Endocrine system screening and selected disorders Flashcards
What is the neuroendocrine system
- specifically refers to the endocrine system responses mediated through CNS, ANS, and visceral system
Where are neuroendocrine cells located?
- throughout the body
- especially in the GI tract, pancreas, gallbladder, thyroid
- lungs, airways, pituitary gland, parathyroid gland, adrenal medulla gland
- thyrmus, kidneys, liver, skin, reproductive glands
What are the main parts of the neuroendocrine system
- thyriod
- esophagus
- liver
- small intestine
- appendix
- bronchi
- lung
- stomach
- pancreas
- colon
- rectum
what are the horomones of the neuroendocrine system
- somatostatin
- gastrin
- insulin
- serotonin
- epinephrine
- growth hormone
Somatostatin: where is it released and what does it do
- hypothalamus: inhibits release of GH and TSH
- pancreas: inhibts release of insulin, glucagon
- GI tract: inhibits release of gastrin, reduces GI motility, reduces gastric secretion
where is gastrin released and what does it do?
- released in gut
- promotes release of gastric acid
- increases gastric motility
- promotes replenishment of gastric mucosa
- promotes action of pancrease and gallbladder
- influenced by vagus nerve and vagal system
vagus nerve = parasympathetic NS rest/digest
Serotonin: where is it produced
- produced in GI tract 90% and brain 10%
what is serotonin important for?
- affects mood, learning, memory
- modulates digestion and appetite
- used by platelets to promote arterial vasoconstriction/clotting
- sleep quality: used to melatonin
- sexual health
- bone health
Low serotonin and depression: medications
- MAOI: older not used as much due to requiring dietary restrictions
- SSRI, SNRI
Signs and symtpoms of neuroendocrine disorders
- abdominal pain, nausea, vomiting
- indigestion, stomach ulcers, diarrhea, constipation
- pneumonia, coughing, fatigue, dyspnea
- cushings
- hypoglycemia, hyperglycemia, blood clots jaundice
varies depending on hormones
Carcinoid syndrome
- neuroendocrine tumor of small intestine with metastsis to liver
- tumor causes increase release of serotonin
Carcinoid syndrome: signs and symptoms
- flushing of face and neck due to hard time managing CV system
- diarrhea
- wheezing, dyspnea
- tachycardia, arrhythmia
- hypotension
What are some common signs of endocrine dysfunction
- muscle atrophy
- changes in fat distribution
- chanages in hair
- excessive or delayed growth
- increased perspiration
- changes in HR, BP,
- changes in skin pigmentation
- changes in mentation
What are some common symptoms of endocrine dysfunction
- myalgia
- muscle weakness
- fatigue
- carpal tunnel*
- adhesive capsulitis*
- rheumatic symptoms
- osteoarthritis
- osteoporosis
- osteonecrosis
- increased perspiration
- arthralgia
- polydipsia
- polyuria
- hand stiffness
- pseudogout
- spondyloarthropahty
*insidous carpal tunnel or adhesive capsulitis = ask about blood sugar
Anterior pituitary gland hypofunction: causes
- tumor
- hypophysectomy: getting rid of pituitary
- post-partum hemorrhage
- anorexia, starvation
- GI disorders, anemia
hypopituitarism
what are common endorcine disorders
- diabetes
- hyper and hypothyroidism
- cushing’s syndrome
- addison’s disease
- giantism, acromegaly
- hyper- and hypoparathyroidism
anterior hypopituitarism symptoms
- delayed growth or puberty
- hypoglycemia
- orthostatis hypotension
- fatigue
- cold sensitivity
- infertiility
- headaches, somnolence
- blindness or bitemporal hemianopsia (tunnel vision)
treatment of anterior hypopituitarism
- removal of cause if possible
- hormone replacement: ACTH, cortisone, GH, TSH, reproductive hormones
Anterior pituitary gland hyperfunction
causes and example disorders
- tumor usually
- specific disorder based on hormones affected
- cushing’s disease (cortisol)
- acromegaly or gigantism (GH)
- hyperprolactinemia (prolactin)
- gynecomastia and impotence
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Growth hormone-secreting ademona
- gigantism: befoe epiphyseal plate closure
- abrupt growth up to 9 feet
- tumor may grow and affect anterior pituitary
- acromegaly: adults b/c epiphyseal are closed
What is acromegaly
- develops slowly
- cartilage and connective tissue overgrowth
- affects hands, face, ears, nose, tongue, jaw
- myopathy common
ademona treatment
- medication: drugs to increase somatostatin (inhibits GH), drugs for prolactin: drugs to inhibit prolactin
- surgery: may need follow up radiation
Adenoma PT implications
- post-surgical hypoglycemia
- weakness, esp. in acromegaly: due to stretching of joints/muscles
- joint pain and dysfunction
Posterior Pituitary Disorders
- diabetes insipidus: related ADH insufficiency
- Cancer: tumor, hypophysectomy, infection, aneurysm, autoimmune or hereditary, alcohol-induced, dilantin induced