Endocrine And Homeostasis Seminar Flashcards
Where is calcium found ?
Bones (99.9%)
Blood
Extraceullar fluid
Normal levels of calcium?
1.1-1.4mm/L
What do we use calcium for ? (4)
Muscle contractions
Nerve function- conducts action potentials
Heart function - contraction
Correct bone density
Hormones that control levels of calcium
(Can’t get to see people, covid)
CALCITROL- comes from kidneys
Promotes calcium ion absorption into digestive tract
GROWTH HORMONE- produced in pituitary gland
Stimulates osteoblasts activity and produces bone matrix
THYROXINE T4- thyroid gland. Stimulates osteoblasts activity and produces bone matrix
SEX HORMONES- produces in testes or ovaries. Stimulates osteoblasts activity, synthesise bone matrix and oestrogen closes growth plates before androgens
PARATHYROID- From parathyroid gland.
Stimulates osteoblasts and clasts activity. Elevates calcium ion conc in blood
CALCITONIN- From thyroid gland C cells.
Inhibits osteoclast activity, promotes calcium ion loss by kidneys and reduces calcium ion in body fluids
Calcium levels decrease
Calcium levels decrease in blood
Detected by receptors on parathyroid gland
Secretes parathyroid hormone
Bone = parathyroid hormone stimulates osteoclast activity so calcium goes from bone into blood
Intestinal= Parathyroid hormone causes more calcium to be absorbed from diet, by producing vitamin D to produce calcitrol - calcium absorbed faster.
Kidneys= PTH stimulates calcitrol production in kidneys to help gut absorb calcium. Kidneys retain calcium and don’t release it into urine.
Calcium levels increase back to normal
Calcium levels increase too much
High calcium ions in blood
Detected by receptors on thyroid gland
C cells / parafollicular cells release calcitonin
Calcitonin inhibits osteoclast activity and osteoblasts continue to trap calcium in their matrix
Intestinal- calcitonin inhibits absorption of calcium
Kidneys - calcitonin means more calcium lost in urine. Less calcitrol produced in kidneys so less calcium absorption in the gut.
Define diabetes
A medical condition where there is a lack of insulin produced, deficit amount of insulin or resistance to insulin which leads to hyperglycaemia (high blood glucose).
Type 1 causes
Viral infection
Autoimmune disease
Family history
Type 2 causes
Linked to obesity, age and ethnicity
Type 2 can be preventable = healthy diet, healthy lifestyles , exercise etc
Incidence of diabetes
2.5 million in UK have diabetes
10% type 1 (250,000) and 90% type 2 (2 million). The other 250,000 have mixture of both
Year 2025, predicted 4 million + cases
500,000 to 1 million undiagnosed type 2
300 new cases diagnosed each day, 1 every 5 mins
Where is pancreas place?
Posterior portion of lower stomach
Name what the clusters of cells are called in pancreas
Islets of Langerhans
What are the three hormone releasing cells in pancreas - what do they all release?
ALPHA cells - release glucagon. Mobilises glycogen from liver and suppresses insulin secretion. Maintain blood glucose between meals.
BETA cells- insulin. Promotes glucose utilisation.
DELTA cells- somatostatin and gastrin. Regulates alpha and beta cell functions.
What is pancreas endocrine functions?
Hormones released from alpha, beta and delta cells
Pancreas exocrine functions?
Acini cells at periphery of islets of langerhans
Secretes digestive enzymes and alkaline fluids through pancreatic duct to duodenum
No diabetes
Carbohydrates broken down into glucose.
Glucose comes from starchy foods, sugary and sweet and from liver via glycogenolysis.
Glucose absorbed into blood
High blood glucose detected by pancreas
Beta cells release insulin
Insulin opens up body cells to fuel them with glucose
People with type 1
Glucose comes from starchy, sweet foods or liver
Glucose absorbed into bloodstream
Type 1 means viral infection or autoimmune disease destroyed beta cells.
Can not produce insulin
Glucose levels increase in blood and cannot enter cells as no insulin to unlock cells
So they get a lot of fatigue
- only 10% of diabetics
- appears before 40 years old
Treatment - insulin injections, healthy diet and exercise
People with type 2
Glucose from carbs, sugar, starch and liver
Glucose absorbed into blood
Detected by pancreas and beat cells produce some insulin
Type two means beta cells don’t produce enough insulin
Less glucose into the cells than normal and less insulin to unlock the cells
Blood glucose will rise
OBESITY:
Enough insulin is produced by beta cells but receptors for insulin on cells don’t work properly as they are blocked by fat cells. Insulin cannot open cells to allow glucose into them
Diagnosis: usually after 40 years
Before 40 years if due to ethnicities like Afro Caribbean and south Asian
90% of diabetics
Treatment : healthy diet and exercise for obesity
If this doesn’t work, you’ll need insulin tablets as beta cells produce some insulin but not sufficient amounts
Course of diabetes
Progressive until death , unless managed and treated
Complications of diabetes
Cardiovascular disease
Need dialysis for kidney damage
Amputations
Sight loss
Microvascular disease- narrowed blood vessels to the heart , decreased blood volume and angina
Retinopathy- abnormal blood flow to retina as abnormal blood flow
Nephropathy- deterioration of kidney function
Neuropathy- peripheral nerve damage
Macro vascular disease- disease of large elastic arteries like aorta and coronary
PVD- blood circulation disorder in blood vessels not to the heart and brain
CVA- cardiovascular accident
MI- heart attack as supply of blood to heart blocked
Prognosis
Improved with early detection and management
80% die with cardiovascular disease
Diabetes is 2-3 more times likely to get a stroke
1000 diabetics start kidney dialysis per year
20 times more likely to go blind
100 people with diabetes a week have amputations
Morbidity
Diabetes doubles risk of CV disease
Type 2 diabetics make up 20% admissions of MI
Mortality
Life expectancy decreases by 20 years in type 1
10 years for type 2
1 in 7 deaths in UK per year are diabetics
Signs of diabetes
Hyperglycaemia - high blood glucose above 180mg/Dl
Hyperketonaemia- increased ketones in blood (break down fat for energy) when little carbohydrates
So glucose cannot enter cells so body needs energy from somewhere so ketones break down fat for energy.
Some diabetes symptoms
Weight loss - body break down fats
Excessive thirst- kidneys try to reduce glucose levels in blood by increasing urination but can cause dehydration
Hunger- body break down fats
Nocturia- urinate lots at night
Fatigue and lethargy- lacking energy from glucose in tissues
Blurred vision- hyperglycaemia alters fluid levels in body and lens of eye prone to this
How is it diagnosed ?
High blood sugars in blood test
High levels of glucose in urine
Physio interventions
Involved when there is side effect from diabetes
Can impact treatment, techniques and their responses
Treatments
Type 1- insulin injections
Type 2- lifestyle changes and insulin tablets
Prevention?
Type 1 can’t be prevented as virus, family or autoimmune
Type 2 prevented by healthy diet with low fat and salts
Exercise
Other people involved in their care
GP Nurse Occupational therapists Diabetic care team Dietician Chiropodist Podiatrist Optometrist Physiotherapist
