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Le parcours de formation de l’enfant et de l’adolescent devra faire l’objet d’un projet personnalisé de scolarisation assorti des ajustements nécessaires en favorisant, chaque fois que possible, la formation en milieu scolaire ordinaire (27). Microsoft Legal Template. Cover Letter Law Cover Letter Law? Il s’agit là d’une inscription législative de pratiques inscrites de longue date dans les réglementations. Accounting Job Description. Resume? La notion de projet était certes absente de la loi de 1975, comme de ses circulaires d’application(28). Microsoft Word Legal Template.? Cependant, dès 1982, une circulaire(29) conjointe des ministères de la Santé et de l’Éducation Nationale évoque déjà un projet d’intégration scolaire qui doit comporter des dimensions à la fois médicale, psychologique et sociale . And Family You Note From? Une circulaire de 1983(30) reprend cette orientation en imposant que l’intervention des SESSAD se fasse dans le cadre d’un projet englobant à la fois les dimensions scolaire, éducative et thérapeutique . Word Template. Cover Letter Law? La réforme des annexes XXIV des années 1988 et 1989 impose une généralisation du projet individuel pédagogique, éducatif et thérapeutique à tout enfant ou adolescent pris en charge dans les établissements médico-éducatifs régis par ces textes. And Family - A Thank From Mom? Une circulaire de 1991(31) charge les commissions de l’éducation spéciale de suivre la mise en œuvre des projets d’intégration qui concrétisent leurs décisions . Microsoft Template. Law Cover? Depuis lors, c’est toute la politique de prise en charge des enfants et adolescents handicapés, scolarisation comprise bien entendu, qui obéit à cette logique de projets individuels, supervisés ou décidés par les commissions d’orientation. On notera également que la formation en milieu scolaire ordinaire (31a) n’est pas posée comme un droit absolu, mais seulement comme une modalité à privilégier chaque fois que possible (31b) . – Letter Writing? On reste très proche des formulations prudentes de la loi de 1975, qui posait comme principe général que l’action poursuivie assure, chaque fois que les aptitudes des personnes handicapées et de leur milieu familial le permettent, l’accès du mineur et de l’adulte handicapés aux institutions ouvertes à l’ensemble de la population et leur maintien dans un cadre ordinaire de travail et de vie (32). Word Legal Template. Cover Letter Law Cover? On est en particulier très en retrait par rapport à une circulaire incendiaire de Ségolène Royal qui affirmait en 1999, très largement au-delà des principes législatifs alors en vigueur : Tous les jeunes, quels que soient les besoins éducatifs qu’ils présentent, doivent trouver dans le milieu scolaire ordinaire la possibilité d’apprendre et de grandir avec les autres pour préparer leur avenir d’hommes et de femmes libres et de citoyens. Interview You Note Samples – Letter Format Writing? (33) La nouveauté, relative, est l’inscription de ce projet de formation dans le cadre global du plan personnalisé de compensation du handicap imposé par la loi(34). Microsoft Template. Law Cover Letter Law? Ce plan est élaboré, dans le cadre de la Maison départementale des personnes handicapées, par une équipe pluridisciplinaire , dont la composition (. Interview Thank You Note – Letter? ) peut varier en fonction de la nature du ou des handicaps de la personne handicapée dont elle évalue les besoins de compensation ou l’incapacité permanente (35). Microsoft Legal Letter? Cette équipe doit entendre les parents, ou leur représentant, comme cela était déjà le cas pour les commissions de l’éducation spéciale(36), mais il est aussi prévu désormais, explicitement, d’entendre l’enfant lui-même : Dès lors qu’il est capable de discernement, l’enfant handicapé lui-même est entendu par l’équipe pluridisciplinaire . Thank From Mom? Cette innovation mérite d’être soulignée : jusqu’à présent, l’enfant, handicapé ou non, était systématiquement exclu de tous les projets, pédagogiques ou autres, le concernant.
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Cette présence nouvelle des élus locaux, ou de leurs représentants, dans les commissions d’orientation devrait peser en faveur d’une meilleure prise en compte des souhaits des familles concernées. Microsoft Cover Letter? Dans une certaine mesure au moins : les élus seront susceptibles d’être sensibles également à leurs responsabilités budgétaires, comme aux réactions possibles des familles non touchées par le handicap. Lease Coloring Pages? Lors des débats parlementaires, le Sénat avait adopté une modification conditionnant l’intégration d’un enfant handicapé en milieu ordinaire à l’absence de mise en danger des autres enfants. Word Legal Template. Cover Letter? Les associations de personnes handicapées et de parents d’enfants handicapés, bien relayées par certains députés, ont obtenu la suppression de cet amendement lors du vote final de l’Assemblée Nationale. Accounting Job Description. Assistant? Cette victoire douteuse est peut-être mal assurée : le Sénat est une émanation des élus locaux, et l’influence de ces élus dans les commissions risque fort de jouer dans le même sens que ce qu’aurait formalisé l’amendement voté par le Sénat. Surtout, les décisions de la CDES s’imposaient aux établissements concernés, mais on Law Cover Letter Law considérait généralement qu’elles restaient soumises à l’accord final des parents. Free Resume Downloads No Fees Resume? La nouvelle commission a peut-être plus nettement le pouvoir d’imposer ses décisions aux parents. Microsoft Legal Template. Letter Law? Elle doit certes donner le choix entre plusieurs solutions adaptées, comme c’était déjà spécifié dans la loi de 1975(37). Printable Coloring? Elle doit également intégrer la préférence des familles pour un établissement ou un service à ses propositions, mais seulement lorsque cet établissement ou ce service entrent dans la catégorie de ceux vers lesquels la commission a décidé [d’orienter l’enfant] (38), toujours dans une logique très proche de la loi de 1975. Word Legal Template.? Mais aucune des procédures de recours prévues(39) ne débouche sur une validation finale du choix des parents. 35 Best Cv Mc Images Ideas And? À vrai dire, la loi de 1975 ne prévoyait pas non plus explicitement une telle disposition. Word Legal Letter Law Cover? C’est seulement la circulaire d’application de 1976 qui précisait : à l’égard des parents ou des personnes responsables de l’enfant : le pouvoir de décision des commissions est seulement relatif (40).
Sans que cette relativisation débouche d’ailleurs sur une validation explicite du choix des parents en cas de conflit avec les commissions. Lease Agreement,horse.printable Coloring Pages? Le poids des choix parentaux était assuré par le fait que leur recours face aux décisions de la commission avait un effet suspensif par rapport à ces décisions(41). Microsoft Template. Cover Letter Law? C’est toujours le cas dans cette nouvelle loi, dans des termes pratiquement similaires(42). Clerk Job Description. Administrative Assistant? Le plus probable est que, faute de choix clair par rapport aux limites de la prise en compte des vœux des familles, cette loi débouchera sur les mêmes situations de conflit que l’on a vues se multiplier ces dernières années. Legal Template. Cover Letter Law? Il est cependant vraisemblable que l’implication directe des politiques dans les commissions d’orientation leur donnera plus de poids et plus de légitimité que les commissions administratives que nous avons connues jusqu’à présent. La dernière nouveauté notoire dans le domaine de la scolarisation des enfants et adolescents handicapés est la création dans chaque département d’ équipes de suivi de la scolarisation (43). And Family Go Together - A You Note? Chargées de suivre l’application des décisions de la commission d’orientation, ou avec l’accord de ses parents ou de son représentant légal, proposer à la commission (. Law Cover Law? ) toute révision de l’orientation d’un enfant ou d’un adolescent qu’elles jugeraient utile (44).
Leur composition est très peu précisée par le texte qui les institue, hormis par l’implication évidente de l’enseignant ou des enseignants qui ont en charge l’enfant ou l’adolescent . Eating Go Together Thank Mom? Il faudra attendre un probable décret d’application pour que cette innovation prenne vraiment forme. Word Law Cover Letter? Équipes définies par un article du Code de l’éducation, chargées du suivi de la seule scolarisation, elles devraient être strictement internes à l’Éducation Nationale. Free Downloads With No Fees? Cela devrait en faire une structure très différente des actuelles commissions de circonscription, CCPE et CCSD, qui, étant des émanations de la CDES, sont des structures de type médico-éducatif, à pouvoir décisionnel. Microsoft Word Cover Letter Law Cover Law? Ces équipes devraient plutôt se rapprocher des innovations locales qui se sont répandues ces dernières années, hors de tout cadre réglementaire clair, comme les maîtres itinérants ou les maîtres d’aide à l’intégration . Horse Agreement,horse.printable Pages? Je suis a priori assez sceptique quant à la pertinence de cette création institutionnelle. Microsoft Word Legal Template. Cover Letter Law Cover Letter? Il existait déjà des structures vouées au suivi et à l’appui de la scolarisation des élèves handicapés. Stocker Download? Ce sont les SESSAD(45), nullement remis en cause par ailleurs par la nouvelle loi. Microsoft Word Cover Letter Law Cover Letter Law? Là où ils avaient été créés, les maîtres itinérants ou les maîtres d’aide à l’intégration avaient des relations pour le moins mal clarifiées avec les SESSAD. Interview Samples Format Writing? Services médico-éducatifs, les SESSAD ont l’avantage évident de comporter un panel complet de professionnels, dont des enseignants spécialisés, et il me semble que le suivi de la scolarisation des élèves handicapés appelle des intervenants plus diversifiés que les ressources internes de la seule Éducation Nationale. Legal Template. Law Cover Letter? Les actions des nouvelles équipes départementales de suivi de la scolarisation des élèves handicapés devront nécessairement s’articuler avec les actions des SESSAD. - A Thank You Note? Elles risquent fort de les chevaucher. Microsoft Word Cover Law Cover Letter? Il aurait certainement été préférable de renforcer les SESSAD, en particulier l’implication d’enseignants spécialisés dans ces structures.
Droit à compensation, guichet unique, renforcement de la représentation des personnes handicapées dans les institutions les concernant, inscription systématique dans un établissement scolaire de référence, la loi de 2005 comporte manifestement des avancées significatives en faveur des personnes handicapées. Pages? Mais les espoirs qu’elle suscite, parfois sur la base d’une lecture hâtive ou partielle, risquent fort de se heurter à ses limites, comme à ses implications politiques. Microsoft Word Template. Cover Law? Le financement d’un droit à compensation, ouvert à l’extrême en principe, est fort loin d’être assuré, comme le montre déjà la tournure ubuesque qu’a pris la suppression d’un jour férié destiné pour une part à alimenter cette solidarité nationale vis-à-vis des personnes handicapées. 35 Best Images Resume Ideas And? Quant au domaine de la scolarisation des enfants et adolescents handicapés, hors de la symbolique de l’établissement de référence, la nouvelle loi ne fait guère qu’entériner les évolutions de ces dernières décennies, sans apporter de transformations décisives. Microsoft Legal Letter? Ce n’est pas nécessairement à regretter : l’immersion de tous les enfants et adolescents handicapés dans les classes ordinaires est une idée certes sympathique, mais ce n’est certainement pas la panacée. Go Together Mom? La longue expérience des résultats d’une telle immersion pour les élèves socialement ou culturellement défavorisés devrait inciter à considérer avec circonspection les avantages et les inconvénients des pratiques intégratives, comme cette nouvelle loi continue à nous y inviter. Professeur de philosophie chargé d’enseignement à l’IUFM de Paris. Formateur d’enseignants spécialisés.
Décembre 2005-Avril 2006. (1) Le texte intégral de cette loi est disponible sur le site Légifrance. Microsoft Word Template. Cover Letter Law Cover Letter Law? Il est également disponible sur mon site personnel, avec un sommaire dynamique complet : (4) En particulier dans les nouvelles certifications des enseignants spécialisés : le SH du CAPA-SH et du 2CA-SH évoque la scolarisation des élèves en situation de handicap . 35 Best Cv Mc Template, Resume Ideas? Décrétées en janvier 2004, ces appellations sont d’ores et déjà hors la loi ! (5) Patrick Declerck , Les naufragés (Avec les clochards de Paris) , Col. Legal Template. Cover Letter Law? Terre Humaine, Plon, 2001, Page 293. (12) Article 16 de la loi, et articles modifiés L. Job Description. Resume? 821-1 et suivants du Code de la sécurité sociale. (13) Article 68 de la loi, et articles modifiés L. Microsoft Legal Letter? 541-1 et suivants du Code de la sécurité sociale. (22) En l’occurrence, la commissions des droits et de l’autonomie des personnes handicapées décrite plus haut, ou une de ses sections . (28) En particulier la circulaire n 76-156 et n 31 du 22 avril 1976 sur la composition et le fonctionnement des commissions de l’Éducation spéciale et des commissions de circonscription . (30) Circulaire n os 83-082, 83-4 et 3/83/S du 29 janvier 1983 sur la mise en place d’actions de soutien et de soins spécialisés en vue de l’intégration dans les établissements scolaires ordinaires des enfants et adolescents handicapés, ou en difficulté en raison d’une maladie, de troubles de la personnalité ou de troubles graves du comportement . (40) Circulaire n 76-156 et n 31 du 22 avril 1976 sur la composition et le fonctionnement des commissions de l’Éducation spéciale et des commissions de circonscription , point 12.130.
(45) Service d’Éducation Spéciale et de Soins À Domicile. Cet article est donné en référence dans un article de Pierre Baligand, Inspecteur honoraire de l’éducation nationale, initialement publié dans la Revue Médecine thérapeutique Pédiatrie , n 4, consacré au thème Handicap de l’enfant : quelles prises en charge ? , juillet-août 2006, pages 211-221 et repris sur le site Intégration scolaire partenariat.
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By entering into this Agreement you're accepting full and total responsibility for the actions Resume Rabbit performs on your behalf and at Word Template. Law Cover Law, your request, as if you had performed those actions yourself. Your further acknowledge and agree that you will take full responsibility and are personally liable for You Note – Letter Writing, any consequences arising from the Microsoft Word Template. Letter Law Cover use of the You Note Site and Services and from this Agreement. Word Legal Letter Letter. Once your resume has been posted, Resume Rabbit will provide you access to a Resume Posting Service Center where you can access your Real-Time Posting Report and your web-based Job Mail. This access is available for one year from the date you sign up with the Interview Thank Samples – Letter Format Writing service. Once the Legal Template. Letter Law Cover Law year has expired you will no longer be able to view your Real-Time Posting Report or your Job Mail. If you select Keep My Identity Confidential during an Online Order Interaction with Resume Rabbit, Resume Rabbit will select the confidentiality option on the Career Sites offering that feature. For sites that do not offer a confidentiality feature, Resume Rabbit will replace your personally identifiable information as follows: First Name Last Name are replaced with Confidential User Street Address is replaced with Address Withheld Phone Number is Accounting Clerk Job Description. Resume replaced with A/C-555-1212 Most Recent Company is replaced with Confidential. Legal Template. Law. Additionally, it is Printable Agreement,horse.printable Pages recommended you remove all unwanted personal information from the cut and Microsoft Word Legal Cover Law, paste version of Stocker Job Description Proposal your resume and cover letter, as these will be posted exactly as you provide them via the Forms. Job Agents are automated search engines at Word Template. Cover Law, Career Sites that search for job openings matching criteria given them and then email leads of matching jobs to the email address provided to the Career Site. Horse Lease Agreement,horse.printable Coloring Pages. For Non-Paid Customers. Resume Rabbit may set up Job Agents, also known as Job Alerts, as a courtesy to customers who create accounts on Resume Rabbit but do not pay for Resume Posting Services.
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Resume Rabbit makes no warrantees or guarantees about any customer's ability to Clerk Administrative Resume procure employment. Microsoft Word Legal Cover Letter. Resume Rabbit does not control any of the Career Sites it posts to, nor does it control any portion of the hiring process related to its customer. Resume Rabbit therefore makes no representations or guarantees regarding the Templates With No Fees | Download effectiveness or timeliness of its Site, Services, Content, or its effectiveness in meeting the Legal Template. Law Cover employment or any other objectives of its customers. Furthermore nothing on the Site shall be considered an endorsement, representation, assumption of responsibility or warranty with respect to any third party, whether in Interview Thank Samples – Letter regards to Microsoft Word Legal Letter Letter Law their web site, products, technologies, services, business practices or otherwise. Additionally, Resume Rabbit makes no warranties of any kind related to its standardization and interpretation of the information gathered in its Forms in order to provide information to Career Sites. You acknowledge and agree that accuracy of Horse Lease Agreement,horse.printable Coloring Pages your Personal Information on Career Sites is your sole responsibility, and that Resume Rabbit is not responsible for correcting, changing or modifying any information provided to Word Legal Cover Letter Law Cover Letter Law 3rd parties on your behalf. Templates With No Fees Resume. RESUME RABBIT DOES NOT WARRANT THAT ITS SITE OR SERVICES WILL OPERATE ERROR-FREE OR THAT THE SITE OR ITS SERVERS ARE FREE OF COMPUTER VIRUSES OR OTHER HARMFUL MECHANISMS. IF YOUR USE OF THE SITE OR THE CONTENT RESULTS IN THE NEED FOR SERVICING OR REPLACING EQUIPMENT OR DATA, RESUME RABBIT IS NOT RESPONSIBLE FOR THOSE COSTS. YOU ASSUME FULL RESPONSIBILITY AND RISK FOR USE OF THIS SITE AND THE INTERNET IN GENERAL. THE SITE AND CONTENT ARE PROVIDED ON AN AS IS BASIS WITHOUT ANY WARRANTIES OF ANY KIND. RESUME RABBIT, TO THE FULLEST EXTENT PERMITTED BY LAW, DISCLAIMS ALL WARRANTIES, WHETHER EXPRESS OR IMPLIED, INCLUDING THE WARRANTY OF MERCHANTABILITY, FITNESS FOR A PARTICULAR PURPOSE AND NON-INFRINGEMENT.
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Resume Rabbit's One-Stop Resume Posting service allows customers to Cover Letter Law Cover Letter Law be automatically posted to multiple 3rd party career web sites using a single online form. Warehouse Proposal. Posting Your Resume Confidentially. If you select Keep My Identity Confidential during our registration process, we will select the confidentiality option on the career websites offering that feature. For Career Websites that do not offer a confidentiality feature, we will replace your personally identifiable information as follows: First Last Name are replaced with Confidential User Street Address is replaced with Address Withheld Phone Number is Word Law Cover Letter Law replaced with A/C-555-1212 Most Recent Company is replaced with Confidential. Additionally, we recommend you remove all unwanted personal information from the Images | Cv Resume Ideas And cut and paste version of your resume and cover letter, as it will be posted exactly as you provide it to Microsoft Word Legal Template. Law Cover us. NOTE: These practices may conflict with the Terms of Service listed on some of the Printable Horse Lease Pages 3rd party career websites where we post your resume. Microsoft Legal Cover Letter Law Cover. If you choose to use this feature you must agree to do so at your own risk.
To visit and review the Interview Thank – Letter Format Writing terms of service on these sites, click here. Spam Prevention Email Forwarding. Posting an email address on the Internet can sometimes give rise to unwanted email (Spam). Word Legal Law Cover Law. To alleviate this problem, Resume Rabbit provides its Spam Prevention Email Forwarding Service, as defined in Resume this section. Resume Rabbit creates a new job search email address (Posted Email Address) for you and Word Letter Law Cover Letter, uses it as part of its Resume Posting Service. Emails sent to the Posted Email Address will automatically go through our Spam detection servers before being forwarded to Printable Lease Coloring the email you give via our Forms (Personal Email Address). This greatly reduces the amount of Spam you would receive at your Personal Email Address. By using the Spam Prevention Email Forwarding service, you give Resume Rabbit the permission and power to choose which emails sent to your Posted Email Address should be filtered and which should be forwarded to Word Legal Cover Law Cover Letter your Personal Email Address. You give Resume Rabbit the permission to alter the content of 3rd party emails for any reason. You also give Resume Rabbit the permission to And Family - A Thank From Mom store copies of the filtered and forwarded email on its servers. Resume Rabbit does not receive or accept any authority over your usage of your Personal Email Address, and Microsoft Cover Law Cover Letter Law, will not be held liable for anything related to your Personal Email Address.
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The customer may contact Customer Service for exemptions to Microsoft Letter Law this clause. Handling of Information Gathered from Printable Lease Agreement,horse.printable, Customers. Template. Cover Law Cover Letter. On our web site you provide contact information, your desired job requirements, your relevant experience and other personal information (collectively Personal Information). Your Personal Information will be electronically reformatted and Cv Mc Template, Resume, submitted to various 3rd party career web sites. Resume Rabbit will not rent or sell any information gathered from Word Legal Law Cover, a customer's use of our web site. Your personal information will not be shared with any 3rd parties for any reason other than what's described in this Privacy Statement or lawfully requested by federal or state authorities. Payment Information collected from customers on Job Description With, the Resume Rabbit web site is Cover Law securely transmitted for payment processing in real-time utilizing PayPal/VeriSign's Online Payment Services. Upon real-time response, credit card or checking account numbers are immediately deleted from the Interview Thank Samples – Letter Writing Resume Rabbit system for Cover Letter Letter, both authorized and declined transactions. Interview Thank You Note Samples Format Writing. PayPal/VeriSign, using its own secure connections and encryption technology, then transmits your payment information for Microsoft Template. Letter Law Cover Letter Law, validation and Interview Thank You Note Writing, processing to Cover Letter Law an authorized and reputable payment-processing clearinghouse. The rest of the associated payment processing is then handled like any other credit card or bank debit transaction. To the best of our knowledge all of the companies and banking institutions involved in our payment processing do not retain, share, store or use personally identifiable information for Clerk Job Description. Administrative Assistant Resume, any purpose outside of Microsoft Legal Template. Law Cover Letter Law processing our payments.
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Essay on Kidneys: Functions, Urine Formation and Hormones. In this article we will discuss about the Microsoft Word Cover kidneys:- 1. Introduction to Kidney 2. Functions of Kidney 3. Printable Agreement,horse.printable Pages! Urine Formation 4. Mechanism of Action of Diuretics 5. Renal Function Tests 6. Congenital Tubular Function Defects 7. Uremia 8. The Artificial Kidney 9. Hormones. Essay on the Introduction to Kidney Essay on the Functions of Kidney Essay on the Urine Formation in Kidney Essay on the Mechanism of Action of Diuretics Essay on the Renal Function Tests Essay on the Congenital Tubular Function Defects in Kidney Essay on the Uremia –Clinical Kidney Condition Essay on the Artificial Kidney Essay on the Hormones of the Kidney. Essay # 1. Introduction to Kidney: A large number of waste products are produced in the body as a result of metabolic activities. The main waste products are carbon dioxide, water, and nitrogenous compounds. The retention of these products produces a harmful effect on the normal health.
Therefore, the removal of these products from the body is a must. Word Legal Cover Law Cover Letter Law! Carbon dioxide is removed mainly through lungs and water as well as nitrogenous compounds are removed through urogenital system. The kidneys are the most important component of this system. The kidneys are two in number, usually bean shaped, and exist behind the peritoneum on either side of the vertebral column extending from the 12th thoracic to the 3rd lumbar vertebra. Each kidney weighs about 120-170 grams and Horse Lease Agreement,horse.printable Coloring Pages is about 11-13 cms. long, the left being larger than the Word Legal Template. Law right one. Each kidney is found to consist of two main parts by section. The outer part is called cortex and the inner one is medulla.
The cortex consists of a large number of glomeruli and convoluted tubules. The medulla is composed of renal tubules projecting into a cavity towards the Interview – Letter Writing inner region of the kidney called the pelvis, the region where the renal artery and vein enters and leaves the kidney respectively. Nephron –Basic Unit od Kidney: It is a functional basic unit of kidney. Legal Law Cover! Each kidney is Go Together Thank You Note From, provided with about one million nephrons containing the glomerulus and the tubule. The glomerulus is a network of afferent and efferent capillaries. Each glomerulus is surrounded by a double-walled epithelial sac known as Bowman ‘s Capsule which leads to the tubule which is divided into three parts—proximal convoluted tubule, loop of Henle, and the distal convoluted tubule. The Proximal Convoluted Tubule (PCT) is about 45 mm long and 50 mm in diameter. This lies in the cortex along with glomerulus.
Its lumen is continuous with that of the Bowman’s Capsule. It consists of cells with scalloped outline and brush border. The brush border is formed by numerous microvilli which increases the surface enormously for absorption. The loop of Legal Cover Letter Law Cover Letter Law, Henle consists of three parts—the descending limb, a thin segment, and an ascending limb. The proximal convoluted tubule opens into the descending limb which is continued into Accounting, the thin segment from where the ascending limb arises. The whole loop of Henle is lined by a single layer of Cover Letter Law Cover Letter Law, flattened epithelial cells. The ascending limb of the loop of Henle continues into the distal convoluted tubule (DCT) which finally opens into a collecting tubule or duct which carries the urine to the renal pelvis from where it is Accounting Clerk Assistant, carried to the bladder by the ureter.
The distal convoluted tubule commences near the Word Legal Template. Letter Letter Law pole of the glomerulus and establishes a close proximity to the afferent arteriole of its parent glomerulus. The DCT contains cuboidal epithelium. Nephrons are mainly of two types—cortical and juxtamedullary. The loop of Henle of the juxtamedullary is long and dips deep into the substance of the medulla. But the loop of Henle of cortical is short and only a very small part of it dips into the medullary tissue and the greater part remains embedded in the cortical substances. Moreover, the Accounting Clerk glomeruli of the juxtamedullary lie very close to the medulla while those of cortical lie close to Word Cover Letter Law Cover the surface of the kidney.
The juxtamedullary nephrons constitute 20 per Clerk Administrative Resume, cent of nephrons, while the cortical nephrons constitute 80 per cent of the Microsoft Legal Cover Letter Law total nephrons. These two types of nephrons have the same common function. Blood Supply of the Warehouse Kidneys: The short renal artery arising from the abdominal aorta supplies the blood to the kidney. The renal artery after entering the kidney divides into a number of Microsoft Cover Letter Law Cover Letter, arterioles—the afferent arterioles which further branch into capillaries and enter into each glomerulus. The capillaries then join to Printable Agreement,horse.printable form another arteriole—the efferent arteriole which opens into another set of Microsoft Word Template. Cover Letter Letter, capillaries called peritubular capillaries surrounding the proximal tubule, the loop of Henle, and the distal tubule.
Ultimately, the capillary set opens into a venule which joins with other venules to Printable Lease Agreement,horse.printable form the renal vein. The renal vein then opens into Microsoft Legal Template. Cover Letter Letter Law, the inferior vena cava. Blood Flow to Kidney through the Nephron: The blood flows through both the kidneys of an adult weighing 70 kg at the rate of about 1200 ml/mt. The portion of the total cardiac output (about 560 ml/ mt.) which passes through the kidneys is called the Warehouse Job Description Download Proposal renal fraction. This is about 560/1200 ml per minute, i.e., about 21 per cent. There are two sets of capillaries—the glomerulus and Legal Law Cover Letter the peritubular. These two capillaries are separated from each other by the efferent arteriole which contributes sufficient resistance to blood flow. Resume Downloads With | Download Resume! The glomerular capillary bed provides a high pressure of about 70 mm Hg, while the peritubular bed provides a low pressure about 13 mm Hg. The pressures in the artery and vein are 100 mm of Hg. and 8 mm of Hg respectively. The high pressure in the glomerulus exerts the filtering of fluids continually into the Bowman’s Capsule.
The low pressure in the peritubular capillary system, on the other hand, functions in the same way as the usual venous ends of the tissue capillaries with the fluid being absorbed continually into the capillaries. Essay # 2. Functions of Kidney : a. Kidney eliminates excess of certain nutrients such as sugar and amino acids when their concentration increases in the blood. b. It removes certain non-volatile waste products such as urea, uric acid, creatinine, and sulphates, etc. from the body. c. It eliminates certain foreign or toxic substances such as iodides, pigments, drugs, and bacteria, etc. from the blood. d. It regulates hydrogen ion concentration of the blood by removing excess of nonvolatile acids and bases. e. It maintains the osmotic pressure of the blood by regulating the excretion of water and inorganic salts and thus preserves the constant volume of the circulating blood. f. It regulates the arterial blood pressure by Law Cover Law causing the secretion of the hormone renin. g. 35 Best Cv Mc Template, Resume And! It maintains the erythrocyte production by Word Template. Law excreting the secretion of the Resume Templates With | Download hormone erythropoietin.
Essay # 3. Urine Formation in Kidney : The regulatory activities of Microsoft Word Template. Letter Law Cover Letter Law, kidneys form urine as a by-product. Urine formation involves three main steps—the glomerular filtration, the tubular reabsorption, and the tubular secretion. a. Glomerular Filtration (Ultrafiltration): Glomerulus filters out substances of low molecular weight from the Warehouse Stocker Download Proposal blood with the Microsoft Word Legal Cover Letter Law Cover Law retention of substances of high molecular weight, especially the proteins. Therefore, proteins are retained in the glomeruli and 35 Best On Pinterest | Cv Template, Resume And are not normally found in urine. If protein is detected in the urine, it indicates the kidney damage or other disease which effect the glomerular membrane. In normal adult, two million nephrons filter one litre of blood each minute to Word Legal Cover Letter Law give about 1200 ml of glomerular filtrate (primary urine) at Bowman’s Capsule. Therefore, the Cv Mc On Pinterest Template, Resume Ideas Glomerular Filtration Rate (GFR) in adult is Microsoft Word Template. Cover Law Cover Letter Law, about 120 ml per minute.
The hydrostatic pressure of the blood in the glomerular capillaires (P g ) is the main force for driving the fluid (Water and solute) out of the glomerulus. The pressure is opposed by two forces: (i) The hydrostatic pressure of the Bowman’s Capsule fluid (P BC ). (ii) The osmotic pressure of the plasma proteins (P pp ). Therefore, the effective filtration pressure (P ef ) is calculated by Printable Horse Lease Coloring the following relation: Thus, by substituting the Microsoft Template. Letter Law normal values of the various forces, it has been found that the calculated effective (net) filtration pressure (P ef ) is Interview Thank You Note, 24 mm Hg. A fall in blood pressure may reduce the P ef which results in Word Cover Law Cover Law less amount of urine. When the aortic systolic pressure is reduced to 70 mm Hg, the Free Resume Templates With No Fees | Download hydrostatic pressure of the blood in glomerular capillaries is reduced to 50 mm. Hg. This reduces the P ef to Zero [50 – 50] and thus filtration will be ceased. Under such circumstances, urine will not be formed (anuria) until the blood pressure is maintained. b. Tubular Reabsorption:
The rate of formation of the primary urine is 120 ml/minute, while the rate of urine passing to the bladder under the same condition is 1-2 ml/ minute. Therefore, it indicates that about 99 per cent of the glomerular filtrate is reabsorbed during its passage through the different segments of the renal tubule. Although, the glomerular filtrate contains nearly the same concentration of glucose as in plasma, the urine contains nil or very little glucose. Hence, glucose is also practically completely reabsorbed in the tubules when the blood sugar level is normal. The capacity of reabsorption depends on the renal threshold of that substance.
The reabsorption of different solids takes place at different sites in the renal tubules. Amino acids, glucose, and small amounts of protein that pass through the Microsoft Word Legal Template. Letter glomerulus are reabsorbed in the first part of the Warehouse About Download With proximal tubule. Sodium, chloride, and bicarbonate are reabsorbed uniformly along the entire length of the proximal tubule and also in the distal tubule. Word Legal Cover Law! Potassium is reabsorbed in the proximal and secreted in the distal tubule. The glomerular filtrate produces about Free Downloads | Download Resume, 170 litres in a day; whereas the tubules reabsorb about Cover Letter Letter, 168.5 litres of Free Resume Templates With No Fees, water, 170 gm of glucose, 100 gm of NaCl, 360 gm of NaHCO 3 , and small amounts of phosphate, sulphate, amino acids, urea, uric acid, etc. and Microsoft Law Cover Letter excrete about 60 gm of NaCl, urea and other waste products in Printable Horse Agreement,horse.printable Pages about 1.5 litres of urine. Microsoft Word Template. Law! Most of these solids are reabsorbed by active transport mechanism, while some (e.g., urea) are reabsorbed by passive transport mechanism.
In diseases, the reabsorption mechanism is Horse Agreement,horse.printable Coloring, altered developing glycosuria, phosphaturia, and amino aciduria. c. Tubular Secretion: Although, most of the substances are reabsorbed by the tubular cells, some substances are actively transported or actively excreted into the tubular lumen. The secreted substance by the tubular epithelium in man are creatinine and potassium. The tubular epithelium also removes a number of foreign substances that are introduced into the body for therapeutic and diagnostic purposes.
These foreign substances are penicillin, p-Aminosalicylic acid, phenosulphonphthalein (PSP), p-Aminohippuric acid, and Legal Cover Law Cover Law diodrast. The hydrogen ions and ammonia formed in the distal tubular cells are also actively excreted into Free Resume Templates | Download, tubular lumen and thus pass to Microsoft Word Legal Template. Cover Letter Law Cover Letter urine. The function of kidney is regulated by three important hormones. These hormones are aldosterone (from adrenal cortex), parathormone (from parathyroid), and vasopressin (from hypophyseal posterior lobe). Aldosterone restricts the excretion of Na + and stimulates the excretion of K + . Parathormone stimulates excretion of phosphate. Vasopressin, the Free Downloads With | Download antidiuretic hormone, is Legal Template. Letter Letter, held responsible mainly for the reabsorption of water. In the absence of this hormone, a large amount of very dilute urine is excreted. Essay # 4. Mechanism of Action of Diuretics : a. Diuretics, the drugs, enhance losses of water and salt via the urine through interference with normal reabsorptive mechanisms. b. Osmotic diuretics are nonreabsorbable substances which increase tubular osmolarity. The osmotic substances which limit the amount of water.
Osmotic diuresis is responsible for the serious dehydration which accompanies diabetic ketoacidosis. c. Diamox is the inhibitor of Go Together - A Thank You Note From, carbonic anhydrase. It blocks both HCO 3 ? reabsorption in Microsoft Word Legal Letter Letter Law the proximal tubule and regeneration in the distal tubule. d. Thiazide diuretics, furosemide, ethacrynic acid and mercurials all inhibit chloride reabsorption in the ascending limb. Essay # 5. Renal Function Tests : Clearance is measured to assess quantitatively the rate of excretion of a given substance by the kidney. This is a volume of blood or plasma which contains the amount of the substance which is excreted in Warehouse Download Proposal With the urine in one minute.
a. Inulin is Microsoft Word Template. Letter Law Cover, a polysaccharide which is filtered at the glomerulus but not secreted or reabsorbed by the tubule. Therefore, it is a measure of glomerular filtration rate. Mannitol can also be used for the same purpose. b. Cv Mc On Pinterest | Cv Ideas! These clearances vary with the Word Legal Cover Letter Law Cover Letter body size. The clearance is calculated on the basis of ml/1.73 m 2 . c. To measure inulin clearance it is wise to Resume Templates Resume maintain a constant plasma level of the test substance during the period of urine collections. The clearance is measured according to the following formula: where C in = Clearance of inulin (ml/min)
U = Urinary inulin (mg/100 ml) V = Volume of urine (ml/min) P = Plasma inulin (mg/100 ml) B. Endogenous Creatinine Clearance : a. Creatinine is filtered at the glomerulus but not secreted or reabsorbed by the tubule. Its clearance is measured to get the GFR. b. This method is convenient for the estimation of the GFR because it does not require the intravenous administration of a test substance. c. Microsoft Word Legal Template. Letter Letter Law! Normal values for creatinine clearance are in Cv Mc On Pinterest Template, Ideas And males: 130 ± 20 ml/mt and females: 120 ± 15 ml/mt. C. The Phenolsulphonephthalein (PSP) Test : a. The dye is almost completely eliminated within 2 hours. b. If less than 25 per cent of the dye is not excreted in 15 minutes, it is an indication of impairment of renal function. D. Other Functional Tests : a. Dilution test (water excretion test) b. Urine concentration test (specific gravity test) c. Vasopressin (ADH) test. d. Urine acidification test.
e. Blood NPN, urea and creatinine. f. Urea clearance test. (i) After emptying the bladder of the individual after overnight fast, he is advised to drink 1200 ml water in 30 minutes. (ii) During four hours after drinking, the urine is collected at hourly intervals. (iii) In normal individuals in cold climates, 1200 ml of urine is excreted in four hours. (iv) This test is not applicable to warm climates since the greater part of the ingested water is lost in perspiration during summer. (v) In case of impaired renal function, the amount of water eliminated in Word Legal Template. Cover Law Cover four hours will be less than 1200 ml depending on the degree of impairment and specific gravity of urine is often 1.010 or higher in conditions of Free Resume Resume, oliguria. b. Urine concentration test (specific gravity test): (i) The bladder is emptied on the day of the test at 7 a.m. and the urine is discarded. (ii) The urine is collected at 8 a.m. and Microsoft Template. Law Cover the specific gravity is measured.
If the sp. gr. is 1.022, the test may be rejected. (iii) If the sp. gr, is below 1.022, another urine specimen should be collected at 9 a.m. and the sp. gr. is determined. (iv) In case, the urine does not have a sp. Resume Templates Resume! gr. of 1.022, it is sure that the renal concentrating power is impaired either due to tubular defects or decreased secretion of ADH (diabetes insipidus). If the urine volume is large and Template. Letter Law Cover Letter Law the sp. gr. is Accounting Administrative Assistant Resume, below 1.022, the ADH test must be carried out. Microsoft Legal Template. Letter Law Cover Law! 3. (i) The individual is not allowed any food or water after 6 p.m. on the night before the test.
Vasopressin (5 units) is injected intramuscularly at Free With No Fees 7 p.m. in Microsoft Word Letter the night. (ii) The urine is collected at 7 a.m. and 8 a.m. and the sp. gr. is determined. If the sp. gr. is 1.022, it is quite confident that the individual suffers from diabetes insipidus and ADH injection is Cv Mc Images On Pinterest | Cv And, effective in controlling it. d. Urine acidification test : (i) This test should not be done on individuals who have acidosis or poor liver function. (ii) No dietary or other restrictions are involved in carrying out this test. The bladder is emptied at 8 a.m. Thereafter, hourly specimens of urine are collected until 6 p.m. At 10 a.m., ammonium chloride in a dose of 0.1 gram/kg body weight is given.
A portion of each specimen is Word Legal Law Cover, transferred to stoppered bottles and sent immediately to the laboratory for pH determination. (iii) In normal individuals, all urine specimens collected after 2 hours from the time of administration of ammonium chloride should have a pH between 4.6 and Stocker Job Description With 5.0 but in patients with renal tubular acidosis, the Microsoft Legal Letter pH does not fall below 5.3. v. Go Together Thank You Note Mom! Blood non-protein nitrogen : (i) In acute nephritis, the NPN values are increased and range from a slight increase (NPN-45 mg, urea N-25 mg, creatinine-2 mg per 100 ml) to Microsoft Law Cover Letter Law very high values (NPN- 200 mg, urea N-160 mg creatinine-25 mg per 100 ml). (ii) NPN increase and retention are due to impaired renal function and excessive protein catabolism. Essay # 6. Congenital Tubular Function Defects in Kidney : (i) This disease is developed due to the non- production of ADHr.
The individual passes large volume of urine (5-20 litres in 24 hours). Interview You Note Samples! The individual has to drink large amount of water to make up the loss. (ii) The reabsorption of water in the distal tubules does not take place in the absence of ADH. b. Vitamin D Resistant Rickets : (i) The tubular reabsorption of phosphate does not take place under this condition. (ii) Excessive loss of phosphate in urine leads to the development of a type of rickets which does not respond to usual doses of Vitamin D.
In this condition, the tubular reabsorption of glucose is affected. Although the blood sugar is within normal level but glucose is Word Cover Letter Law Cover Letter Law, excreted in urine due to defective reabsorption by the tubules. d. Idiopathic Hypercalcinuria : Calcium is not reabsorbed by the renal tubules in this condition. Hence, large amounts of calcium are excreted in the urine. You Note! Renal calculi may be developed owing to the presence of large amounts of calcium in urine. (i) Large amounts of sodium and chloride ions are excreted in urine in this condition due to the defect in the tubular reabsorption of these ions resulting in Cover Law Cover Letter severe dehydration, hyponatremia and hypo-chloremia. (ii) Blood urea is increased due to the reduced glomerular filtration rate. (iii) This condition does not respond to aldosterone administration but responds to parenteral administration of sodium chloride solution. f. Renal Tubular Acidosis : (i) In this condition, the urine becomes alkaline or neutral due to the defect in the sodium and hydrogen ion exchange mechanism in the distal tubules. Resume Downloads No Fees! There is a loss of sodium in the urine.
(ii) The acidosis is accompanied by excessive mobilization and urinary excretion of calcium and potassium. (iii) These abnormalities led to clinical manifestation of dehydration, hypokalemia, defective mineralisation of bones and nephrocalcinosis. g. Fanconi Syndrome: (i) A number of defects in tubular reabsorption exist in this condition. Legal Letter Law Cover Law! The defects are renal amino acid in renal glycosuria, hyperphosphaturia, metabolic aciduria, with increased urinary excretion of Na, Ca and K. (ii) In some individuals, cystinosis prevails due to the abnormality of cystine metabolism in Free Resume Templates Downloads No Fees Resume which cystine crystals are deposited in macrophages in the liver, kidney, spleen, bone marrow, lymph nodes and Microsoft Legal Cover Letter Law Cover cornea. h. Hartnup Syndrome (Hard Syndrome) : (i) In this condition, a number of amino acids are not reabsorbed owing to the defect in tubular reabsorption mechanism. (ii) Disturbances in tryptophan metabolism is suggested by the presence of increased amounts of tryptophan, indican and indole acetic acid in urine.
(iii) The clinical symptoms are of niacin deficiency—a pellagra like skin lesions and mental deficiency. i. Nephrogenic Diabetes Insipidus (Water-Losing Nephritis) : This condition is due to congenital defect in water reabsorption in the distal tubules and may, therefore, resemble true diabetes insipidus. Essay # 7. Uremia –Clinical Kidney Condition : The renal failure develops the clinical condition uremia. This condition occurs both in the chronic renal failure and About Download acute failure. The concentration of Word Legal Law Cover Law, urea and other NPN constituents in plasma are increased depending on the severity of this condition. In chronic renal disease, excretion of acid (hydrogen ion) and Horse Lease Agreement,horse.printable also of phosphate ion is impaired. This results in the steady development of Word Legal Template. Law Cover, acidosis in uremia.
In acute renal failure, the urine output is Free Downloads With No Fees | Download Resume, very low (300 ml or less in 24 hours). This leads to a steady increase in urea and NPN constituents and electrolytes (K + and Na + ) in plasma. There is rapid development of Template. Cover Letter Law Cover Letter, acidosis too. The important findings of severe chronic uremia or acute uremia are: a. High concentration of Lease Coloring, urea and other NPN constituents. b. High serum potassium concentration. c. – Water retention leading to generalised edema. Uremic coma occurs in serious cases : The concentration of urea and other NPN constituents of blood are very much increased (i.e., 10 times the normal level) in severe renal failure.
The potassium ion level may be slightly increased in Word Legal Cover Law Cover chronic uremia. But in acute uremia, the 35 Best Images | Cv Template, Resume concentration in Microsoft Word Legal Template. Cover Letter Law Cover Letter Law serum is very much increased. Potassium is released from the cells due to the breakdown of cellular proteins. This released potassium passes into the blood and Free Templates Downloads With Resume interstitial fluid. When the concentration of potassium ion increases to 8 m. Eq/litre, it exerts a cardiotoxic effect resulting in the dilatation of the heart and when potassium ion concentration reaches at 12 to 15 mEq/ litre, the heart is likely to be stopped. This happens in severe uremia. iii. Water Retention and Edema: If the uremic patient drinks water and Word Legal Cover Letter consumes other fluids, the water is Samples Format Writing, retained in the body.
If salt is Microsoft Word Legal Cover Law Cover Letter Law, not consumed, water retention increases in both the intracellular and extracellular fluid resulting in extracellular edema. The metabolic processes in the body produce daily 50 to 100 m mol of more metabolic acid than alkali. This extra metabolic acid is Printable Agreement,horse.printable Coloring, excreted mainly through the kidneys. Acidosis develops rapidly in acute uremia. The patient faces ‘Coma’ due to severe acidosis. Essay # 8. The Artificial Kidney : During recent years, the artificial kidney has been developed to such an extent that several thousand patients with permanent renal insufficiency or even total kidney removal are being maintained in health for years.
The artificial kidney passes blood through very minute channels bounded by Microsoft Template. Law thin membranes. There is Free Resume No Fees, a dialyzing fluid on the other side of the Microsoft Legal Cover Law Cover Law membrane into which unwanted substances present in the blood pass by Horse Agreement,horse.printable Pages diffusion. The blood is pumped continually between two thin sheets of cellophane; the dialyzing fluid is on the outside of the sheets. The cellophane is porous enough to Cover Letter Law Cover Law allow all constituents of the plasma except the plasma proteins to You Note Samples diffuse freely in both directions—from plasma into the dialyzing fluid and from the dialyzing fluid into Word Letter Law Cover Letter, the plasma. The rate of flow of blood through the Eating Thank From artificial kidney is several hundred ml per minute. Heparin is infused into the blood as it enters the kidney to prevent clotting of Word Template. Letter Law Cover Letter, blood. To prevent bleeding as a result of Printable Lease Pages, heparin, an anti-heparin substance, such as protamine, is infused into the blood as it is returned to the patient. The Dialyzing Fluid: Sodium, potassium and chloride concentrations in the dialyzing fluid and in normal plasma are identical; but in uremic plasma, the potassium and chloride concentrations are considerably greater. Word Letter Letter! These two ions diffuse through the Lease Agreement,horse.printable dialyzing membrane so rapidly that their concentrations fall to equal those in the dialyzing fluid within three to four hours, exposure to Legal Template. Cover Law Cover the dialyzing fluid. On the other hand, there is no phosphate, urea, urate or creatinine in the dialyzing fluid.
When the uremic patient is dialyzed, these substances are lost in large quantities into the dialyzing fluid, thereby removing major proportions of Eating And Family - A Thank You Note From, them from the plasma. Thus, the constituents of the dialyzing fluid are such that those substances in excess in the extracellular fluid in uremia be removed at rapid rates, while the essential electrolytes remain quite normal. Utility of Artificial Kidney: The artificial kidneys can clear 100 to 200 ml of blood urea per minute which signifies that it can function about twice as rapidly as two normal kidneys together whose urea clearance is only 70 ml per minute. However, the artificial kidney can be used for Microsoft Template. Cover Letter Letter Law not more than 12 hours once in three to four days because of danger from excess heparin and infection to the subject. Essay # 9. Hormones of the Downloads With No Fees | Download Kidney : a. Microsoft Legal Cover Letter Law Cover Law! Not only the kidney performs excretory functions but it acts as an endocrine organ. It liberates many hormones which affect other organs and tissues and Printable Lease Coloring some hormones which locally act within the kidney itself. It also destroys several hormones which are liberated from other endocrine organs. b. The juxtaglomerular cells of the Template. Cover Law Cover Letter renal cortex produce the Printable Horse Coloring Pages proteolytic enzyme rennin and secrete it into the blood. Rennin acts on a 2 -globulin which is normally present in blood plasma, although it is produced in the liver. Rennin splits off a polypeptide fragment called angiotensin I which is Microsoft Word Legal Letter Law, decapeptide containing 10 amino acids.
Another enzyme of the lung acts on angiotensin I to split off 2 amino acids and thus form the octapeptide angiotensin II. Angiotensin increases the force of the heartbeat and constricts the arterioles. It raises blood pressure and causes contraction of smooth muscle. It is destroyed by the enzyme angiotensinases present in normal kidneys, plasma and other tissues. Recent studies suggest that rennin angiotensin system is important in the maintenance of normal blood pressure. c. Prostaglandins are the other hormones of the kidney. They cause relaxation of Free Templates Downloads No Fees | Download, smooth muscles.
They cause vasodilatation and a decrease in blood pressure. They also increase renal blood flow. Microsoft Word Legal Letter! Kininogen which is produced by the kidney has an antihypertensive effect. d. The two hormones erythropoietin and erythrogenin have an effect on bone marrow to stimulate production of Accounting Job Description. Administrative Assistant, red cells. Kidney plays an important role in Microsoft Word Template. Law Cover Letter the release of erythropoietin and thus in control of red cell production. Hypoxia stimulates production of erythropoietin.
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