15. Endocrine System II Flashcards
Low blood osmotic pressure has
Blood volume:
Solute:
Low blood osmotic pressure has
Blood volume: HIGH
Solute: LOW
Stimulates ADH secretion
High blood osmotic pressure
Reduce fluid intake
Excessive sweating
Diarrhea
Hormone responsible for Calcium reabsorption
Parathormone
Responsible for water reabsorption
Adh or vasopressin
Responsible for sodium reabsorption
Aldosterone
Deficiency of Antidiuretic hormone or vasopressin
Diabetes insipidus
2Ps of Diabetes Insipidus
Polyuria
Polydipsia
Shapes of thyroid gland
Butterfly shape or H shape gland
Largest endocrine gland
Thyroid gland
Connects L/R thyroid gland
Isthmus
Thyroid gland is located
Below the:
Just the level of:
Thyroid gland is located
Below the: thyroid cartilage
Just the level of: cricoid cartilage
Shape of the cricoid cartilage
Signet ring
Secretes major thyroid hormones
Follicular cells of the thyroid gland
MAIN hormones of thyroid gland
T3
T4
ALL hormones of thyroid gland
T3/T4
Calcitonin
Increases metabolic function of the body
Maintains body temperature
T3/T4
Normal body temperature
36.5-37C
Secretes calcitonin
Parafollicular cells of the thyroid
Decreases blood calcium levels
Calcitonin
Has opposite function of calcitonin
Parathyroid hormone
Blood calcium levels
Calcitonin (parafollicular cells) :
Parathyroid hormone (chief cells) :
Blood calcium levels
Calcitonin (parafollicular cells) : decreases
Parathyroid hormone (chief cells) : increases
Thin = excessive metabolic function
High body temp = heat intolerance
Moist skin
Exophthalmia
Hyperthyroidism
Most common cause of hyperthyroidism
Grave’s disease
Another possible cause of hyperthyroidism
Plummer’s disease
Drug contraindicated for hyperthyroidism
Epinephrine
- because it increases metabolic rate
Severe hyperthyroidism
Complication associated with Epinephrine
Thyroid storm or thyrotoxicosis
Anes that can be used with pxs with hyperthyroidism (without epi)
Mepivacaine
Characterized by thick, cold body, cold intolerant, dry skin
Hypothyroidism
Organ that uses iodine to function
Thyroid gland
Drugs for hyperthyroidism
Methimazole
Propylthiouracil (PTU)
Most common cause of hypothyroidism?
Hashimoto’s thyroiditis
Another cause of hypothyroidism
Iodine deficiency
Hypothyroidism in children?
Cretinism
Hypothyroidism in adults?
Myxedema
Drugs for hypothyroidism?
Synthetic thyroxine (T4)
Normal blood calcium
9-11mg/dL
Normal PT
9-13s
Parathyroid glands are found _ to the thyroid gland
Posterior to the thyroid gland
PTH/Parathormone/Parathyrin is produced by
Chief cells of parathyroid gland
Increases blood calcium
Parathormone
MAJOR blood calcium regulator
Parathyroid hormone
Calcitonin is released during (stimulus for secretion)
High blood calcium levels ⬆️
- so calcitonin will decrease it
PTH is released during (stimulus for secretion)
Deficient or low blood calcium levels ⬇️
- so pth will increase it
Site of production of PTH
Chief cells of parathyroid gland
Site of production of calcitonin
Parafollicular cells of thyroid gland
PTH increases blood calcium levels by: 3
- Bone resorption - (kukuha sa bone para bigay sa blood)
- Increase calcitriol formation - (para ma⬆️ absorption ng Ca sa intestines)
- Increase Ca reabsorption in DCT
When PTH increases blood calcium levels; what is decreased? (Kapalit)
Decrease blood phosphate levels
- ⬇️ blood phosphate reabsorption in DCT
Calcitonin decreases blood calcium levels by
Bone formation
- (ung mga calcium sa blood, ibbigay sa bone)
Excessive PTH
Hyperparathyroidism
Features:
Osteoporotic bone
Absence of lamina dura
Hypercalcemia
HYPERPARATHYROIDISM
Features:
Osteoporotic bone - (bec of bone resorption)
Absence of lamina dura - (bone resorption)
Hypercalcemia - (because of ⬆️PTH:increases)
What is the radiographic appearance of HYPERPARATHYROIDISM?
Ground glass
Diseases with GROUND GLASS radiographic appearance
“HAF GLASS”
Hyperparathyroidism
Albers-Schonberg/Marble bone dse/osteopetrosis
Fibrous dysplasia
Other name for OSTEOPETROSIS
Albers schonberg
Marble bone dse
(boards: Albrights)
Histologic appearance of Fibrous dysplasia
Chinese character
Fibrous dysplasia is associated with what syndromes
Jaffe-Lichstenstein syndrome
McCune Albright syndrome*(boards)
Triad of McCune Albright Syndrome
Fibrous dysplasia
Cafe au lait spots
Hyperfunctioning endocrine system (esp in FEMALES= early menstruation 5-6y/o)
Severe form of hyperparathyroidism?
Von recklinghausen’s disease of the BONE
Boards*: other term for hyperparathyroidism
*Von recklinghausen’s disease of the BONE
Real other term: “osteitis fibrosa cystica”
Histologic appearance of von recklinghausen’s disease of the bone
Brown tumor
Aka osteitis deformans
Pagets disease of the bone
Radiographic appearance of pagets disease
Cotton wool rx app
Histologic appearance of Paget’s dse
Jigsaw puzzle
Deficient PTH
Hypoparathyroidism
*2 dses with Punched out rx appearance
Multiple myeloma
Hand-Schuller-Christian disease
HYPOcalcemia and HYPERcalcemia may lead to
Cardiac arrhythmia
and *tetany(not sure if hypocalcemia lang)
Where is sino atrial node located
Crista terminalis
⬇️PTH ⬇️ Blood calcium =
Hypocalcemia
Hyperexcitability of neurons and muscles
Tetany
Hypersenstive facial nerve
Chvostek sign
Brachial artery compression
“hand of obstetrician”
Trousseous sign
Located superior to the kidney
Adrenal glands or suprarenal glands
2 regions of adrenal gland
Inner -
Outer -
Inner - adrenal medulla
Outer - adrenal cortex
3 zones of the ADRENAL CORTEX
“GFR”
Zona glomerulosa
Zona fasiculata
Zona reticulosa
Hormone secreted by Zona glomerulosa
Mineralocorticoid (aldosterone)
Aldosterone regulates
Sodium reabsorption and *water reabsorption(follows)
End product of RAAS
Aldosterone
Excessive aldosterone
Hyperaldosteronism
Other term for hyperaldosteronism
Conn’s disease
Deficient aldosterone
Hypoaldosteronism
Regulates the blood volume
Juxtaglomerular apparatus
Detects NaCl concentration in the DCT
High NaCl = afferent arterioles constrict
Low NaCl = aff art dilate + JG to release RENIN
Macula densa cells of DCT
Stimulus for juxtaglomerular cells to release RENIN
Low NaCl concentration in the DCT
Cells that secretes RENIN that is impt for RAAS
Juxtaglomerular cells
RAAS effect to vessels
- Vasoconstriction = Increases BP
- Release of aldosterone
- ⬆️BP + Reabsorp of Na + Excretion of PO4 - Inc GFR
Stimulus for RENIN secretion
Low aNaCl concentration in DCT
Low blood pressure
Decrease renal blood flow = Decrease GFR
Sympathetic activation
Na ion regulator and BP regulator
RAAS
Angiotensinogen (from:_) + Renin (from:) =
Angiotensinogen (from:LIVER) + Renin (from:KIDNEY) = Angiotensin I
Angiotensin I is converted by what enzyme to form ANGIONTENSIN II
ACE : Angiotensin converting enzyme
Happens in the lungs
Angiotensin II or ACE* is found in the
Lungs
Stimulates secretion of aldosterone in the zona glomerulosa of adrenal cortex
Angiotensin II
Angiotensin II effects on:
Afferent arterioles:
Blood pressure:
Angiotensin II effects on:
Afferent arterioles: vasoconstricts
Blood pressure: increase BP
Major Na ion regulator
- increases reabsorption of sodium in the DCT (+water)
- increases EXCRETION of K in urine
Aldosterone
Drugs for Hypertension (to decrease BP)
ACE Inhibitors - (dont convert angiotensin I to II=no vasoconstriction & inc in bp
Angiotensin II Antagonist - (no vasoconstriction and inc in bp)
Example of ace inhibitors “ACE-pril”
Captopril
Ex of A2 antagonist
Lozartan
Detects pressure in the blood*
Baroreceptors
Baroreceptors are found in the
Carotid and Aortic SINUS
RAAS = _ blood volume : _BP
RAAS = ⬆️blood volume : ⬆️BP
When baroreceptors detects ⬇️BP(⬇️blood volume) = it signals the Juxtaglomerular cells to secrete
Renin
Hormone secreted by zona fasiculata
Cortisol (glucocorticoids)
Primary stress hormone
Cortisol
Excessive cortisol
- exhibits: buffalo humo and moon face
Cushing’s disease
⬇️ cortisol
- hyperpigmentations
Addison’s disease
Effects of cortisol
Anti inflammatory
Immunosuppressant
Stimulus for cortisol release?
Stress
Hypoglycemic state (“GG EC”)
Trauma - (antiinflam)
What drugs mimics cortisol?
Steroidal drugs
- Corticosteroids: prednisone
Zona reticulosa secretes
Androgens
Male sex hormones important for hair growth
Androgens
Tx for hair loss
Minoxidil
Cells of the adrenal medulla that secretes catecholamines(DoNE)
Chromaffin cells
Malignancy of chromaffin cells
Pheochromocytoma
Important for activation of SYMPATHETIC ADRENERGIC RECEPTORS
Catecholamines
- Dopamine
- norepi
- epi
Endocrine portion of pancreas
Tail or end part
Exocrine portion of pancreas
Head part
Tiny clusters of cells found in pancreas
Islets of langerhans
Cells of pancreas
Alpha
Beta
Delta
Secretes glucagon
Alpha cells
Stimulus for secretion of glucagon
Hypoglycemia
Glucagon effect
Increases blood glucose levels
Decreases blood glucose levels
Insulin
Stimulus for secretion of insulin
Hyperglycemia
4 secreted during HYPOGLYCEMIA
GG EC Glucagon Growth hormone Epinephrine Cortisol
Delta cells of pancreas secretes
Somatostatin - STOP (git secretions)
Insulin dependent diabetes mellitus
Congenital DM
DM TYPE I
Insulin is injected by what technique
Subcutaneous - 45 degrees
Non insulin dependent DM
Acquired DM
Dm type II
Pregnancy diabetes
Gestational diabetes
Normal fbs
70-100
Triad of Diabetes mellitus (3Ps)
Polyphagia*
Polyuria
Polydipsia
Type of necrosis seen in diabetes
Gangrenous necrosis
Secretes melatonin
- which inc at night = modulates circadian rhythm
Pineal gland
What is the respiratory epithelium?
Pseudostratified columnar ciliated with goblet cells
From ⬆️upper RT to ⬇️lower RT
Goblet cells :
Cilia :
From ⬆️upper RT to ⬇️lower RT
Goblet cells : ⬇️
Cilia :⬇️
Secretes mucus
Goblet cells
Moves mucous towards the oropharynx so you can swallow or expectorate it
Cilia
Part of respiratory system that carries gas but NO GAS EXCHANGE
Conducting portion
- NC-Nasopharynx-Oropharynx-Larynx-Trachea-Bronchi123-Bronchioles-TERMINAL bronchioles
Connects nasopharynx to ear
Eustachian tube
Epithelium of nasopharynx
Respi epi and
Nasopharyngeal epi- (stratified squamous=exposed to friction post part)
Voice box
Larynx
Closest larynx during swallowing
Epiglottis
Where initial sound is produced
Vocal cords
Opening of vocal cords
Rima glottis
Wind pipe
Trachea
Tracheal rings are made up of what cartilage
Hyaline cartilage
Shape of tracheal rings
C shaped with open post end
Beq: if you cut the trachea midsagittally, how many times can you can the tracheal rings?
Once - because open on post end
Part of trachea where L-R bronchi divides
Carina of trachea
Level of the STERNAL ANGLE or Angle of loui
Bronchi enters the HILUM of the Lungs which is seen where
Posterior area of lungs
Wider
Shorter
Straighter (strighter)
Right bronchi
Bronchi associated with Aspirations of objects and Lung infections
Rigt bronchi
Beq: cricoid cartilage can be cut how many times
Twice - bec it is closed all throughout
Shape of cricoid cartilage
Signet ring
Thyroid cartilage has “adam’s apple” or aka
Laryngeal prominence
Anatomical structure used when there is airway obstruction during an emergency
Cricothyroid ligament
Emergency procedure done if theres airway obstruction
Cricothyrotomy
Coniotomy
Emergency tracheostomy
Cells present in the bronchioles and terminal bronchioles
Ciliated cuboidal epithelium
Clara cells - non cuboidal
Non ciliated cuboidal epithelium
Clara cells
Be:Clara cells are seen in what organ
Lungs
Lobes of right lung
3 lobes
Lobes of left lung
2 lobes
What anatomic structure is seen in the left lung
Cardiac notch
Most distal part of the conducting tree
Terminal bronchioles
Type of cellular transport involved in gas exchange
Simple diffusion
Sites of gas exchange
Respiratory bronchiole
Alveolar ducts
Alveoli
Major site of gas exchange or external respiration
Alveoli
Cells in alveoli that are squamous in shape
Type I Pneumocytes
Most numerous cells in the alveoli
Cannot multiply
Inv in gas exchange
Type I pneumocytes
Cells of alveoli that are cuboidal in shape
For surfactant production - which decreases surface tension within alveoli
Type II pneumocytes
What happens when there are no type II pneumocytes
There will be surface tension in alveoli
Water compresses or constricts alveoli resulting to difficult gas exchange
Determined by partial o2 pressure and partial Co2 pressure
Gas exchange
Exchange of gas from ALVEOLI to Blood stream
External respiration
Exchange of gas from blood stream to CELLS
Internal respiration
Macrophage of the lungs
Alveolar macrophages or dust cells or heart failure cells
Lines OUTside of lungs
Visceral pleura
Lines THORACIC cavity
Parietal pleura
Space between visceral pleura and parietal pleura
Pleural cavity
Edema inside the lungs
Pulmonary edema
Edema in the pleural cavity
Hydrothorax
Where do you incise to drain fluid in the respiratory system
7th intercostal space
Substances inhibiting ADH secretion
Alcohol
Low blood osmotic pressure