GINJAL KUNCORO PUGUH S
FUNGSI <ul><li>Pengaturan keseimbangan air & elektrolit </li></ul><ul><li>Pengaturan konsentrasi osmolaritas cairan tubuh ...
<ul><li>Excretion </li></ul><ul><ul><li>The removal of organic waste products from body fluids </li></ul></ul><ul><li>Elim...
ANATOMI FISIOLOGI GINJAL ANJING
ANATOMI FISIOLOGI GINJAL SAPI
Figure 26.3  The Urinary System in Gross Dissection Figure 26.3
ANATOMI & FISOLOGI
<ul><li>Cortical nephrons </li></ul><ul><ul><li>~85% of all nephrons </li></ul></ul><ul><ul><li>Located in the cortex </li...
Figure 26.7  Cortical and Juxtamedullary Nephrons Figure 26.7a
Figure 26.7  Cortical and Juxtamedullary Nephrons Figure 26.7b, c
 
<ul><li>Production of filtrate </li></ul><ul><li>Reabsorption of organic nutrients </li></ul><ul><li>Reabsorption of water...
<ul><li>Regulating blood volume and composition </li></ul><ul><li>Excreting waste products </li></ul><ul><ul><li>Urea </li...
<ul><li>Filtration </li></ul><ul><ul><li>Blood pressure  </li></ul></ul><ul><ul><li>Water and solutes across glomerular ca...
Figure 26.9  An Overview of Urine Formation Figure 26.9
<ul><li>Filtration in the kidneys modified by carrier mediated transport </li></ul><ul><ul><li>Facilitated diffusion </li>...
<ul><li>Accomplished via diffusion, osmosis, and carrier-mediated transport </li></ul><ul><li>T m  determines renal thresh...
<ul><li>Superficial outer cortex and inner medulla </li></ul><ul><ul><li>The medulla consists of 6-18 renal pyramids </li>...
NEPHRON <ul><li>Merupakan unit fungsionil terkecil ginjal </li></ul><ul><li>   1 Juta / Ginjal </li></ul><ul><li>Panjang ...
GLOMERULUS <ul><li>Kapsula Bowman : pars visceralis & pars parietalis </li></ul><ul><li>Filter glomerulus : 3 lapis </li><...
Figure 26.10  Glomerular Filtration Figure 26.10
Figure 26.8  The Renal Corpuscle Figure 26.8a, b
Figure 26.8  The Renal Corpuscle Figure 26.8c, d
Figure 26.10  Glomerular Filtration Figure 26.10a, b
<ul><li>Proximal convoluted tubule (PCT) </li></ul><ul><ul><li>Actively reabsorbs nutrients, plasma proteins and ions from...
<ul><li>Glomerular filtration produces fluid similar to plasma without proteins </li></ul><ul><li>The PCT reabsorbs 60-70%...
TUBULUS PROKSIMALIS <ul><li>P = 15 mm </li></ul><ul><li>Tight junction </li></ul><ul><li>Lateral intercellular space </li>...
Figure 26.12  Transport Activities at the PCT Animation: Proximal Convoluted Tubule PLAY Figure 26.12
The loop of Henle and countercurrent multiplication <ul><li>Countercurrent multiplication  </li></ul><ul><ul><li>Between a...
ANSA HENLE <ul><li>Pars decendent : 2- 14 mm </li></ul><ul><li>Pars Ascendent : mithokondria >>, Sel Junxtaglomerular vas....
Figure 26.13  Countercurrent Multiplication and Concentration of Urine Figure 26.13a
Figure 26.13  Countercurrent Multiplication and Concentration of Urine Figure 26.13b
Figure 26.13  Countercurrent Multiplication and Concentration of Urine Figure 26.13c
<ul><li>Distal convoluted tubule (DCT) </li></ul><ul><ul><li>Actively secretes ions, toxins, drugs </li></ul></ul><ul><ul>...
<ul><li>DCT performs final adjustment of urine </li></ul><ul><ul><li>Active secretion or absorption </li></ul></ul><ul><li...
TUBULUS DISTALIS <ul><li>P = 5 mm </li></ul><ul><li>Ephitel lebih pipih dari ephitel tubulus proksimalis </li></ul><ul><li...
Figure 26.14  Tubular Secretion and Solute Reabsorption at the DCT Figure 26.14 Animation: Distal Convoluted Tubule PLAY
Figure 26.14  Tubular Secretion and Solute Reabsorption at the DCT Figure 26.14c
Reabsorption and secretion along the collecting system <ul><li>Water and solute loss is regulated by aldosterone and ADH <...
DUKTUS COLLIGENTES <ul><li>P = 20 mm </li></ul><ul><li>Menampung beberapa tubulus distalis </li></ul><ul><li>Ber muara di ...
Figure 26.6  A Representative Nephron Figure 26.6
Figure 26.5  The Blood Supply to the Kidneys Figure 26.5c, d
Figure 26.5  The Blood Supply to the Kidneys Figure 26.5a, b
SUPLAI DARAH GINJAL
 
<ul><li>RENAL FRACTION </li></ul><ul><li>Vasa afferent glomerulus  membentuk vasa recta </li></ul><ul><li>Renal Blood Flow...
KECEPATAN ALIRAN DARAH TIAP 100 g JARINGAN 3 54 58 84 420  Otot Skelet Otak Hati Otot Jantung Ginjal BLOOD FLOW (ml / min ...
ALIRAN CAIRAN DLM TUBUH 65 15 10 9,3 0,7 125 45 25 12 1 Tubulus Proksimal Ansa Henle Tubulus Distalis Duct. Colligentes Ur...
REABSORPSI ELEKTROLIT <ul><li>( kation ) perlu dikendalikan, bila berubah : kegagalan faal ginjal </li></ul><ul><li>K+ > :...
<ul><li>Amount of filtrate produced in the kidneys each minute </li></ul><ul><li>Factors that alter filtration pressure ch...
GLOMERULAR FILTRATION RATE  ( GFR) <ul><li>Jumlah filtrat yg disaring dr plasma dalam satu menit </li></ul><ul><li>Normal ...
<ul><li>A drop in filtration pressure stimulates Juxtaglomerular apparatus (JGA) </li></ul><ul><ul><li>Releases renin and ...
FAKTOR YG MEMPENGARUHI <ul><li>Perubahan Tek. Darah </li></ul><ul><li>Tek. Darah umum </li></ul><ul><li>Status vasa affere...
<ul><li>Perubahan Tekanan Capsular :  Obstruksi, Edema jaringan </li></ul><ul><li>Perubahan Tek. Osmotik Koloid : Dehidras...
FILTRASI GLOMELURUS <ul><li>Effective Filtration Pressure (EFP) </li></ul><ul><li>Tek. Darah – Tek Capsular – Tek Koloid O...
DIURETIKA <ul><li>Zat yg dpt meningkatkan kec.pembentukan urine </li></ul><ul><li>Cara : </li></ul><ul><li>Meningkatkan GF...
MENINGKATKAN GFR <ul><li>Cara :  </li></ul><ul><li>Tek darah > </li></ul><ul><li>Vasodilatasi vasa afferent </li></ul><ul>...
BEBERAPA JENIS OBAT <ul><li>EPINEPHRINE :  Tek darah       Tek Caps Bowman       GFR      Diuresis   </li></ul><ul>...
MENINGKATKAN MUATAN OSMOTIK TUBULUS <ul><li>Mempunyai efek terutama di tub. Proks: Ureum, Sukrosa, Manitol, Glukosa </li><...
Menghambat ADH <ul><li>ADH       reabsorpsi H2O di Ductus colligentes       diuresis  </li></ul><ul><li>Alkohol, nark...
Figure 26.11  The Response to a Reduction in the GFR Figure 26.11a
Figure 26.11  The Response to a Reduction in the GFR Figure 26.11b
Figure 26.16  A Summary of Renal Function Figure 26.16a
Figure 26.15  The Effects of ADH on the DCT and Collecting Ducts Figure 26.15
Figure 26.15  The Effects of ADH on the DCT and Collecting Ducts Figure 26.15a, b
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Ginja lwarnaanimal2010

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Ginja lwarnaanimal2010

  1. 1. GINJAL KUNCORO PUGUH S
  2. 2. FUNGSI <ul><li>Pengaturan keseimbangan air & elektrolit </li></ul><ul><li>Pengaturan konsentrasi osmolaritas cairan tubuh & elektrolit </li></ul><ul><li>Pengaturan keseimbangan asam basa </li></ul><ul><li>Ekskresi hasil sisa metabolisme </li></ul><ul><li>Pengaturan tekanan arteri </li></ul><ul><li>Sekresi hormon </li></ul><ul><li>Glukoneogenesis </li></ul>
  3. 3. <ul><li>Excretion </li></ul><ul><ul><li>The removal of organic waste products from body fluids </li></ul></ul><ul><li>Elimination </li></ul><ul><ul><li>The discharge of waste products into the environment </li></ul></ul><ul><li>Homeostatic regulation of blood plasma </li></ul><ul><ul><li>Regulating blood volume and pressure </li></ul></ul><ul><ul><li>Regulating plasma ion concentrations </li></ul></ul><ul><ul><li>Stabilizing blood pH </li></ul></ul><ul><ul><li>Conserving nutrients </li></ul></ul>Functions of the urinary system
  4. 4. ANATOMI FISIOLOGI GINJAL ANJING
  5. 5. ANATOMI FISIOLOGI GINJAL SAPI
  6. 6. Figure 26.3 The Urinary System in Gross Dissection Figure 26.3
  7. 7. ANATOMI & FISOLOGI
  8. 8. <ul><li>Cortical nephrons </li></ul><ul><ul><li>~85% of all nephrons </li></ul></ul><ul><ul><li>Located in the cortex </li></ul></ul><ul><li>Juxtamedullary nephrons </li></ul><ul><ul><li>Closer to renal medulla </li></ul></ul><ul><ul><li>Loops of Henle extend deep into renal pyramids </li></ul></ul>Two types of nephron
  9. 9. Figure 26.7 Cortical and Juxtamedullary Nephrons Figure 26.7a
  10. 10. Figure 26.7 Cortical and Juxtamedullary Nephrons Figure 26.7b, c
  11. 12. <ul><li>Production of filtrate </li></ul><ul><li>Reabsorption of organic nutrients </li></ul><ul><li>Reabsorption of water and ions </li></ul><ul><li>Secretion of waste products into tubular fluid </li></ul>Nephron functions include:
  12. 13. <ul><li>Regulating blood volume and composition </li></ul><ul><li>Excreting waste products </li></ul><ul><ul><li>Urea </li></ul></ul><ul><ul><li>Creatinine </li></ul></ul><ul><ul><li>Uric acid </li></ul></ul>Urine production maintains homeostasis
  13. 14. <ul><li>Filtration </li></ul><ul><ul><li>Blood pressure </li></ul></ul><ul><ul><li>Water and solutes across glomerular capillaries </li></ul></ul><ul><li>Reabsorption </li></ul><ul><ul><li>The removal of water and solutes from the filtrate </li></ul></ul><ul><li>Secretion </li></ul><ul><ul><li>Transport of solutes from the peritubular fluid into the tubular fluid </li></ul></ul>Basic processes of urine formation
  14. 15. Figure 26.9 An Overview of Urine Formation Figure 26.9
  15. 16. <ul><li>Filtration in the kidneys modified by carrier mediated transport </li></ul><ul><ul><li>Facilitated diffusion </li></ul></ul><ul><ul><li>Active transport </li></ul></ul><ul><ul><li>Cotransport </li></ul></ul><ul><ul><li>Countertransport </li></ul></ul><ul><li>Carrier proteins have a transport maximum (T m ) </li></ul><ul><ul><li>Determines renal threshold </li></ul></ul>Carrier Mediated Transport
  16. 17. <ul><li>Accomplished via diffusion, osmosis, and carrier-mediated transport </li></ul><ul><li>T m determines renal threshold for reabsorption of substances in tubular fluid </li></ul>Reabsorption and secretion
  17. 18. <ul><li>Superficial outer cortex and inner medulla </li></ul><ul><ul><li>The medulla consists of 6-18 renal pyramids </li></ul></ul><ul><ul><li>The cortex is composed of roughly 1.25 million nephrons </li></ul></ul><ul><li>Major and minor calyces along with the pelvis drain urine to the ureters </li></ul>Sectional anatomy of the kidneys
  18. 19. NEPHRON <ul><li>Merupakan unit fungsionil terkecil ginjal </li></ul><ul><li> 1 Juta / Ginjal </li></ul><ul><li>Panjang seluruh nephron = 45 – 65 mm </li></ul>
  19. 20. GLOMERULUS <ul><li>Kapsula Bowman : pars visceralis & pars parietalis </li></ul><ul><li>Filter glomerulus : 3 lapis </li></ul><ul><li>Endhotelium kapiler :100nm </li></ul><ul><li>Lamina basalis :8 nm </li></ul><ul><li>Epithel Pars viceralis kapsula Bowman </li></ul><ul><li>( Podocyt) : 25 nm </li></ul><ul><li>Luas area filtrasi  0,8 m 2 </li></ul><ul><li>Ultra filtrat = plasma - protein </li></ul>
  20. 21. Figure 26.10 Glomerular Filtration Figure 26.10
  21. 22. Figure 26.8 The Renal Corpuscle Figure 26.8a, b
  22. 23. Figure 26.8 The Renal Corpuscle Figure 26.8c, d
  23. 24. Figure 26.10 Glomerular Filtration Figure 26.10a, b
  24. 25. <ul><li>Proximal convoluted tubule (PCT) </li></ul><ul><ul><li>Actively reabsorbs nutrients, plasma proteins and ions from filtrate </li></ul></ul><ul><ul><li>Released into peritubular fluid </li></ul></ul><ul><li>Loop of Henle </li></ul><ul><ul><li>Descending limb </li></ul></ul><ul><ul><li>Ascending limb </li></ul></ul><ul><ul><li>Each limb has a thick and thin section </li></ul></ul>Functional anatomy of the nephron Animation: Urinary System Anatomy PLAY
  25. 26. <ul><li>Glomerular filtration produces fluid similar to plasma without proteins </li></ul><ul><li>The PCT reabsorbs 60-70% of the filtrate produced </li></ul><ul><ul><li>Reabsorption of most organic nutrients </li></ul></ul><ul><ul><li>Active and passive reabsorption of sodium and other ions </li></ul></ul><ul><ul><li>Reabsorption of water </li></ul></ul><ul><li>Secretion also occurs in the PCT </li></ul>Reabsorption and secretion at the PCT Animation: Early Filtrate Processing PLAY Animation: Glomerular filtration PLAY
  26. 27. TUBULUS PROKSIMALIS <ul><li>P = 15 mm </li></ul><ul><li>Tight junction </li></ul><ul><li>Lateral intercellular space </li></ul><ul><li>Brush border </li></ul><ul><li>Reabsorbsi 65 % </li></ul><ul><li>Zat yg direabsorbsi tidak disekresi kecuali K + </li></ul><ul><li>Sekresi zat diikat oleh protein plasma </li></ul>
  27. 28. Figure 26.12 Transport Activities at the PCT Animation: Proximal Convoluted Tubule PLAY Figure 26.12
  28. 29. The loop of Henle and countercurrent multiplication <ul><li>Countercurrent multiplication </li></ul><ul><ul><li>Between ascending and descending limbs of loop </li></ul></ul><ul><ul><li>Creates osmotic gradient in medulla </li></ul></ul><ul><ul><li>Facilitates reabsorption of water and solutes before the DCT </li></ul></ul><ul><ul><li>Permits passive reabsorption of water from tubular fluid </li></ul></ul>
  29. 30. ANSA HENLE <ul><li>Pars decendent : 2- 14 mm </li></ul><ul><li>Pars Ascendent : mithokondria >>, Sel Junxtaglomerular vas. Afferent mensekresi RENIN </li></ul><ul><li>ANSA HENLE SEGMEN TIPIS : permeabilitas besar, metabolisme minimal </li></ul><ul><li>ANSA HENLE SEGMEN TEBAL : tidak permeabel thd H2O & Ureum, reabsorbsi aktif Cl - & Na + </li></ul>
  30. 31. Figure 26.13 Countercurrent Multiplication and Concentration of Urine Figure 26.13a
  31. 32. Figure 26.13 Countercurrent Multiplication and Concentration of Urine Figure 26.13b
  32. 33. Figure 26.13 Countercurrent Multiplication and Concentration of Urine Figure 26.13c
  33. 34. <ul><li>Distal convoluted tubule (DCT) </li></ul><ul><ul><li>Actively secretes ions, toxins, drugs </li></ul></ul><ul><ul><li>Reabsorbs sodium ions from tubular fluid </li></ul></ul>Functional anatomy of the nephron Animation: Urinary System Dissection and Flythrough PLAY
  34. 35. <ul><li>DCT performs final adjustment of urine </li></ul><ul><ul><li>Active secretion or absorption </li></ul></ul><ul><li>Absorption </li></ul><ul><ul><li>Tubular cells actively resorb Na + and Cl - </li></ul></ul><ul><ul><li>In exchange for potassium or hydrogen ions (secreted) </li></ul></ul>Reassertion and secretion at the DCT
  35. 36. TUBULUS DISTALIS <ul><li>P = 5 mm </li></ul><ul><li>Ephitel lebih pipih dari ephitel tubulus proksimalis </li></ul><ul><li>Brush border ( ─) </li></ul><ul><li>Bagian proksimal = segmen tebal ansa henle </li></ul><ul><li>Bagian distal terjadi ion exchange K+ dg Na+ : Hormon Aldosteron </li></ul>
  36. 37. Figure 26.14 Tubular Secretion and Solute Reabsorption at the DCT Figure 26.14 Animation: Distal Convoluted Tubule PLAY
  37. 38. Figure 26.14 Tubular Secretion and Solute Reabsorption at the DCT Figure 26.14c
  38. 39. Reabsorption and secretion along the collecting system <ul><li>Water and solute loss is regulated by aldosterone and ADH </li></ul><ul><li>Reabsorption </li></ul><ul><ul><li>Sodium ion, bicarbonate, and urea are resorbed </li></ul></ul><ul><li>Secretion </li></ul><ul><ul><li>pH is controlled by secretion of hydrogen or bicarbonate ions </li></ul></ul>
  39. 40. DUKTUS COLLIGENTES <ul><li>P = 20 mm </li></ul><ul><li>Menampung beberapa tubulus distalis </li></ul><ul><li>Ber muara di papilla renalis </li></ul><ul><li>Bagian Cortex : tidak permeabel thd ureum </li></ul><ul><li>Bagian medulla ; permeabel thd ureum </li></ul><ul><li>ADH < : tidak permeabel thd H2O </li></ul>
  40. 41. Figure 26.6 A Representative Nephron Figure 26.6
  41. 42. Figure 26.5 The Blood Supply to the Kidneys Figure 26.5c, d
  42. 43. Figure 26.5 The Blood Supply to the Kidneys Figure 26.5a, b
  43. 44. SUPLAI DARAH GINJAL
  44. 46. <ul><li>RENAL FRACTION </li></ul><ul><li>Vasa afferent glomerulus membentuk vasa recta </li></ul><ul><li>Renal Blood Flow = 1200 ml/menit </li></ul><ul><li>Cardiac Out Put = 5000ml/ menit </li></ul><ul><li>Renal Fraction = 1200/5000 X 100% = 24% </li></ul>
  45. 47. KECEPATAN ALIRAN DARAH TIAP 100 g JARINGAN 3 54 58 84 420 Otot Skelet Otak Hati Otot Jantung Ginjal BLOOD FLOW (ml / min ) ORGAN
  46. 48. ALIRAN CAIRAN DLM TUBUH 65 15 10 9,3 0,7 125 45 25 12 1 Tubulus Proksimal Ansa Henle Tubulus Distalis Duct. Colligentes Urine Reabsorpsi ( %) Kecepatan (ml/min) JARINGAN
  47. 49. REABSORPSI ELEKTROLIT <ul><li>( kation ) perlu dikendalikan, bila berubah : kegagalan faal ginjal </li></ul><ul><li>K+ > : potensial membran < : paralisis </li></ul><ul><li>K+ < : potensial membran > : paralisis </li></ul><ul><li>Na+ << : Potensial aksi < : paralisis </li></ul><ul><li>Ca++ < : permeabilitas membran > : tetani </li></ul>
  48. 50. <ul><li>Amount of filtrate produced in the kidneys each minute </li></ul><ul><li>Factors that alter filtration pressure change GFR </li></ul>Glomerular filtration rate (GFR)
  49. 51. GLOMERULAR FILTRATION RATE ( GFR) <ul><li>Jumlah filtrat yg disaring dr plasma dalam satu menit </li></ul><ul><li>Normal :  125 ml / min </li></ul><ul><li>Lebih dr 99% direabsorpsi </li></ul><ul><li>Produk urine :  1 L / hari </li></ul><ul><li>Zat yg digunakan untuk mengukur : Inulin, Manitol </li></ul>
  50. 52. <ul><li>A drop in filtration pressure stimulates Juxtaglomerular apparatus (JGA) </li></ul><ul><ul><li>Releases renin and erythropoietin </li></ul></ul>Factors controlling the GFR
  51. 53. FAKTOR YG MEMPENGARUHI <ul><li>Perubahan Tek. Darah </li></ul><ul><li>Tek. Darah umum </li></ul><ul><li>Status vasa afferent / efferent </li></ul><ul><li>Contoh : </li></ul><ul><li>latihan jasmani : vasokontriksi vasa afferent </li></ul><ul><li>Caffein : Vasodilatasi vasa afferent </li></ul>
  52. 54. <ul><li>Perubahan Tekanan Capsular : Obstruksi, Edema jaringan </li></ul><ul><li>Perubahan Tek. Osmotik Koloid : Dehidrasi, Hipoprotein </li></ul><ul><li>Perubahan Permeabilitas : Peny. Ginjal, Keracunan Obat </li></ul><ul><li>Perubahan Luas Area Filtrasi : Peny. Ginjal, Nephrotomy </li></ul>
  53. 55. FILTRASI GLOMELURUS <ul><li>Effective Filtration Pressure (EFP) </li></ul><ul><li>Tek. Darah – Tek Capsular – Tek Koloid Osmotik = 70 – 20 – 32 = 18 mmHg </li></ul>
  54. 56. DIURETIKA <ul><li>Zat yg dpt meningkatkan kec.pembentukan urine </li></ul><ul><li>Cara : </li></ul><ul><li>Meningkatkan GFR </li></ul><ul><li>Mengurangi reabsorpsi cairan dlm tubuh </li></ul><ul><li>Terapi : Edema , Hipertensi </li></ul><ul><li>Mekanisme kerja : </li></ul><ul><li>Meningkatkan GFR </li></ul><ul><li>Meningkatkan muatan osmotik koloid tubuh </li></ul><ul><li>Menghambat ADH </li></ul>
  55. 57. MENINGKATKAN GFR <ul><li>Cara : </li></ul><ul><li>Tek darah > </li></ul><ul><li>Vasodilatasi vasa afferent </li></ul><ul><li>Vasokonstriksi vasa efferent </li></ul><ul><li>Tek. Osmotik Koloid < </li></ul>
  56. 58. BEBERAPA JENIS OBAT <ul><li>EPINEPHRINE : Tek darah   Tek Caps Bowman   GFR   Diuresis  </li></ul><ul><li>DIGITALIS : Decompensatio Cordis  sirkulasi diperbaiki  P Bowman   GFR   Diuresis  </li></ul><ul><li>THEOPHYLIN & CAFFEIN : Vasodilatasi Vasa Aff.  P Bowman   GFR   Diuresis  </li></ul>
  57. 59. MENINGKATKAN MUATAN OSMOTIK TUBULUS <ul><li>Mempunyai efek terutama di tub. Proks: Ureum, Sukrosa, Manitol, Glukosa </li></ul><ul><li>Menghambat Reabsopsi Na+ </li></ul><ul><li>Di Ansa Henle : Furosemide, Ethacrynil Acid </li></ul><ul><li>Di Tub. Distal bgn Proksimal : thiazide, metalazone </li></ul><ul><li>Di tub. Distalis bgn Distal : spironolactone, amiloride </li></ul>
  58. 60. Menghambat ADH <ul><li>ADH   reabsorpsi H2O di Ductus colligentes   diuresis  </li></ul><ul><li>Alkohol, narkotika, anastesi </li></ul>
  59. 61. Figure 26.11 The Response to a Reduction in the GFR Figure 26.11a
  60. 62. Figure 26.11 The Response to a Reduction in the GFR Figure 26.11b
  61. 63. Figure 26.16 A Summary of Renal Function Figure 26.16a
  62. 64. Figure 26.15 The Effects of ADH on the DCT and Collecting Ducts Figure 26.15
  63. 65. Figure 26.15 The Effects of ADH on the DCT and Collecting Ducts Figure 26.15a, b

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