urinary system c25
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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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