Endocrine path/ physiology Flashcards by Anjali Yapa

What is the function of Calcitonin in the Kidneys

Increases excretion of calcium AND phosphate

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What stimulates renin secretion

-reduction in extracellular fluid volume
-low BP
-sympathetic stimuli

eg: cardiac failure, hypotension, renal artery constriction, sodium depletion, hemorrhage, dehydration

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What converts angiotensinogen to angiotensin I

Renin

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What converts angiotensin I to angiotensin II

ACE (angiotensin converting enzyme)

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What factors stimulate growth hormone secretion

Sleep
exercise
protein rich diet
circulating oestradiol
HYPOglycaemia

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What factors inhibit growth hormone secretion

HYPERglycaemia
carb rich diet
free fatty acids
somatostatin
cortisol

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How would you differentiate between a primary and secondary adrenal insufficiency

Presence of hyperpigmentation:

present= ACTH produced by pituitary= ACTH also acts as melanocyte stimulating hormone= primary insufficiency

absent= no ACTH produced by pituitary= secondary insufficiency

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During embryological development, when does the thyroid gland first appear and where

Week 4

At the foramen caecum of the base of the tongue

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Where is the final position of the thyroid gland and when does it reach this position

Thyroid travels along the thyroglossal duct to reach its final position at week 24

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What is the communication between the initial and final positions of the thyroid gland called

Thyroglossal duct

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What is the complication of I&D or untreated thyroglossal cyst

Fistula

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What is a thyroglossal cyst

A cystic remnant of the thyroglossal duct

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What are the actions of insulin

1- movement of glucose + potassium from blood into cells

2- glycogenesis (converts glucose to glycogen and stores in liver/ muscles)

3- lipogenesis (converts glucose to triglycerides and stores in liver/ adipose tissue)

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Function of following hormones on glucose/ glycogen:

Glucagon
Cortisol
adrenaline
thyroxine

Glucagon- glycogenolysis, gluconeogenesis

Cortisol-glycogenesis, gluconeogenesis

adrenaline-glycogenolysis, gluconeogenesis

thyroxine-increased blood glucose

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What are the structures present anterior to the thyroid gland

Pre-tracheal fascia
Infrahyoid muscles:
-sternothyroid
-sternohyoid
-omohyoid

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At what level of the neck does the thyroid sit?

C5-T1

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What fascia surrounds the thyroid

Pre-tracheal fascia

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What nerves are found and where are they situated in relation to the thyroid

external and recurrent laryngeal nerves (medial to thyroid)

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Arterial supply of thyroid

superior + inferior thyroid arteries

3-10% also have thyroid ima/ internal mammary arteries

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Venous drainage of thyroid

superior
middle
inferior thyroid veins

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Which veins supplying the thyroid drain into the internal jugular

superior + middle thyroid veins

Which veins supplying the thyroid drain into the subclavian vein

inferior thyroid vein

Where do the arteries supplying the thyroid originate from

superior thyroid = external carotid
inferior thyroid= thyrocervical trunk

Which nerve is in close proximity to the superior thyroid artery

external laryngeal nerve

Which nerve is in close proximity to the inferior thyroid artery

recurrent laryngeal nerve

In thyroidectomy for a well-differentiated thyroid carcinoma- what is the level of neck dissection carried out

Level 6 neck dissection

Which lymph nodes drain the thyroid

deep cervical

Where can the recurrent laryngeal nerve be found (_____ triangle) and describe its boundaries

Beahr's triangle superior= inferior thyroid artery medial= trachea lateral= common carotid artery

Describe the path of the recurrent laryngeal nerve

right: hooks under the brachiocephalic trunk travels in tracheo-oesophageal groove goes under the thyroid gland inferiorly left: hooks under arch of aorta travels in tracheo-oesophageal groove goes under the thyroid gland inferiorly

What artery is related to the external laryngeal nerve

superior thyroid

Action of the recurrent and external laryngeal nerves

recurrent: innervates ALL the instrinsic muscles of the larynx (EXCEPT cricothyroid) -thyroarytenoids -posterior cricoarytenoids -lateral cricoarytenoids -transverse arytenoid -oblique arytenoid external laryngeal: -cricothyroid

What are the intrinsic muscles of the larynx

-thyroarytenoids -posterior cricoarytenoids -lateral cricoarytenoids -transverse arytenoid -oblique arytenoid -cricothyroid

What are the extrinsic muscles of the larynx

supra + infrahyoid muscles

Name the suprahyoid muscles

geniohyoid mylohyoid digastric (sup/ inferior bellies) stylohyoid

Name the infrahyoid muscles

thyrohyoid sternohyoid sternothyroid omohyoid (2x bellies)

What are the 8 steps of thyroid hormone production

1. active transport of iodine from blood into follicular cells 2. Oxidation of iodine to iodide (I-) in follicular cells 3. Iodide moves into to colloid and binds with the tyrosine+thyroglobulin molecule with the help of thyroid peroxidase 4. depending on how many iodine bind to tyrosine+thyroglobulin molecule, MIT and DIT are made 5. TSH from pituitary stimulates the movement of MIT/ DIT back into follicular cells via vacuoles BY PINOCYTOSIS 6. lyzosomes/ proteases are released into these vacuoles and breakdown MIT/ DIT, alanine is produced as a byproduct 7. thyroglobin is released back into colloid 8. remaining T3/ T4 is released in the plasma

What are the hormones produced by the thyroid gland

Thyroxine T4 Triiodothyronine T3 calcitonin

What plasma proteins transport T3/4

Thyroid binding globulin (TBG) Thyroid binding prealbumin (TBPA) Albumin

At which point in the production of T3/4 does carbimazole/ PTU act

blocks oxidization of iodine to iodide

What is the structure of thyroid follicles

follicular cells are arranged around colloid and surrounding these clusters of follicular cells are capillaries

What hormone stimulates the secretion of testosterone

Luteinizing hormone from leydig cells (interstitial cells)

What cells produce the hormone that stimulates testosterone secretion

Basophilic gonadotrophs in the anterior pituitary

Function of FSH in men

Works with testosterone to make androgen binding protein (ABP) ABP keeps testosterone levels high in the tubular fluid

What inhibits secretion of prolactin

Somatostatin Dopamine

What factors increase prolactin secretion

Pregnancy Stress response

What hormones increase following the stress response

Glucagon cortisol growth hormone ADH/ vasopressin prolactin (preg)

What happens to thyroid hormones and insulin in the stress response

Decreased levels of Insulin, T3, T4

In response to hyponatremia-what happens to renin levels

INCREASES

Effect of Growth hormone on glucose concentrations

increases glucose