Practice Exam: Urinary System

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1) The urinary system does all of the following except
A) contributing to stabilizing blood pH.
B) excreting excess albumin molecules.
C) eliminating organic waste products.
D) regulating blood volume.
E) regulating plasma concentrations of electrolytes.

Answer: B


3) A glomerulus is
A) the source of erythropoietin.
B) the expanded end of a nephron.
C) the horseshoe-shaped segment of the nephron.
D) a knot of capillaries within the renal corpuscle.
E) attached to the collecting duct.

Answer: D


4) How is the kidney involved with normal bone ossification and development?
A) Growth hormone is produced by the kidneys.
B) The kidney produces calcitriol.
C) Growth factors from the kidney direct the growth the epiphyseal cartilage plate in the bone.
D) Osteoblasts migrate from the kidney into the bone.
E) Injury to bone triggers a response in the kidney, which makes more rennin hormone.

Answer: B


5) Urine is eliminated through the
A) urinary bladder.
B) kidney.
C) liver.
D) urethra.
E) ureter.

Answer: D


7) Urine is carried to the urinary bladder by
A) the urethra.
B) blood vessels.
C) the ureters.
D) lymphatics.
E) the calyces

Answer: C


8) Each of the following organs is part of the urinary system except the
A) urethra.
B) kidney.
C) rectum.
D) urinary bladder.
E) ureter.

Answer: C


9) Urine passes, in the order given, through which of the following structures?
A) renal pelvis, collecting duct, bladder, ureter, urethra
B) collecting duct, renal pelvis, ureter, bladder, urethra
C) renal pelvis, urethra, bladder, ureter, collecting duct
D) collecting duct, ureter, renal pelvis, urethra, bladder
E) collecting duct, renal pelvis, urethra, bladder, ureter

Answer: B


10) All of the following are true of the kidneys except that they are
A) located in a position that is retroperitoneal.
B) covered by peritoneum.
C) surrounded by a fibrous capsule.
D) held in place by the renal fascia.
E) located partly within the pelvic cavity.

Answer: E


11) The prominent indentation on the medial surface of the kidney is the
A) ureter

B) hilum.

C) pyramid.

D) pelvis.

E) calyx.

Answer: B


12) The renal sinus is
A) part of a renal pyramid.
B) a renal corpuscle.
C) a large branch of the renal pelvis.
D) the innermost layer of kidney tissue.
E) an internal cavity lined by the fibrous capsule.

Answer: E


13) The outermost layer of the kidney is the
A) fibrous capsule.
B) major calyx.
C) renal medulla.
D) renal cortex.
E) renal pelvis.

Answer: A


14) The cavity of the kidney that receives urine from the calyces is called the
A) renal cortex.
B) renal papilla.
C) renal pelvis.
D) renal medulla.
E) renal sinus.

Answer: C


15) Triangular or conical structures located in the renal medulla are called
A) renal pelvises.
B) pyramids.
C) renal columns.
D) calyces.
E) nephrons.

Answer: B


16) Blood leaves the glomerulus through a blood vessel called the
A) efferent arteriole.
B) afferent arteriole.
C) interlobular arteriole.
D) vasa recta.
E) renal vein.

Answer: A


17) The left kidney lies ________ to the right kidney.
A) superior
B) transverse
C) inferior
D) anterior
E) posterior

Answer: A


19) The condition called ________ is especially dangerous because the ureters or renal blood vessels can become twisted or kinked during movement.
A) pyelonephritis
B) floating kidney
C) renal failure
D) renal calculi
E) polycystic kidney disease

Answer: B


21) The ________ delivers urine to a minor calyx.
A) papillary duct
B) distal convoluted tubule
C) ureter
D) renal corpuscle
E) nephron loop (loop of Henle)

Answer: A


22) Typical renal blood flow is about ________ ml/min under resting conditions.
A) 800

B) 1200

C) 500

D) 1800

E) 2500

Answer: B


23) In the renal corpuscle, the glomerular epithelium is a layer of specialized cells called
A) macula densa cells.
B) glomerulocytes.
C) juxtaglomerular cells.
D) tubular cells.
E) podocytes.

Answer: E


24) What is the proper order for the structures of the renal corpuscle through which a substance during filtration?
1. filtration slit (slit pore)
2. capsular space
3. dense layer
4. capillary endothelium

A) 2, 4, 3, 1

B) 4, 1, 2, 3

C) 4, 3, 1, 2

D) 3, 1, 4, 2

E) 4, 3, 2, 1

Answer: C


25) Capillaries that surround the proximal convoluted tubules are
A) peritubular capillaries.
B) vasa recta capillaries.
C) efferent arterioles.
D) corticoradiate capillaries.
E) proximal capillaries.

Answer: A


26) The renal veins drain into the
A) inferior vena cava.
B) peritubular capillaries.
C) renal arteries.
D) abdominal aorta.
E) segmental arteries.

Answer: A


27) ________ is/are an inflammatory disorder of the glomeruli that affects the filtration mechanism of
the kidneys.
A) Pyelonephrosis
B) Kidney stones
C) Glomerulonephritis
D) Floating kidney
E) Polycystic kidney disease

Answer: C


28) Glomerulonephritis may occur as a consequence of an infection with the bacterium
A) varicella.
B) Clostridium difficile.
D) Streptococcus.
E) All of the answers are correct.

Answer: D


29) ________ is an inherited abnormality that affects the development and structure of kidney tubules.
A) Renal failure
B) Calculus
C) Hematuria
D) Glomerulonephritis
E) Polycystic kidney disease

Answer: E


30) Renal columns are
A) expanded ends of the ureters.
B) the basic functional units of the kidney.
C) conical structures that are located in the renal medulla.
D) bundles of tissue that extend between pyramids from the cortex.
E) internal cavities lined by the fibrous capsule.

Answer: D


31) The expanded beginning of the ureter connects to the
A) renal calyx.
B) renal hilum.
C) renal pelvis.
D) renal sinus.
E) renal corpuscle.

Answer: C


32) Major calyces are
A) expanded ends of nephrons.
B) the expanded ends of renal pyramids.
C) large branches of the renal pelvis.
D) basic functional layers of the kidney.
E) conical structures that are located in the renal medulla.

Answer: C


33) Glomerular (Bowman's) capsule and the glomerulus make up the
A) nephron loop (loop of Henle).
B) renal corpuscle.
C) collecting tubule system.
D) renal papilla.
E) renal pyramid.

Answer: B


34) The region known as the macula densa is part of
A) the proximal convoluted tubule.
B) the nephron loop (loop of Henle).
C) the collecting duct.
D) the distal convoluted tubule.
E) glomerular (Bowman's) capsule.

Answer: D


35) The cells of the macula densa and the juxtaglomerular cells form the
A) filtration membrane.
B) afferent arteriole.
C) juxtaglomerular complex.
D) nephron loop (loop of Henle).
E) renal corpuscle.

Answer: C


36) You have been diagnosed with lupus erythematosus, a very severe autoimmune disorder with a wide variety of associated organ-related problems. Your doctor is particularly worried about how this will affect your kidney function. He says that you are susceptible to ________ because of the lupus.
A) polycystic kidney
B) cystitis
C) renal calculi
D) glomerulonephritis
E) diabetes

Answer: D


37) The filtration of plasma takes place in the
A) renal corpuscle.
B) nephron loop (loop of Henle).
C) ureter.
D) distal convoluted tubule.
E) papillary duct

Answer: A


38) Filtrate first passes from the glomerular capsule to the
A) collecting duct.
B) minor calyx.
C) proximal convoluted tubule.
D) nephron loop (loop of Henle).
E) distal convoluted tubule.

Answer: C


39) The portion of the nephron that empties into the collecting duct is the
A) nephron loop (loop of Henle).
B) calyx.
C) papillary tubule.
D) proximal convoluted tubule.
E) distal convoluted tubule.

Answer: E


40) Which of the following descriptions best matches the term renal papilla?
A) It creates high interstitial NaCl concentration.
B) It is the tip of the medullary pyramid.
C) initial filtrate enters here.
D) final urine enters here.
E) It releases renin.

Answer: B


41) The efferent arteriole of a nephron divides to form a network of capillaries within the cortex called the ________ capillaries.
A) cortical
B) peritubular
C) efferent
D) glomerular
E) vasa recta

Answer: B


42) The U-shaped segment of the nephron is the
A) proximal convoluted tubule.
B) collecting loop.
C) nephron loop (loop of Henle).
D) minor calyx.
E) distal convoluted tubule.

Answer: C


43) The primary function of the proximal convoluted tubule is
A) filtration.
B) adjusting the urine pH.
C) secretion of acids and ammonia.
D) secretion of drugs.
E) absorption of ions, organic molecules, vitamins, and water.

Answer: E


44) The following is a list of the blood vessels that carry blood to the kidney. In what order does blood pass through these vessels?
1. afferent arteriole
2. arcuate artery
3. interlobar artery
4. renal artery
5. glomerulus
6. cortical radiate artery
7. efferent arteriole
8. peritubular capillary

A) 4, 3, 2, 6, 1, 5, 7, 8
B) 4, 3, 2, 6, 7, 5, 1, 8
C) 4, 6, 2, 3, 7, 5, 1, 8
D) 4, 6, 2, 3, 1, 5, 7, 8
E) 4, 3, 6, 2, 1, 5, 7, 8

Answer: A


45) The process of filtration occurs at the
A) glomerular (Bowman's) capsule.
B) collecting duct.
C) distal convoluted tubule.
D) nephron loop (loop of Henle).
E) proximal convoluted tubule.

Answer: A


46) The filtration barrier in the renal corpuscle consists of which three layers?
A) fenestrations, matrix, and foot processes
B) filtration slits, foot processes, and slit pores
C) endothelium of glomerulus, dense layer of glomerulus, and podocyte filtration slits
D) podocyte filtration slits, matrix cells in the glomerulus, and endothelium of glomerulus
E) dense layer of glomerulus, foot processes, and fenestrations in the capsule

Answer: C


52) Which of the following is not a normal constituent of urine?
A) large proteins
B) amino acids
C) creatinine
D) urea
E) hydrogen ions

Answer: A


53) The glomeruli are best described as being tufts of
A) arteries.
B) arterioles.
C) capillaries.
D) veins.
E) venules.

Answer: C


54) The majority of glomeruli are located in the ________ of the kidney.
A) vasa recta

B) medulla

C) pelvis

D) calyces

E) cortex

Answer: E


55) Which of the following components of the nephron is largely confined to the renal medulla?
A) distal convoluted tubule
B) collecting ducts
C) proximal convoluted tubule
D) glomerulus
E) glomerular (Bowman's) capsule

Answer: B


56) Renal blood flow is about
A) 1 liter/min.
B) 2 liter/min.
C) 3 liter/min.
D) 4 liter/min.
E) 5 liter/min.

Answer: A


57) The renal threshold for glucose is approximately ________ mg/dl.
A) 75

B) 180

C) 140

D) 90

E) 100

Answer: B


58) Substances larger than ________ are normally not allowed to pass through the filtration membrane.
A) urea
B) glucose
C) amino acids
D) sodium ions
E) albumin

Answer: E


59) Sympathetic stimulation of the kidney can do all of the following except
A) produce renal ischemia.
B) produce powerful vasoconstriction of the afferent arterioles.
C) reduce blood flow to kidneys.
D) increase the glomerular filtration rate.
E) trigger renin release.

Answer: D


60) The process of filtration is driven mainly by
A) blood hydrostatic pressure.
B) active transport.
C) solvent drag.
D) blood osmotic pressure.
E) renal pumping.

Answer: A


61) Approximately ________ liters of glomerular filtrate enter glomerular capsules each day.
A) 18

B) 480

C) 1.8

D) 180

E) 125

Answer: D


62) Under normal conditions, glomerular filtration depends on three main pressures. From the list below, what are these three main pressures?
1. blood hydrostatic pressure
2. capsular hydrostatic pressure
3. capsular colloid osmotic pressure
4. blood colloid osmotic pressure
5. urinary bladder hydrostatic pressure

A) 1, 2, and 4 are correct.
B) 2, 3, and 4 are correct.
C) 2, 4, and 5 are correct.
D) 1, 2, and 3 are correct.
E) 3, 4, and 5 are correct.

Answer: A


63) Which of the following formulas will allow you to calculate correctly the net filtration pressure (FP)? (Hint: CsHP is capsular hydrostatic pressure.)
B) FP = BCOP + (BHP - CsHP)
C) FP = BHP - (CsHP + BCOP)

Answer: C


64) Measurement of the functions of a nephron reveals a glomerular capillary pressure of 69 mm Hg, and a pressure in the capsular space of 15 mm Hg. Assuming that the colloid osmotic pressure is 30 mm Hg, and that essentially no plasma proteins are filtered by the glomerulus, what is the net filtration pressure in this case?
A) 24 mm Hg
B) 84 mm Hg
C) 99 mm Hg
D) 30 mm Hg
E) 69 mm Hg

Answer: A


66) One mechanism the kidney uses to raise systemic blood pressure is to
A) increase release of angiotensin II by the suprarenal glands.
B) decrease urinary albumin concentration.
C) decrease secretion of aldosterone.
D) increase filtration into glomerular (Bowman's) capsule.
E) increase secretion of renin by the juxtaglomerular complex.

Answer: E


67) Calculate filtration pressure (FP) in a nephron with a glomerular hydrostatic pressure of 55 mm Hg, a blood colloid osmotic pressure of 25 mm Hg, and a capsular hydrostatic pressure of 15 mm Hg.
A) FP = 95 mm Hg
B) FP = 10 mm Hg
C) FP = 55 mm Hg
D) FP = 45 mm Hg
E) FP = 15 mm Hg

Answer: E


68) Blood colloid osmotic pressure (BCOP) in the glomerulus is generated by
A) presence of albumin proteins in blood plasma.
B) blood pressure.
C) filtrate in the capsular space.
D) protein in the filtrate.
E) constriction of the efferent arteriole.

Answer: A


69) The main force that causes filtration in a nephron is
A) blood colloid osmotic pressure.
B) osmotic pressure of the urine.
C) glomerular hydrostatic pressure.
D) reabsorption in proximal convoluted tubule pulls filtrate from blood.
E) capsular hydrostatic pressure.

Answer: C


70) The ability to form concentrated urine depends on the functions of the
A) proximal convoluted tubule.
B) nephron loop (loop of Henle).
C) distal convoluted tubule.
D) loop of Henle and the collecting duct.
E) collecting duct.

Answer: D


71) Tubular reabsorption involves all of the following except
A) cotransport.
B) countertransport.
C) stem cell movements.
D) active transport.
E) facilitated diffusion.

Answer: C


72) Reabsorption of filtered glucose from the lumen in the PCT is largely by means of
A) countertransport.
B) diffusion.
C) active transport.
D) cotransport.
E) facilitated diffusion.

Answer: D


73) Secretion of hydrogen ion by the PCT is by the process of
A) facilitated diffusion.
B) diffusion.
C) active transport.
D) cotransport.
E) countertransport.

Answer: E


74) Chloride ion is reabsorbed in the thick ascending limb by
A) countertransport for bicarbonate ion.
B) facilitated diffusion.
C) active transport.
D) cotransport with Na and K ions.
E) simple diffusion.

Answer: D


76) The thick ascending limb of the nephron loop (loop of Henle) is almost impermeable to water, but reabsorbs sodium, potassium, and chloride ions from the filtrate.
A) Both statements are true most of the time.
B) The first statement is false but the second statement is true.
C) The first statement is true but the second statement is false.
D) Both are true and relate to production of a dilute urine.
E) Both statements are false.

Answer: D


77) A patient excretes a large volume of very dilute urine on a continuing basis. This is may be due to
A) overproduction of aldosterone.
B) excessive ADH secretion.
C) absence of ADH.
D) hematuric oliguria.
E) dilation of the afferent arterioles.

Answer: C


78) Antidiuretic hormone
A) is secreted by the anterior pituitary.
B) is secreted in response to low potassium ion in the blood.
C) increases the permeability of the collecting ducts to water.
D) causes the kidneys to produce a larger volume of very dilute urine.
E) release is insensitive to the osmolarity of interstitial fluid.

Answer: C


79) If a urine sample is distinctly yellow in color, which of the following will be true?
A) It will have a low pH.
B) Its pH is below normal.
C) It will contain excess chloride ion.
D) It will have the odor of ammonia.
E) It will contain large amounts of urobilin.

Answer: E


82) Which of the following substances undergo tubular secretion?
A) sodium ions
B) glucose
C) ammonium ions
D) water
E) All of the answers are correct.

Answer: C


83) Which of the following substances are not normally found in the filtrate?
A) urea
B) chloride ions
C) water
D) protein
E) potassium ions

Answer: D


86) When the level of ADH (antidiuretic hormone) decreases,
A) a concentrated urine is produced.
B) less urine is produced.
C) water reabsorption increases in the loop of Henle.
D) the osmolarity of the urine decreases.
E) permeability to water in the collecting system increases.

Answer: D


87) Agents that increase urine excretion are known as
A) alpha-1 antagonists.
B) diuretics.
C) ADH agonists.
D) calcium channel blockers.
E) muscarinic antagonists.

Answer: B


88) As the filtrate passes through the renal tubules, approximately what percentage is reabsorbed and returned to the circulation?
A) 1

B) 99

C) 63

D) 74

E) 38

Answer: B


89) In response to increased levels of aldosterone, the kidneys produce
A) a larger volume of urine.
B) urine with less glucose.
C) urine with a higher concentration of sodium ions.
D) urine with a lower concentration of potassium ions.
E) urine with a lower concentration of sodium ions.

Answer: E


98) The ureters and urinary bladder are lined by ________ epithelium.
A) transitional
B) pseudostratified columnar
C) simple columnar
D) stratified squamous
E) simple cuboidal

Answer: A


99) The detrusor muscle
A) compresses the urinary bladder and expels urine through the urethra.
B) surrounds the renal pelvis.
C) functions as the internal urinary sphincter.
D) functions as the external urinary sphincter.
E) moves urine along the ureters by peristalsis.

Answer: A


100) The inability of the kidneys to excrete adequately to maintain homeostasis is
A) polycystic kidney disease.
B) calculi.
C) glomerulonephritis.
D) hematuria.
E) renal failure.

Answer: E


102) Changes that occur in the urinary system with aging include all of the following except
A) a decline in the number of functional nephrons.
B) a reduction in the GFR (glomerular filtration rate).
C) loss of sphincter muscle tone.
D) problems with the micturition reflex.
E) increased sensitivity to ADH.

Answer: E


103) Each of the following organ systems excretes wastes to some degree except the ________ system.
A) digestive
B) endocrine
C) integumentary
D) respiratory
E) urinary

Answer: B


104) Urine is temporarily stored in the
A) trigone.
B) urinary bladder.
C) urethra.
D) kidney.
E) ureter.

Answer: B


105) Urine is carried from the urinary bladder to the outside of the body by the
A) glomerulus.
B) urethra.
C) convoluted tubule.
D) collecting duct.
E) ureter.

Answer: B


106) Which of the following activities is not related to kidney function?
A) control of wastes in the blood
B) control of hydrogen ion and pH in the blood
C) lipid digestion
D) maintenance of various blood ion concentrations
E) regulation of blood pressure

Answer: C


107) Eighty percent of nephrons in the human kidney are located in the ________ and have short nephron loops.
A) pyramids

B) cortex

C) pelvis

D) medulla

E) capsule

Answer: B


108) Nephrons located close to the medulla with long nephron loops are called ________ nephrons.
A) juxtaglomerular
B) vasa recta
C) Henle
D) cortical
E) juxtamedullary

Answer: E


109) The ________ is a capillary bed that parallels the nephron loop (loop of Henle).
A) peritubular capillary bed
B) afferent arteriolar bed
C) collecting duct
D) glomerulus
E) vasa recta

Answer: E


110) The concentration at which all of the carriers for a given substance are saturated is the
A) blood colloid maximum.
B) renal threshold.
C) osmotic pressure.
D) hydrostatic threshold.
E) tubular maximum

Answer: E


111) The ________ is the plasma concentration at which a specific compound will begin appearing in the urine.
A) hydrostatic threshold
B) blood colloid maximum
C) renal threshold
D) osmotic pressure
E) tubular maximum

Answer: C


112) Because of various factors-your weight gain over the last 5 years, your hereditary predisposition to heart disease that runs in your family, and an interest in getting "back to nature"-you decide to go on a vegan diet, totally restricting your intake of all meat and dairy. Because you dislike taking pills of any sort, you depend upon your vegetable intake as the source for all nutrients for your body. When explaining this to your doctor beforehand, she cautions you about the possibility of low lysine and methionine levels. What is the problem?
A) Plants contain less urea, uric acid, and creatinine than meats.
B) You may be at risk for deficiency of certain essential amino acids.
C) Plants have much more sugar and carbohydrates than meats.
D) There are not enough vitamins in a meatless diet to make enough lysine and methionine.
E) Your insulin levels will be very low, causing lysine and methionine levels to also be low.

Answer: B


113) The filtration pressure at the glomerulus is equal to
A) blood hydrostatic pressure - (capsular hydrostatic pressure + capsularcolloid osmotic pressure).
B) glomerularhydrostatic pressure - (capsular hydrostatic pressure + glomerular capillary osmotic pressure).
C) (capsular hydrostatic pressure + capsular osmotic pressure) - blood hydrostatic pressure.
D) capsular hydrostatic pressure + capsular osmotic pressure + blood hydrostatic pressure).
E) blood hydrostatic pressure - (capsular hydrostatic pressure + interstitial fluid osmotic pressure).

Answer: B


114) The amount of filtrate produced by the kidneys each minute is called the
A) net filtration pressure.
B) kidney filtrate volume.
C) colloid pressure.
D) glomerular filtration rate.
E) plasma volume.

Answer: D


115) The ________ test is often used to estimate the glomerular filtration rate.
A) creatinine clearance
B) inulin
C) glucose tolerance
D) CBC or complete blood count

Answer: A


116) The process of ________ involves a carrier protein that can transport a molecule across the cell membrane down its concentration gradient.
A) bulk transport
B) osmosis
C) facilitated diffusion
D) active transport
E) simple diffusion

Answer: C


117) A transport mechanism that can move a substance against a concentration gradient by using cellular energy is
A) osmosis.
B) facilitated diffusion.
C) active transport.
D) bulk transport.
E) simple diffusion.

Answer: C


118) Basically, what occurs in the countercurrent multiplier process?
A) Uric acid is excreted into the kidney tubules while urea is reabsorbed in the loops of Henle.
B) A higher sodium concentration is produced in the kidney medulla tissue that osmotically draws out water, reducing it within the tubules and the urine.
C) Creatinine is actively transported out of the blood into urine.
D) Sodium is pumped into the blood while potassium is actively transported out of the blood back into the tissues.
E) Glucose and sodium are cotransported from urine back into blood.

Answer: B


119) In the process of ________, two substances are moved across a cell membrane in the same direction without directly using cellular energy. One of the substances can be moved against a concentration gradient by this process.
A) cotransport
B) simple diffusion
C) active transport
D) countertransport
E) co-osmosis

Answer: A


121) The area of the urinary bladder bounded by the openings of the two ureters and the urethra is called the
A) vasa recta.
B) renal pelvis.
C) pyramid.
D) trigone.
E) JG apparatus.

Answer: D


122) Insoluble deposits that form within the urinary tract from calcium salts, magnesium salts, or uric acid are called kidney stones or renal
A) calculi.
B) plaque.
C) caries.
D) lithotrophs.
E) otoliths.

Answer: D


123) You complain to the doctor about constant pain and discomfort in the low back area. What test might logically be recommended?
A) a pyelogram
B) a liver biopsy
C) an angiogram
D) a liver enzyme assay
E) an MRI

Answer: A


124) Which of the following statements is false regarding micturition?
A) Stretch receptors in the bladder are stimulated by the warm temperature of the urine.
B) Bladder contractions can force open the internal urethral sphincter.
C) Urination will be completed despite voluntary opposition.
D) Parasympathetic nervous control is involved with the micturition reflex.
E) When you relax the external urethral sphincter, the internal sphincter will relax.

Answer: A


125) Your doctor has diagnosed you with prostatitis, an inflammation and swelling involving the prostate gland. One of your primary symptoms is
A) large amounts of dilute urine.
B) renal failure.
C) glycosuria.
D) hematuria.
E) dribbling urination.

Answer: E

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