Chapter 005

Unit 2
Chapter 5:
Membrane Potentials and

Action Potentials
Slides by Thomas H. Adair, PhD

Copyright © 2021 by Saunders, an imprint of Elsevier Inc.
Active Transport of Na+ and K +
Remember: sodium is pumped out of the cell, potassium is pumped in ...
Inside Outside
K +
ATP Na +
Na+
K+
3 Na +
ADP 2 K+

Simple Diffusion of Na+ and K +
Through leak channels
Inside Outside
K + K+
Na+
Na +

Membrane Potential (Vm):
—Is a charge difference across the membrane
Inside Outside
… how can passive
diffusion of
potassium and
K + K+
sodium lead to
development of
negative membrane
potential?
Na+
Na +

Simplest Case Scenario for K+
Inside Outside
If a membrane were permeable to
only K+ then …
K+ would diffuse down its

concentration gradient until the
K + K+
electrical potential across the

membrane countered diffusion.
The electrical potential that counters net

diffusion of K+ is called the K+ equilibrium
potential (EK).

The Potassium Nernst Potential
… also called the equilibrium potential
Ki
EK = −61 × log
Ko
Example: If Ko = 5 mM and Ki = 140 mM

EK = −61 log(140/4)
EK = −61 log(35)
EK = −94 mV
So, if the membrane were permeable

only to K+, the membrane potential (Vm)
would be −94 mV.

Simplest Case Scenario for Na+
If a membrane were permeable to Inside Outside

only Na+ then …
Na+ would diffuse down its

concentration gradient until potential
Na+ Na+
across the membrane countered
diffusion.
The electrical potential that counters net

diffusion of Na+ is called the Na+
equilibrium potential (ENa).

The Sodium Nernst Potential
Nai
ENa = -61 x log
Nao
Example: If Nao = 142 mM and Nai = 14 mM

ENa = -61 log(14/142)
ENa = -61 log(0.1)
ENa = +61 mV
So, if the membrane were permeable only to Na+,

the membrane potential (Vm) would be +61 mV.

Resting Membrane Potential
Vm −90 to −70
0 mV
EK −94 ENa +61
Why is Vm so close to EK?

ANS: The membrane is far more permeable to
K+ than Na +.

Why Is the Cell Membrane so
Permeable to K?
There is 100× more K+ leak channels compared to Na+ leak channels.
Carbonyl oxygens
Figure 5-4

The Goldman-Hodgkin-Katz
Equation (1 of 2)
(Also called the Goldman Field Equation)
Calculates Vm when more than one ion is involved.
+ + −
+ +
p' K [ K ]o p' Na [ Na ]o p' Cl [Cl ]i
=
Vm 61. log + +
p' K [ K ]i + p' Na [ Na ]i + p' Cl [Cl − −]o-
or
+ +
p' K [ K ]i p' Na [ Na ]i + p' Cl [Cl − ]o
+
Vm = −61. log + +
p' K [ K ]o + p' Na [ Na ]o + p' Cl [Cl − ]i
Vm = membrane potential
P’ = permeability

The Goldman-Hodgkin-Katz
Equation (2 of 2)
Take home message…
The resting membrane potential is closest to the

equilibrium potential for the ion with the highest
permeability!

Summary: Resting Membrane
Potential
Figure. 5-5

Resting Vm for Various Cell
Types
Cell type Resting potential

Skeletal muscle fibers −85 to 95 mV
Smooth muscle fibers −50 to −60 mV
Astrocytes −80 to −90 mV
Neurons −60 to −70 mV
Erythrocytes −8 to −12 mV
Photoreceptor cells −40 mV (dark) to −70 mV (light)
Why is the resting membrane potential for RBCs so

close to 0 mV?
ANS: Resting membrane permeability to sodium

ions is high compared to most other cells.

Net Driving Force on Ions
The net driving force on any ion is the difference in millivolts between the
membrane potential (Vm) and the equilibrium potential for that ion (Eion).
Normal conditions
Vm −74 ENa+61
EK −94
0
mV
20 mV 135 mV
What is the net driving force on K+ ions?

What is the net driving force on Na+ ions?
Which way do the ions diffuse when permeability increases?

Effect of Changing Permeability of Na+
and K + on Membrane Potential
Vm ENa+61
EK −94
0
mV
What effect does increasing K+ permeability have on Vm?

What effect does increasing Na+ permeability have on Vm?

Resting and Action Potentials
What is the effect of high and
low plasma potassium on
• There are some terms that need threshold potential?
to be understood and
remembered: Overshoot
– Depolarization 0 mV
Excitability
– Hyperpolarization +
Repolarization
– Overshoot
• means positive to 0 mV Threshold
Depolarization Resting
– Repolarization −90 mV
Hyperpolarization potential
• toward resting potential
– Excitability -
– Threshold (for action What is the effect of high and
potential generation) low plasma potassium on
membrane potential?

Effect of Serum K+ on Vm and Threshold
Potential and Cell Excitability
Serum K+ = 4 mEq/L Serum K+ = 6 mEq/L
0 mV 0 mV
Threshold
Threshold
11 mV
15 mV
−90 mV −90 mV
So, an increase in extracellular potassium concentration

increases the excitability of the cell because the resting
membrane potential is closer to the threshold potential.

Theoretical Operation
… of voltage-gated sodium channel
Why do voltage-gated sodium

channels open when the
membrane potential becomes less
negative and reaches threshold?
Outside
Studies in bacteria indicate that + + + + + Voltage
the positive charges on the voltage Selectivity + Sensor
sensor could be arginine. filter +
+
+
_ _ _ _ +
Inside Gate
Inactivation
Gate

Effect of Ca++ on Threshold Potential
Ca++ ions
What is the effect of low plasma
calcium on threshold potential? ++
++ ++
++
Outside
ANS: Threshold potential + + + + + Voltage
Selectivity + Sensor
becomes more negative,
filter +
and thus closer to Vm. This
increases the excitability of +
the cell. +
_ _ _ _ +
Inside Gate
Inactivation
Gate

Hypocalcemia Is the Most
Common Cause of Muscle Tetany
Tetany in respiratory muscles can be lethal.
Threshold potential
How does low calcium levels (i.e., hypocalcemia) in
blood cause muscle tetany?
↑Ca
mV N
Low calcium increases excitability of nerve axons by
↓Ca
causing sodium channels to open following very small
increases in Vm.
Vm
How do calcium ions affect Na channel?
Calcium ions appear to bind to the exterior surfaces of

the voltage-gated sodium channel. A decrease in the
number of calcium ions reduces the voltage level
(threshold) required to open the sodium gate, i.e., the
threshold potential is more negative and thus closer to
Vm (green line) when plasma calcium is low.

Hyperkalemia Can Be Deadly, But What
Does This Have to Do With Calcium?
Hyperkalemia is one of the deadliest electrolyte disorders because
of deadly cardiac arrhythmias. Recall that high K + makes Vm less
negative (from −90 to −80 mV as shown), and hence closer to
threshold potential (−75 mV). So with hyperkalemia, Vm is only 5
-75 mV
mV more negative than threshold potential; this increase in
excitability can lead to arrhythmias.
Increased plasma calcium concn causes threshold potential to be Hyperkalemia

less negative (i.e., from normal value of −75 mV to − 65 mV as
shown in red). So, treatment with calcium reestablishes a 15 mV
difference between Vm and threshold potential, and thus reduces
arrthymias..
For this reason, the initial treatment of hyperkalemia should be

intravenous administration of calcium.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1413606/

Measurement of Membrane
Potential
Figure 5-2

Measurement of Action Potential
Figure 5-6

The Action Potential (AP)
Stimulate Recording
• An action potential: of AP
– is a regenerating depolarization of AP
membrane potential that axon
propagates along an excitable   
membrane.
= 60 mm or 6 cm
Propagates: conducted without decrement (an
“active” membrane event) AP velocity ~ 60 m/s = 60 mm in 1 ms
Excitable: capable of generating action potentials
Upstroke
+61
ENa
• Action potential basics:

• All-or-none event (need to reach
threshold) 0
• Constant amplitude (do not summate) Downstroke
•
(mV)
Initiated by depolarization
• Involve changes in permeability
• Rely on voltage-gated ion channels -90 
 EK
1 ms
Properties of Action
Potentials
+60
• Action potentials:
0
 Are all-or-none events
mV
 Threshold voltage (usually 15 mV positive to Threshold
resting potential)
-70
 Are initiated by depolarization
 Action potentials can be induced in nerve and
Stimulus
muscle by extrinsic (percutaneous) stimulation.
 Have constant amplitude
 APs do not summate - information is coded by Time
frequency not amplitude.
 Have constant conduction velocity 75
Myelinated
Velocity (m/s)
 True for given fiber. Fibers with large diameter (cat)
50
conduct faster than small fibers. As a general
rule: 25 Nonmyelinated
 Myelinated fiber diameter (in mm) × 4.5 = (squid)
velocity in m/s. 0
0 3 6 9 12 15
 Square root of unmyelinated fiber diameter
= velocity in m/s
0 400 800
Fiber diameter (mm)
Functions of Action
Potentials
• Deliver sensory information to CNS
– APs in sensory nerves are blocked by local anesthetics. This usually produces
analgesia without paralysis. Why no paralysis? LAs are more effective against
small diameter neurons with a large surface area to volume ratio. Hence, small C-
fibers that conduct pain sensations are affected more than large, alpha-
motorneurons.
• Information encoding
– The frequency of APs encodes information (amplitude of AP is constant).
• Rapid transmission over distance (nerve cell APs)
– The speed of transmission depends on fiber size and whether it is myelinated.
Information of lesser importance is carried by slowly conducting unmyelinated
fibers (nonmyelinated c-fibers conduct pain sensations).
• In non-nervous tissues, APs initiate various cellular responses.
– muscle contraction
– secretion (e.g., Epinephrine from chromaffin cells of medulla)

The AP—Membrane
Permeability
+61 ENa
• During upstroke of action potential:
Dow
 Na permeability increases
ke
 due to opening of Na+ channels
nstr
0
Upstro
 memb. potential approaches ENa
oke
(mV)
• During downstroke of action potential:
Resting potential
 Na permeability decreases
-90
 due to inactivation of Na+ channels
EK
1 ms Membrane
Number of open channels

 K permeability increases
 due to opening of K+ channels hyperpolarized
 mem. potential approaches EK Na+ channels
• After hyperpolarization (aka, positive after K+ channels
potential) of membrane following an action
potential:
 Not always seen!
 There is increased K+ conductance
 due to delayed closure of K+ channels

Ion Channels (1 of 2)
Closed
• Ion channels - structure
 Proteins that span membrane
 Have water-filled channel that runs
through protein Re
p
n
• Ion channel - properties ol
tio
ar
iza
iza
lar
 Have conducting states and non- tio
po
n
conducting states
De
 Transition between states = “gating”
Inactivation
Open Inactivated
• Channels “gate” in response to:
 Changes in membrane potential (usually depolarization)
 voltage-gated channels. Action potential propagation relies on voltage-gated channels
 Occupation of receptor
 ligand-gated or receptor operated channels (ROCs). These initiate action potentials
 Mechanical forces
 mechanosensitive channels - important for hearing

Ion Channels (2 of 2)
• Permeability of axon membrane to ions is determined by the:
number of open channels.
• Ion channels are usually selectively permeable
– permeable to specific ions
• some pass only Na ions and are generally called “Na channels”
• some pass only K ions = “K channels”
• some pass only Ca ions = “Ca channels” (important in synaptic transmission)
• some pass only Cl ions = “Cl channels”
– permeable to classes of ion
• Some channels are selective only for cations (Na, K and Ca) over anions (e.g., Cl -)
– These are called ‘non-selective cation channels’
• Ion channel gating (using voltage-gated as example)
– Most voltage-gated channels open in response to depolarization.
– The terms “gate” and “gating” refer to transitions between different states.
• These “different states” reflect different conformational states of the channel protein
– Has minimum of two gating transitions.
• activation = opening of channel when membrane is depolarized
• deactivation = closure of channel when membrane repolarizes

Ion Channels—Inactivation and
Deactivation (1 of 2) +50
Voltage command
• Depolarization causes: -90 mV
 Na channels to activate (open)
but it also causes inactivation Na+ channels
open channels
 Inactivated channels do not pass any ions
(nonconducting state).
Number of
 By contrast, K channels show activation but
not inactivation.
• The fall in current at the end is K+ channels
deactivation (opposite of activation).
closed
Number of open channels

Na+ channels
re
po
n
K+ channels
tio
lar
iza
iza
ar
tio
ol
n
p
de
inactivation
open inactivated

Ion Channels—Inactivation and
Deactivation (2 of 2)
deactivation
Figure 5-9

Summary of Voltage and Conductance
Changes
2
3 1 3
2 2
1 2
1
2
3
1
Figure 5-7
Figure 5-10
Voltage Gated Na+ Channels Have
a Selectivity Filter
Studies in bacteria indicate

that the selectivity filter
consists of negatively charged
amino acids such as glutamate.
Figure 5-7

Ratio of Conductances
Figure 5-10

Extracellularly Recorded APs
• Most text books show intracellularly

- +
a
recorded action potentials. +++++ --------------
------- +++++++++++
– Such recordings are usually not made in
clinical practice. Extracellular recordings are
made in clinical practice.
- +
b
– A so-called bipolar action potential is ---+++++++ --------
+++---------+++++++
shown.
+ -
c
Stimulus b ------ +++++++-----
artefact
- +++++ ---------++++
2 mV - +
d
c e ------------ +++++++
a ++++++++++ ---------
d
+ + -
e
----------------++++
• Why does the bipolar action potential +++++++++++++-----
Direction
look like this?
Conduction Velocity of AP (1 of 2)
• Compound action potentials are Stimulating

recorded from nerve trunks. electrodes
 Measured percutaneously from α

nerves that are close to surface
β
(e.g., ulnar nerve) R1
S 50 mm
 Passage of action potentials in all α
axons of nerves is seen as a small β
(mV) voltage signal on body R2
S
95 mm α
surface. α β δ
β C
 As recordings are made further
R3 S
from the site of stimulation the S 155 mm
waveform develops into several 10 ms 10 ms

discrete peaks.
Figure 5-15
 The first signal to arrive at a distant recording site has travelled the fastest!
 Thus, each peak represents a set of axons with similar conduction velocity.
 Velocity is calculated from the distance between R1 and R3 and the time taken to
traverse that distance - distance/time = velocity (ranges from 0.5 to ~100 m/s).

Conduction Velocity of AP (2 of 2)
• Compound action potentials are Stimulating

recorded from nerve trunks. electrodes
 Measured percutaneously from α

nerves that are close to surface
β
(e.g., ulnar nerve) R1
S 50 mm
 Passage of action potentials in all α
axons of nerves is seen as a small β
(mV) voltage signal on body R2
S
95 mm α
surface. α β δ
β C
 As recordings are made further
R3 S
from the site of stimulation the S 155 mm
waveform develops into several 10 ms 10 ms

discrete peaks.
 The first signal to arrive at a distant recording site has travelled the fastest!
 Thus, each peak represents a set of axons with similar conduction velocity.
 Velocity is calculated from the distance between R1 and R3 and the time taken to
traverse that distance - distance/time = velocity (ranges from 0.5 to ~100 m/s).

Refractory Periods
mV
0
Threshold
-40
-80
0 1 2 3 4 5 msec
ARP RRP
Absolute refractory period—AP not possible due to voltage inactivation
of Na channels
Relative refractory period—greater than normal stimulus required to
elicit AP
Refractory periods limit the maximum frequency of Aps.
Propagation of Action Potential
Opening of Na+ channels generates local current that depolarizes adjacent
membrane, opening more Na+ channels …
Rest
Stimulated
(local depolarization)
Propagation
(current spread)
Figure 5-11

Signal Transmission
Myelination
• Schwann cells surround the nerve
axon forming a myelin sheath.
• Sphingomyelin decreases membrane

capacitance and ion flow 5000-fold.
• Sheath is interrupted every 1–3 mm

by a node of Ranvier.
Figure 5-16
A, Modified from Leeson TS, Leeson R: Histology. Philadelphia: WB Saunders, 1979

Saltatory Conduction
• APs only occur at the nodes (Na channels are concentrated here!).
• Increased velocity
• Energy conservation
Figure 5-17

Conduction Velocity
Nonmyelinated vs myelinated
Nonmyelinated
Myelinated

Multiple Sclerosis
MS is an immune-mediated Patients have a difficult time

inflammatory demyelinating describing their symptoms. Patients
disease of the CNS. may present with paresthesias of a
hand that resolves, followed in a
About 1 person per 1000 in US couple of months by weakness in a leg
is thought to have the disease - or visual disturbances. Patients
The female-to-male ratio is 2:1 frequently do not bring these
—whites of northern European complaints to their doctors because
descent have the highest they resolve. Eventually, the resolution
incidence. of the neurologic deficits is incomplete
or their occurrence is too frequent, and
http://www.emedicine.com/pmr/topic82.htm the diagnostic dilemma begins.
Neurons Communicate via Synapses
• Point of communication
between neurones
Dendrite
Axo-dendritic
• Most synapses involve synapse
transmitter substances. Myellin
• Synapses can be:

- Excitatory
- Inhibitory

Synapses and Electrotonic
Responses
• Neurons communicate with specialized structures - synapses.
• An action potential in the presynaptic cell causes transmitter to be released.
• In fast synapses, transmitter substances bind to receptors on postsynaptic
cell to directly open ion channels (ligand-gated)
• The permeability of this region of the “postsynaptic” membrane to ions is
increased.
• The selectivity of the channels for particular ions determines
whether the membrane is hyperpolarized or depolarized.
• The membrane potential will move towards the equilibrium
potential for the permeant ion(s)
• Excitatory transmitters depolarize the membrane.
– Synaptic responses that reach threshold initiate an action potential.
– Subthreshold responses can summate with others.

Graded (Electrotonic) Potentials
Remember that “local current flow” • Importantly, local potentials:
depolarizes adjacent regions of a – do not induce refractoriness
neuron. – are graded
• bigger stimulus = bigger response!
 Now consider subthreshold stimuli
– summate
– The membrane potential does not • multiple stimuli = summed response
reach the threshold voltage.
– The local currents still flow but slowly
the membrane potential returns to Stimulus
the resting value.
 If the stimulation is restricted to a small 100
Voltage response (%)

area of membrane
– the depolarization will be greatest at Recording electrodes
that point and will fall exponentially
with distance.
 because the effect is “local” to the
stimulus, these are called
“electrotonic” or “local” potentials. 0
3 6 Distance (mm)
Compare Action Potential and
Electrotonic Potential
Subthreshold potential change Action potential

(electrotonic)
• proportional to stimulus strength • independent of stimulus
(graded) strength (all or none)
• not propagated but decremental • propagated unchanged in
with distance magnitude
• exhibits summation • summation not possible

Synaptic responses—Excitatory
Presynaptic neuron
• The upper record is from the presynaptic
cell. The lower record is from the
postsynaptic cell.
+ Postsynaptic neuron
• no action potentials - none
reached threshold
Presynaptic
– The excitatory post synaptic potential neuron
(epsp) is an electrotonic response - it
0
decays with an exponential time
course. mV
– The last epsp is larger because it occurs
-70
before the previous epsp has fully
decayed. Threshold
-60
mV
Which ions are involved? epsp
-70 Postsynaptic
EPSP: cation channels, Na channels 10 ms neuron
 This is “temporal summation” —successive epsp’s from the same synapse.

 compare with “spatial summation—distant synapses whose epsp’s overlap.

Synaptic Responses—Inhibitory
Presynaptic neuron
• The postsynaptic cell is hyperpolarized.

– Remember that hyperpolarization
- Postsynaptic neuron
depresses excitability – inhibitory.
– This is an inhibitory post synaptic
potential (ipsp).
• IPSPs can summate too. 0
mV
• epsp’s and ipsp’s result from increases Presynaptic neuron
in membrane permeability. -70
So, ask yourself:
– to which ions? You need to
-60
consider the equilibrium mV Postsynaptic neuron
potentials. -70
ipsp
IPSP: K or Cl -80
10 ms

Transmission at a Chemical Synapse
Vesicle of tx-R operated

transmitter (tx) channel
pre post
[Ca2+]
+++
Ca2+
+++ Na+
Na+,
K+, Ca++
V-G Na+
channels
V-G Ca2+ tx release open APpost
channels tx-R
Diffuse
APpre open
<20 nm>
[Ca]
Depolarization
0.5 ms

Ligands and Receptors?
What is a ligand? • A ligand is any substance that binds
to a receptor!
• Acetylcholine
• Receptors are often named and
• Norepinephrine classified largely by reference to the
• Epinephrine “ligand.”
• Serotonin (5-HT) • Acetylcholine and norepinephrine
are “physiological” ligands, i.e.,
• Dopamine provided by the body.
• Glycine • Receptors are often subdivided by
• Glutamate reference to ligands.
 ACh receptors include nicotinic (nACh) and
• Adenosine muscarinic (mACh) receptors.
 Nicotine stimulates nACh receptors.
 All above are ligands.  Muscarine stimulates mACh receptors

Excitatory and Inhibitory Synapses
 Inhibitory
 Examples—GABAA, Glycine Inhibitory postsynaptic
– Permeable to anions (Cl-) potential (ipsp)
– Equilibrium potential ~ -90 mV
– Hyperpolarizes post-synaptic cell
– Depresses excitability
 Excitatory
 Examples—nAChR, Glutamate Excitatory postsynaptic
– Permeable to cations (Na+, K+, and Ca2+) potential (epsp)
– Equilibrium potential ~ 0 mV
– Depolarizes postsynaptic cell
– Enhances excitability

Recap
Overshoot
0 mV
Excitability
+
Repolarization
Threshold
Depolarization Resting
-90 mV
potential
Hyperpolarization

Ventricular Action Potential
+20
1
0 2
Membrane -20
potential
-40 0 •0 Phase 0 (depolarization)
(mV)
-60
3 • Inward Na + current
-80
-100 4
•1 Phase 1 (early repolarization)
Relative
High • Outward K + current
Potassium
Conductance
Low
•2 Phase 2 (plateau)
High • Inward Ca++/Na+ current
Relative • Na + current shown as dashed line
Sodium
Conductance • Decreased outward K + current
(fast channel)
Low •3 Phase 3 (repolarization)

• Outward K + current
Relative High
Calcium
Conductance
(slow channel)
•4 Phase 4 (Resting potential)
Low
0 100 200 300 400

Time (msec)

Sinoatrial Node Action Potential
Mv •0 Phase 0 (depolarization)
0 − inward Ca + + current
-20 0 3 •3 Phase 3 (plateau)

− outward K + current
-40 Threshold
•4 Phase 4 (slow depolarization)
4 − inward Na + current
-60
-80

SA Node Action Potential (1 of 2)
—Parasympathetic mechanism
Mv
0
-20 time
-40
-60
-80
Increasing the permeability to
which ion would cause this
effect?
ANS: K+ Annu. Rev. Physiol. 2001. 63:235–57
SA Node Action Potential (2 of 2)
—Sympathetic mechanism
Mv
0
-20 Time
-40
-60
-80 Increasing the permeability to

which ion would cause this
effect? Annu. Rev. Physiol. 2001. 63:235–57
ANS: Na+,Ca++

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Chapter 005

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Unit 2

Membrane Potentials and

Slides by Thomas H. Adair, PhD

Copyright © 2021 by Saunders, an imprint of Elsevier Inc.

Copyright © 2021 by Saunders, an imprint of Elsevier Inc.

Copyright © 2021 by Saunders, an imprint of Elsevier Inc.

K+ would diffuse down its

electrical potential across the

The electrical potential that counters net

Copyright © 2021 by Saunders, an imprint of Elsevier Inc.

Example: If Ko = 5 mM and Ki = 140 mM

So, if the membrane were permeable

Copyright © 2021 by Saunders, an imprint of Elsevier Inc.

If a membrane were permeable to Inside Outside

Na+ would diffuse down its

The electrical potential that counters net

Copyright © 2021 by Saunders, an imprint of Elsevier Inc.

Example: If Nao = 142 mM and Nai = 14 mM

So, if the membrane were permeable only to Na+,

Copyright © 2021 by Saunders, an imprint of Elsevier Inc.

EK −94 ENa +61

Why is Vm so close to EK?

Copyright © 2021 by Saunders, an imprint of Elsevier Inc.

Copyright © 2021 by Saunders, an imprint of Elsevier Inc.

Calculates Vm when more than one ion is involved.

Copyright © 2021 by Saunders, an imprint of Elsevier Inc.

Take home message…

The resting membrane potential is closest to the

Copyright © 2021 by Saunders, an imprint of Elsevier Inc.

Copyright © 2021 by Saunders, an imprint of Elsevier Inc.

Cell type Resting potential

Why is the resting membrane potential for RBCs so

ANS: Resting membrane permeability to sodium

Copyright © 2021 by Saunders, an imprint of Elsevier Inc.

What is the net driving force on K+ ions?

Copyright © 2021 by Saunders, an imprint of Elsevier Inc.

What effect does increasing K+ permeability have on Vm?

Copyright © 2021 by Saunders, an imprint of Elsevier Inc.

Copyright © 2021 by Saunders, an imprint of Elsevier Inc.

Serum K+ = 4 mEq/L Serum K+ = 6 mEq/L

So, an increase in extracellular potassium concentration

Copyright © 2021 by Saunders, an imprint of Elsevier Inc.

Why do voltage-gated sodium

Copyright © 2021 by Saunders, an imprint of Elsevier Inc.

Copyright © 2021 by Saunders, an imprint of Elsevier Inc.

Calcium ions appear to bind to the exterior surfaces of

Copyright © 2021 by Saunders, an imprint of Elsevier Inc.

Increased plasma calcium concn causes threshold potential to be Hyperkalemia

For this reason, the initial treatment of hyperkalemia should be

Copyright © 2021 by Saunders, an imprint of Elsevier Inc.

Copyright © 2021 by Saunders, an imprint of Elsevier Inc.

Copyright © 2021 by Saunders, an imprint of Elsevier Inc.

Copyright © 2021 by Saunders, an imprint of Elsevier Inc.

Number of open channels

Copyright © 2021 by Saunders, an imprint of Elsevier Inc.

Copyright © 2021 by Saunders, an imprint of Elsevier Inc.

Copyright © 2021 by Saunders, an imprint of Elsevier Inc.

Number of open channels

Copyright © 2021 by Saunders, an imprint of Elsevier Inc.

Copyright © 2021 by Saunders, an imprint of Elsevier Inc.

Studies in bacteria indicate

Copyright © 2021 by Saunders, an imprint of Elsevier Inc.

Copyright © 2021 by Saunders, an imprint of Elsevier Inc.