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00:02 | Alright, you guys um up here looking at the exam distribution for exam |
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00:09 | , I think we still have three um exams. So they'll open up |
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00:14 | early next week. Um Anyway so can see average was about 68 which |
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00:19 | great. Uh Hi 96 minimum. so great, but that's okay, |
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00:24 | all have bad days. Um standard deviation you can see it's kind |
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00:28 | , it's still kind of squishing It'd be better if I was around |
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00:31 | but I'll take 16. Uh This putting the exams all three together so |
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00:36 | can see really you guys kind of have found your sweet spot. So |
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00:41 | a class and you know, I looking at last semester's or the last |
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00:44 | I taught the class, so I've last fall and your numbers are like |
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00:48 | points higher than that class. So as a as a unit, as |
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00:52 | group, you guys are actually doing lot better than the previous group and |
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00:56 | think that group was just as bad the one before. So let me |
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01:00 | say you're on the top of the , you're doing good, so I'm |
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01:03 | . You should be happy if I'm . You should be happy. You're |
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01:07 | happy though. Alright, so this the rolling average. This does include |
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01:13 | um but this is 100% accurate because some stuff that I still want to |
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01:17 | in there, but it kind of you a sense, remember no extra |
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01:20 | on this. So if you want just add in your extra credit, |
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01:23 | can figure out what your average is your extra credit. It will shift |
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01:25 | on this, this is not gonna the final average for the class. |
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01:29 | probably will change about a point or along all three of those things. |
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01:33 | it kind of gives you a sense where the A. B. And |
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01:35 | . Range are gonna be remembered. range always starts at 50. So |
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01:40 | B's roughly sees you know the ones here. Um A couple of them |
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01:46 | the ones that didn't take the A couple of those. I think |
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01:50 | three of those are students who actually the class and haven't dropped the |
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01:54 | In other words they've only taken one and they're still enrolled. So um |
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02:00 | looking like right now that there's probably gonna be an F. In the |
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02:02 | unless you guys really screwed things So for those of you who are |
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02:06 | there going I'm failing the class because that's all that's the email I always |
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02:10 | , I'm failing the class and then blah blah and I look at the |
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02:12 | like you're not failing the class you're doing as well as you want |
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02:16 | Um But it looks like we're on to have no f. For the |
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02:19 | . So see this see do you why I'm happy. That makes me |
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02:25 | when there are no f that's a thing. Um We're not gonna talk |
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02:29 | the paper yet. I haven't released grades on blackboard yet for the papers |
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02:33 | blackboard sucks One and two. There's couple things like I said um I |
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02:37 | there's one student actually has a medical for why they didn't do the reviews |
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02:41 | I want to deal with that. um and I just want to deal |
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02:46 | those kind of things and so there's be some small modifications but in essence |
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02:51 | can go and look at your reviews now. Um And I can tell |
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02:56 | how to do the math. You the conversion but it's a real pain |
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02:58 | the butt. So let's not waste time. Um Well, we can |
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03:02 | with that on another day. So I want to do today is I |
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03:04 | to talk about the kids. ma'am. It's a letter grade. |
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03:11 | , no, it's it's it's Yeah. Yeah. Yeah. There's |
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03:15 | . So what I do is so , you maybe you opened up the |
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03:18 | of worms. So here they All right. So you have in |
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03:23 | five reviews. Some of you will four reviews because someone didn't do their |
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03:27 | . But what I usually do is take the fourth, you know, |
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03:29 | you have four reviews, I'll take top review and I'll count it |
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03:31 | So it's not gonna be a penalty you. It's against the person who |
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03:35 | do their review. So do your is number one. All right. |
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03:40 | what I do is I take I take that average and you get |
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03:43 | , get a score based on 1 5. So it's gonna be out |
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03:46 | three decimal places. And then what can do is I convert that to |
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03:50 | numerical score, a perfect one like across the board, that would be |
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03:54 | 50 a perfect five across the That would be 100. But it's |
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03:59 | a direct scale. It's a weird of scale. So I don't want |
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04:03 | do that math, which is, , you're welcome. That was a |
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04:08 | of worms. And that's so if wondering why I'm sitting here going like |
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04:12 | is I not only teach this I also teach a freshman class and |
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04:17 | in a constant state of panic. ? And so I'm literally sieving |
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04:24 | you know, 10, I mean four students of class, 10, |
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04:27 | a day going, what's my What's my grade? What's my |
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04:29 | What's my grade? And it's I don't care. I don't |
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04:33 | I don't know. I don't Um, but you have to say |
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04:36 | politely because when a professor says, don't care and quit emailing me, |
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04:41 | usually get upset about that. So got to find nice ways to |
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04:44 | hey, let's worry about this in weeks when we have some time to |
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04:49 | worry about stuff. I'd rather talk this. This is more fun. |
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04:53 | interesting. And um, I'm I'll lay this out for you. |
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04:57 | think, you know, right, regard to this unit, grades tend |
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05:02 | slip a little bit and that's not function of that. The material is |
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05:06 | . It's because you're going to Right? So you're kind of in |
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05:10 | panic mode, right? You're dealing multiple classes. You have not only |
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05:16 | classes that have a test, but also have a test and a |
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05:19 | So you're gonna be really busy. so your time is gonna be heavily |
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05:24 | between a lot of things. That's number one. Number two, |
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05:28 | covering a lot of stuff in this . We cover the kidneys, digestive |
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05:32 | in the Quran and the reproductive And if you go back and look |
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05:36 | the stuff that we've covered previously, usually cover two systems at the |
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05:40 | Right? So, it's kind of jammed in there. But the good |
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05:44 | about this section is that all the are tube systems. And so when |
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05:48 | studying tube systems, you're gonna start one end of the tube and you |
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05:51 | your way through the other end of tube, right? It's like trying |
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05:54 | describe, for example, a car . You start at one end of |
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05:56 | car wash. You put a dirty at one end on the back |
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05:59 | You have a clean car. So asking what do I do along the |
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06:02 | . That's kind of a way to these things is kind of look at |
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06:04 | tube and kind of walk your way the tube and ask the question. |
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06:07 | , it's kind of an easy way organization. Now, here's the pitfall |
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06:11 | this class, reproduction. one. love reproduction, but I'm not gonna |
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06:14 | a jerk about it. All In other words, the whole test |
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06:17 | about reproduction, even though I wish was. I wish I could talk |
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06:19 | five lectures. There used to be reproductive class I used to teach. |
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06:23 | they have me teaching this because this a great. Need for this. |
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06:26 | it was 27 lectures on reproduction. you imagine talking 27 lectures on? |
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06:32 | still not enough. As far as concerned, there ain't enough time to |
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06:35 | about reproduction. Alright. But we're gonna have two. If |
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06:38 | three lectures on reproduction. Here's the . You're under pressure. You got |
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06:44 | to study. You're gonna look at and go, I know how my |
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06:47 | works. That's easy. What I understand is the opposite sex. |
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06:51 | you'll end up studying the opposite You'll miss all the questions. |
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06:55 | if there are eight questions on female , ladies, that is 16 points |
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06:59 | you're probably gonna get taken off of exam. If you do not study |
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07:03 | reproduction. Men. Same thing. questions that's probably 16 points on male |
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07:10 | . And you're gonna sit there and are easy. Women are complicated, |
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07:13 | know, and you're gonna miss the questions. So, be sure not |
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07:17 | skip over your own sex. It's important because it's more complicated than |
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07:23 | think it is. All right. I'll make some pretty lot of bold |
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07:29 | at the beginning of these lectures. , to kind of wake you up |
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07:32 | offend you a little bit to kind say, I'm gonna prove you |
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07:35 | Dr Wayne. We're gonna have some . All right. Anyway, |
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07:41 | with that in mind, the reason say all that is that I think |
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07:44 | all the stuff that we're gonna cover is usually the most difficult. And |
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07:49 | not saying it's the most difficult stuff . It's not Pekin. Alright. |
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07:53 | just there's some things in it that a little bit complicated. Make you |
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07:56 | of have to pause and go, a second. I'm not sure if |
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07:59 | get this. And it's usually in next lecture. All right. |
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08:02 | it's not this lecture. This is anatomy and kind of looking at the |
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08:05 | picture to kind of get a sense what's going on in the kidney and |
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08:08 | next one deals with some physiology. just seems a little bit when I |
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08:13 | in your when I was in your . I look first time I |
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08:15 | I was like, I don't get . And I don't want to |
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08:16 | So, I sat there with la la la la. The second time |
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08:19 | took physiology as a grad student, did the exact same thing. |
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08:22 | la la la la la la Third time I did it, you |
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08:26 | , it's like, I'm still not learn this and I had to actually |
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08:28 | a class I had to learn. I was like, oh, this |
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08:30 | really as hard as I thought it . I just put my own barriers |
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08:34 | to make sure I didn't learn All right. So, I'm just |
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08:37 | you now, don't put your barriers if you get lost and you're |
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08:39 | I don't get it. Just We'll we'll we'll walk through it and |
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08:43 | to understand it. Okay, Because is not as bad. But once |
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08:47 | get past kidney, it's literally it's downhill. So, and this |
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08:53 | like, it's not like this is hard. So when we talk about |
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08:56 | renal system or urinary system, we're be covering these different structures. The |
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09:00 | ureter urinary bladder and urethra in a , very general sense kidneys are forming |
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09:05 | urine pass the urine that you make the kidneys down to the bladder. |
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09:09 | bladder stores the urine until it's time make sure it that to go to |
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09:14 | bathroom or p in english. And finally, the urethra is a little |
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09:19 | two between the bladder and the And it also serves a unique function |
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09:24 | males and that it's also a duck the passage of even during copulation or |
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09:31 | in the reproductive system. But in very general sense, your kidneys are |
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09:35 | gonna be producing urine. So you to store this because right now you're |
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09:40 | going to the bathroom, I Right? I mean, but you're |
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09:46 | making urine and so you need to the storage. So there's a time |
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09:50 | a place and that's what we all to do. Hopefully, when we're |
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09:53 | younger, um in terms of this is the big picture again, |
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09:59 | what we're dealing with, is filtering blood and removing the waste products from |
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10:02 | blood. All right, So this a conditioning organ. Its job is |
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10:07 | condition the blood and what we're gonna making is we're initially going to be |
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10:12 | what is called infiltrate. In other , we haven't selected and actually created |
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10:16 | . And then over through the course the actual micro structures of the |
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10:20 | we're going to create the union. , the fluid that leaves the kidney |
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10:24 | urine, the kidneys. The fluid in the kidney is called filtration. |
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10:29 | right. And so that ultimately the system is responsible for eliminating that urine |
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10:33 | those pathways. Now, there are functions which we don't really get |
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10:38 | Alright, so this is when we kidney, that's what we think up |
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10:41 | . But it also plays a role forming calc trial. That's vitamin |
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10:45 | Three um it helps to produce and erythropoietin to regulate the production of red |
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10:51 | cells which we talked about in a general sense. It regulates ion levels |
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10:56 | your in your body. Um It a role in water water based or |
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11:01 | uh solute balance and thus also blood and it plays a role in acid |
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11:06 | bounds which in conjunction with the So there's a whole bunch of other |
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11:11 | that that it that it governs. because of the limit of the class |
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11:16 | don't get to talk about all that . Um It also has the potential |
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11:21 | produce glucose for the in the process glucose neurogenesis when your body needs |
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11:26 | But the big picture needs condition the . All right. So that's what |
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11:33 | looking at. We're gonna be looking those those questions of really the elimination |
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11:37 | and less about the other aspects of . Alright so this is your |
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11:42 | Um it is primarily responsible for maintaining stability of your E. C. |
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11:49 | . Volume. So that's the amount fluid that's in your body. Your |
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11:53 | composition of your blood as well as body as well as its osmolarity or |
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11:58 | you can say as morality as So what do we do? We |
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12:02 | just modify how much water we're putting and pulling out of the fill trait |
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12:07 | we're making that Phil traits so that composition of the urine is going to |
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12:11 | depending upon the state of our So if we're dehydrated, we're gonna |
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12:15 | to hold on the water more We're going to basically try to hold |
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12:20 | the water. But if we have much water and body, we're just |
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12:23 | to try to release it. All . So it's conservation or elimination is |
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12:27 | goal here. So structurally, there's things that we need to be aware |
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12:33 | . All right. And some of things probably go a little bit further |
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12:36 | we need to know. But it's so that we can kind of move |
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12:39 | way around the structure of the So, everything you see here in |
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12:43 | on the edge that is called the . It's the outer region. Everything |
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12:47 | that. The thing that looks like little onions and the yellow stuff that |
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12:50 | be considered the medulla. Alright, cortex, for any structure is always |
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12:55 | medulla is always internal. We have columns. The renal columns are basically |
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13:00 | projections in between that kind of separate the the medulla into these different |
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13:07 | And then in between the columns. are going to be the renal |
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13:10 | The pyramids look like shells in this . But you can see here, |
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13:15 | got the base of the pyramid and apex of the pyramid, like |
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13:19 | so they have the straight appearance. the reason for that is because of |
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13:22 | micro structure, which is where we're to be spending our time. And |
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13:26 | they do is we refer to the of the medulla, in the in |
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13:30 | cortex here at the base of the . So that's the cortical medullary |
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13:36 | And the reason this is important is these two regions are very different from |
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13:40 | other in terms of their osmolarity, we'll deal with mostly on Tuesday next |
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13:47 | . And then the apex of the . That is called the renal |
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13:51 | And what they do is they open into these callouses. So the yellow |
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13:55 | here, this is kind of the point where everything kind of converges all |
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14:00 | . And so you have this is referred to as the sinus. So |
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14:04 | have the minor callouses which converge and major callouses. And then the major |
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14:09 | form that renal pelvis which then uh the ureter as you leave out. |
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14:15 | so what you're dealing with is you're urine um at the apex which is |
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14:20 | being collected in the minor Calix. then to the to the major Calix |
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14:25 | then ultimately into the to the pelvis out through the ureter, the region |
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14:31 | which the ureter leaves the artery entry and the vein exits. And there's |
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14:37 | lymphatic vessels there well is referred to the helium and you'll see helium. |
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14:43 | Often referred to any point in an where these things enter in and exit |
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14:47 | . Alright. But this one's really overt. And so there's nerves |
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14:51 | travel in as well. And I'm gonna be asking which nerves are |
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14:54 | But you can see parasympathetic and sympathetic well. All right. So, |
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15:00 | what we've done is we've kind of in and then the micro view. |
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15:03 | this is trying to show you look the pyramid poorly drawn. All |
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15:07 | You can see that we have these going up and down. And what |
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15:11 | really looking at here is what is an Effron. And saffron is the |
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15:16 | unit of the kidney. So, we're going to talk about is taking |
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15:19 | at the level of the saffron and two halves to an Effron. We |
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15:24 | the corpus cell and we have the . And so the way you can |
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15:28 | about this is the core puzzle is point of contact for the blood to |
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15:33 | filtered. Alright, so, it's it's a capillary unit is really what |
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15:37 | is and it's going to come into with the tubular. And what you're |
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15:40 | do is you're gonna be able to the fluid of the plasma through that |
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15:45 | puzzle into the tubular component and then the tube, you'll is the long |
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15:52 | portion that travels all over the And that's where you're taking the |
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15:56 | You're making modifications to it to ultimately the urine. Alright, So both |
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16:03 | these units are gonna be primarily found here in the cortex. But there's |
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16:08 | portion of the tubular portion bad There's a component of the tubular half |
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16:16 | is going to make up the or to be found in the medulla, |
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16:20 | is gonna be the new Franek loop the loop of Henle E. It |
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16:23 | even be pronounced loop of Henle. actually never really looked it up to |
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16:27 | out. And I've heard people pronounce multiple different ways. So you get |
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16:30 | have the benefit of me changing the over and over again throughout the |
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16:35 | All right. So, let's look the core puzzle. All right |
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16:41 | the core puzzle has primarily a vascular to it, but it's going to |
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16:48 | that point of contact where the tube you'll is. And so there's gonna |
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16:52 | a small portion that is tubular in . Alright. And so what we're |
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16:56 | at here, is this going So, it's going in? You |
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17:00 | all this wiggle waggle and then it out again and with that wiggle waggle |
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17:04 | is the capillary aspect. All And so we're looking at here is |
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17:08 | looking at the glamorous Alice. All . So this is the glamorous |
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17:12 | This is the point of contact that blood from or fluid from the blood |
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17:18 | out into the tubular component and the component that it's actually engaged with And |
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17:24 | by. Is this right here, called bowman's capsule. Alright. So |
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17:29 | it is, and the way you think about that, this is like |
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17:31 | blunt ended tube that you pushed into jammed into that capillary unit. |
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17:37 | so you can just think I've got type of capillary that's kind of like |
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17:40 | ball, hence the name. And I've done is I've jammed it in |
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17:44 | push it in. So the capillary right up against epithelium that makes up |
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17:49 | end of the tube and it's between two that you're gonna see filtration taking |
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17:54 | All right, and that's where it all that wiggle waggle and so on |
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17:58 | so forth. The portion that leads that capillary bed is called the different |
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18:06 | . Alright. Different goes in. . It's carrying blood from the body |
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18:11 | this capillary for this process of filtration then on the other side is the |
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18:17 | arterial and this is also carrying blood from that capillary. Now we gotta |
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18:23 | a little bit of fun. You a capillary going in as an |
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18:28 | Do you expect on the other side venue or vein? Alright. But |
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18:33 | be a venue all but here we an arterial capillary arterial, something's not |
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18:41 | , so what's going on here? this is actually a modification of an |
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18:48 | , this glue Maria list. So we've done here is we've taken a |
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18:51 | arterial and we mucked with it. don't know just say tied it into |
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18:56 | bow or something like that. And it's created a capillary system that plays |
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19:01 | role in oxygen or gas exchange. sole purpose is to serve as a |
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19:06 | system between the arterial and that Bowman's . Alright. That that collection |
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19:15 | And so what we're going to see little bit further down is that that |
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19:18 | is then going to go into a system that plays a role in nutrient |
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19:23 | gas exchange. All right. So idea here is this arterial or this |
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19:29 | is not a capillary like everything And so they've kept the two arterial |
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19:35 | on either side, but one goes a different area list. One comes |
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19:40 | different now, Bowman's capsule is the structure, right? This is part |
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19:46 | the tubular component. It's doubled So you can see here is the |
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19:49 | wall and then it comes in and . Goes around the outside. And |
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19:54 | you're looking out there. Those are making making up Bowman's capsule and then |
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19:59 | comes back around the other way. , These type of cells. |
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20:04 | what they are is they're called potus and we're going to come to that |
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20:08 | just a moment. I think I a slide on that. So we |
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20:10 | two poles here as a result of . And so that little space on |
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20:14 | inside is going to be where the is going to collect before it goes |
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20:17 | down the tube and that's what the is? We'll deal with the tube |
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20:20 | just a moment? Alright. Yeah. So the so the glamorous |
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20:29 | is a capillary surrounded by the tubular that line up right next up against |
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20:36 | . All right. So, we'll probably I think we don't have a |
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20:40 | picture here. So we can use portion right here. So, these |
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20:43 | cells, those are the epithelium of capillary, the yellow cells here. |
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20:48 | are the potus sites from Bowman's So, you can see we've created |
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20:53 | special barrier between those two points. . But this space right here collects |
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21:00 | , right? It's not interstitial It's within the tube itself. And |
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21:04 | tube keeps going on. This is a bulge in the at the end |
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21:06 | the tube. Okay, So this a filtering system is what we've |
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21:13 | Yeah, only a small portion. ? Because if all your blood went |
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21:21 | that on the other side would be sledge. Which would be bad because |
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21:26 | is harder to push. So it's I think the number is 20%. |
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21:31 | can't remember exactly. All right. , what we say is when we |
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21:35 | at this corpus of what we say we have a vascular half and we |
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21:39 | a tubular half, or vascular pole a tubular pole. So, when |
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21:43 | hear that term it's just referring to side am I looking at? Am |
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21:46 | looking at the sending side? Am looking at the receiving side? The |
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21:49 | side would be vascular. The receiving is the tubular side. So if |
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21:54 | come to this picture right here, can kind of see this a little |
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21:56 | better um better represented. So here would be Bowman's capsule. Inside Bowman's |
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22:02 | . That would be the glamorous List. And then we have one |
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22:05 | goes in and one that goes The one that goes in is the |
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22:09 | that comes out is different. so that's dealing with the vascular |
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22:15 | The tubular half is what we're seeing . Alright. The tube that's closest |
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22:21 | the glam aerialist or bowman's capsule, way you want to do. It |
|
|
22:25 | called the nearest tube. You'll proximal . Now you can see here that |
|
|
22:31 | actually has a component to it. all uh wiggly, wobbly. I |
|
|
22:37 | know, I'm trying to use a that's not actually in the name. |
|
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22:39 | then it straightens out and then it into something else. That region that |
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|
22:44 | of travels all over the place is to as the convoluted portion. So |
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|
22:48 | have the proximal convoluted tubules. You we got the same and then the |
|
|
22:52 | portion would be the proximal straight You'll but we're just gonna refer to |
|
|
22:56 | as the proximal tubules? Or very you'll see me refer to as a |
|
|
22:59 | convoluted tubules? Because that's where we to focus. And then the tube |
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23:04 | out, dives deep into the goes all the way down to the |
|
|
23:08 | turn and comes all the way back . Now, what we're looking at |
|
|
23:11 | is what is called the loop of E. Right? Or the imaginary |
|
|
23:16 | . It has two portions. The portion is the descending portion, so |
|
|
23:20 | begins first and then it turns around then it becomes the a sending |
|
|
23:24 | And these descending limbs and a sitting are unique in in terms of their |
|
|
23:30 | . Alright, so it's important to able to distinguish them. Lastly we |
|
|
23:34 | the distal tube distal tubules, so loop of Henle comes on out and |
|
|
23:39 | it becomes the distal tube. And you can see we have a convoluted |
|
|
23:42 | against often is referred to as the convoluted tubules and then you're gonna see |
|
|
23:48 | . There's a boundary. So if look right here, there is the |
|
|
23:51 | ending, this is the or the the a sending the parent and the |
|
|
23:55 | arterial. So you can think about like this if my fingers represent the |
|
|
24:02 | and different arterial that my hand represents gloom aerialist. This would be bowman's |
|
|
24:07 | surrounding the glow mary list. My would go off. That would be |
|
|
24:11 | proximal convoluted tubules. So it's to goes on and does its little thing |
|
|
24:15 | then it comes back up and it's the distal convoluted tubules and what it |
|
|
24:19 | is it sits between both the parent the parent. Alright. The point |
|
|
24:25 | it passes through is called the just apparatus. Alright, there's a lot |
|
|
24:33 | parts to this thing right now. does Jackson refer to when you see |
|
|
24:38 | as a prefix next to? So to glamorous Dallas apparatus. So it |
|
|
24:45 | you again to kind of learn what words mean. So it's like, |
|
|
24:49 | , so this tells me something, ? It's the part where it passes |
|
|
24:53 | . Now this is a unique It plays an important role in regulating |
|
|
24:57 | flow of Phil trait. So we'll to that in just a bit. |
|
|
25:03 | , if you look at this picture kind of seeing. Well, the |
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|
25:06 | chose to draw a picture up here the picture down there, right? |
|
|
25:09 | putting tuna franz. Well, there's two different types of different, there |
|
|
25:14 | no franz who are found near the of the cortex and actually kind of |
|
|
25:19 | out up here in the cortex. then there are those that are down |
|
|
25:22 | next to the medulla. So we them the name, we refer to |
|
|
25:27 | as being superficial. This is most the net franzen the body about 80% |
|
|
25:31 | the net franzen your kidney are these ones. And if you look here |
|
|
25:34 | the glamorous up high. If you at the loop of Henle, you |
|
|
25:37 | follow along, there's approximate convoluted there's a straight tube and then we |
|
|
25:41 | into the loop of henley, it down into the medulla and then it's |
|
|
25:46 | , very short and it comes right out again and then off to the |
|
|
25:49 | convoluted tubules. And then we'll get the other structures in just a |
|
|
25:52 | All right, so, they don't do a lot, they just kind |
|
|
25:56 | dip down and come back up. they are missing something we haven't talked |
|
|
26:00 | , but I have to mention it . They lack what is called a |
|
|
26:03 | director. When you see Vanessa, do you think of mm things? |
|
|
26:10 | actually what it refers to. It's vast director refers to vasculature. Um |
|
|
26:15 | is going to be playing an important in regulating the surrounding area. |
|
|
26:21 | The remainder are these jokes, imaginary . Alright. And you can see |
|
|
26:27 | my uh bowman's capsule, it's near medulla. The glamorous places near the |
|
|
26:32 | , approximate convoluted tubules, straight tube into the medulla. And then down |
|
|
26:37 | go and I keep traveling very, deep. And so they have these |
|
|
26:42 | traveling loop of henley's. Alright, they go down deep, they plunge |
|
|
26:47 | the way through the medulla and then come back up and just return back |
|
|
26:51 | where they started. These are the that have the correct to this is |
|
|
26:55 | unique type of para tubular capillary. you hear the word para tubular, |
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|
26:58 | do you hear? Perry Around or . And then tubes tubular tubules, |
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|
27:05 | ? And then capillary, so around the tubes. So, remember we |
|
|
27:10 | when we talked about capillary, there's a cell in your body that is |
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|
27:13 | than 10 microns away from a Para tubular capillaries are the are the |
|
|
27:19 | that surround in our filling up the , doing the job of what capillaries |
|
|
27:22 | expected to do. So this is primary elicits aside as that filtering capillary |
|
|
27:28 | tubular capillaries provide the nutrients and take the waste. All right, it's |
|
|
27:34 | that are really, really important to the unique environment that we're gonna find |
|
|
27:38 | the medulla. It's what is called vertical osmotic gradient. Alright. And |
|
|
27:43 | this gradient that we're going to take of to make the urine of varying |
|
|
27:48 | densities or water concentrations. And so is why you can pee out very |
|
|
27:54 | urine or make urine. That's like , deep, dark gold. And |
|
|
28:00 | the truth is is that you can it down into a g maroon colors |
|
|
28:04 | that's a dangerous point. You don't to go there. Alright. |
|
|
28:08 | continuing on, you can see we have a little region that's referred |
|
|
28:12 | as the collecting tube. You'll so your collecting tubules. And that joins |
|
|
28:16 | with these larger structures that are like . These are the collecting ducts usually |
|
|
28:22 | somewhere between 6 to 12 different franz to one of these collecting ducts. |
|
|
28:28 | they collectively are gathering up the fill and they're pushing that fill trait down |
|
|
28:35 | the pyramid until ultimately they're opening up the minor Calix, which will then |
|
|
28:41 | into the renal pelvis. Now through two different regions there's two different types |
|
|
28:47 | cells. One is called the principal . Why do you think it was |
|
|
28:50 | the principal cell? You could say 1st 1 the most most common. |
|
|
28:59 | they're like, oh there's a lot cells that look a lot alike here |
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|
29:02 | is the principal cell of the that's where they get their name. |
|
|
29:06 | right. They're not principles as in regulating stuff, although they do respond |
|
|
29:11 | tou hormones. We've already seen Aldo and anti diuretic hormone vasopressin. The |
|
|
29:16 | these are the inter collated, sells once in your life. You're gonna |
|
|
29:20 | to learn something that is easily memorize ble Well, I mean, some |
|
|
29:24 | them, but there's two types. Type A. And type B. |
|
|
29:27 | self type A eliminate acid type B bass. Thank you. Person who |
|
|
29:36 | this. It just makes life so . A. For acid B. |
|
|
29:40 | base. We're good. Alright, remember we said that it plays your |
|
|
29:45 | plays a role in regulating acid base . It's through these types of cells |
|
|
29:50 | they're doing it determining which things to or which things to uh to get |
|
|
29:54 | of. All right. So I this we're gonna get to this structure |
|
|
30:01 | aerial apparatus. And so here we , once again, back to this |
|
|
30:05 | . Here's our affair and arterial. our different arterial. There's a glimmer |
|
|
30:10 | this stuff all collectively is referred to the just regular apparatus. That is |
|
|
30:16 | distal tubules. And over there, would be the proximal convoluted tubules over |
|
|
30:21 | . Alright, so, first what do we have? Well, |
|
|
30:24 | have granular cells. Graner cells are of the different arterial. They're being |
|
|
30:30 | right here is these big giant monster . All right. What are |
|
|
30:33 | Well, they're basically smooth muscle And what their job is is to |
|
|
30:38 | respond to sympathetic stimulation to determine, know, the amount of flow going |
|
|
30:44 | the glam aerialists. But they also and store an enzyme called Renan. |
|
|
30:53 | gonna be released into the blood under conditions. Alright. And the specific |
|
|
30:59 | are gonna help us regulate long term pressure, not minute to minute, |
|
|
31:04 | our to our day by day type pressure. So, it's going to |
|
|
31:08 | part of a system we're gonna look on thursday. So, this is |
|
|
31:11 | they're coming from, from these granular on the different arterial we also have |
|
|
31:16 | here, marked in the darker yellow the distal convoluted tubules. The macula |
|
|
31:22 | cells. What their job is to is they monitor the flow of sodium |
|
|
31:28 | through the distal convoluted tubules. Alright they're going to say, hey um |
|
|
31:36 | the sodium chloride levels drop, in words, if the flow of fluid |
|
|
31:41 | the tubular is less than the rate which I'm detecting sodium chloride decreases. |
|
|
31:46 | that's a signal that blood pressure has . And we're gonna see why in |
|
|
31:51 | second. So I'm gonna tell the cells to release the Renan so that |
|
|
31:57 | can raise blood pressure. Alright, I'm monitoring here to have effects here |
|
|
32:04 | will have larger ramifications throughout your whole . And you guys just thought kidneys |
|
|
32:09 | gonna be about getting rid of This is primarily what we deal with |
|
|
32:14 | then all the other cells inside These are extra Massengill cells. There's |
|
|
32:18 | intra cellular Massengill cells. We're not worry about them. Just know that |
|
|
32:23 | exist. They're their function is not established. Um If you guys know |
|
|
32:26 | dr dryer is in the biology anyone Doctor Dryer? No, he |
|
|
32:31 | these these cells and and so but play a role in regulating other things |
|
|
32:36 | are going on there. But they're not significant enough for us to deal |
|
|
32:40 | . I just want to point them . Should I make you memorize all |
|
|
32:46 | . Okay. She said no, we're not going to. Alright, |
|
|
32:49 | I do is I'm just starting this so you can have a visual representation |
|
|
32:52 | so you can see how the Right? So here's the aorta, |
|
|
32:56 | is your name artery? So this when I say named artery, that's |
|
|
32:59 | major artery that goes into the And then you can see that we |
|
|
33:03 | break it down and break it down more and more smaller and smaller |
|
|
33:07 | And you can actually kind of figure . It's like their name for what |
|
|
33:10 | do. So here I'm marking. it's rq it, right? I'm |
|
|
33:15 | . That's cortical radiant, right? in the cortex. So but the |
|
|
33:19 | here is that if you look at notice red always represents oxygen carrying |
|
|
33:24 | Blue always represents you know de And so what we have is we |
|
|
33:29 | red. So it's oxygen carrying. look at where your glamorous is. |
|
|
33:35 | ? It sits in between that a different arterial it doesn't play a role |
|
|
33:40 | gas exchange. It's over here where territorial capital is located, where the |
|
|
33:45 | Sarepta is located. That's where you're see that. And then off you |
|
|
33:51 | back out again through the venus So this is not a thing to |
|
|
33:56 | . It's to understand where the position the glamorous palaces. Alright, It |
|
|
34:01 | within the arterial older structure. Prior where the capillaries are located. They |
|
|
34:07 | not the same thing. You can in this picture uh much better what |
|
|
34:16 | cap players would look like. Do see how they're around the tube I |
|
|
34:20 | it's not a great cartoon, but a cartoon, right? You can |
|
|
34:23 | here, it's like, look, go all over the place, |
|
|
34:27 | And then you can see here these dripping down, you know, just |
|
|
34:30 | of go down, that's still para . But these are the, that's |
|
|
34:34 | vase, Correcto. Alright, so loop of Henley, we said, |
|
|
34:40 | a role in establishing the vertical osmotic . That was its definition, That's |
|
|
34:46 | role the vase, correct to maintains , right? And it's this aspect |
|
|
34:54 | the kidney that becomes the complex and again, that's gonna be a |
|
|
34:58 | thing, but I'm pointing it out that you can kind of put that |
|
|
35:00 | star in your brain and saying this where I'm gonna pay close attention. |
|
|
35:04 | , the loop of Henley is responsible establishing the osmotic gradient. The Va's |
|
|
35:09 | , which runs alongside, like, series of what kind of necklaces are |
|
|
35:14 | called? They know they're not but there's like a series of |
|
|
35:19 | they get longer and longer. I know what they're called. They have |
|
|
35:21 | name to them, but I'm a and I barely understand the names of |
|
|
35:25 | , much less, you know? anyway, that's what it kinda looks |
|
|
35:29 | . Those dripping chains, I don't , but you can see it goes |
|
|
35:33 | the way down, It follows along loop mentally over here on the cortical |
|
|
35:40 | Ephron, you don't have it, still have para tubular up here, |
|
|
35:45 | still parroted around that one. So these are the ones that supplied |
|
|
35:49 | kidney with the blood that needs to to maintain osmotic gradient. So, |
|
|
35:57 | I have one statement on slide is important statement. Yeah. So once |
|
|
36:02 | urine is made, it can't be in composition, nor can it be |
|
|
36:07 | in volume. Alright, so, we talk about the kidney and we |
|
|
36:12 | about the net from we're gonna be with the question of producing fill |
|
|
36:16 | We can modify that all along, all along the lane. But once |
|
|
36:21 | Phil trait becomes urine, it's it you're in it is what it |
|
|
36:25 | and you can't make adjustments to To put that in perspective. Let's |
|
|
36:28 | take that urine and put it into bladder. If it's sitting in your |
|
|
36:31 | , you can't go to your bladder say, you know, I'm feeling |
|
|
36:33 | little dehydrated body. Can't go to bladder and say, I'm gonna pull |
|
|
36:37 | out of the bladder to satisfy that . Alright, so, once the |
|
|
36:43 | is made, it's going out of body. All right now, you |
|
|
36:48 | make adjustments to fill trait. Like second. You're making Phil trait for |
|
|
36:51 | who's dehydrated in about a couple minutes . Now, you got tons of |
|
|
36:55 | . So you can adjust filtration as making it, but once a year |
|
|
36:58 | is made, it can't be changed composition or in its volume. All |
|
|
37:07 | . So are we okay with the structures so far? I know that |
|
|
37:10 | not like I can throw your quiz now and say, hey, let's |
|
|
37:13 | test to see if you know But I mean, we're any of |
|
|
37:16 | structures confusing anything you have a question and I can go back to |
|
|
37:23 | No. Okay. So, what gonna do for the next portion of |
|
|
37:28 | lecture is to talk about these three processes were really spend all our time |
|
|
37:34 | about this today and then these other , I believe are in the next |
|
|
37:39 | . All right. And it's not any one of these things, |
|
|
37:42 | I was right, remember 20%. know, the odds of that happening |
|
|
37:47 | it's like Yeah, Alright, So not that this process is difficult. |
|
|
37:55 | just different aspects to it. And there's lots of things going |
|
|
37:58 | So that's why it takes so And then the rest of this is |
|
|
38:01 | ensuring but but you kind of give a sense of what's going on. |
|
|
38:05 | , with regard to filtration, you're about 20% of your plasma every |
|
|
38:08 | So it's about 125 mils per That's again, think of that uh |
|
|
38:13 | ounce, like your water bottle, up your water bottle. Yeah, |
|
|
38:17 | hold up, it's a quarter of . That's how much your kidney is |
|
|
38:21 | from the blood into the fill trait minute, how much fluid you have |
|
|
38:27 | your body. You guys remember roughly five L. Alright, you're processing |
|
|
38:33 | 180 L per day. So, can imagine 100 and 25 mils per |
|
|
38:38 | . So, let's just do the here in four minutes. That is |
|
|
38:43 | full bottle or 1/10 of all your . Right? So in eight |
|
|
38:49 | that is 20% of your blood, then eight times like 40 minutes. |
|
|
38:54 | all your blood. And so you imagine very quickly that fluid would become |
|
|
38:59 | . And so this is not obviously everything out at once. It's actually |
|
|
39:04 | things back. And that's what the step is, is to take much |
|
|
39:09 | that back. So that the end is that what's traveling through that Phil |
|
|
39:13 | is or really? What what ultimately urine is about one mil per |
|
|
39:18 | So even while you're sitting here every that we talk, you're adding a |
|
|
39:22 | of urine to your bladder. Or roughly one point leaders per |
|
|
39:29 | Now, we're gonna get to I think in this it might be |
|
|
39:32 | another lecture a little further back, I want you to think roughly about |
|
|
39:36 | many times you go to the restaurant day. Give me give me a |
|
|
39:39 | number five. Okay, that's that's that's about right, 57. It's |
|
|
39:47 | vary. It's good. It's gonna around averaging around six times 56 times |
|
|
39:51 | day. All right. Your bladder it's time to empty itself roughly every |
|
|
39:58 | mils. So let's do that math quick. And does that come up |
|
|
40:02 | about that 1.5 liters? Six times day? 250 times four would be |
|
|
40:10 | liter and then two more times So you kind of see, oh |
|
|
40:19 | , if I think about how often go to the bathroom and if I |
|
|
40:21 | I'm around 250 mils roughly, You know, measure if you want |
|
|
40:26 | . But you know, I don't to It comes out about that. |
|
|
40:31 | if you drink more water, like pick up your jug, right? |
|
|
40:35 | you're one of these people, there's wrong with that you're doing. Your |
|
|
40:42 | needs fluid. We're gonna learn when get the digestion. You need to |
|
|
40:45 | in a lot of fluid to do digestion and all the other fun |
|
|
40:50 | You know? But the lies. don't need to drink a gallon of |
|
|
40:54 | every day. You know, you what you need to drink your body |
|
|
40:58 | tell you. All right. But what it roughly comes out to about |
|
|
41:01 | meal per minute or one. And there's other things that we want to |
|
|
41:06 | out of our body quicker than would possible through the process of filtration. |
|
|
41:10 | so a third method or really a process that we're looking at is a |
|
|
41:14 | secretion. And here what we do secretion is there are things in the |
|
|
41:19 | tubular capillaries that are running right next those tubules that are ourselves and say |
|
|
41:25 | have receptors that say this is something we need to get rid of. |
|
|
41:28 | , I'm gonna grab it and I'm put it directly into that Phil |
|
|
41:32 | That's what the process of secretion Alright, so, it's a selective |
|
|
41:36 | of materials that didn't get filtered the time through. All right. And |
|
|
41:41 | the end process of all three of . So this is, you |
|
|
41:45 | pushing things through in an indiscriminate manner then taking things back out. That |
|
|
41:50 | be re absorption and then putting things in. That's secretion. So, |
|
|
41:55 | end of all three of these that's the production of urine. |
|
|
41:59 | your urine is dependent on all three these things. We want to focus |
|
|
42:04 | this first one. So, I want to kind of show you |
|
|
42:06 | So, roughly 20% of the volume your blood is going to be filtered |
|
|
42:10 | . That means 80% stays in your still stays liquidy as opposed to turning |
|
|
42:15 | sludge and then over the course of time, that portion returns back so |
|
|
42:21 | you're only saving back a little bit that fluid. All right. |
|
|
42:24 | what you're really doing here is here the level of filtration it's very |
|
|
42:30 | it's only based on size. So something is too big to be |
|
|
42:34 | it stays out in the blood. if something is small enough to get |
|
|
42:37 | those cells, it's gonna find its into that Phil trait is through the |
|
|
42:43 | of bulk flow. So, there things that you want to hold |
|
|
42:46 | Like, did you have lunch Yeah. Did you work hard for |
|
|
42:51 | glucose? I mean, did you to stand in line? That's that's |
|
|
42:56 | work. Right? I mean, you had to punch something into an |
|
|
43:00 | and you had to make adjustments like times. Because the apple isn't working |
|
|
43:03 | way you want to write. You to get your bonus points right? |
|
|
43:07 | didn't know how to use your bonus to get that free shake. That's |
|
|
43:12 | , right? Like did I spend ? Did I save it? I |
|
|
43:14 | know. You know. So, got glucose that you fought for? |
|
|
43:17 | like your ancestors fought wooly mammoth You fought for that food today. |
|
|
43:23 | in a very different way like What you're eating right now. Did |
|
|
43:26 | take effort to pull up that Sure, Yes. I mean, |
|
|
43:32 | was trauma there for a very short of time because you knew food was |
|
|
43:35 | the other side of that packaging, ? So, that glucose was well |
|
|
43:40 | for kudos to you. You Pass on those genes to your ancestors |
|
|
43:45 | to your descendants. All right. , obviously there are things that your |
|
|
43:50 | wants and you don't want them to be peed out glucose is one of |
|
|
43:56 | . All right. So the reabsorption that the things that your body wants |
|
|
44:02 | put back in and the things that body doesn't want, there is no |
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44:08 | for. Okay, So that's kind the idea here. Now. How |
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44:15 | we get this filtration? Oh back pressures. Do you remember how we |
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44:22 | about those pressures? And you all at me and said please don't make |
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44:25 | do the math. And I said don't have to do the math but |
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44:28 | should know how they're related. those pressures are showing up again, |
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44:32 | that we're not dealing with interstitial We're dealing with our interstitial fluid. |
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44:36 | dealing with the bowman's capsule. But there's still four pressures, |
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44:39 | We have a pressure inside the We have a caller id pressure inside |
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44:43 | capillary. We have a hydrostatic pressure moment space where there's fluid and then |
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44:49 | have a narcotic pressure or an osmotic as well. And so basically they're |
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44:56 | fight against each other and it's going determine the rate of flow and the |
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45:02 | of flow for the fluid is going be going out of the capillaries. |
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45:05 | going to be going in, So all you gotta do is just |
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45:09 | them the right thing. Now, I want you to do here is |
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45:11 | want you to picture for a moment a kid again, remember being a |
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45:16 | , how fun it was, you have to worry about tests and |
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|
45:18 | it was awesome. Did you play in the yard a lot if you |
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45:21 | a yard, did you have a ? We talked about putting your finger |
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45:25 | the hose right now. Do you taking that hose and shove it in |
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45:28 | mouth? Never, you never did . You know, you put a |
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45:34 | in your mouth and you try to the water as fast as you |
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45:36 | You might be able to keep up like maybe a second. But after |
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45:39 | while that water is gonna come around around your lips. Maybe if it's |
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45:44 | , really high pressure might come out nose. Your friends will laugh at |
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45:48 | . Right? So what I want to picture here is I want you |
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45:52 | picture Bowman's capsule like your mouth and want you to picture the glamorous a |
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45:56 | like that hose. Alright? And it in your mouth, right? |
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46:00 | mouth is gonna fill up pretty quickly fluid, right? And what's driving |
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46:04 | ? Is that capillary blood pressure? right now the pressure here is fairly |
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46:10 | , it's actually higher than most places a result. And the reason for |
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46:13 | is because you have an airplane to and it's wide open, right? |
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46:16 | so it's just gonna allow blood to in. You have an different arterial |
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46:20 | well. And what you can do you can restrict and open that one |
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46:23 | needed. So for example if you the blood pressure drops in the area |
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46:29 | , all you gotta do is squeeze different arterial and open up the different |
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46:32 | , you're creating that back pressure. so that fluid is just looking for |
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46:36 | path of least resistance, right? so what you're doing is you're you're |
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46:40 | that blood pressure. Alright now that flows into bowman's space and so it's |
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46:45 | empty space but eventually it fills with just like the hose water fills your |
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46:50 | , right? So it feels very quickly. Now if you're really good |
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46:54 | swallowing you can probably get some of fluid moving away. But eventually the |
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46:58 | into that space is quicker than you swallow. And it's gonna create |
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47:03 | That would be the Bowman space hydrostatic . Alright, so it's just the |
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47:07 | . It's the back pressure. That's this is trying to show you. |
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47:10 | showing you the big p. Is pressure moving in the big P. |
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47:14 | is the pressure moving back out. they're opposite each other, right? |
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47:18 | it's a resisting pressure. And then we deal with osmotic pressures or narcotic |
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47:23 | . Remember those are pulling pressures. so if you have plasma proteins in |
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47:26 | blood which you do, that's gonna water back into the capillaries. And |
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47:32 | you had um plasma proteins out into space then that would pull water this |
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47:38 | . But the filtering system doesn't allow proteins in. So this is actually |
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47:44 | zero. So again, we have consider it because, you know, |
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47:48 | pathologies they may show up but in physiology it doesn't it's zero. And |
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47:56 | we gotta do now is just consider the, you know, the positive |
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48:00 | , the driving pressure together, push negative pressures or the pushing pressures in |
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48:05 | opposite direction and just do the And I think that's what the next |
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48:08 | has Just kind of shows that that would be the net filtration |
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48:13 | The pressure is out. So the here is about 60 of mercury. |
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48:18 | said there's no colloids in there. no plaza protein. So zero pressure |
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48:24 | going the opposite direction. And the here refers into the capillaries versus out |
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48:30 | the capillaries. Again, your frame reference, just remember what in and |
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48:34 | means to you. So here the inside the the narcotic pressure is about |
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48:39 | mm of mercury. The back pressure the hydrostatic pressure is about 18. |
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48:45 | do your math 16 -50. That out to 10. So it's a |
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48:50 | pressure that's driving fluid out into bowman's . Yeah, this one right here |
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49:01 | Yeah, yeah. So what is saying the pressure inside the inside that |
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49:05 | . So there's gonna be pressure inside your capillaries. right? Yeah, |
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49:10 | kind of makes sense? Or did go through that too quickly. So |
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49:14 | idea here is just asking how do create the pressure that drives the fluid |
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49:18 | ? It's a bulk pressure. How we create it? It's from capillary |
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49:22 | pressure, hydrostatic pressure inside Bowman's capsule each other. Oh no, |
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49:26 | we can't forget there's an on Codec that that opposes the movement of the |
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49:32 | in both directions as well. And where those those values come from. |
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49:36 | notice that this pressure is positive. fluid flows from the capillaries into Bowman's |
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49:44 | . So once he goes to bowman's , it can then travel on. |
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49:48 | . What we're looking at here is dealing with pressure that that drives the |
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49:55 | of filtration. Alright, The net pressure is what we use to determine |
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50:02 | rates. Now again, think about hose, you stuck in your |
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50:06 | right? If I turn the hose really low, right? And the |
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50:11 | only dripping a little bit of I can swallow water pretty easily, |
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50:15 | ? But I'm not getting a lot water. The filtration rate is pretty |
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50:19 | , but if I do one little you know, to really to the |
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50:23 | and you'd be like, I'd get lot more. My filtration will be |
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50:27 | lot faster. That's kind of what dealing with here, is that if |
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50:31 | increase this pressure, right? So I have 10 of mercury is my |
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50:36 | ? If I increase this to 12 the rate of filtration increases. If |
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50:40 | increases to 14 the rate of filtration . If I take this and decrease |
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50:45 | from 10 to 8, my rate filtration decreases. So the rate of |
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50:51 | is dependent upon the filtration rate. sorry, the rate of filtration is |
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50:56 | upon the net filtration pressure, F. P. All right now |
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51:02 | is usually a result of one not in any of the others. |
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51:08 | the driving pressure again. Let me back. This one is the big |
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51:13 | . Right, This is the one can adjust. So how do I |
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51:15 | that one bigger? How do I this glamorous or blood pressure greater? |
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51:20 | would be based on the three things are there that we talked about? |
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51:24 | what can we do? I can the different, I can dilate the |
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51:34 | . Right? Or I can do at the same time. Right. |
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51:37 | that would cause that pressure to Is there any way for me to |
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51:42 | ? I mean just this is a , is there any way for me |
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51:44 | change this pressure right here? The inside moment space? Well, if |
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51:50 | could somehow constrict the tubular here to less fluid leave? That would be |
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51:55 | way I don't know if I can that but that would be one |
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51:58 | Right. What's another way that I adjust this? What about this pressure |
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52:08 | this pressure? If this was leaky I allowed plasma proteins, would that |
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52:17 | the pressure? Yeah. Right. you can see that these all have |
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52:22 | impact. But under normal physiological these don't really change all that |
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52:29 | The one that we can change pretty as you just said is gonna constrict |
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52:34 | dilate. I mean that can do instantaneously. In fact you do when |
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52:39 | stand up, your body's blood pressure , right? And so your kidneys |
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52:45 | by adjusting so that their work doesn't . And what you're doing is you're |
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52:51 | that now. If I change that pressure. So if if I increase |
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52:58 | parrot tubular blood pressure that causes the filtration pressure to go up then the |
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53:02 | of sodium chloride which is just circulating your body. And in that fill |
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53:08 | increases in terms of its rate of . And remember we had we had |
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53:11 | macula cells and they're just sitting there and counting sodium chloride. Really there |
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53:16 | sodium but sodium travels with chloride. it's like oh this is the rate |
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53:20 | which sodium is coming. Oh it to be coming faster. Huh? |
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53:24 | does that mean? That means my pressure has gone up. Alright. |
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53:29 | there counting sodium chloride. It's slowing . That's an indicator. My blood |
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53:34 | has dropped. All right. your you can monitor blood pressure simply |
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53:42 | watching the sodium chloride. Right? that increase is a result of that |
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53:50 | is really what I'm trying to get also substances infiltrate, as well as |
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53:54 | drop in the filtration reabsorption rate. in other words, how much my |
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53:58 | back of the body? I can that as well now. How do |
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54:01 | adjust this? How do we make in this filtration rate? Well, |
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54:05 | can do this through a process called regulation. We can do this through |
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54:08 | regulation or hormonal regulation. So you see one is gonna be the kidneys |
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54:12 | it on its own. The other I'm dependent upon factors outside the |
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54:18 | And I want to just focus first these auto regulations. First was biogenic |
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54:22 | the second is to be to below feedback. All right, Before we |
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54:26 | at my agenda, what do you it means muscles? All right. |
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54:31 | is tubular tubes? Talking to the aerialists? Alright. There you |
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54:38 | So, you already see where this going to go. This has got |
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54:40 | do with the macula cells that we talked about. This has to do |
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54:44 | the muscles that are there. All . So, this is really what's |
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54:47 | on on a minute to minute Right? We're trying to determine What |
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54:53 | we need to do to make sure the kidneys maintain their activity. And |
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54:57 | we're it's a pretty broad range. ? We want to maintain somewhere between |
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55:01 | and 100 of mercury inside the So, that's a pretty high |
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55:05 | right? We said the real and enough to just drive things out. |
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55:09 | right. So, when you stand , if your blood pressure drops, |
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55:12 | I'm gonna do is I'm gonna open the a fair and arterials and allow |
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55:15 | to happen. And probably easier if just show you the pictures. All |
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55:19 | . Yeah. Alright. So, gonna we're gonna get to dealing with |
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55:31 | salt in just a moment. But what it is is that your kidneys |
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55:35 | are responsible for determining how much salt in your blood, but through the |
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55:40 | portion of the kidney, except for little area, it basically returns salt |
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55:46 | to the body at a regular So, only one little small portion |
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55:49 | going to be dealing with regulating water balance. Alright. And we'll deal |
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55:53 | that on thursday. So, if don't answer the question, then just |
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55:58 | you suck and just say it politely wayne. I kindly tell you that |
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56:04 | suck or something like that. I know. All right, apologize for |
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56:10 | pictures because they're not meant to express I'm trying to express. All |
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56:14 | But I want you to picture that is normal circumstances. Okay. And |
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56:20 | , what we're trying to do here this picture is basically, say, |
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56:23 | regard to Maya genic regulation. I'm to adjust pressure to ensure that my |
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56:31 | is maintained to do the function of kidney. So, when my general |
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56:35 | pressure changes, I'm trying to maintain constant. Alright, So, what |
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56:40 | saying here is when your blood your systemic systemic blood pressure increases, |
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56:46 | have something we want to do or you're systemic blood pressure decreases. We |
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56:51 | we have something we want to All right. So and again, |
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56:55 | picture is not the best. But , if blood pressure drops, so |
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56:58 | that systemic, then you're smooth muscle going to relax to allow for that |
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57:03 | . So, you guys have already me this is what's gonna happen. |
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57:06 | we're just confirming that we're just establishing that that is true. So, |
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57:11 | going to happen is your affair arterial . When your arterial dilates, that |
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57:16 | more blood flows into the into the , which is a sign of greater |
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57:21 | pressure inside the realist, which means you're going to get a greater filtration |
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57:26 | . All right. So, in words, even though my blood pressure |
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57:29 | dropped, I'm ensuring that that blood to stay low inside the realist. |
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57:35 | bringing it up. That's what we're to get at. And then the |
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57:38 | is true as well. All The idea is that the blood flow |
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57:42 | the or the blood pressure drops in memory list. I'm gonna do one |
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57:45 | two things I can constrict the different . Alright, well, actually, |
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57:51 | here, I can also constrict. was what I was going to is |
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57:54 | see more action on the different side less on the different side. But |
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57:57 | can constrict the different over here. you're doing is primarily I'm going to |
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58:03 | the arterial because that's where all the is coming from. So I'm just |
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58:06 | to reduce the amount of blood coming . So if I reduce the amount |
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58:10 | blood flow into the gloom aerialist that's drop the blood pressure inside the glamorous |
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58:14 | . Which means I'm gonna drop the or filtration rate. Alright so the |
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58:21 | themselves are detecting the drop in All right they're doing the job. |
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58:31 | it's it's staying within that range of and 80. Well the G. |
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58:34 | . R. Is 180 to 1 but the idea is yeah. So |
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58:37 | want my kidneys to just be constantly like this as opposed to having highs |
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58:41 | lows and highs and lows because that problems. Bingo. That's a very |
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58:46 | question. Say it again. Why the, so here what we're doing |
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58:55 | we're we're including the flow of blood just remember this is a resistance vessel |
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58:59 | and so what you're doing is you're it to come through and what you're |
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59:03 | saying I'm not gonna let you come . That's that's the reason why I |
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59:09 | that that aspect of the vasculature is of confusing. It's like when you're |
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59:13 | about moving things from one part to other. When you constrict, |
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59:17 | you're reducing the amount of flow through . But you're also increasing the rate |
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59:22 | maintain well back up, you're increasing flow rate through something, but you're |
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59:29 | um you're trying to maintain a constant from the heart to make sure that |
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59:34 | whole system stays in motion. Thank to become a real feedback. All |
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59:49 | . This is where the macula dinsa are talking to the granular cells. |
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59:56 | , so, here and again. the brain cells are smooth muscle |
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60:00 | so, they're going to constrict and as well. And really what what |
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60:04 | have here, And I'm gonna show two slides to show you this |
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60:07 | This is this is the truth. is the thing that you walk away |
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60:11 | . The second slide is the long for why this happens. All |
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60:15 | Because I've taught this and got halfway it and my brain stalls, and |
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60:20 | started saying the opposite. I've seen gill do the same thing. I've |
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60:25 | dr ogletree do the same thing. right. It's an easy thing to |
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60:29 | confused with. All right. But idea here is if the rate of |
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60:35 | chloride flowing through the filtration goes right, then, what I'm gonna |
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60:40 | is I'm gonna cause vaso constriction. in doing so, I'm going to |
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60:45 | the pressure drop inside the affairs arterial amount of flow through the arterial and |
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60:52 | a drop in the glamorous infiltration So what this is telling us is |
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60:55 | salt is an indicator of flow rate the tube. You'll and then the |
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61:02 | is true as well. Alright, a drop in same card is visa |
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61:06 | . Now these are all the Alright. And there's nothing complicated about |
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61:13 | other than that if you go to than you get lost. Alright, |
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61:18 | we've already talked about G. R. Is dependent upon the blood |
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61:21 | , uh filter. The flow rate the tube is dependent on the |
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61:24 | F. R. So the amount sodium chloride flowing through the tubules is |
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61:29 | upon the filtration rate. All right the rate of sodium reabsorption is going |
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61:35 | be constant in three areas or two , approximate constitutional and luke. |
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61:40 | we know this to be true. , there's specific mechanisms that do |
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61:44 | This constant rate of of reabsorption, only in the distal convoluted tubules. |
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61:51 | that we're gonna see modulation of And this is the question that you're |
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61:55 | of uh alluding to or the thing you're alluding to. So like when |
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61:59 | say it's a high salt diet is for your blood pressure. This is |
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62:03 | they're talking about. Is this you're talking about the other stuff. Okay |
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62:07 | again deal with that at a later . Alright, so this is the |
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62:12 | if you're very low blood pressure That means the glamorous filtration rate |
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62:16 | That means the tubular flow rate drops . If your tubular flow rate drops |
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62:22 | means the amount of sodium passing by macular cells drops right? And so |
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62:29 | it's detecting at a specific rate if sees that concentration go down it says |
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62:36 | problem we need to to adjust. what I need to do is I |
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62:40 | to adjust the gamma real blood So I'm telling the different arterial to |
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62:46 | to increase that blood pressure. And that's why we get all that |
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62:50 | That's why that bison dilation occurs. if you get lost on this turn |
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62:57 | this slide because it just walks you the steps. All right. |
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63:10 | So yes but again that's gonna be the level of the D. |
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63:14 | T. All right. And so is where that that question comes |
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63:19 | Is that oh you mean people with salt diets they have a tendency to |
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63:23 | high blood pressure. Is it a or correlation? It's a really good |
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63:28 | right? Because it's actually kind of it's a little bit of both. |
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63:32 | what your body is doing is it's to maintain a specific osmolarity and by |
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63:37 | an extra salt in your body that is going up and so what it's |
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63:41 | want to do is it's gonna want get rid of it. But we |
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63:44 | what we refer to as a so load as well, how much salt |
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63:48 | your body want? So it's not osmolarity, it's the amount of |
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63:52 | And so if you muck with that going to draw water in and we're |
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63:55 | to deal with the whole that whole of increasing blood volume simply by increasing |
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64:01 | load. Now we can get rid it. But if you keep eating |
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64:05 | you're increasing that load over and over . So all this is done through |
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64:11 | macula Dinsa sells those yellow cells that talking to little uh smooth muscle cells |
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64:18 | with the apparent arterial, that's a regular feedback. Alright. Oh did |
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64:24 | just get through everything? Oh my , what time is it? Holy |
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64:31 | . Maybe I should talk slower. me see. Yeah. So let's |
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64:37 | that the next thing is reabsorption. so with that I mean I guess |
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64:42 | talked really, really fast. Are are there any questions before I let |
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64:48 | out 20 minutes early? Like I like I'm Jipping you, I mean |
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64:51 | paid for an hour and 20 minutes Yeah, bigger. Well so you're |
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65:03 | in terms of the pressures, So so the idea is if you |
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65:06 | think of the tubular being the pressure the tube, you're responding to the |
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65:12 | that's inside the glamorous list. And you want to do is you want |
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65:14 | regulate what's going on into the glam . Alright. So using this as |
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65:20 | feedback tool, right? That's how going to do it. So |
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65:24 | all these things are connected to each but their their their funk connected to |
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65:30 | other, you know, through just physics, right? So if I |
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65:34 | blood volume then the pressure is going naturally go up. So how do |
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65:37 | increase the volume of blood going in same area as well? I just |
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65:41 | , Right? And that's going to more filter more fluid into the |
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65:45 | You'll and that's going to make it faster again. Why? Because increased |
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65:50 | , increased pressure wants to get through finite space quicker because the pressure is |
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|
65:57 | it forward. Does that answer that of I mean, it's kind of |
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66:01 | , but it's it's it's they're intimately to one another because of that. |
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5999:59 | |
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