endocrine and metabolic systems 1 Flashcards
what is the function of the endocrine system and the nervous system?
control and integrate body function to maintain homeostasis
what role do hormones play in the endocrine system and how do they travel?
endocrine system sends its messages in the form of hormones via the blood stream
what are the five general functions of the endocrine system?
- differentiation of the reproductive and central nervous system of the developing fetus
- stimulation of sequential growth and development during childhood and adolescence
- coordination of the male and female reproductive systems
- maintenance of optimal internal environment throughout the life span
- initiation of corrective and adaptive responses when emergency demands occur
what is the main integrative center for the endocrine and autonomic nervous systems?
hypothalamus
what is the function of the hypothalamus?
controls the function of endocrine organs by neural and hormonal pathways
what is classified as an endocrine gland because it secretes several hormones responsible for metabolism, hunger, vasoconstriction, and cellular growth?
adipose tissue
what does the secretion of ADH depend on?
plasma volume and osmolality
what are the most powerful stimulators of ADH?
pain
emotional stress
trauma
morphine
hyposecretion of GH causes what medical condition?
dwarfism
hypersecretion of GH causes what medical condition? (children vs adults)
gigantism in children
acromegaly in adults
what does ectopic hormone production cause?
cancer
what is psychoneuroimmunology?
endocrine system, together with the immune system and the nervous system, mounts an integrated response to stressors
which three hormones or catecholamines are responsible for the fight or flight responses?
epinephrine
norepinephrine
dopamine
what are the physiological effects of cortisol?
food metabolism
body response to stress
gluconeogenesis
suppresses inflammation and immune function
true or false: equilibrium concentrations are the principal hormones necessary to maintain homeostasis are altered with age.
FALSE: it is does not alter with age, but what may differ as we get older is the way we achieve equilibrium hormone levels, which points to changes in regulatory control
what is neuroendocrine theory of aging?
suggests that cells are programmed to function only for a given time
what is an example of neuroendocrine theory of aging?
menopause (a result of programmed changes in the reproductive system is an example of this theory)
what are some symptoms that clients with a variety of endocrine and metabolic disorders report to PTs?
fatigue
muscle weakness
muscle or bone pain
what does the lack of progress in therapy signal to to therapist?
the possibility of a systemic origin of musculoskeletal symptoms
rheumatoid arthritis can be an indicator of what medical condition?
endocrine disease
what four signs are early manifestations of thyroid or parathyroid disease, acromegaly, diabetes, Cushing syndrome, or osteomalacia?
muscle weakness
atrophy
myalgia
fatigue
_____ is a common finding in people with certain endocrine and metabolic conditions such as acromegaly, diabetes, pregnancy, and hypothyroidism.
carpal tunnel syndrome (CTS)
what one characteristic may distinguish endocrine related CTS from overuse syndromes and other causes of CTS?
it is bilateral (happens in both wrists)
flexor tenosynovitis with stiffness is a common finding in people with what endocrine malfunction?
hypothyroidism
what are two anterior lobe disorders?
hyperpituitarism
hypopituitarism
where do individuals with acromegaly have back pain?
thoracic and lumbar region
what are skeletal manifestations of anterior lobe disorders
arthritis of the hands
osteoarthritis of the spine
what should the program a therapist provides promote to counter orthopedic considerations that accompany acromegaly, arthritis, or osteoarthritis?
maximum joint mobility
muscle strength
functional skills
what is acromegaly?
excessive secretion of growth hormone after normal completion of body growth
acromegaly results the overgrowth of bone in the ____, _____, and _____.
face
head
hands
what should someone with acromegaly be screened for?
weakness
changes in joint mobility
poor exercise tolerance
what are the three primary hormones produced by the thyroid?
T4
T3
Calcitonin
what is the function of the T3 and T4 hormones?
regulate the metabolic rate of the body and increase protein synthesis
calcitonin has a weak physiologic effect on ____ and _____ balance in the body
calcium
phosphorus
thyroid function is regulated by what feedback controls and an intrinsic regulator mechanism with the gland?
hypothalamus and pituitary
disorders of the thyroid gland may lead to anatomic abnormalities such as? (3)
thyroiditis, goiter, and thyroid cancer
changes in nails, hair, skin, eyes, GI tract, respiratory tract, heart, and blood vessels, nervous tissue, bone, and muscle are signs of what malfunction?
alterations in thyroid function
how do women know if they have a thyroid gland problem?
mood and in menstrual cycles
true or false: both hyperthyroidism and hypothyroidism can adversely affect cardiac function
true
what is hyperthyroidism?
creates a generalized elevation of body metabolism
what is the most common form of hyperthyroidism?
graves disease
what hormone does graves disease effect? and how?
increases T4 production
creates a generalized elevation of body metabolism, the effects of which are manifested in almost every system
true or false: hyperthyroidism affects men more than women
FALSE (affects women more than men in a 4:1 ratio)
what is a thyroid storm?
acute episode of thyroid-over activity
about 95% of people with Graves disease have circulating autoantibodies called? (they react against thyroglobulin, a precursor for thyroid hormone)
TSI (thyroid stimulating immunoglobulins
TSI is associated with pathogenesis of what disorder of the thyroid gland?
hyperthyroidism
what is the function of TSIs?
stimulates enlargement of the thyroid gland
react against a component of the thyroid cell membrane
secretion of excess thyroid hormone
what thyroid disfunction is manifested with these symptoms?
- mild symmetric enlargement of the thyroid
- nervousness
- heat intolerance
- weight loss despite increased appetite
- sweating
- diarrhea
- tremor
- palpitations
hyperthyroidism
should a PT work with a patient with hyperthyroidism?
no, pt is not recommended until after the endocrine problem is solved
true or false: hyperthyroidism may induce atrial fibrillation, precipitate congestive heart failure, and increase the risk of underlying CAD for myocardial infarction
true
what is per-arthritis? and what thyroid dysfunction is it associated with?
inflammation that involves the per-articular structures, including the tendons, ligaments, and joint capsule
hyperthyroidism
is per-arthritis unilateral or bilateral?
can be either
what is myopathy? and what thyroid dysfunction is it associated with?
hyperthyroidism
what is dyspnea or respiratory muscle weakness associated with?
hyperhyroidism
what lab tests should be conducted for graves disease?
TSH and antithyroid antibodies
what is positive in lab tests for people with grave disease?
TSI
what are three major forms of therapy for hyperthyroidism?
antithyroid medication
radioactive iodine
surgery
what is the prognosis for hyperthyroidism?
lifelong follow up is recommended because many remissions are not permanent
if a PT sees unusual swelling, enlargement with or without symptoms of pain, tenderness, hoarseness, or dysphagia, what is the next plan of action?
medical referral
true or false: hyperthyroidism is not associated with exercise intolerance and reduce exercise capacity
FALSE; IT IS!
what is hypothyroidism?
a generalized slowed body metabolism (basal metabolic rate)
what is primary or type 1 hypothyroidism?
hormone deficient
what is secondary or type 2 hypothyroidism?
hormone resistant
what is elevated or increased in hypothyroidism?
TSH secretion from the anterior pituitary gland
what type of hypothyroidism involves reduced functional thyroid tissue mass or impaired hormonal synthesis or release?
type 1
hypothyroidism: _____ of all body processes which leads to bradycardia, ____ GI tract motility, _____ neurologic functioning, a _____ in body heat production, and achlorhydria
slow and decrease
what happens to lipid metabolism during hypothyroidism?
lipid metabolism is altered –> increase in serum cholesterol and triglyceride levels –> increase in arteriosclerosis and coronary heart disease
true or false: hypothyroidism develops anemia
TRUE: thyroid hormones also play a role in the production of RBCs
what is type 2 or secondary hypothyroidism?
the result of failure of the pituitary gland to synthesize and release adequate amounts of TSH
what type is more common in hypothyroidism?
type 1
what is myxedema and what is it associated with?
non-pitting, boggy edema, especially around the eyes, hands, feet, and in supraclavicular fossae
hypothyroidism
what is the most sensitive indicator of primary hypothyroidism?
TSH levels
how are T3 and T4 levels effected in hypothyroidism?
T3 does not change dramatically
T4 levels decrease gradually until they are well below normal in advanced hypothyroidism
what happens to levels of serum cholesterol, alkaline phosphatase, and triglyceride levels in hypothyroidism?
they are significantly elevated
what are the goals of hypothyroidism treatment?
correct thyroid hormone deficiency, reverse symptoms, and prevent further cardiac and arterial damage
what condition is hypothyroidism similar to?
rheumatoid arthritis
what do patients with hypothyroidism complain of?
muscle complaints (aches, pain, and stiffness)
pain increases with onset of cold, rainy weather
what is CPPD or calcium pyrophosphate dihydrate associated with?
hypothyroidism
what should PTs be more aware of with people that have hypothyroidism and fibromyalgia?
they have more dry and swollen tissues which makes their skin more likely to tear or develop sores
in older adults with hypothyroidism who just got a thyroid replacement, a PT should screen for what?
symptoms of hyperthyroidism, aggravated CVD, and abnormal vital signs and fall risk (due to increased risk of osteoporosis and fracture)
what hormones do the parathyroid gland secrete? and what do they regulate?
PTH, regulates calcium and phosphorus metabolism
how does PTH exert its effect?
increasing the release of calcium and phosphate from the bone
increasing the absorption of calcium and excretion of phosphate by the kidneys
promoting calcium absorption in the GI tract
(CALCIUM ABSORPTION)
what is hyperparathyroidism?
increased bone resportion
what is hypoparathyroidism?
decreased bone resorption
what does the PTH hormone target?
bone, kidney, intestinal tract
what is the full definition of hyperparathyroidism?
over-activity of one or more of the four parathyroid glands that disrupts calcium, phosphate, and bone metabolism
who are more affected by hyperparathyroidism?
women are more affected more than men (2:1), usually after 60 years (post menopausal)
what is primary hyperparathyroidism?
one or more of the parathyroid glands enlarged
what level of hyperparathyroidism is the following lab result:
normal regulatory relationship between serum calcium levels and PTH secretion is interrupted
primary
what is secondary hyperparathyroidism?
glands are hyperplastic from malfunction of another organ system
what level of hyperparathyroidism is the following:
this level is a compensatory response to chronic hypocalcemia due to renal failure (decreased renal activation of vitamin D)
secondary
what is tertiary hyperthyroidism?
glands ultimately become autonomous in function and unresponsive to serum calcium levels
what level of hyperparathyroidism is exclusive to dialysis clients?
tertiary
what does excessive circulating PTH lead to?
bone damage
true or false: PTH is regulated by the pituitary and hypothalamus
FALSE: it maintains blood calcium levels by increasing bone resorption and GI absorption of calcium
what happens if hyperparathyroidism is left untreated?
exacerbates many conditions in older adults such as osteoporosis and coronary artery disease
what is the treatment for hyperparathyroidism?
surgical removal for primary hyperparathyroidism
what is periarthritis and tendinitis caused by?
hyperparathyroidism
true or false: it is important to treat the underlying cause first (hyperparathyroidism) because the intervention for arthritis will be frustrating and poorly effective
true
why should you monitor a person on digitalis drug when they have hyperparathyroidism?
monitor for toxic effects produced by elevated calcium levels because clients with hypercalcemia are hypersensenstive to digitalis drug and may quickly develop symptoms
what is the true definition of hypoparathyroidism?
causes hypocalcemia and produces a syndrome opposite that of hyperparathyroidism with abnormally low serum calcium levels, high serum phosphate levels, and possible neuromuscular irritability
what is the most common form of hypoparathyroidism?
iatrogenic (acquired)
what is iatrogenic?
glandular damage or accidental removal during thyroid removal or anterior neck surgery
what is idiopathic hypoparathyroidism?
affect more children; may be an autoimmune disorder with a genetic basis
what happens to serum phosphate levels in hypoparathyroidism?
rises
what happens to bone resorption during hypoparathyroidism?
slows down
what hormone is reduce during hypoparathyroidism?
PTH
what is tetany? and what thyroid condition is it associated with?
neuromuscular irritability
hypoparathyroidism
what is acute tetany?
a life threatening disorder due to laryngeal spasm and subsequent respiratory obstruction
adrenal glands!
