Question

Bob has been active all of his life. He played soccer from elementary school all the way through college. He even played on a community team but now at age 45, he’s been diagnosed with high blood pressure (hypertension). At times he ate too much junk food and occasionally drank too much alcohol but he couldn’t get around the fact that the men in his family all had high blood pressure. Dr. Miller, Bob’s primary care physician, had to prescribe two different antihypertensive medications in order to get his blood pressure under control. She also recommended Bob continue his regular soccer workouts but suggested a low-salt diet and more modest alcohol intake. Bob heeded Dr. Miller’s recommendations. His father and his 2 uncles had hypertension at a young ages, and all 3 men ended up on dialysis before dying from complications of kidney failure.Bob began the recommended lifestyle changes at age 45 and even started running regularly to keep his blood pressure under control. Now, 10 years later, he was a marathoner and participated in local marathons, competing with, and outrunning many his own age. However, Bob noticed that during the past several months, he’d experienced more fatigue than normal and some dehydration symptoms after his long runs. After consulting with Dr. Miller, Bob sought the help of Ty, an exercise physiologist, to help him maintain his exercise regime and his health without feeling “old”.Ty worked with Dr. Miller to make sure that Bob was monitored closely since he was still taking his anti-hypertensive medications. Ty suggested a urinalysis to assess Bob’s physical condition before, during and after his workouts. Bob dutifully supplied urine samples to Dr. Miller for evaluation as Ty recommended. Ty explained that Bob’s dehydration symptoms were more difficulty to evaluate since the medication Bob took to control his high blood pressure could affect his renal status or physiologic functioning.Dr. Miller logged the following results of Bob’s urinalysis immediately after, and six hours after, a rigorous 2-hour run.

Time	color	Specific gravity	protein	glucose	PH
Before exercise	pale yellow	1.002	none	none	6.0
Immediately after exercise	dark yellow	1.035	small amount	none	4.5
6 hours after exercise	yellow	1.025	none	small amount	5.0

Based on the urine color and specific gravity, Ty assessed Bob’s hydration status at the three different urine collection times. Explain what you believe to be Bob’s hydration status before Bob began his workout, immediately after his work and 6-hours after his workout.

Antidiuretic hormone (ADH) plays a large part in regulating the formation of concentrated or dilute urine. During Bob’s long runs, his ADH secretion would change based on how much he perspired. Explain why ADH secretions would fluctuate during Bob’s long runs.

Answer 1

Exercise affects the system in the same way as the vast majority of the urinary system.
Blood flow to the kidneys.

When you exercise it, and by spraying blood on your stomach, it will be affected, resulting in increased action of the sympathetic nervous system, in the "fight or flight" part of the nervous system. It is necessary to reduce blood flow in blood pressure to keep muscles working and dilate blood vessels. Because of the decrease in the blood that spills into your stomach, and the fluid supply is reduced during moderate exercise intensity is filtered, so it becomes the decrease in urine production.

Exercise sodium and fluids

You can lose significant amounts of sodium in your sweat stream and during exercise. To maintain water balance and conserve sodium, the kidneys reabsorb water, which favors the reduction of urine production. Since the amount of fluid during exercise is conserved in this way is small compared to the amount of sweat, the kidneys continue to hold sodium for hours or even days after vigorous exercise to restore normal levels.

Hormonal effects on the kidneys.

Maintaining fluid balance during exercise is involved in an important antidiuretic hormone, or ADH, to cleanse the kidneys of sodium and preserve it. Results are more concentrated in urine Adh which should be avoided. Hormones are responsible for restoring aldosterone aceias in the normal electrolyte level of the kidney and after exercise. The response of a man to a strong regulator of the sodium balance of the hormone renin aceiae secreted by the stimulation of the sympathetic nervous system that is carried out by Proposition A.

Another effect is kidney exercise

During exercise, the kidney filter also tends to have more protein, so producing a high level of protein in the urine should be avoided. The kidneys are partly responsible for maintaining the acid-base balance. When you exercise intensely, in the production of lactic acid with you, as to what fat the kidneys excrete. For this and other reasons, it is made from the acidic water in your feet during exercise. After exercise, it is metabolized into lactic acid and not to the aid of the rest of the kidneys, that is, it is converted into glucose or blood sugar.

Osmolarity increases or decreases the volume of ADH release into blood plasma and other problems. The front tonically stimulates the hypothalamus Osmoreceptors magnocellular neurons in the secret of Adh. Decrease ADH secretion increases plasma osmolarity increases osmolarity leads backward. This would see a negative action that ADH will handle the water in the kidneys. In a word, that ADH is the increase of with the mechanism of the waters, and the V2 Gs, the permeability to urea of ​​the first that harbored them in establishing a relationship with the duct cells by means of the latent recruiters gathered. together and poured aquaporin water-2: let the apex fill a page. The ADH is sent down, the reabsorption of water is passed is a large volume of the compact fruit that can abound; ADH is a large volume of about the same that is diluted with urine and lowers it. The osmolarity decreases the secretion of ADH that is sent down, the blood returns to the normal osmolarity of water to produce the loss of salt and water in the kidneys. ADH secretion leading to increased osmolarity increases water reabsorption. It excreted more salt water to return to the main plasma osmolarity.

to clean the bitter belly, but it does not increase much, and osmolarity. High-pressure receptors in the arc of the terminal carotid leaflet of the aorta and pulmonary vein and low-pressure receptors in the atria, central nervous system to report status and in motion. The journey through the 9 cranial nerves (nerve) and 10 (roaming) to the medulla. Such exitibusque tonically inhibits ADH release. Reduces the volume of the burning rate reduction of stretch receptors in the blood, thus reducing the release. ADH is the medicine of the commandment of and for the promotion of energy, from which the water is extracted from the kidney. This does not hold the blood book, but it helps conserve the water for which it is used. The ADH is bound to reach the V1 receptors, causing the GG vasoconstriction technique to begin by pressing on the film.

Salt and water excretion can adjust the correct setting of plasma osmolarity and excess plasma volume, only water conservation, can not correct plasma volume control. To achieve this, you need to drink fluids and swallow the fluid in your blood. Similarly, in the sense that it can encourage the government to release ADH, the high- and low-pressure receptors in the osmoreceptors of the anterior hypothalamus.