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Tubular secretion is necessary for four major processes: disposing of drugs, eliminating undesirable substances, eradicating extreme potassium, and controlling blood pH. Tubular secretion disposes of certain drugs and metabolites which might be tightly bound to plasma proteins. Over time, the cysts substitute the renal parenchyma and renal failure outcomes that requires dialysis. Polycystic kidney is associated with aneurysms of the aorta and brain, diverticula of the colon, and cysts of the pancreas, liver, and testes. This situation is recognized via belly computed tomography, magnetic resonance imaging, or ultrasound and by intravenous pyelogram. Nephron processing of urea is difficult, however basically up to 50% of filtrate urea is excreted. Nearly all potassium ions within the filtrate are reabsorbed within the proximal convoluted tubule and ascending nephron loop. Therefore, nearly all potassium in the urine is derived from lively tubular secretion into the last parts of the distal convoluted tubule and collecting ducts. When blood pH drops toward being acidic, renal tubule cells actively secrete extra hydrogen ions into the filtrate. Composition of Urine 585 At the distal convoluted tubule, potassium ions are removed from the peritubular fluid in exchange for sodium ions from the tubular fluid. Hydrogen ions generated by carbonic acid dissociation are secreted in exchange for sodium ions in the tubular fluid. Because production of lactic acid and ketone our bodies throughout postabsorption could cause acidosis, both the proximal and distal convoluted tubules deaminate amino acids to strip off the amino groups. The reaction sequence binds hydrogen ions and yields ammonium and bicarbonate ions. The ammonium ions are pumped into the tubular fluid, whereas the bicarbonate ions enter the bloodstream via the peritubular fluid. Composition of Urine Function of the Vasa Recta the vasa recta features to return solutes and water reabsorbed within the renal medulla to the bloodstream without changing the concentration gradient. These long, straight capillaries are parallel to the long nephron loop of the juxtamedullary nephrons. When blood enters the vasa recta from the peritubular capillaries, its osmotic focus is almost 300 mOsm per liter. Solute absorption is the main factor since plasma proteins management the osmotic flow of water from the blood. However, osmosis is the main factor here, since the presence of plasma proteins has no opposition to the osmotic move of water into the blood. Normally, removing of solutes and water by the vasa recta allows for exact balancing of solute reabsorption and osmosis inside the medulla. Urine is the final product of glomerular filtration, tubular reabsorption, and tubular secretion, and contains both filtered and secreted substances. Of this, 650 mL are plasma and, approximately, one hundred twenty five mL are filtrate compelled into the glomerular capsules. Urea is a result of amino acid catabolism and its plasma focus displays the quantity of protein in the diet. Urea filters into the renal tubule with about 80% reabsorbed, whereas the rest is excreted in the urine. Active transport reabsorbs many of the uric acid current in the glomerular filtrate. The chemical composition of urine is related to water quantity and the amount of solutes the kidneys should remove or retain to keep homeostasis. Urine production of 50�60 mL per hour is regular, with output of lower than 30 mL per hour possibly indicating kidney failure. In decreasing concentrations, urine incorporates largely urea, followed by sodium, potassium, phosphate, sulfate, creatinine, and uric acid. Tiny yet variable quantities of calcium, magnesium, and bicarbonate are additionally current. The physical traits of urine include shade, transparency, odor, pH, and particular gravity.

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The extracellular fluid compartment consists of all fluid outside of cells, making up about 37%, by volume, of whole physique water. This contains the plasma within the blood vessels, the lymph in the lymphatic vessels, and the interstitial fluid within the tissue spaces. Some extracellular fluid is separated from other forms of fluid and is called transcellular fluid and contains Body Fluid Distribution Total body water adjustments with age, body mass, and relative quantity of body fats. Once the toddler grows into childhood, the decline in complete body water has already begun. By the time an individual is aged, only about 45% of the body mass consists of water. Notice in the equation the concentration of ions is calculated in milligrams per liter. Therefore, to understand how this works, using sodium and calcium as examples, we need to calculate the mEq/L for each. By utilizing the equation, we discover the following for each: Sodium = 3,300 mg/L � 1 particle = 143 mEq/L 23 mg/mmol Fluid Composition Many various kinds of solutes are dissolved in water, the common solvent. Most nonelectrolytes are natural molecules such as creatinine, glucose, lipids, and urea. Electrolytes have much more osmotic power than nonelectrolytes, as a end result of their molecules dissociate into two or extra ions. For example, though the nonelectrolyte glucose remains undissociated and contributes one solute particle, a sodium chloride (NaCl) molecule contributes two and a magnesium chloride (MgCl2) contributes three. Magnesium chloride dissociates into a magnesium particle and two chloride particles. Water at all times strikes based on osmotic gradients, regardless of the kind of solute particles contained, which means water at all times strikes from an area of lesser osmolality to an area of larger osmolality. As a outcome, electrolytes have extra capability to cause fluid shifts than nonelectrolytes. In the physique fluids, electrolyte concentrations are commonly expressed in milliequivalents per liter (mEq/L). They have decrease quantities of magnesium, phosphate, and potassium ions than do intracellular fluids. In extracellular fluids, the first cation is sodium and the primary anion is chloride. Plasma accommodates fewer chloride ions than the interstitial fluid as a result of plasma is electrically neutral, and nonpenetrating plasma proteins are usually anions. These pumps maintain intracellular sodium ion concentrations low, and potassium ion concentrations high. The kidneys help by secreting potassium into the filtrate, whereas sodium is reabsorbed from the filtrate. In intracellular fluids, the primary cation is potassium and the first anion is hydrogen phosphate. The cells moreover contain large quantities of soluble proteins, in amounts which might be about triple to those found in plasma. Electrolytes are probably the most abundant solutes in the fluids of the body and management most chemical and bodily reactions. In the extracellular fluid, proteins and certain nonelectrolytes similar to cholesterol, phospholipids, and triglycerides are large molecules which would possibly be present. In the plasma, these make up approximately 90% of the mass of dissolved solutes and 60% in the interstitial fluid. The plasma is the medium that allows substances to be delivered to all areas of the body. Hydrostatic pressure inside cells and surrounding interstitial fluid is normally equal and secure. When the degrees of sodium in the extracellular fluid lower, this causes motion of water from the extracellular compartment into the intracellular compartment, by way of osmosis.

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S-A Node the sinoatrial node (S-A node) is a small crescentshaped mass of specialized tissue simply beneath the epicardium, in the proper atrium. It is situated near the opening of the superior vena cava, with fibers continuous with these of the atrial syncytium. No different part of the conduction system has a sooner depolarization fee than the S-A node. The path of a cardiac impulse travels from the S-A node into the atrial syncytium. The Functions of the Heart 461 characteristic rhythm of the S-A node known as the sinus rhythm, which determines heart price. Why is it important for impulses from the atria to be delayed on the A-V node before they cross into the ventricles A-V Node the impulse passes alongside junctional fibers of the conduction system to a mass of specialized tissue referred to as the atrioventricular node (A-V node), located in the inferior interatrial septum, beneath the endocardium. The A-V node offers the one normal conduction pathway between the atrial and ventricular syncytia. The atria due to this fact have extra time to contract and empty all their blood into the ventricles before ventricular contraction happens. Impulse conduction is slower in the A-V node than in different parts of the conduction system. Typically, 12 leads or electrodes are used that reply to weak electrical modifications by shifting a pen or stylus on a moving strip of paper. The regular movement of the paper permits the gap between the pen actions to record the time between phases of the cardiac cycle. They measure voltage differences between both arms or between one arm and one leg. The total of 12 leads offers an entire image of the electrical activity of the guts. A normal electrocardiographic sample includes a quantity of waves or deflections throughout each cardiac cycle. Right and Left Bundle Branches the A-V bundle soon splits into the proper and left bundle branches. These branches move along the interventricular septum toward the apex of the guts. Purkinje Fibers Nearly halfway down the septum, the right and left bundle branches unfold into enlarged Purkinje fibers, extending into the papillary muscular tissues. The Purkinje fibers have numerous small branches that turn into steady with cardiac muscle fibers and irregular whorls. Purkinje fiber stimulation causes the ventricular partitions to contract in a twisting motion to drive blood into the aorta and pulmonary trunk. The Purkinje fibers are also referred to because the subendocardial conducting network. As the impulse reaches ventricular fibers, they rapidly depolarize, displaying a higher electrical change because of the thicker ventricular partitions. Atrial repolarization is lacking from the pattern as a end result of atrial fibers repolarize at the similar time the ventricular fibers are depolarizing. The P-R interval contains atrial depolarization, contraction, and the passage of the depolarization wave by way of the remainder of the conduction system. The S-T phase occurs when the action potentials of the ventricular myocytes are in their plateau phases. It is the period from the beginning of ventricular depolarization by way of ventricular repolarization. Speed of Conduction From the time the S-A node generates an impulse till depolarization of the ultimate ventricular muscle cells takes only 220 ms in a healthy heart. After the ventricular depolarization wave, ventricular contraction is kind of instant.

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It is discovered in the walls of hole organs such as the intestines, abdomen, urinary bladder, and uterus. The nervous system communicates with skeletal muscles at which of the following websites The neuromuscular junction A cycle of contraction and leisure produced by a single stimulus is called a(n) A. Which of the next neurotransmitters incorporates the synaptic terminal of the neuromuscular junction Which of the following is the distinction between skeletal muscle cells and typical cells Skeletal muscle cells are controlled by the central and peripheral nervous methods Which of the next is the function of myoglobin In which of the following durations are the skeletal muscular tissues briefly unable to respond to stimuli Name the muscular tissues of the abdominal wall and explain the motion of the rectus abdominis. Describe the quadriceps femoris group and the operate of the muscles it contains. Overview Skeletal muscle tissue usually operate in teams, with the nervous system stimulating the desired muscular tissues to carry out the meant operate. A muscle that contracts to provide most of a desired motion is called a main mover or agonist. A good instance is the pectoralis main muscle, which is a main mover of arm flexion. Other muscular tissues, often known as synergists, work with a main mover to make its action more practical by adding a small amount of further pressure. For example, if you bend your forearm, the agonist muscle tissue are the biceps and the synergists are the triceps. In muscle tissue that cross several joints, contraction causes movement in any respect the spanned joints except other muscular tissues act as stabilizers of the joints. Other flexors may trigger some undesirable movements in a joint, however synergists forestall this and allow the whole pressure of the prime mover to happen in the desired directions. Some synergists, generally identified as fixators, can also assist an agonist by stopping another joint from moving to stabilize the origin of the agonist. Fixator muscles running from the axial skeleton to the scapula trigger the scapula to be immobilized. Antagonists and their prime movers are situated on the opposite sides of joints across which they operate. An instance is the pectoralis major, which acts as an antagonist to the latissimus dorsi, the prime mover that extends the arm. It is important to perceive that antagonists can truly also be prime movers similar to latissimus dorsi when it acts as the prime mover of arm extension. Origins and Insertions One end of a skeletal muscle normally is fastened to a relatively immovable part (origin) at a movable joint. The other finish connects to a movable part (insertion) on the other side of the joint. There may be multiple origin or insertion similar to in the biceps brachii muscle of the arm. Arrangement of Skeletal Muscles Skeletal muscles, based on the association of their fascicles, are divided into four distinct varieties: parallel muscle tissue, convergent muscles, pennate muscular tissues, and round muscular tissues. The pennate muscle tissue are subdivided into unipennate, bipennate, and multipennate muscular tissues. Parallel Muscles Most skeletal muscle tissue are classified as parallel muscle tissue, during which the fascicles are parallel to the lengthy axes. Some are flat muscular bands with broad 242 Chapter 10 Muscular System Origin Tendon Gaster leg, which has its fascicles inserted into only one side of the tendon. One instance of a bipennate muscle is the rectus femoris in the thigh, which has fascicles inserted into the tendon from opposite sides.

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The lumbosacral plexuses are so named due to substantial overlap of the lumbar and sacral plexuses, with many lumbar plexus fibers combining with the sacral plexus by way of the lumbosacral trunk. The lumbar plexuses are nervous plexuses within the lumbar area, formed by components of the first 4 lumbar nerves and parts of the subcostal nerve. The nerves of the lumbar plexuses pass in entrance of the hip joints and mostly assist the anterior muscles of the thighs. Each lumbar plexus lies throughout the psoas major muscle, branching proximally to innervate belly wall muscles and the psoas muscle itself. The largest terminal nerve of the lumbar plexus is the femoral nerve, which runs deep to the inguinal ligament. Its motor branches innervate the quadriceps (anterior thigh muscles), which are vital for flexing the thigh and extending the knee. The obturator nerve enters the medial thigh through the obturator foramen, innervating the adductor muscle tissue. If the obturator nerve can be impaired, pain or numbness of the medial thigh occurs. The widespread fibular nerve (also called the frequent peroneal nerve) descends to wrap across the neck of the fibula and divides into superficial and deep branches. The branches innervate the knee joint, pores and skin of the leg (anterior and lateral), and dorsum of the foot. They also innervate the anterolateral leg, so its extensors can dorsiflex the foot. If the proximal space of the sciatic nerve is injured, the lower limb could also be impaired in different methods, primarily based on which nerve roots are affected. This sort of harm could additionally be caused by a disc herniation, a fall, or an injection into the mistaken portion of the buttocks. The sacral plexus lies instantly caudal to the lumbar plexus, arising from spinal nerves L4 to S4. It has approximately 12 named branches, half of which serve the buttocks and lower limbs. The sciatic nerve is the most important branch of the sacral plexus and can be the longest and thickest nerve in the whole physique. The sciatic nerve is definitely two nerves in a common sheath, called the tibial and common fibular nerves. The sciatic nerve strikes from the pelvis, via the larger sciatic notch, deeply into the gluteus maximus muscle. It then enters the posterior thigh medial to the hip joint, with motor branches to the hamstring muscular tissues and adductor magnus. In the hamstrings, it comprises all muscle tissue that reach the thigh and flex the knee. Just above the knee, the tibial and customary fibular nerves diverge into totally different directions. List the quantities of spinal nerves that originate in each of the five major divisions of the spinal twine. The intercostal nerves supply the intercostal muscular tissues, the skin and muscles of the anterolateral thorax, and nearly all of the stomach wall. Varicosities are knob-like swellings that comprise mitochondria and synaptic vesicles, resembling a string of pearls. As a outcome, visceral motor responds are slower than these brought on by somatic motor fibers, which cause direct opening of ion channels. They are associated to the innervation of skeletal muscle in addition to the innervation of visceral muscles and various glands. Define the term "neuromuscular junction" and the connection to axon terminals and the top plate potential. The ending of every axon department, at its goal muscle fiber, splits right into a cluster of axon terminals, branching over the sarcolemma folds of the fiber. Because sodium enters cells more quickly than potassium is misplaced, the muscle cell interior turns into depolarized. This graded potential, known as the end plate potential, spreads to close by areas of the membrane, causing voltage-gated sodium channels to open. An action potential results along the sarcolemma, stimulating contraction of the muscle fiber.

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When blood pressure or volume falls, certain cells of the juxtaglomerular advanced of the kidneys are excited, which reply by releasing renin into the blood. The cells of the zona glomerulosa within the adrenal cortex are instantly influenced by fluctuating blood ranges of potassium. When elevated, potassium stimulates aldosterone release, and the alternative can additionally be true. This helps to ship vitamins and respiratory gases in an attempt to deal with the stressors. It regulates blood strain and sodium�water steadiness and tremendously inhibits the renin�angiotensin�aldosterone mechanism. Renin and aldosterone secretion are blocked, and atrial natriuretic peptide additionally inhibits different mechanisms that enhance sodium and water reabsorption. Overall, it decreases blood stress by allowing sodium and water to depart the body in the urine. Cortisol, which is also identified as hydrocortisone, helps stability blood glucose and is controlled by unfavorable feedback. Other glucocorticoid hormones embody cortisone and corticosterone, however these are comparatively insignificant in contrast with cortisol. Cortisol responds to stress by causing a big rise in blood glucose, amino acids, and fatty acids. Its metabolic impact generally known as gluconeogenesis is defined as the formation of glucose from fats and proteins. Cortisol, in an try and conserve glucose for the brain, mobilizes fatty acids from adipose tissue to permit them to be used for vitality. Stored proteins are broken down, vasoconstriction is enhanced, and vitamins are dispersed to the cells extra shortly than regular. Excessive cortisol, however, causes anti-inflammatory and anti-immune effects to a big degree. The two major kinds of issues that outcome are hypertension and edema because of extreme sodium and water retention and increased excretion of potassium ions. When this second problem is excessive, the neurons become nonresponsive and muscles weaken until they eventually turn into paralyzed. Cortisol is a glucocorticoid produced within the middle adrenal cortex or zona fasiculata that also influences protein and fat metabolism. It disrupts normal cardiovascular, gastrointestinal, and neural function and inhibits irritation through the decrease within the launch of inflammatory chemical compounds. Gonadocorticoids the internal adrenal cortex or zona reticularis produces intercourse hormones. Some androgens from the zona reticularis are converted to estrogens, which are the dominant sex hormones in females. Adrenal androgens stimulated improvement of pubic hair in both sexes prior to puberty. The affected person usually develops a swollen, "moon-shaped" face, fat redistribution to the stomach and posterior neck, poor wound healing, and simple bruising. In the posterior neck, fats distribution is often referred to as a "buffalo hump. It results from atrophy or destruction of each adrenal glands, which finally ends up in a deficiency of each glucocorticoids and mineralocorticoids. Less often, adrenal destruction may end result from tuberculosis, histoplasmosis, or metastatic cancer. Because of glucocorticoid and mineralocorticoid deficiency, blood glucose ranges could decline and hypoglycemia might develop. Other signs embody weight reduction, lowered plasma glucose and sodium, and increased blood potassium. Severe hypotension and dehydration usually happen, and therapy is with corticosteroid replacements.

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C C proteins: Skeletal muscle contractile proteins concerned in the assembly of myosin. Calcarine sulcus: A groove of the medial surface of the occipital lobe that separates the wedge-shaped cuneus of the cerebrum from the lingual gyrus. Calcitonin: A thyroid hormone that regulates the concentrations of blood calcium and phosphate ions. Calmodulin: A calcium-binding messenger protein in eukaryotic cells that transduces calcium alerts by binding calcium ions after which modifying interactions with target proteins. Canaliculi: Microscopic canals in bones, by way of which mobile processes move to allow osteocytes to communicate with other cells. Canines: the 4 teeth, one on all sides of the higher and decrease jaws, situated between the lateral incisors and first premolars. Glossary Capacitation: the process in which the spermatozoon, after it reaches the ampulla of the fallopian tube, undergoes a series of adjustments that lead to its capability to fertilize an ovum. Capillaries: the smallest diameter blood vessels, which connect the smallest arterioles to the smallest venules. Capsules: Well-defined anatomic structures that enclose an organ, such because the kidneys and adrenal glands. Carbonic anhydrase: An enzyme in pink blood cells that speeds reaction of carbon dioxide and water, leading to carbonic acid. Cardiac conduction system: the initiation and distribution of impulses by way of the myocardium that coordinates the cardiac cycle. Cardiac cycle: A heartbeat; it consists of an entire sequence of systolic and diastolic events. Cardiac muscle tissue: A special striated muscle of the myocardium, containing dark intercalated discs on the junctions of abutting fibers. Cardiac output: the amount discharged from the ventricle per minute, calculated by multiplying stroke quantity by heart price, in beats per minute. Cardiac tamponade: Compression of the heart produced by the accumulation of blood or different fluids within the pericardium. Cardinal ligaments: Parts of the thickenings of the visceral pelvic fascia beside the cervix and vagina; they pass laterally to merge with the upper fascia of the pelvic diaphragm. Carina: Any construction formed like a ridge, cleft, or keel; such because the carina of the trachea, which projects from the bottom tracheal cartilage. Carotid our bodies: Small buildings within the carotid arteries that include chemoreceptors that are involved in the control of respiration. Carotid sinuses: Dilations of the arterial walls at the bifurcations of the widespread carotid arteries. Carpals: the bones of the wrist; they embrace the scaphoid, lunate, triquetrum, pisiform, trapezium, trapezoid, capitate, and hamate bones. Cartilage: A rigid connective tissue that helps, frames, and attaches to many underlying tissues and bones. Cartilaginous joints: Those connected by hyaline cartilage, or fibrocartilage, such because the joints that separate the vertebrae. Catalysts: Atoms or molecules that can change the speed of a reaction with out being consumed in the course of the process. Catecholamines: A group of secreted sympathomimetic chemicals; the most typical catecholamines are epinephrine, norepinephrine, dopamine, and serotonin. Caudate nucleus: An elongated, curved mass of gray matter lateral to the thalamus in the floor of the anterior horn and body of the lateral ventricle. Cavernous sinuses: A pair of irregularly shaped bilateral venous channels between the sphenoid bone of the cranium and the dura mater. Cecum: A pouch-like construction firstly of the massive intestine that receives waste materials from the small intestine. Celiac trunk: the arterial trunk arising from the stomach aorta from which originate the left gastric, frequent hepatic, and splenic arteries. Cell membrane: the plasma membrane; it controls motion of drugs into and out of the cell. Cellular immune response: Cell-mediated immunity; it happens when T cells connect to international, antigen-bearing cells such as bacterial cells, and interact with direct cell-to-cell contact. Cellulose: An indigestible polysaccharide found in plants, which features as bulk (a form of fiber), aiding in peristalsis of feces.

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General Senses 331 Muscle spindles: Fusiform (spindle-shaped) proprioceptors throughout the skeletal muscle perimysium. Each of them has a bundle of modified intrafusal fibers inside a connective tissue capsule. Tendon organs: Proprioceptors inside tendons, close to junctions between the tendons and skeletal muscle. When tendon fibers stretch due to muscle contraction, compression of nerve fibers prompts the tendon organs (proprioceptors). Joint kinesthetic receptors: Proprioceptors that monitor stretching of articular capsules enclosing synovial joints. They have at least 4 receptor varieties, together with free nerve endings, lamellar corpuscles, bulbous corpuscles, and receptors that seem like tendon organs. The tonic receptors are referred to as slow-adapting receptors as a end result of they show little peripheral adaptation. Central adaptation refers to inhibition of nuclei located alongside a sensory pathway. Pain Receptors in Visceral Organs Pain receptors in the visceral organs act differently from these located in floor tissues. When visceral tissues are stimulated on a widespread foundation, strong pain sensations can observe. This type of ache seems to be brought on by mechanoreceptor stimulation, decreased oxygenated blood flow, or accumulation of pain-stimulating chemicals. Visceral pain may seem to be coming from a different area of the body from the one actually being stimulated. Heart ache, for example, could seem to be occurring within the shoulder or upper left arm. Heart pain impulses journey by way of the same nerve pathways as do pores and skin pain impulses similar to those from the skin of the left shoulder and upper left arm. Acute ache fibers are thin, myelinated nerve fibers that conduct nerve impulses quickly and largely produce sharp pain. Chronic ache fibers are skinny, unmyelinated nerve fibers that conduct impulses more slowly and largely produce uninteresting, aching pain. Pain stimulation usually causes each types of sensations-a sharp ache adopted by a uninteresting ache. The aching pain is commonly more intense, worsening as time passes, and can cause extended struggling. Other neurons conduct impulses to the thalamus, hypothalamus, and cerebral cortex. The midbrain, pons, and medulla oblongata regulate how pain impulses move from the spinal twine. Biochemicals are launched to block ache indicators by inhibiting presynaptic nerve fibers within the spinal wire. Somatosensory System Sensation is the awareness of environmental adjustments both externally and internally. To survive, humans depend on sensation as nicely as how they interpret these changes (perception). The a half of the sensory system that serves the limbs and wall of the body is identified as the somatosensory system. The sensory receptors make up the receptor degree of this method, whereas processing in the ascending pathways makes up its circuit stage. The price at which action potentials are generated changes when stimulus increases or decreases. Phasic receptors are normally inactive, but become active for a brief time frame when a change happens in the situations they monitor. These receptors provide details about depth and rates of change of a stimulus. The preliminary 332 Chapter 13 Peripheral Nervous System and Reflex Activity the posterior horn of the spinal wire releases enkephalins to suppress pain impulses of assorted severities.

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