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Advanced 12 Lead EKG Lecture Worksheet #4 True or False ____1. An abnormal (pathological) Q wave indicates the presence of dead myocardial tissue ____2. In most patients, the posterior wall of the left ventricle is supplied by the right coronary artery ____3. Consider the presence of right ventricular infarction if a patient with an inferior wall Infarction becomes hypotensive after administration of nitrates. ____4. A normal ECG rules out a myocardial infarction. ____5. In a patient experiencing an acute coronary syndrome, ST segment elevation in the shape of a “smiley” face (upward concavity) is usually associated with an acute injury pattern. ____6. Placement of right Precordial leads is identical to the standard Precordial leads except on the right side of the chest. ____7. 0.12 seconds is equal to 120 milliseconds ____8. The axes of leads I, II, and III form an equilateral triangle with the heart at the center. (Einthoven’s triangle). If the augmented limb leads are added to this configuration and the axes of the six leads moved in a way in which they bisect each other, the result is the hexaxial reference system. ____9. The area supplied by an obstructed coronary artery goes through a characteristic sequence of events that have been identified as zones of ischemia, injury and infarction. Multiple Choice 1. Which of the following leads are anatomically sharing common boundaries. a. V2, V3, V4 c. II, V2 b. II, III, V3 d. I, V3, V4 Advanced 12 Lead EKG Lecture Worksheet #4 2. Which leads face the septal area of the left ventricle? a. II, aVF c. V5, V6 b. V1, V2 d. I, aVL 3. A posterior wall infarction should be suspected if: a. V1 and V2 have a tall R wave only b. V1 and V2 ST segment depression with a tall R wave 4. Leads I, aVL, V5 and V6 view the _____surface of the left ventricle. a. Anterior c. Lateral b. Posterior d. Inferior 5. Each electrode place on the chest in a “V” position is a _____________ electrode. a. Positive b. Negative 6. In the setting of myocardial infarction, a new onset of bundle branch block carries a _____________ mortality rate. a. Decreased b. Increased 7. A delay or block that occurs in one of the bundle branches affects ventricular ______________. a. Repolarization c. Depolarization b. Automaticity d. Contraction 8. Two conditions must exist to suspect bundle branch block. First, the QRS complex must have an abnormal duration (<0.12 seconds) and second: a. A slurred upstroke of the QRS complex must exist b. The QRS complex must arise as the result of supraventricular activity c. An rSR’ complex must be seen in leads V1 d. A QS pattern must be seen in leads I, II and III 9. What is meant by Poor R wave progression?