Table of Contents
This particular study relates to Jane and her physical condition. Jane is a marathon runner who is experiencing light-headedness and significant muscle pain after her last three runs. She has been feeling lethargic and unsteady. This particular study takes into account the results of her physical examination. The case study attributed several factors of discussion related to Jane. The discussion of the study will comprehend Jane’s urinalysis, ANS response, role of ADH, her kidney function and mean arterial pressure. The case study will take into account her haemorrhage during her caesarean delivery and calcium deficiency.
There were changes in terms of the volume as well as the pressure in Jane’s chest cavity during the exhalation after a long run. As when an individual inhales, two sets of muscles are at work. The dome-shaped diaphragm contracts, and will become flattered, and, with deep breathing, muscles in the chest and neck contract. Now to notice the changes it is required to explain the process through which changes are occurring (Barroso et al., 2018).In case of Jane, the mentioned process causes a slight vacuum. This was not sufficient, as there is a decrease in pressure relative to the ambient air and pulls air into the lungs. In case of Jane, those muscles were unable to relax, while she exhaled. Now she was unable to amplify the exhalation by contracting the abdominal muscles. On her inhale, the diaphragm is not moving down completely hence her muscles in the body wall were unable to move the ribcage outward and upward properly. Her chest cavity was not moving satisfyingly, unable to properly expand against air pressure and increasing its volume. It is therefore, air flows have decreased through the nose and lungs (Lillie et al., 2017).
Through the case study, it can be conferred that the gas exchange that is occurring in Jane’s alveolar air and pulmonary blood can be explained through a simplified diagram-
Jane’s Venous blood is pumped into the right side of the heart-then pumped out of the pulmonary artery and into the capillaries that line the alveoli. After venous blood is oxygenated/ CO2 dissolves then blood is pumped into the left side of the heart and to the body, to be used by the cells. The rate of gas exchange does changes during exercise conducted by Jane as her alveoli that refers to small sacs in the lungs that contain massive amounts of capillaries. There is a very small layer of cells between the capillaries and the air she inhales. That layer is thin enough for the molecules of gas to slip through and exchange in the haemoglobin. In the case of Jane, there are the dangers of the skin being as thin as the respiratory damage easily occurs if foreign compounds or objects are inhaled (Koeroghlian, Nichols & Longoria, 2020).
In the context of the case study, as the exercise begins (Jane), the activation of the sympathetic nervous system occurs. This causes increase in heart rate (due to release of adrenaline). This activation promotes blood supply to muscles to fulfil oxygen demand.The parasympathetic system (acetylcholine) causes bradycardia and slows down the heart rate (Dietrich et al., 2016).
The autonomic nervous system modulates the secretion of insulin and also influences the metabolic activity of muscles, liver and adipose tissues.Adrenaline promotes renal gluconeogenesis and release of glucose. It also causes decrement in uptake of glucose. The hypothalamus-pituitary axis also regulates glucose metabolism (Kliszczewicz, et al., 2018).
The role of the kidneys in maintaining body fluid balance concerning ADH in case Jane is also described. It was suspected that she was at risk of not maintaining homeostatic fluid mechanisms. To understand her problem it is necessary to get an overview of the system's mechanism. As in the case of Jane, low levels associated with those of the anti-diuretic hormone eventually will cause an increase in water excretion by the kidneys. Urine volume increase can lead to dehydration and low blood pressure. Low levels associated with the anti-diuretic hormone may indicate toward the damaging of the hypothalamus or in the direction of pituitary gland, or primary polydipsia. It can either be compulsive or else it can be caused more than water drinking which is common amongst the sprinters like Jane. In case of primary polydipsia, the levels are low in case of anti-diuretic hormone that is instrumental in representing an effort that is through the assimilation of the body in the direction of getting rid of the body’s excess water (Bankir, Bichet & Morgenthaler, 2017). All forms of Diabetes that are insipidus are considered to be in a condition in which Jane is bound to be either making a very little amount of anti-diuretic hormone. When osmotic pressure of blood is increased in Jane as in dehydration, ADH is secreted from pituitary gland. It increases water reabsorption so water is less excreted and urine output decreases (Bankir, Bichet & Morgenthaler, 2017) Jane as of now can maintain her homeostatic fluid but in future, she might not give her urinalysis report.
Urinalysis is the examination of urine to detect any abnormality, problem or disease. The given case study reflects that urinalysis is significant for the case of Jane as the case study report says that there is no presence of blood and proteinuria (protein) in the urine. Still, it is necessary to check. Besides, the presence of 6–8 pus cells means there may be slight urine infection as well. Either she is suffering from urinary tract infection, probably in urinary bladder (possibility of cystitis), or it may be that she was in the menstrual cycle (that's why age is relevant). In case she is too small to have her periods, then it is most probably due to urinary tract infection. Further test in form of ultrasound KUB or a repeat of urine routine and microscopic will prove whether she was in periods, or she is in order (Shaikh, Shope &Kurs-Lasky, 2019).
Concerning the specific gravity (SG) component the doctors need to measure the amount of protein in the urine (Jane). The test will find that if the amount of protein is low, and this is a double plus, which indicates a large amount then she is suffering from proteinuria. There is normally not any blood in the urine of Jane (Alleman & Wamsley, 2017).
From the case study, it is evident that Jane's blood pressure result shows that the mean arterial pressure is high from normal. Blood pressure causes much more damage to our body. When the level of blood pressure increases the veins are affecting. These pressures damage the veins of all the body. This damage is occurring due to large pressure exerted by the blood. So sometimes the veins of the body cannot bear and in some case, the veins burst. There are nephrons and glomerulus are present in the kidney that is too much affected by the increased pressure of the blood. So it can be stated that due to increasing level of blood pressure it can cause the abnormal activities of nephrons that affect the kidney. It decreases their ability to filter out the chemical waste products created by each body cell's daily metabolism of glucose. Those waste products build up in the bloodstream and can easily be detected by a simple blood test. Impaired kidney function leads to very untimely death (Meidert & Saugel, 2018).
Atrial natriuretic peptide (ANP)is chosen in context to blood pressure homeostasis in the case of June. It is instrumental in lowering blood pressure through the causing of vasodilatation. It is caused by stimulation of the kidneys in the direction of excretion that in case of Jane consists of water. It is therefore referred to the Na + which leads to the lowering of blood pressure by blood volume’s reduction. In her case, maybe the Nitric oxide (NO), those are secreted by endothelial cells, causes vasodilatation. So blood pressure might be related to hormones as well, but this is not only the cause of high blood pressure (Ichiki & Burnett, 2017).
Jane suffered a significant amount of haemorrhage in due course of her caesarean delivery that requires a blood transfusion. In case of a Hemolytic transfusion, the contextual reactions are instrumental in causing serious problems, but in rare cases. All these reactions can let to occurrence at times when Jane’s ABO or her Rh blood type along with those of the transfused blood that tend not to match. If this thing happens with her, then her immune system must have attacked her transfused red blood cells. Hence requiring more blood if not possible then can create life-threatening circumstances (Akinlusi et al., 2018).
During the time of her caesarean delivery, it was found that Jane was sufficiently deficient of calcium in her body and this issue was capable of affecting the ability of her blood to clot. As described in the below-mentioned, Calcium is required in multiple steps of the coagulation pathway platelet activation. Calcium is also required in the intrinsic pathway of coagulation. As per her medical history, she had a chance of blood clotting during her delivery as she was having calcium deficiency (Sarode et al., 2017).
To conclude it can be stated that Jane was physically unfit which was reflected in her physical examination and urinalysis. Her health complications made her feel lethargic and tired. The total examination of Jane reflected that her weight loss and all the problems were related to her previous health issues described in the study.
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