39

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

A) Nonspecific
B) Penumbra
C) Reciprocal
D) Ischemic

Question 40

Hypomagnesemia may predispose the patient to a form of polymorphic ventricular tachycardia called ____.

A) supraventricular tachycardia
B) Torsade de Pointes
C) WPW syndrome
D) Lown-Ganong-Levine syndrome

Question 41

____________________ is a physiologic process where dead cells are replaced with new cells.

Question 42

Because of the prolonged conduction, and the resultant decreased inotropy, a patient with a LBBB may experience as much as a(n) ____________________% loss of cardiac output.

Question 43

Pathologic ____________________ waves indicate electrical silence (i.e., no depolarization) in that portion of the ventricular wall.

Question 44

Some patients are born with their heart in the right side of their chest, a condition called ____________________.

Question 45

A(n) ____________________ is a type of heart block (when the impulse fails to be conducted) that involves one or both the left fascicles of the left bundle.

Question 46

A(n) ____________________ can be likened to an early warning system, alerting the Paramedic to the possibility of sudden cardiac death before other ECG changes, such as ST segment elevation, occur.

Question 47

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.

Question 48

One of the first ECG changes that can occur as a result of AWMI can be a(n) ____________________ QT interval.

Question 49

Axis ____________________ occurs any time the heart's axis is not normal.

Question 50

____________________ is an inflammation of the pericardium.