Endocrine and Metabolic Systems Flashcards
Hypothalamus controls release of
pituitary hormones - CRH, TRH, GHRH, somatostatin
Anterior pituitary gland controls release of
GH, ACTH, FSH, LH, prolactin
Posterior pituitary gland controls release of
ADH and oxytocin
Adrenal cortex controls release of
mineral corticosteroids (aldosterone)
glucocorticoids (cortisol)
adrenal adrogens (DHEA)
androstenedione
The adrenal medulla controls release of
epinephrine and norepinephrine
The thyroid controls release of
triiodothyronin and thyroxine
Thyroid C cells control release of calcitonin
Parathyroid glands control release of
parathyroid hormone (PTH)
Pancreatic islet cells control release of
insulin, glucagons, somatostatin
Kindey control release of
I,25 dihydroxy vit D
Ovaries control release of
estrogen and progesterone
Tested control release of
androgens (testosterone)
Hormones released by islets of langerhans in pancreas
Insulin
Glucagon
Amylin
Somatostatin
Hormones released by islets of langerhans in pancreas - Insulin
allows uptake of glucose from blood stream
suppresses hepatic glucose production, lowering plasma glucose levels
secreted by the beta cells
Hormones released by islets of langerhans in pancreas - glucagon
stimulates hempatic glucose production to raise glucose levels, especially in fasting state
secreted by the alpha cells
Hormones released by islets of langerhans in pancreas - amylin
modulates rate of nutrient delivery (gastric emptying)
suppresses release of glucagon
secreted by the beta cells
Hormones released by islets of langerhans in pancreas - somatostatin
acts locally to depress secretion of both insulin and glycogen
decreases motility of stomach, duodenum, gallbladder,
decreases secretion and absorption of GI tract
secreted by the delta cells
Metabolic syndrome (syndrome X) - is what
a cluster of risk factors that increase the liklihood of developing heart disease, stroke, and type 2 diabetes
Metabolic syndrome (syndrome X) - criteria for diagnosis
Abdominal obesity High cholesterol Low HDL cholesterol High BP (135 or higher sys, 85 or higher diast) Fasting blood sugar 100 or higher
Metabolic syndrome (syndrome X) - etiology
no one cause
unhealthy lifestyle with diet high in fats may contribute
Metabolic syndrome (syndrome X) - incidence
1 in 4 individuals
more common in older adults and individuals prone to blood clots and inflammation
might run in families
Metabolic syndrome (syndrome X) - Treatment
manage risk factors
Lifestyle modifications and meds
Diabetes Mellitus is what
A complex disorder of carbohydrate, fat, and protein metabolism caused by deficiency or absence of insulin secretion by the beta cells of the pancreas or by defects of the insulin receptors
Causes abnormally high level of sugar or glucose in the blood
Type 1 DM
AKA insulin dependent, juvenile onset diabetes
Affects about 1% of population and 10% of all with diabetes
Type 1 DM - characteristics
Dec size and number of islet cells - deficiency in insulin secretion
Usually in children and young adults
Etiology type 1 DM
caused by autoimmune abnormalities, genetic causes, or environmental causes
Type 1 DM - insulin ___
dependent - requires insulin delivery by injection, insulin pump, or inhalation
Type 1 DM - prone to ____
ketoacidosis - presence of ketone bodies in the urine, the by products of fat metabolism (ketonuria)
Type 2 DM results from
inadequate utilization of insulin (insulin resistance) and progressive beta cell dysfunction
AKA non-insulin dependent or adult onset diabetes
90-95% of cases
Type 2 DM characteristics
Gradual onset
Usually not insulin dependent
Not prone to ketoacidosis
Type 2 DM etiologu
caused by combination of factors
insulin resistance in mm and adipose tissue
progressive decline in pancreatic insulin production
excessive hepatic glucose production
inappropriate glucagon secretion
Type 2 DM risk factors
linked to obesity and older adults obese children family hx unhealthy eating lack of physical activiy
Secondary diabetes
associated with other conditions - endocrine disease, drugs, chemical agents
Gestational DM
glucose intolerance associated with pregnancy
most likely in third trimester
affects 4% of pregnancies
Prediabetes
impared glucose tolerance with abnormal response to oral glucose test
10-15% of individuals will convert to type 2 DM within 10 years
Classic signs of DM
Elevated blood sugar (hyperglycemia) Elevated sugar in urine (glycosuria) Excessive excretion of urine (polyuria) Excessive thirst (polydipsia), dry mouth Excessive hunger (polyphagia) Unexplained weight loss Fatigue Blurred vision HA
Complications with DM
Microvascular disease (retinopathy, renal, polyneuropathy)
Macrovascular disease (dyslipidemia, CVA, MI, PAD)
Integumentary impairmens
Musculoskeletal impairments - inc adhesive cap and OP
Neuro (diabetic polyneuropathy, diabetic autonomic polyneuropathy)
Kidney, vision, liver impairments
Diagnositc criteria for DM
1 symptoms plus casual plasma glucose concentration greater than or equal to 200
Casual meaning nonfasting and without regard to last meal
2 fasting greater than or equal to 126
3 two hour post load glucose greater than or equal to 200 with oral glucose tolerance test
DM - PT - benefit of regular exercise
improved glucose tolerance
increased insulin sensitivity
decreased glycosylated hemoglobin
decreased insulin requirements
DM - PT - exercise rx
50-80% vo2 max
3-7 days/wk
2-3 sets, 8-12 reps with 60-80% 1 rep max
DM - PT - exercise precautions - RED FLAGS
Monitor glucose levels prior and following exercise
Observe for s/s of hypoglycemia
Do not exercise when have hyperglycemia
Do not exercise without eating at least 2 hrs beforehand
Do not exercise without adequate hydration
Do not exercise alone
Do not inject into exercising muscles
Hypoglycemia defined as
below 70 or rapid drop in glucose - onset is rapid
pale, shacking, sweating, hungry, tachycardic, feel faint
Hypoglycemia - what to do
if awake - give sugar (juice, candy bar, glucose tablets, gel
if not awake - medical attention - need injection
Hyperglycemia is defined as
over 300
gradual onset
weak, inc thirst, dec appetite, n/v, flushed, pulse is rapid and weak
Hyperglycemia - what to do
medical attention
Obesity - BMI is calculated how
by dividing and individuals weight in kg by the square of the perons height in meters
Overweight - BMI - defined how
25 to 29.9
Obesity - BMI - defined how
greater than or equal to 30
Morbid obesity - BMI - defined how
Over 40
Obesity - measurement with skin calipers - what is considered excess body fat
more than 1 inch
Obesity - RED FLAGS
CP compromise
Altered biomechanics of joints
Inc risk of skin breakdown
Inc heat intolerance
Thyroid disorders - Hypo
Decreased activity of the thyroid gland with deficient thyroid secretion
Slowed metabolic processes
Thyroid disorders - Hypo - Etiology
dec thyroid releasing hormone secreted by the hypothalamus or by the pituitary gland, atrophy of the thyroid gland, chronic autoimmune thyroiditis, over dosage with antithyroid med
Thyroid disorders - Hypo - s/s
weight gain, lethargy, dry skin and hair, low BP, constipation, intolerance to cold, goiter
Thyroid disorders - Hypo - if untreated can lead to
myxedema (severe hypothyroidism) with symptoms of swelling in hands, feet, face
Can lead to coma and death
Thyroid disorders - Hypo - PT RED FLAGS
can lead to exercise intolderance, weakness, apathy, exercise induced myalgia, reduced CO
Thyroid disorders - Hyper
hyperactivity of the thyroid gland
Unknown etiology
metabolic processes are accelerated
Thyroid disorders - Hyper - s/s
nervousness, hyperreflexia, tremor, hunger, weight loss, fatigue, heat intolerance, palpitations, tachycardia, diarrhea
Thyroid disorders - Hyper - PT RED FLAG
can lead to exercise intolerance, fatigue associated with hypermetabolic state
Adrenal disorders - primary adrenal insufficieny (Addisons)
Partial or complete failure of adrenocortical function
Results in decreased production of cortisol and aldosterone
Adrenal disorders - primary adrenal insufficieny (Addisons) - etiologu
autoimmune processes, infection, neorplasm, hemorrhage
Adrenal disorders - primary adrenal insufficieny (Addisons) - s/s
inc bronze pigmentation of skin weak, dec endurance anorexia, dehyrdrated, weight loss, GI issues Anxxiety, dep Dec tolerance to cold Intolerance to stress
Adrenal disorders - secondary adrenal insufficiency
can result from prolonged steroid therapy (ACTH)
Rapid withdrawal of the drugs and hypothalamic or pituitary tumors
Adrenal disorders - Cushing’s syndrome
Metabolic disorder resulting from chronic and excessive production of cortisol by the adrenal cortex
Adrenal disorders - Cushings - etilogy
most commonly from pituitary tumor with increased secretion of ACTH
Adrenal disorders - Cushings - s/s
Dec glucose tolerance Round mood face Obesity Dec testosterone or dec menstrual periods Muscular atrophy edema hypokalemia emotionla changes
