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question 11
ECG stands for electrocardiogram. It records the electrical activity of heart in the form of waves. This happens due to the depolarization and repolarization of the heart. Deviations from the normal ECG is indication of heart problems and disease. There are three components of the ECG
- P wave: Depolarization of auricles
- QRS complex: Depolarization of ventricles
- T wave: Repolarization of ventricles.
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- 1. Mr. Garcia had a myocardial infarction. Explain what happened to his heart muscle and vascular system. What is a STEMII? 2. Mr. Garcia's chest pain resolved after two sublingual NTF at 3-minute intervals and 2 mg of IV morphine. In the cardiac catheterization lab he was "found to have a totally occluded distal right coronary artery and a 70% occlusion in the left circumflex coronary artery. The left anterior descending artery was patent. Angioplasty of the distal right coronary artery resulted in a patent infarct- related artery with near normal flow. A stent was left in place to stabilize the patient and limit infarct size. Left ventricular ejection fraction was normal at 42%, and a posterobasilar scar was present with hypokinesis." a. Explain angioplasty and stent placement. Define occluded occlusion. b. What is the purpose of this medical procedure?21) Female,35 years old. She came to the clinic because of persistent precordial pain for 2 days. Physical examination: frictional sounds can be heard in the fourth rib space on the left side of the sternum,which can still be heard after holding the breath. The ECG suggests bow-dorsal downward elevation of the ST seament in the conventionai leads. What is her most likely clinical diagnosis? A Acute myocardial infarction() B Variant angina C Acute pleurisy D Acute pericarditis E Acute pulmonary embolism8. Circle the term that does not belong in each of the following groupings. 1. AV valves closed AV valves open. SA node is pacemaker Ventricular systole 2. No P wave 3. Ventricles fill 4. Early diastole Semilunar valves open Ventricular pressure drops 5. Stenotic valve Restricted blood flow Heart sound after valve closes 6. Isovolumetric ventricular systole Semilunar valve closed Ventricular systole AV node is pacemaker AV valves open Semilunar valves open Junctional rhythm Late diastole Isovolumetric relaxation High-pitched heart sound Blood volume unchanging AV valve open
- 1- A. How is the blood in the pulmonary artery and pulmonary veins different from the blood in the other arteries veins? B. Describe one SIMILARITY and one STRUCTURAL DIFFERENCE between AORTA and VENA CAVA 2- Kathleen decided to donate blood to the Canadian Red Cross. After donating blood, her blood pressure reading was 140 mm Hg / 95 mm Hg. Is this an example of hypotension OR hypertension? What are TWO possible side effects Kathleen may experience? EXPLAIN why she may experience them67-year-old diagnosed with an irregular heart rhythm. For the past month, she has been taking the following medications for management of her heart condition: Digoxin 0.25mg once daily Warfarin (Coumadin) 5mg once daily During her F/U visit, you notice that Mrs. Pender has developed purpura on her arms & lower legs. When you ask her about these “purple spots” she states that she started noticing them about a week ago. The provider has ordered serum LFTs & renal function tests 1.Based on the knowledge of drug pharmacokinetics, how should the nurse explain to the patient the possible cause of the purpura? 2.Mrs. Pender’s renal function test results show mild kidney impairment. What changes can the nurse anticipate regarding the patient’s medication regimen? 3.The patient asks the nurse, “Why did you have to check the function of my liver?” What is the most appropriate response by the nurse?Identify the function of the following terms IN THE CARDIAC CELL. (1-2 sentences only). Please use a credible source when answering. 1. Sacromere 2. Sarcroplasmic Reticulum (SR) 3. I-type Ca channel (aka Dihydropyridine Receptors) 4. Ryanodine Receptors (RyR-2) for myocardial cells 5. SERCA 6. NCX 7. Na+ - K+ - ATPase Pump
- 19) Male,30 years old, came to the clinic with paroxysmal palpitations for 2 days. Physical examination BP:125/70 mmHg. HR: 190 bpm, the heart rhythms and the sounds are normal. 1 minute later his heart rate suddeniy decreased to 80 bpm with the normal heart rhythm. What is his most likely clinical diagnosis? A Sinus tachycardia B Paroxysmal atrial fibrillation C Paroxysmal supraventricular tachycardia D Paroxysmal atrial flutter E Third degree atrioventricular blockes) V 11. Trace the flow of impulses through the conduction system (step by step) and include at what points the following happen: 2 atria contract together 000 P F4 ● ● AV node delay occurs • interventricular septum contracts the outer walls of the 2 ventricles contract together ● F5 SEP 20 MacBook Air F6 F7 Focus ▶11 F8 BO F9 =I F10Match the following terms with their meanings below: coronary arteries normal sinus rhythm mitral valve deoxygenated blood pacemaker murmur myocardium electrocardiogram pericardium endothelium 1. Double-layered membrane surrounding the heart - 2. Muscular, middle layer of the heart - 3. Positioned between the left upper and lower heart chambers 4. Innermost lining of blood vessels - 5. Resting rate of 60 to 100 beats per minute - 6. Blood lacking in oxygen - 7. Blood vessels that carry oxygen-rich blood to the heart muscle - 8. Abnormal heart sound – 9. Specialized nervous tissue in the right atrium that begins the heartbeat; sinoatrial node - 10. Record of the electricity flowing through the heart -
- A 50-year-old male patient arrives in the emergency department complaining of severe chest pain. He is taken to the cardiac cath lab for a coronary angiogram and left ventriculogram. The cardiologist discovers a lesion in the left main coronary artery branch and orders an immediate CABG. 1. Why does the location of this lesion make it more dangerous than lesions in other locations? 2. What does the acronym CABG stand for? 3. Assuming that the CABG is successful, what is the patient's postoperative prognosis? 4. Could the cardiologist perform an angioplasty to repair the lesion?1- Label the major arteries and veins of the systemic and pulmonary circuits, using the terms provided. Identify the main blood vessels in the model provided. Aortic arch Pulmonary artery 10 Right lung 11 Liver 12 Right kidney 13 14 Urinary bladder Deep femoral artery 15 Terms: Aorta Brachiocephalic vein Common carotid artery Common iliac artery Common iliac vein External jugular vein Femoral artery Femoral vein Great saphenous vein Inferior vena cava Internal jugular vein Pulmonary vein Subclavian artery Subclavian vein Superior vena cava20) Female,40years old. Ventricular septal defect was found for 38 years and persistent fever since the tooth extraction 3 months ago. Physical examination: temperature:37.6°c, petechiae on the skin, systolic murmur can be heard in the aortic valve auscultation area, and eniarged spleen. What is the most likely clinical diagnosis for this patient? A Myocarditis B Pericarditis C Left heart failure D Infective endocarditis E None of the above
