Cardiac nursing by Susan L Woods; et al

By Susan L Woods; et al

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Each molecule consists of a charged hydrophilic (water-attracting) globular head and a noncharged hydrophobic (water-repelling) tail. The molecules organize into thin sheets, with the heads oriented in a consistent direction. Two sheets are aligned tail-to-tail to form a double layer (bilayer). The tails form the core of the sheet, and the heads are directed outward in both directions. The result is a 7- to 9-nm, high-resistance, insulated barrier to ionic movement. Proteins embedded within the phospholipid bilayer may compose more than half the mass of the membrane.

35 A dense supply of vagal fibers innervates the sinus node, AV node, and ventricular conducting system. Consequently, many parasympathetic ganglia are found in the region of the sinus and AV nodes. 35 Right vagal fibers have more effect on the sinus node; left vagal fibers have more effect on the AV node and ventricular conduction system. However, there is overlap. The clinical importance of vagal stimulation for ventricular function continues to be debated. Although neurotransmitters from cardiac nerves are important modulators of cardiac activity, the success of cardiac transplantation illustrates the capacity of the heart to function without nervous innervation.

If one were to perform such an experiment, placing an intact muscle cell in a dish bathed in solutions with varying potassium ion concentrations as the potassium ion concentration in the external solution is raised, the membrane becomes more depolarized. When the concentration of potassium ion in the extracellular fluid becomes equal to the concentration in the intracellular fluid, the membrane potential is 0 mV. In cardiac surgery, when it is important to have a heart without electrical and mechanical activity, the organ is sometimes perfused with cool cardioplegic solution.

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