class 5: other systems Flashcards
what is Metabolic syndrome
consists of signs and symptoms that are risk factors and are strongly linked to type 2 diabetes, cardiovascular disease, and stroke.
Metabolic syndrome diagnosis parts
Waist circumference
Triglycerides
High Density Lipoprotein (HDL)
Blood Pressure
Fasting Plasma Glucose
Metabolic syndrome diagnosis - Waist circumference
> 40 inches in men or > 35 inches in women
Metabolic syndrome diagnosis - Triglycerides
150 mg/dL or higher
Metabolic syndrome diagnosis - High Density Lipoprotein (HDL)
< 40 mg/dL in men or < 50 mg/dL in women
Metabolic syndrome diagnosis - Blood Pressure
Systolic 130 mm Hg and/or diastolic BP = 85 mm Hg
Metabolic syndrome diagnosis - Fasting Plasma Glucose
> 100 mg/dL
is HDL or LDL better
HDL good
LDL bad
Hypothalamus function
responsible for regulation of the ANS (body temperature, appetite, sweating, thirst, sexual behavior, rage, fear, blood pressure, sleep)
Pituitary gland function
secretes endorphins and reduces a person’s sensitivity to pain.
It controls ovulation and works as a catalyst for the testes and ovaries to create sex hormones
Thyroid gland function
produces hormones that act to control the rate at which cells
burn the fuel from food
Parathyroid gland function
regulate calcium and phosphate metabolism
Adrenal gland function
produces corticosteroids that will regulate water and sodium
balance, the body’s response to stress, the immune system, and metabolism
what is Addison’s Disease
Adrenal insufficiency – decreased cortisol and aldosterone
what causes Addison’s Disease
infections, neoplasm, hemorrhage,
autoimmune process.
Addison’s Disease - BP and hydration
Decreased BP, dehydration
Addison’s Disease - glucose
Decreased glucose
Addison’s Disease - skin
Bronze pigmented skin – increased MSH
Addison’s Disease - weight
Weight loss, anorexia, GI disturbances
Addison’s Disease - muscles
Generalized weakness (asthenia)
Addison’s Disease - tolerance
Intolerance to cold and stress, anxiety and depression
what is Cushing’s Disease
Elevated cortisol and aldosterone
what causes Cushing’s Disease
pituitary tumor with increased ACTH secretion
Cushing’s Disease - BP and hydration
Increased BP, water retention
Cushing’s Disease - postassium
Hypokalemia
Cushing’s Disease - glucose
increased glucose
Cushing’s Disease - skin
Ruddy appearance, striae on skin
Cushing’s Disease - weight
Weight gain, centripetal obesity, round moon face
Cushing’s Disease - muscle strength
Proximal muscle weakness and atrophy
Cushing’s Disease - tolerance
Increased susceptibility to infection, osteoporosis (buffalo hump), poor wound healing
Cushing’s Disease vs. Cushing’s Syndrome
Cushing’s Disease: Pituitary Adenoma → more ACTH secreted by
PITUITARY GLAND → stimulates Adrenal gland → more CORTISOL
is released
Cushing’s Syndrome: Adrenal gland tumor → Adrenal gland
secretes more CORTISOL → drug toxicity
sym are common in both
what are the two thyriod problems
hyperthyroidism and hypothyroidism
what are the two adrenal cortex problems
cushing and addison’s
what is Hyperthyroidism 2/2
Increased T3 and T4, low TSH
what is the function of cortisol
- regulate BP
- glucose formation
- stress response
- decreases inflammation
what is the function of aldosterone
kicks out K
matains NA and H2O
Hyperthyroidism - HR and heat
HR increase
heat intolerance
Hyperthyroidism -glucose and GI, weight
Increased glucose absorption
Diarrhea
weight loss and decreased appeitite
Hyperthyroidism - sweat
Increased perspiration
Hyperthyroidism - what are example of these disease
Exophthalmos, Graves’ disease
Hyperthyroidism - relfexes
Hyperreflexia
Hyperthyroidism - skin
Silky hair, moist palm
mrs. Addison
thin old brown lady walking with a stick
- weak
- hyperpigmentation
- cold intolerence
- weight loss
- decreased BP
what is Hypothyroidism 2/2
Decreased T3 and T4, high TSH
mr. Cushing
has more cushion because he drinks a lot of beer (red skin)
weak because he never works out
gets sick a lot
increased BP
Hypothyroidism - HR and tolerance to heat
decreased HR
Cold intolerance
Hypothyroidism - glucose and GI, weight
Decreased glucose absorption
Constipation
Weight gain and decreased appetite.
Hypothyroidism - skin
Brittle nails, dry skin and hair
Hypothyroidism - sweat
Decreased perspiration
Hypothyroidism - reflexes
Prolonged deep tendon reflexes
Hypothyroidism - examples
Myxedema, Hashimoto’s disease
Parathyroid Conditions
Hyperparathyroidism
Hypoparathyroidism
what is Hyperparathyroidism 2/2
Elevated calcium and decreased serum phosphate
what are the sym of Hyperparathyroidism
̶Can demineralize bone = bone weakness and decreased density
Osteopenia, gout, arthralgia, kidney stones, renal insufficiency,
peptic ulcers, proximal muscle weakness, fatigue, depression, confusion, drowsiness, glove/stocking sensory loss
bones, stones, groans, mones, sensory
hypothyroidism story
lazy person laying on the couch all day under a comforter
cold intolerance - under the blanket
lazy - sleepiness,
all day - dry hair, skin and nails (brittle)
not moving - consitpation, weight gain, increased BP
notmoving - inclreased Blood glucose (not being absorbed)
what is Hypoparathyroidism 2/2
Low calcium and high phosphorus
what are the symtoms hypo parathyroid
Convulsions, cardiac arrhythmias, muscle twitching, tetany,
muscle cramps, muscle spasms, paresthesia of fingertips and mouth, fatigue, weakness
CATs are NUMB
what is type 1 DM
Pancreas produces no insulin → insulin dependent DM
what is the function of insulin
glucose storage (in cells remove glucose from the blood stream)
when is type 1 normally diagnosised
Diagnosed mostly at childhood, but can be any age
Symptoms of DM 1
Polyphagia, weight loss, ketoacidosis, polyuria, polydipsia, blurred vision and dehydration
what is myxedema
puffiness of the hands and feet
Hypothyroidism
what is type 2 DM
Body’s resistance to insulin → insulin resistant DM
why does DM 2 occur
Occurs secondary to other dysfunctions
Hypoglycemia - glucose levels
Glucose is <70 mg/dl
hype man - Hyperthyroidism
hype man
running around - Weight loss and increased appetite, Increased perspiration, Restlessness, insomnia, Increased HR
fast - Hyperreflexia, Heat intolerance
sweat - Silky hair, moist palm
Hypoglycemia - early signs
Pallor, sweating
Shakiness
Poor coordination and unsteady gait
Tachycardia & palpitations
Dizziness, fainting
Excessive hunger
Hypoglycemia - late signs
Slurred speech, drowsiness, confusion
Loss of consciousness & coma
what is graves disease
bulging eyes
hyperthyroidism
an autoimmune disorder that causes the thyroid gland to produce too much thyroid hormone
Hyperglycemia - glucose level
Glucose >300 mg/dl
Hyperglycemia - early signs
Weakness
Dry mouth
Frequent, scant urination
Deep and rapid respirations
Dull senses, confusion, diminished reflexes
Excessive thirst
Hyperglycemia - late signs
Fruity odor (acetone breath)
Hyperglycemic coma
when do we avoid exercise in pt’s with DM
̶Avoid exercise during peak insulin hours
insulin and active muscles
̶Insulin is absorbed much more quickly in an active extremity. Always apply the insulin injections in the abdomen/ non active extremity
insulin dosage after exercises
̶Insulin dosage should be reduced after exercise
exercises reccomendation for DM
Exercise in the morning is recommended to avoid hypoglycemia resulting from fluctuations
in insulin sensitivity
FITT Principle for DM Patients - F
3-7 days/week
FITT Principle for DM Patients - I
11-13 on RPE Scale (can go up to 17)
FITT Principle for DM Patients - T
Minimum of 150 mins./week, can be progressed to 300 min/week
FITT Principle for DM Patients - T
Moderate intensity aerobic exercises involving larger muscle groups
what is Stress Incontinence
Involuntary leakage of urine during cough, sneezing, or exertion.
Can be seen postpartum, pelvic floor muscle weakness
Urge Incontinence
Involuntary contraction of the detrusor muscle with a strong desire to void (urgency).
sudden and compelling need to urinate
Can be seen with infections, Parkinson’s disease, UMN lesions
Overflow Incontinence
Incontinence caused by an acontractile or underactive detrusor muscle.
Bladder is overdistended, can not empty completely, and urine dribbles or leaks out. Can be seen with
benign prostatic hyperplasia, DM
Functional Incontinence
Incontinence due to mobility, dexterity, or cognitive deficits.
Can be seen with dementia, lower extremity weakness
Stress incontinence: PT intervention
Strengthen pelvic floor muscles
Urge incontinence: PT intervention
Treat infections, voiding schedule
Functional incontinence: PT intervention
Clear clutter, improve accessibility, and prompted voiding
Overflow incontinence: PT intervention
Behavioral modification like double
voiding, medication and catheterization
DM fasting glucose
f fasting blood glucose is 126 mg/dL (7 mmol/L) or higher on two separate tests, diabetes is diagnosed.
DM random blood glucose (taken at any time)
> 200 mg/dl
what is HbA1C
a blood test that measures a person’s average blood sugar levels over the past two to three months.
DM HbA1C levels
> 10% –> immediated insulin therapy
what is normal values for HbA1C
4-6%
what happen if the pt takes too much insulin
hypoglycemia
hypoglyemia remember
cold and clam - give me a candy
hyperglycemia remember
hot and dry - sugar high
what happen to the sensitivity of insulin with exercise
insulin sensitivity increases
what are safe blood glucose levels
101 - 250 mg/dL
blood glucose 70 - 100 indicates what
can exercise
but give pt CHO snack and wait 15 mins to see if levels are up to 101 - 250
what is considered cho snack
15 g
what do we do if blood glucose in <70 or >300
no exercise
what do we do if blood glucose in 250-300
proceed with caution if there is not D-ketoacidosis
Adhesive capsulitis and thyroid condition
any thyroid problem can lead to thyroid problems
what do we used to remeber hyperglycemia
hot and dry - sugar high
what is kussmaulus breathing
a medical term describing a rapid, deep breathing pattern that indicates a metabolic acidosis
increase in rate and depth
when is the peak insulin time
2-4 hours after taking
extreme temp and DM
do not exercise in theses temps
to avoid dehydration
indivudal with DM do we soak feet, callus, mosizeruse, socks, nails, when to buy shoe
nope
no mositizer between does
no sharp techniques fo callus
white socks to see cuts
nail - square cut
buy shoes in PM
when is BP low in pregnacy
first and 2nd trimester
when is BP high in pregnacy
the 3rd tri
when do we stop supine lying in preg
1st trimester
pregnancy and heart rate with exercise
since the heart rate is high it does not proportionatly increase with exercise
what kind of incontinuence is seen with DM
overflow - scant peeing
what causes yellowing of the skin
liver issues
jaudice
urine and stool with liver disease
clay colored stolls
dark colored urine
what is asterexis
Flapping tremor
where are the kindey located in the back
t10-t12
what is represented with lowback/pelvis/sacrum pain
kindey
colon. pelvic
viscera
appendix
what is the psoas sign
put r leg into ext
lead to pain in the appendix
what is the heel raise sign
patient supine the right heel is elevated by 10-20 degrees is hit firmly with palm of the examiner’s hand.
