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urinary system c25

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Question
Answer
show though the lungs and skin do some as well  
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Kidneys also react as   show
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show gluconeogenesis during prolonged fasting; Producing the hormones renin and erythropoietin; Metabolizing vitamin D to it's active form  
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RENIN   show
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show stimulates red blood cell production  
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show kidneys, urinary bladder, plus 3 tubelike organs (paired ureters, and rurethra) (transportation channels)  
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Renal Hilum   show
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show renal fascia, perirenal fat capsule, fibrous capsule  
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show outer layer, dense fibrous connective tissue; anchors kidney to surrounding structures  
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show fatty mass that surrounds the kidney and cushions it against blows  
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Fibrous capsule   show
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Hydronephrosis   show
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3 distinct regions of the kidney   show
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Renal cortex Pg 962   show
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Renal Medulla Pg 962   show
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show separate pyramids. each pyramid and its surrounding cortical tissue constitutes on of approximately eight LOBES of a kidney  
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show funnel-shaped tube; continuous w/ ureter leaving the hilum;  
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show branching extensions of the pelvis form 2 or 3 major CALYCES; cup shaped area that enclose papillae  
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show which drains to papillae,; empty into pelvis; the flows from pelvis to ureter; this moves it to the bladder to store;  
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show smooth muscle that contracts rhythmically to propel urine by PERISTALSIS  
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Pyel/itis   show
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show infections that affect entire kidney  
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Kidneys have rich blood supply   show
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Renal arteries Pg 963   show
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show right angles from the abdominal aorta, and the right renal artery is longer than the left because the aorta lies to the left of the midline  
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Segmental arteries pg964   show
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show each segmental artery branches further to form these in renal sinus  
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show branched from interlobar arteries, in medulla-cortex junction; arch over bases of medullary pyramids  
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show radiate outward from the arcuate arteries to supply the cortical tissue  
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90% of blood entering kidney perfuses the renal cortex   show
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Afferent Arterioles   show
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Veins   show
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Blood leaving the renal cortex Pg 964   show
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Renal veins issue from   show
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show true  
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show network of autonomic nerve fibers and ganglia, ; provides the nerve supply of the kidney and its ureter  
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Renal plexus is supplied by sympathetic fibers from the most inferior thoracic and fist lumbar splanchnic nerves   show
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show STRUCTURAL and FUNCTIONAL units of the kidneys  
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Each kidney contains over 1 mission nephrons (blood processing units)   show
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1000's of collecting ducts,   show
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Glomerulus   show
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show cup-shaped end which called the Glomerular capsule (or Bowman's capsule); which is blind and completely surrounds glomerulus  
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Renal capsule   show
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Endothulium of the glomerular capillaries if FENESTRATED (penetrated by many pores)   show
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show raw material that renal tubules process to form urine  
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show simple squamous epithelium; simply contributes to capsule structure, and plays NO PART in forming FILTRATE  
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Visceral layer pg966   show
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Foot processes   show
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Filtration slits   show
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Capsular space   show
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remainder of Renal tubule has   show
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Proximal convoluted tubule (PCT) Pg966   show
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show hairpin loop coming from the PCT  
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Distal convoluted tubule (DCT)   show
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show receives filtrate from many nephrons; runs through pyramids(gives striped appearance); as they approach the renal pelvis, they fuse together and deliver urine into the minor calyces via papillae of the pyramids.  
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show single layer of polar epithelial cells on basement membrane; but each region has a unique cellular anatomy;  
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show cuboidal epithelial cells w/ large mitochondria; luminal(exposed) side bear dense microvilli  
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brush border   show
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show ascending and descending limbs  
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show proximal part is continuous w/ proximal tubule and its cells are similar  
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show the rest of the descending limb, is simple squamous epithelium freely permeable to water;  
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show becomes cuboidal or even low columnar  
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show ascending part of loop of Henle where it becomes cuboidal or columnar  
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show descending limb. In others, it extends into ascending limb as well  
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show are cuboidal and confined to the cortex, but they are thinner and almost entirely lack microvilli  
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Transition between DCT and collecting duct   show
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show INTERCALATED CELLS, (cuboidal cells w/ abundant microvilli) and more numerous PRINCIPLE CELLS which have sparse/short microvilli  
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Principle cells help maintain   show
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Nephrons; divided into two major groups   show
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show 85% of nephrons; located entirely in cortex (except small part in the loop of Henle)  
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Juxtamedullary nephrons   show
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Nephron capillary beds Pg 966   show
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Glomerulus   show
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Afferent arteriole   show
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BP is extremely high in glomerulus because   show
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Peritubular capillaries pg968   show
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show tend not to break up into meandering particular capillaries. Instead the form bundles of straight vessels called VASA RECTA  
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show extend deep into medulla paralleling the longer loops of Henle; thin-walled; Play important role in forming concentrated urine  
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In summary   show
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show Blood flow encounters high resistance  
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show from 95mm Hg in the renal arteries to 8mm Hg or less in the renal veins  
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show protects the glomeruli form large fluctuations in systemic BP  
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Resistance in the efferent arterioles   show
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Juxtaglomerular Apparatus Pg 968   show
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show granular cells (also called juxtaglomerular (JG) cells)  
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Granular cells   show
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Macula densa   show
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show chemoreceptors that respond to changes in the NaCl content of the filtrate  
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show interconnected by gap junctions and may pass signals between macula dense and granular cells  
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show lies between blood and interior of glomerular capsule; porous allows free passage of water and solutes smaller that plasma proteins  
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show fenestrated endothelium of the glomerular capillaries; visceral membrane of the glomerular capsule, made of podocytes which have filtration slits between their foot processes; and between these two layers is the basement membrane composed of fused basal  
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show allow passage of plasma but not blood cells; basement membrane restricts all but smallest proteins;  
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Structural makeup of basement membrane   show
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Urine formation Pg 969-970   show
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Maintain volume and chemical makeup   show
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show From there, the kidneys reclaim (by tubular reabsorption) everything the body needs to keep (almost everything)  
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next   show
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show some 650ml is plasma; about one-fifth of this (120-125) is forced into the renal tubules  
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Kidneys consume 20-25% of all oxygen used by the body at rest   show
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show everything found in blood plasma EXCEPT proteins  
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show mostly metabolic wastes and unneeded substances.  
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The kidneys process 180L (47 gallons) of blood derived fluid daily   show
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show passive process ; hydrostatic pressure forces fluids and solutes through; "simple mechanical filter", because filtrate formation doe not consume metabolic energy  
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Glomerulus filtration membrane   show
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Glomerular BP   show
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show 180L of filtrate daily, in contrast to the 2 to 4 L formed daily by all other capillary beds combined  
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Molecules smaller than 3nm in diameter   show
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Keeping plasma proteins in capillaries   show
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show True  
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Net Filtration Pressure (NFP) Pg 971   show
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Glomerular hydrostatic pressure (HPg)   show
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HPg is opposed by two forces   show
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show volume of filtrate formed each minute  
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show total surface area available for filtration Filtration membrane permeability NFP (10mm Hg)  
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show true  
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Glomerular pressure drop of only 18%,   show
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GFR is directly proportional pg972   show
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show in the absense of regulation  
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Regulation of Glomerular filtration Pg 972   show
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show on the other hand; the body needs constant BP and therefore a constant blood volume  
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Intrinsic controls (renal autoregulation)   show
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show maintain BP  
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show extrinsic controls take precedence over intrinsic controls  
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show adjusting its own resistance to blood flow; 2 types of controls- myogenic mechanism and tubuloglomerular feedback mechanism  
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show reflects tendency of vascular smooth muscle to contract when stretched  
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show which restricts blood flow into glomerulus and prevents glomerular BP from rising to damaging levels  
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show both responses help maintain a normal GFR  
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show autoregulation ; directed by the MACULA DENSE cells of the JUXTAGLOMERULAR apparatus  
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show there is insufficient time for reabsorption and the concentration of NaCl in the filtrate remains high. This causes the macula dense to release vasoconstrictor chemical (probably ATP) that causes tense constriction of the afferent arteriole  
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Extrinsic Controls; Neural and Hormonal Mechanisms Pg 972   show
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show volume of extracellular fluid is normal-sympathetic nervous system is at rest-the renal blood vessels are DIALATED and renal auto regulation mechanisms prevail  
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show true  
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show triggered when various stimuli cause the granular cells to release the hormone RENIN  
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show acts enzymatically on ANGIOTENSINOGEN; converting it to ANGIOTENSIN I; this, in turn, is converted to ANGIOTENSIN II by ANGIOTENSIN CONVERTING ENZYME(ACE)  
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show plasma globuloin made by the liver  
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Angiotensin II acts to;   show
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Angiotensin II acts to   show
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show stimulate reabsorption of Na+. Both directly by acting on renal tubules and indirectly by triggering the release of aldosterone from the adrenal cortex; Because water follows Na+, blood volume and BP rise  
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Angiotensin II acts to pg973   show
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Angiotensin II acts to   show
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REMEMBER: ALL of the effects of Angiotensin II are aimed at RESTORING blood volume and BP!   show
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Triggers for RENIN release Pg 974   show
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Other factors affecting GFR   show
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show vasodialatory paracrine counteracts vasoconstriction by norepinephrine and angiotensin II within the kidney. The adaptive value of these opposing action is to prevent renal damage while responding to body demands to increase peripheral resistance  
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Intrarenal angiotensinII   show
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show released as such or produced extracellularly form ATPreleased by macula dense cells. Although it functions as a vasodilator systemically, adenosine CONSTRICTS the renal vasculature  
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anuria   show
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show nephrons cease to function; acute nephritis, transfusion reactions, crush injuries  
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Tubular Reabsorption (reclamation process) pg974   show
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Reabsorbed sustances follow   show
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Trans/cellular Route   show
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Movement in paracellular route between the tubule cells is   show
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show tight junctions are "leaky" and allow some important ions through (Ca, Mg, K, and some Na)  
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Virtually all Organic nutrients are completely reabsorbed   show
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Reabsorption Process is either   show
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show SODIUM IONS are single most ABUNDANT CATION 80% of energy used for active transport is devoted to their reabsorption.  
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show ACTIVE and via TRANS/CELLULAR route  
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2 basic processes that promote active Na reabsorption   show
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From there;   show
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show True  
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SECONDARY active transport (symport or antiport carriers)   show
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via FACILITATED DIFFUSION through channels, this occurs   show
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show Reabsorption of Na by primary active transport provides energy and means for reabsorbing almost every other substance, even WATER  
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show glucose, amino acids, lactate, and vitamins; Luminal carrier moves Na DOWN concentration gradient as it co transports (SYMPORTS) another solute  
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show basolateral memebrane before moving into the peritubular capps  
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show reflects number of transport proteins in the renal tubules available to ferry each substance; Generally plenty of transporters; Tm high for glucose and few for substance of no use  
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when Transport are saturated (all bound to substances)   show
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Passive tubular reabsorption Pg 975   show
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show transmembrane proteins; form water channels across cell membranes  
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Aquaporins in continuously water-permeable regions   show
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this water flow is called Obligatory water reabsorption   show
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Aquaporins are virtually absent   show
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show concentration of solutes in filtrate increases and begin to follow gradients into peritubullar capps  
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Solute following solvent   show
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show they will follow their concentration gradients and be reabsorbed, even if this is "not desirable"  
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Reabsorption capabilities of Renal Tubules and Collecting Ducts pg976 Pg976   show
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show PCT cells most active in reabsorption; Normally absorb all glucose, lactate, and amino acids and 65% of Na and water; 80% of bicarbonate, 60% of Cl, and 55% of K.  
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Bulk of reabsorption of electrolytes is accomplished by the time filtrate reaches loop of Henle   show
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Loop of Henle   show
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Water can leave the DESCENDING loop but not ASCENDING loop   show
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show True  
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show it leaves descending (but not ascending) limb of Henle and OPPOSITE is true for SOLUTES  
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Virtually NO solute reabsorption occurs in the descending limb, but   show
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In THIN PORTION of ascending limb   show
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Na+ -K+ -2Cl symporter is main means of Na entry at lumina surface in THICK PORTION of ascending limb   show
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Na -K ATPase operates   show
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show has Na -H antiporters  
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50% of sodium passes via paracellular route in thick region   show
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show by time DCT is reached only 10% of originally filtered NaCl and 25% of water remain in tubule  
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Most reabsorption from this point on depends on the bodies needs   show
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show so reabsorption of more water depends on presence of ADH, which insert aquaporins  
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show decreased BV or BP, low extracellular Na concentration (hyponatremia), or high extracellular K concentration (hyperkalemia) can cause adrenal cortex to release aldosterone to the blood  
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Except for hyperkalemia (which directly stimulates the adrenal cortex to secrete aldosterone)   show
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show without aldosterone, much less Na is is reabsorbed , resulting in Na losses of about 2% of Na filtered daily an amount IMCOMPATIBLE WITH LIFE  
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show increase BV , and therefor BP, by enhancing Na reabsorption. Also reduces K concentrations because it induced reabsorption of Na is couple to K secretion in principal cells. That is Na enters K moved into lumen  
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Atrial natriuretic peptide (ANP) reduces   show
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show another way is TUBULAR SECRETION  
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show essentially reabsorption in reverse; H, K NH, creatinine and certain organic acids either move into the filtrate from the peritubular capps through the tubule cells or are synthesized in the tubule cells and secreted.  
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show with one major exception, (K) the PCT is the MAIN site of SECRETION, but the cortical parts of the COLLECTING DUCTS are also active  
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Tubular secretion is important for; Pg 978   show
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Regulation of Urine Concentration and volume pg979 Pg 979   show
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show number of solute particles dissolved in 1 kg of water and reflects solution's ability to cause osmosis  
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1 osmol (equivalent to 1 mole of particles)   show
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Kidneys keep the solute load of body fluids constant at 300 mOsm   show
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Countercurrent mechanisms   show
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Countercurrent mechanisms are   show
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Vasa Recta blood vessels are   show
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Osmolality of filtrate entering PCT is identical to plasma, 300 mOsm   show
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Osmolality increases from 300 to 1200 mOsm in the deepest part of the medulla   show
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show true  
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show 1)descending limb of loop is relatively impermeable to solutes and freely permeable to water 2) ascending limb is permeable to solutes, but not to water  
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show Urea enters the filtrate by facilitated diffusion in ascending thin limb; water reabsorbed; now highly concentrated is transpired by facilited diffusion out of tubule into IF of the medulla, forming pool of urea; recycles back into thin limb  
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ADH, stimulates exertion of urine,   show
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show maintaining gradient ; blood flow is sluggish;passive exchanges w/ IF. as blog flows into medullary depths, it LOSES water and GAINS sal (hypersonic). as it emerges from medulla to cortex, it picks up water and loses salt  
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Water picked up by ascending vasa includes not only water lost from descending vasa, but water reabsorbed form loop   show
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Vessels of the vasa recta act as   show
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Formation of Dilute or Concentrated Urine Pg 981   show
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show controlling reabsorption of water from filtrate order to adjust the body's osmalality  
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show When ADH is not ring released; the collecting ducts remain essentially impermeable to water du to absence of aquaporins in luminal cell membranes, and no further water reabsorption occurs  
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show osmolality of urine can plunge as low as 50 mOsm about one sixth the concentration of glomerular filtrate or blood plasma  
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show formation of concentrated urine depends on medullary osmotic gradient and the presence of ADH  
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show as filtrate flows through the collecting ducts and is subjected to hyperosmolar conditions, water rapidly leaves followed by urea  
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show urine concentration my rise as high as 1200 mOsm, the concentration of IF in the deepest part of the medulla  
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Maximal ADH secretion,   show
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Ability of our kidneys to produce such concentrated urine is   show
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Facultative water reabsorption   show
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show any event that raises plasma osmolality above 300 mOsm, such as sweating diarrhea, or reduced BV or BP  
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Release of ADH is the "signal" to produce concentrated urine that opens the door for water reabsorption (through aquaporins)   show
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show several types; chemicals that enhance urinary output  
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show substance that is not reabsorbed and that carries water out with it  
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show other diuretics increase urine flow by inhibiting Na reabsorption and the obligatory water reabsorption that normally follows.  
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show common diuretics inhibit Na associated symporters.  
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Loop diuretics (like furosemide(lasix)   show
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show refers to volume of plasma that is cleared of a particular substance in a given time(usually 1 min)  
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Renal Clearance Test are done   show
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Renal clearance rate (RC)   show
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show freely filtered and neither reabsorbed nor secreted by the kidneys; is standard used to determine the GFR  
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show has a renal clearance value equal to GFR; when inulin is fused such that its plasma concentration is 1mg/ml(P = 1mg/ml), then generally U =125 mg/ml, and V = 1 ml/min. Therefor RC = (125 x 1)/1 = 125 ml/min  
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Meaning that   show
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show GFR of less than 60 ml/min for at least three months  
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Renal failure   show
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show color and transparency; UROCHROME, a pigment that results from the body's destruction of hemoglobin  
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More concentrate the urine, the deeper the yellow color   show
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cloudy urine   show
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show fresh is slightly aromatic, but let stand it develops ammonia odor as bacteria metabolize its urea solutes  
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uncontrolled DM urine smells fruity   show
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show usually slightly acidic (pH 6) changes in body metabolism or diet may cause the pH to vary form 4.5 to 8.0.  
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A predominantly acidic diet that contains large amount of protein and whole wheat products produces acidic urine   show
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show urine is water plus solutes, a given volume has a greater mass than the same volume of distilled water; ratio of mass to mass of equal volueme of distilled water is SPECIFIC GRAVITY; distilled water 1.0; Urine ranges from 1.001 to 1.035  
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show 95% water; 5% solutes;  
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largest component of urine by weight, apart form water, is UREA   show
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show in urea, include uric acid (end product of nucleic acid metabolism) and creatinine (metabolite of creatine phosphate which stores energy for regeneration of ATP. Found in large amounts in skeletal muscle tissue  
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show urea, Na, K, PO, SO, creatinine, and uric acid; much smaller but highly variable amounts of Ca, Mg, and HCO are also present  
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show true  
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Ureters Pg 985   show
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Any increase in bladder pressure   show
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show transitional epithelium of its lining MUCOSA is continuous w/ that of kidney pelvis superiorly and bladder medially; Middle MUSCULARIS two smooth muscle sheets (internal longitudinal layer, external circular layer)cont'd  
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show true  
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Ureter plays an active role in transporting urine;   show
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show strength and frequency of peristaltic waves are adjusted to the rate of urine formation  
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Each ureter is INNERVATED by both SYMPATHETIC and PARASYMPATHETIC fibers   show
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show smooth, collapsible, muscular sac; stores urine temporarily;  
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show both ureters and urethra  
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Trigone   show
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show mucosa(transitional epithelium) Thick muscular layer Fibrous adventitia (except on its superior surface)  
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Detrusor muscle   show
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Rugae   show
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show 12cm (5inches); holds 500 ml (1 pint); Can hold double; When tense w/ urine it can be palpated well above the pubi symphysis; MAX capacity 800-1000ml  
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Urethra Pg 987   show
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show at bladder-urethra junction; thickened detrusor smooth muscle; involuntary; UNUASUAL in that contraction OPENS, relaxation CLOSES it  
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External urethral sphincter   show
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show also serves as a voluntary constrictor of the urethra  
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Female urethra   show
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show external opening; lies anterior to vaginal opening and post to clit  
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Male urethra   show
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show runs w/in prostate  
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show runs through the urogenital diaphragm, extends about 2cm from prostate to beginning of penis  
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Spongy urethra (15cm)   show
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Micturition (urinate) Pg 988   show
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Detrusor muscle and its internal urethral sphincter   show
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External urethral sphincter is   show
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Spinal reflex coordinate the process of micturition   show
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show as a result, detrusor muscle contracts nad internal sphincter opens; Visceral afferent impulses also inhibit tonically active somatic effernts that keep the external urethral sphincter closed  
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by age 2 descending circuits have matured enought to begin to override relexive urination   show
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show which acts to inhibit urination by suppressing parasym and enhancing symp output to bladder  
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Choose not to void   show
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show 3 different sets of kidneys develop from the UROGENITAL rigdges, paired elevations of the intermediate mesoderm that give rise to both urinary organs and reproductive organs  
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Pronephros   show
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show connects pronephros to cloaca; it is retained and used by later developing kidneys  
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show true  
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show 2nd renal system claims the pronephric duct (now called mesonephric duct); these degenate once the 3rd set makes their apperance  
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Metanephros (after Kidneys)   show
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show become ureters  
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show true  
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as metanephros develope   show
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Urinary bladder and the Urethra develope   show
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show male infants only; orifice is located on the ventral surface of the penis  
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show disorder; presence of many fluid filled cysts in kidneys; cause renal failure  
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show 1500 ml/day  
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