The movements of breathing are innervated from a nervous centre situated in the medulla oblongata, in the grey substance of the floor of the fourth ventricle a little above the point of the calamus scriptorius. The part above this may be sliced away without stopping the respiratory movements, but they completely cease when the part indicated is destroyed.
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The kidneys lie on either side of the spine in the retroperitoneal space between the parietal peritoneum and the posterior abdominal wall, well protected by muscle, fat, and ribs. They are roughly the size of your fist, and the male kidney is typically a bit larger than the female kidney. The kidneys are well vascularized, receiving about 25 percent of the cardiac output at rest.
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Having reviewed the anatomy and microanatomy of the urinary system, now is the time to focus on the physiology. You will discover that different parts of the nephron utilize specific processes to produce urine: filtration, reabsorption, and secretion. You will learn how each of these processes works and where they occur along the nephron and collecting ducts. The physiologic goal is to modify the composition of the plasma and, in doing so, produce the waste product urine.
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All systems of the body are interrelated. A change in one system may affect all other systems in the body, with mild to devastating effects. A failure of urinary continence can be embarrassing and inconvenient, but is not life threatening. The loss of other urinary functions may prove fatal. A failure to synthesize vitamin D is one such example.
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The kidney is covered by a fibrous capsule, which is slightly attached at its inner surface to the proper substance of the organ by means of very fine bundles of areolar tissue and minute blood vessels.
From the healthy kidney, therefore, it may be easily torn off without much injury to the subjacent cortical portion of the organ. At the hilus of the kidney, it becomes continuous with the external coat of the upper and dilated part of the ureter.
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The major hormones influencing total body water are ADH, aldosterone, and ANH. Circumstances that lead to fluid depletion in the body include blood loss and dehydration. Homeostasis requires that volume and osmolarity be preserved. Blood volume is important in maintaining sufficient blood pressure, and there are nonrenal mechanisms involved in its preservation, including vasoconstriction, which can act within seconds of a drop in pressure. Thirst mechanisms are also activated to promote the consumption of water lost through respiration, evaporation, or urination. Hormonal mechanisms are activated to recover volume while maintaining a normal osmotic environment. These mechanisms act principally on the kidney.
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