1.6.15 - Endocrine Cases Flashcards
addisons disease
adrenal insufficiency
tests is suspect adrenal insufficiency
basal plasma cortisol
ACTH level
low cortisol and high ACTH
addisons
normal or low cortisol - adrenal fatigue - subclinical addisons
ACTH stimulation test
cosyntropin IV and measure preinjection
30 and 60 minute cortisol
don’t rise - addisons
5 S’s
for adrenal insufficiency
-salt, sugar, steroids, support, search
arterial supply to adrenal gland
superior, middle, inferior suprarenal arteries
venous drainage of adrenal glands
suprarenal veins
lymphatic drainage of adrenals
para-aortic nodes
driven by motion of resp diaphragm**
to thoracic inlet back to heart
autonomics for adrenal
T8-T10
SD for adrenals
flexed segment - T/L junction
OPP for adrenals
lympatics - resp diaphragm
sympathetics T6-L2
PS - OA, AA, C2, temporal, occiput
cranial
ventral abdominal release
fascial restriction of adrenal
champmans
anterior chapmans for adrenals
2-2.5 inches above and 1 inch lateral to umbilicus
posterior chapmans for adrenals
intertransverse space between T11 and T12 bilaterally
sympathetics to adrenals
T6-L2
labs for hypothyroid
TSH, T4, and T3
TSH increase
T4 decrease
primary hypothyroid
TSH decrease
T4 decrease
central hypothyroid
TSH elevated
T4 normal
subclinical hypothyroid
arterial to thyroid
superior and inferior thyroid arteries
levothyroxine
T4
tx of hypoT