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AzureRanthos AzureRanthos
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6 years ago
Which of the following best describes an accelerated idioventricular rhythm (AIVR)?
 
  a. Rapid, chaotic rhythm with no pattern or regularity
  b. Gradual alteration in the amplitude and direction of the QRS; atrial rate indiscernible, ventricular rate 150 to 250 beats/min
  c. Regular ventricular rhythm with QRS complexes measuring 0.10 seconds or less; P waves may occur before, during or after the QRS; ventricular rate 41 to 60 beats/min
  d. Essentially regular ventricular rhythm with QRS complexes measuring 0.12 seconds or greater; atrial rate not discernible; ventricular rate 41 to 100 beats/min

Question 2

Poor R-wave progression is a phrase used to describe R waves that decrease in size from V1 to V4 . This is often seen in an _____ infarction.
 
  a. anteroseptal
  b. anterolateral
  c. inferolateral
  d. inferoposterior

Question 3

Thin strands of fibrous connective tissue extend from the atrioventricular (AV) valves to the papillary muscles and prevent the AV valves from bulging back into the atria during ventricular systole. These strands are called _____.
 
  a. cardiac cilia
  b. Purkinje fibers
  c. papillary muscles
  d. chordae tendineae

Question 4

What does the QRS complex represent?
 
  a. Atrial depolarization
  b. Ventricular contraction
  c. Ventricular repolarization
  d. Ventricular depolarization

Question 5

How would you differentiate a junctional escape rhythm at 40 beats/min from a ventricular escape rhythm at the same rate?
 
  a. It is impossible to differentiate a junctional escape rhythm from a ventricular escape rhythm.
  b. The junctional escape rhythm will have a narrow QRS complex; the ventricular escape rhythm will have a wide QRS complex.
  c. The rate (40 beats/min) would indicate a junctional escape rhythm, not a ventricular escape rhythm.
  d. The junctional escape rhythm will have a wide QRS complex; the ventricular escape rhythm will have a narrow QRS complex.
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wrote...
6 years ago
The answer to question 1  D
Characteristics of accelerated idioventricular rhythm:
Rhythm Ventricular rhythm is essentially regular.
Rate 41 to 100 (41 to 120 per some cardiologists) beats/min
P waves Usually absent or, with retrograde conduction to the atria, may appear after the QRS (usually upright in the ST segment or T wave)
PR interval None
QRS duration Greater than 0.12 seconds; the T wave frequently in the opposite direction of the QRS complex

The answer to question 2  A
Poor R-wave progression is a phrase used to describe R waves that decrease in size from V1 to V4 . This is often seen in an anteroseptal infarction, but may be a normal variant in young persons, particularly in young women. Other causes of poor R-wave progression include left bundle branch block, left ventricular hypertrophy, and severe chronic obstructive pulmonary disease (particularly emphysema).

The answer to question 3  D
Chordae tendineae are thin strands of connective tissue. On one end, they are attached to the underside of the AV valves. On the other end, they are attached to small mounds of myocardium called papillary muscles. Papillary muscles project inward from the lower portion of the ventricular walls. When the ventricles contract and relax, so do the papillary muscles. The papillary muscles adjust their tension on the chordae tendineae, preventing them from bulging too far into the atria.

The answer to question 4  D
When the ventricles are stimulated, a QRS complex is recorded on the ECG. Thus, the QRS complex represents ventricular depolarization.

The answer to question 5  B
Although junctional and ventricular rhythms are ectopic pacemaker sites, their rhythms can generally be differentiated by the width of their QRS complexes. The junctional escape rhythm will have a narrow QRS complex; the ventricular escape rhythm will have a wide QRS complex.
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