Introduction To Telemetry Practice Test

In normal sinus rhythm, where does the electrical impulse originate?

SA Node AV Node Purkinje Fibers Bundle Branches

Correct Answer:

SA Node

Explanation:

The impulse in normal sinus rhythm begins with the Sinoatrial node, the heart’s natural pacemaker. Located in the right atrium near the superior vena cava, SA node cells automatically generate impulses, setting the pace for the heart usually around 60–100 beats per minute. This impulse starts there and then travels through the atria to cause atrial contraction, proceeds to the atrioventricular node (which provides a brief delay to allow filling), and then moves down the His-Purkinje system to rapidly depolarize the ventricles. Purkinje fibers and bundle branches are key conduits for the signal to reach the ventricles, but they do not initiate the rhythm themselves. The AV node can take over only if the SA node fails, which is not the case in normal sinus rhythm.

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