Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

OPP IV: Test 1 > Endocrine CIS/DSA > Flashcards

Endocrine CIS/DSA Flashcards

1
Q

chapmans for thyroiditis?

A

a: intercostal space b/w second and third ribs close to sternum
p: across face of transverse process of second vetrebra - midway b/w the spinous and transverse process

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

chapman’s for kidneys?

A

a: 1 inch lateral and 1 inch above umbilicus

P: space b/w T12 and L1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

adrenals chapman’s?

A

A: 2 inches above, 1 inch lateral of umbilicus

p: between T11-T12

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

pancreas chapmans?

A

A: b/w rib 7 and 8 on right side close to cartilage

P: between 7 -8 vertebra on right side

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

congestion of liver and gallbladder chapman?

A

A: ICS from mid-mammillary line to right side of 6 and 7 rib

P: between 6-7 vertebra on right side

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

short stature

A

> 2 SD below the mean

1st year: 25 cm/year
age 1-4: 10 cm/year
age 4-8: 5 cm/year

girls = fathers height -13 cm + mom’s height / 2

boys = moms height + 13 cm + dad’s height / 2

** 8.5 cm on either side of calculated TH equates to 3rd and 97th percentile

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

familial short stature

A 
height below 2.3rd percentile
normal HV, normal growth pattern, inherited - onset of puberty is same and bone age makes sense
bone age concordant
parents are short
no tx needed
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

CDGP

A

constitutional delay of growth and puberty = : temporary delay in the skeletal growth and thus height of a child with no other physical abnormalities causing the delay. These children ‘catch-up’ during mid-puberty

  • normal size at birth, HV decreases in 3-5 years of life
  • growth and stature concordant with bone age, but NOT with chronological age
  • dealyed but normal puberty - experience later than friends “late blooming”
  • HV is low in first 5 years, most experience a growth spurt
  • growth to normal heigh during delayed puberty
  • no medical tx - though some may benefit from testosterone and estrogen to trigger the growth that would occur during puberty
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

small for gestational age

A
  • born with lower than expected weight and length: below 2.3rd percentile
  • 10% don’t experience growth catch up by age 2 and may have persistent short stature
  • specialist referral needed
  • GHT to increase HV - early tx may be necessary
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Achondroplasia

A
  • dispropportionate short stature, short limbs, frontal bossing, children do well but have delayed motor development
  • no tx available
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

IUGR

A

reflects fetal/maternal issues

- fetal weight below 10th percentile for gestational age - may results in a SGA fetus or infant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

TS = turners syndrome

A
  • short stature and CV abnormalities
  • stocky figure: widely spaced nipples
  • short neck, webbing,
  • females with XO genotype
  • treatment with GHT increases adult height
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

PWS = prader wili syndrome

A
  • poor suckling reflex, hypotonia in infancy, weight gain and central obesity along with develomental delays
  • tx with GHT in order to imiprove body composition and lean mass
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

NS = netherton syndrome

A

birth weight and length are normal - may see right sided cardiac problems
- growth failure and developmental delays along with scoliosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

chronic kidney disease

A

can present with growth failre in children - height deficits at a young age

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

short stature d/t SHOX deficiency

A

birth length mildly reduced, growth failure apparent in childhood - more severe in girls - see reduced arma nd leg length

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

chrohn’s disease

A

50% of children with CD have decreased growth and 90% are underweight
tx - nutritional intervention and monoclonal Abs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Juvenile idiopathic arthritis

A 
Approximately 10%-40% of children with
juvenile idiopathic arthritis have short
stature due to long-term inflammation,
stiffening, and deformation of affected
joints.
" Delayed puberty
" Short stature is generally related to reduced
growth in lower extremities.
" Clinical course is highly variable among
patients.
" Incidence is 6-19/100 000
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Hypothyroidism

A

may cause short stature

  • do thyroid ultrasound and look at mother’s history
  • measure TSH and T4 levels
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

GHD

A

growth hormone deficiency - short stature

measure GH levels and IGF-1 levels

GHT should be started as soon as possible

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Cushing syndrome

A

short stature but high BMI - should measure cortisol levels and do high-dose dexamethasone supression test

22
Q

idiopathic short stature - ISS

A

short stature may be only presenting factor

Idiopathic: a condition characterized by a height more than 2 sd below average for age, or below the 2.5 percentile for age and gender

23
Q

Addisons disease

A
  • hypotension, w/l, fatigue, weakness, vomiting, decreased cold tolerance, salt craving, thin, tanned looking

order:
- basal plasma cortisol and ACTH level (low cortisol and high ACTH indicate Addison’s)
- do ACTH stimulation test - if cortisol levels don’t increase then its Addison’s

5 S’s for adrenal crisis:

  • salt, sugar, steroids, support and search for precipitating illness
  • managed with hydrocortisone and fludrocortisione and DHEA
24
Q

arterial supply of adrenal gland?

A

Superior, middle and inferior suprarenal arteries

25
Q

venous drainage of adrenal glands?

A

suprarenal veins

26
Q

lymph drainage of adrenal glands?

A

Para-aortic nodes

Largely driven by the motion of the respiratory diaphragm

Ultimately courses through the thoracic inlet on the way back to the heart

27
Q

Autonomic innervation of adrenals?

A

Sympathetics arise from spinal cord segments T6-L2 (T8-T10 NBOME). Have vasomotor function. Stimulation also results in secretion of epinephrine and norepinephrine. Commonly see somatic dysfunction (flexed) segment at the thoracolumbar junction

Parasympathetic fibers (vagus) may be present, however, role not clearly delineated

28
Q

opp tx for adrenal disease?

A

Lymphatics - thoracic inlet, respiratory diaphragm and other associated structures

Sympathetics – T6-L2

Parasympathetics – although role not clearly defined, consider treating structures that impact vagal function (temporal bone, occipitomastoid suture compression, OA, AA, C2)

Cranial – altered hypothalamic or pituitary function (SBS compression or other strain pattern)

Ventral abdominal release to improve function of celiac, aorticorenal, superior mesenteric and inferior mesenteric ganglion

Locally in region of adrenal gland to address fascial restrictions (don’t forget psoas major muscle and attachments)

Chapman’s reflexes
Anteriorly – 2-2.5 inches above and 1 inch lateral to the umbilicus (bilateral)
Posteriorly – Intertransverse spaces between T11 and T12 bilaterally

29
Q

hypothyroidism

A

fatigue, conspitation, mm. aches, 15 lb weight gain, cold intolerance, decreased DTRs, skin is dry

order: TSH (would be increased and T4 decreased in primary) (TSH would be decreased and T4 decreased with central)
- TSH elevated, T4 normal = subclinical hypothyroidism
- TSH and T4 elevated - OC’s

clinical management:

  • Medical management – levothyroxine (T4)
  • Repeat TSH every 6 weeks until stabilized
  • Consider liothyronine (T3) if no response to levothyroxine
30
Q

arterial supply / venous of thyroid gland?

A

Superior and inferior thyroid arteries

Superior, middle and inferior thyroid veins

31
Q

lymph drainage of thyroid?

A

Via prelaryngeal, pretracheal and paratracheal nodes

Largely driven by the motion of the respiratory diaphragm

Ultimately courses through the thoracic inlet on the way back to the heart

32
Q

ANS of thyroid

A

Sympathetics arise from upper thoracic spinal cord segments (T1)

Contributions from superior (located at level of transverse processes of C2 and C3), middle (C6) and inferior cervical (stellate) ganglia (near 1st rib)

Sympathetic fibers are vasomotor, not secretomotor

Parasympathetic innervation and role not clearly delineated

33
Q

OMM tx of thyroid?

A

Lymphatics - thoracic inlet, respiratory diaphragm and other associated structures

Sympathetics – upper thoracics

  • T1 (flexed segment)
  • Clinically, may also see compensatory extended segments around T3-4

1st rib (commonly elevated) – inferior cervical (stellate) ganglion

Cervical spine – remember superior and middle cervical ganglion

Consider potential parasympathetic influences

Cranial – altered hypothalamic or pituitary function (SBS compression or other strain pattern)

Locally in region of thyroid gland to address fascial restrictions (anterior cervical fascia and attachments)

Chapman’s:
Anterior – intercostal space between the 2nd and 3rd ribs close to sternum bilaterally
Posterior – over the transverse process of T2

34
Q

What is the function of the sympathetic fibers that innervate the thyroid gland?

A

vasomotor

35
Q

type II DM, dysplipidemia, HTN = / Metabolic syndrome

A
  • Constellation of altered function including abdominal obesity, dyslipidemia, hypertension and insulin resistance and possible impaired glucose tolerance
  • involves fn of thyroid, adrenals, pancreas, liver, kidney
36
Q

arterial/venous supply of pancreas?

A

Superior and inferior pancreaticoduodenal arteries

Portal system – superior and inferior pancreaticoduodenal veins

37
Q

lymph of pancreas

A

Pancreaticosplenic and pre-aortic nodes

38
Q

ANS of pancreas?

A

Sympathetics – arise from spinal cord segments T6-9. Have vasomotor function

Parasympathetics – derived from vagus and have secretomotor function. Parasympathetic stimulation results in the secretion of:
Insulin
Bicarb
Somatostatin, glucagon

39
Q

liver fns.

A

Metabolizes, detoxifies and inactivates substances
Stores carbohydrate, lipids, vitamins and minerals
Activates some hormones (thyroid T4 conversion to T3) and vitamins
Synthesizes or regulates albumin, glucose, cholesterol, phospholipids and fatty acids for triglycerides

40
Q

aa/vv/ll supply of liver

A

hepatic artery

portal venous system and hepatic veins

lymph Passes to nodes above and below diaphragm

41
Q

ANS of liver

A

Sympathetics arise from spinal cord segments T6-T9. Sympathetic stimulation promotes breakdown of glycogen to glucose (increased energy)

Parasympathetics arise from vagus. Parasympathetic stimulation decreases breakdown of glycogen to glucose (decreased energy)

42
Q

aa/vv/ll supply of kidney

A

renal arteries
renal vv.
lateral aortic nodes

43
Q

ANS of kidney

A

Primarily sympathetic - arise from spinal cord segments T10-L1. Vasomotor in function. Frequently see somatic dysfunction (flexed segment) at the thoracolumbar junction

Parasympathetic role not clearly delineated. Fibers probably arise from vagus

Increased sympathetic tone to the kidney may result in:
Vasoconstriction
Enhanced Na+ reabsorption from proximal tubule cells
Increased renin secretion
Net effect – increased fluid retention and increased blood pressure
Possible role in hypertensive component of metabolic syndrome?

44
Q

omm of metabolic syndrome

A

Lymphatics
Autonomics – remember spinal cord segments, associated ganglia (ventral abdominal release) and potential parasympathetic influences

Myofascial and/or osseous restrictions in area of involved organs

Chapman’s reflexes (outlined in DSA)

Goal – improve function and motion – physiologic support

weight reduction and physical activity

45
Q

ddx of metabolic syndrome?

A

Abdominal obesity
Men > 102cm
Women > 88cm

BP ≥ 130/85

Triglycerides ≥ 150 mg/dl

HDL
Men < 40 mg/dl
Women < 50 mg/dl

Fasting glucose ≥ 100 mg/dl

46
Q

adrenal fatigue

A

normal/low cortisol along with symptoms = subclinical addison’s

47
Q

growth failure

A

loss of two ore more percentile lines

Many reasons: Failure to thrive (environmental, dietary (celiac)), hormonal (growth hormone, thyroid), metabolic (storage disorders), etc.

48
Q

noonan

A

triangular face, downward slanting eyes, low set ears, pectus carinatum/excavatum
webbed neck, double curve scoliosis and rib deformities

49
Q

Russell- silver syndrome

A

Russel-Silver: triangular face, clinodactyly, blue sclera, lack of sub-cutaneous fat - normal head, downward slanting face

50
Q

flow chart for growth delay

A

dysmorphic figures –> think syndrome

no dysmorphic figures then do tests:

  • normal bone growth for age = genetic short stature
  • bone age minimally delayed = constitutional delay
  • bone age delayed: think celiac, cushings, GH deficiency, hypotH –> refferral
51
Q

OMM in kids with GD?

A

When we treat an adult, we are removing an obstacle to function and allowing the somatosensory map to express itself. In children, we are removing obstacles to function so that the somatosensory map may be set down as optimally as possible. Motion is the key to laying down the map. During a growth spurt, the child’s body is moving (growing) quickly. This is a time of tremendous biomechanical stress, and areas that have been under stress before (somatic dysfunction, congenital abnormalities, etc) are likely to become stressed during these times. This is the ideal time to treat them with OMT. We get in there to treat the obstacles to optimal somatic motion so that they can lay down as optimal a somatic map as possible.

treat what you find

  • look at junctions
  • look at feet, ankles, hips, shoulders, cranial base

OPP IV: Test 1 (4 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions