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A&P II (Spring 2025) > [Exam 1] Lecture 6: Thyroid > Flashcards

[Exam 1] Lecture 6: Thyroid Flashcards

1
Q

What is mitral regurgitation?

A

A leaky valve between the left ventricle and left atrium

It causes retrograde perfusion when ventricular pressure exceeds atrial pressure.

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2
Q

During which phase does backward blood flow begin due to mitral regurgitation?

A

Phase 2, at the beginning of isovolumetric contraction

The valve is leaking, making it no longer isovolumetric.

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3
Q

What factors influence backward blood flow in mitral regurgitation?

A

Delta P and the relative fullness of the atria

Delta P refers to the pressure difference between the ventricle and atria.

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4
Q

During which phase is backward blood flow expected to be highest?

A

Phase 3

Backward blood flow continues throughout systole.

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5
Q

What happens to backward blood flow during Phase 4 of mitral regurgitation?

A

There is still some backward blood flow, but it diminishes as ventricular pressure decreases

The highest backward blood flow occurs at the beginning of Phase 4.

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6
Q

True or False: Backward blood flow is constant throughout the cardiac cycle in mitral regurgitation.

A

False

Backward blood flow varies with different phases of the cardiac cycle.

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7
Q

What is the formula for calculating ejection fraction (EF)?

A

Stroke Volume divided by End Diastolic Volume

Normal EF is approximately 58%.

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8
Q

What does a high ejection fraction in mitral regurgitation indicate?

A

It may be falsely high due to backward flow

Echo measurements can be misleading in regurgitation cases.

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9
Q

What type of hypertrophy is characterized by thin ventricular walls?

A

Eccentric hypertrophy

Eccentric hypertrophy involves adding sarcomeres in series.

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10
Q

What type of hypertrophy is characterized by thick ventricular walls?

A

Concentric hypertrophy

Concentric hypertrophy involves adding sarcomeres in parallel.

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11
Q

Which endocrine system significantly impacts the cardiovascular system?

A

The thyroid system

Thyroid hormones influence metabolism and cardiovascular health.

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12
Q

What is a common sign of hyperthyroidism?

A

Increase in resting heart rate

This can occur in patients without any heart problems.

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13
Q

What is a goiter?

A

Protrusion of the neck due to an enlarged thyroid gland

It can be caused by various factors.

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14
Q

What is the role of the parathyroid gland?

A

Controller of calcium levels in the blood

It works alongside the thyroid gland.

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15
Q

What is the risk associated with manipulating the thyroid gland during surgery?

A

Bleeding due to its rich vascular supply

The thyroid has extensive blood vessels that pose a bleeding hazard.

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16
Q

What nerve controls the muscles inside the larynx?

A

Right recurrent laryngeal nerve

It branches off the vagus nerve.

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17
Q

What happens to the name of the recurrent laryngeal nerve after it curves around a blood vessel?

A

It may be referred to as the inferior laryngeal nerve

This occurs after the initial curve beneath the artery.

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18
Q

What is another name for the inferior laryngeal nerve?

A

Recurrent laryngeal nerve

The recurrent laryngeal nerve is named for its anatomical path, which involves a curve around major blood vessels.

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19
Q

Where does the left recurrent laryngeal nerve pass before turning back towards the voice box?

A

Under the aortic arch

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20
Q

What happens if one of the laryngeal nerves is cut during surgery?

A

The patient may have a hard time speaking

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21
Q

What is the predominant thyroid hormone released by the thyroid gland?

A

T4 (Thyroxine)

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22
Q

What percentage of thyroid hormone released by the thyroid gland is T4?

A

93%

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23
Q

What is the chemical name for T3?

A

Triiodothyronine

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24
Q

What is the other name for T4?

A

Thyroxine

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25
Q

What is monoiodotyrosine?

A

Tyrosine with one iodide stuck to it

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26
Q

What is the role of the hypothalamus in thyroid hormone regulation?

A

It controls the release of TSH from the pituitary gland

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27
Q

What does TRH stand for?

A

Thyrotropin releasing hormone

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28
Q

What is the main source of iodine in most people’s diets?

A

Table salt

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29
Q

Name the three main carrier proteins for thyroid hormones.

A
  • Thyroxine binding globulin
  • Thyroxine binding prealbumin
  • Albumin
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30
Q

What is the effect of increased levels of thyroid hormone on metabolic rate?

A

Increases metabolic rate

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31
Q

What happens to cardiac output when thyroid hormone levels increase?

A

Cardiac output increases

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32
Q

True or False: Blood pressure typically increases when thyroid hormone levels are elevated.

A

False

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33
Q

Fill in the blank: The thyroid gland releases more __________ than __________.

A

T4, T3

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34
Q

What is the function of thyroid hormone at the cellular level?

A

Turns on genes to ramp up cell processes

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35
Q

What happens to glucose absorption when thyroid hormone levels are elevated?

A

Increases

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36
Q

How does thyroid hormone affect the respiratory system?

A

Increases respiratory rate or depth

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37
Q

What can result from a deficiency of iodine in the diet?

A

Goiters

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38
Q

What is the role of TSH in thyroid hormone regulation?

A

Stimulates the release of T3 and T4 from the thyroid gland

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39
Q

What is the anterior pituitary gland’s role in thyroid hormone regulation?

A

Releases TSH

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40
Q

What is the significance of T3 and T4 being lipid soluble?

A

They can easily cross cell membranes

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41
Q

What happens to oxygen consumption when thyroid hormone levels are elevated?

A

Increases

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42
Q

What is the thyroid hormone’s primary target within cells?

A

Nucleus

43
Q

What is the consequence of liver failure on thyroid hormone transport?

A

Difficulty in creating carrier proteins, affecting thyroid hormone levels

44
Q

What happens to heart rate during increased blood flow and nutrient delivery?

A

Heart rate typically increases.

45
Q

Does blood pressure always increase with enhanced cardiac output?

A

No, blood pressure doesn’t necessarily go up due to reduced systemic vascular resistance (SVR).

46
Q

What changes occur in the respiratory system to meet increased oxygen demand?

A

Respiratory rate or depth increases.

47
Q

Why is thyroid hormone important during growth and development?

A

It is required for processes critical to maturation and development, particularly of the nervous system.

48
Q

What can happen if there is an absence of thyroid hormone during development?

A

Major deficiencies in the central nervous system can manifest, leading to personality issues and cognitive deficits.

49
Q

What effect does hyperthyroidism have on blood cholesterol levels?

A

It typically causes blood cholesterol levels to drop.

50
Q

What is the reason for the drop in cholesterol levels in hyperthyroidism?

A

Cholesterol is consumed at the cellular level to build compounds, leading to faster usage than normal.

51
Q

How quickly does thyroid hormone typically take effect?

A

It may take six to eight hours for changes to manifest, and up to 10 days for effects to peak.

52
Q

What is thyroid storm?

A

A condition where thyroid hormone problems can occur rapidly.

53
Q

What is a pituitary tumor’s effect on TSH and thyroid hormone levels?

A

It can cause elevated TSH and thyroid hormone levels, leading to hyperthyroidism.

54
Q

What happens to TRH levels in the presence of a pituitary tumor?

A

TRH production stops as the pituitary gland releases excess TSH independently.

55
Q

How does a thyroid gland tumor affect TSH and TRH levels?

A

It causes a reduction in both TRH and TSH levels due to excess thyroid hormone production.

56
Q

What is the expected outcome of a hypothalamic tumor secreting excess TRH?

A

Elevated levels of TSH, TRH, and thyroid hormones.

57
Q

What is the predominant form of thyroid hormone delivered to cells?

A

T4 (thyroxine) is 93% of circulating thyroid hormone.

58
Q

What enzyme converts T4 to the more active form T3?

A

Iodinase.

59
Q

What is the primary function of T3 in the body?

A

T3 binds with thyroid hormone receptors to exert effects.

60
Q

What is the relationship between thyroid hormone and metabolic rate?

A

Thyroid hormone increases metabolic rate and nutrient requirements.

61
Q

What is Graves’ disease?

A

An autoimmune disorder where antibodies activate TSH receptors, increasing thyroid hormone production.

62
Q

What is exophthalmos and its concern in Graves’ disease?

A

Protrusion of the eyes, which can lead to corneal injury.

63
Q

What is Hashimoto’s thyroiditis?

A

An autoimmune condition where antibodies destroy the thyroid gland.

64
Q

What happens during iodine deficiency regarding thyroid hormone production?

A

The thyroid gland cannot produce enough thyroid hormone, leading to elevated TRH and TSH levels.

65
Q

What type of goiter can result from iodine deficiency?

A

An enlarged thyroid gland that is not producing sufficient thyroid hormone.

66
Q

How is radioactive iodine used in treating thyroid cancer?

A

Radioactive iodine targets thyroid cells, minimizing effects on other body parts.

67
Q

What happens with excessive iodine intake in relation to thyroid hormone production?

A

It can decrease the thyroid gland’s ability to produce thyroid hormone.

68
Q

What is a potential consequence of consuming a massive dose of iodine?

A

It confuses the cellular system and reduces thyroid hormone production.

69
Q

What happens when a very high dose of iodine is taken?

A

The cells can’t handle that much iodine; it can lead to oxidative stress and dysfunction.

70
Q

Can excessive iodine intake be used for hyperthyroidism?

A

Yes, sometimes a high iodine intake can be used for acute issues with hyperthyroidism.

71
Q

What is amiodarone and its relation to iodine?

A

Amiodarone is packaged in a solution with high iodine content, and care must be taken with iodine levels when administering it.

72
Q

Does exophthalmos occur in iodine deficiency with goiter?

A

No, exophthalmos is a result of excessive thyroid hormone, not iodine deficiency.

73
Q

Is the effect of very high iodine intake on the thyroid gland permanent or temporary?

A

Temporary, it may be used to shut down the thyroid gland in certain situations.

74
Q

What happens to blood cholesterol levels in hyperthyroidism?

A

In hyperthyroidism, blood cholesterol and triglycerides are probably low.

75
Q

What is a chief concern with hypothyroidism in older adults?

A

Atherosclerosis due to elevated cholesterol levels.

76
Q

What happens to cholesterol and fatty acids in hypothyroidism?

A

Their levels in the bloodstream rise because low thyroid hormone leads to less usage.

77
Q

What is the primary risk associated with untreated hypothyroidism?

A

Significant cardiovascular risks, particularly atherosclerosis.

78
Q

What is the patient compliance rate for synthetic thyroid hormones like Synthroid?

A

Incredibly low due to side effects like insomnia and anxiety.

79
Q

What is shock in a medical context?

A

A problem getting required nutrients to tissues.

80
Q

What characterizes cardiogenic shock?

A

Problems with the heart’s ability to pump sufficient cardiac output.

81
Q

What can cause neurogenic shock?

A

Loss of sympathetic tone, often induced by anesthetics or high spinal procedures.

82
Q

What is anaphylactic shock driven by?

A

Histamine released from mast cells due to an immune response.

83
Q

What type of bacteria is usually involved in septic shock?

A

Usually gram-positive bacteria.

84
Q

What is the most common form of shock?

A

Hypovolemic shock, often due to blood loss or dehydration.

85
Q

What role does the sympathetic nervous system play in cardiovascular maintenance?

A

It helps maintain blood pressure and cardiac output during blood loss.

86
Q

What happens to arterial pressure and cardiac output when 20% of blood volume is lost?

A

Arterial pressure may appear normal, but cardiac output is low.

87
Q

What is the significance of measuring cardiac output?

A

It provides a clearer picture of cardiovascular health than blood pressure alone.

88
Q

What happens to animals when blood pressure drops to less than 45% of normal?

A

Those animals typically do not survive.

89
Q

What compensatory mechanisms occur after significant blood loss?

A

Catecholamines increase, kidneys conserve volume, and fluid shifts happen.

90
Q

What happens to the body when blood pressure is reduced to about 50% of normal during hemorrhage?

A

The body compensates through catecholamines and kidney efforts to conserve volume

Fluid shifts may occur to maintain blood volume, utilizing water reserves in cells and interstitial spaces.

91
Q

What is non-progressive shock?

A

A state where the body’s compensation mechanisms successfully manage to stabilize blood pressure and organ function despite blood loss

This is typically seen in the first three animals described.

92
Q

What occurs during progressive shock?

A

The body’s compensation fails, leading to insufficient perfusion of vital organs and potential organ failure

This is observed in animals four, five, and six.

93
Q

What percentage of blood volume can be lost without affecting cardiac output or blood pressure?

A

About 10%

Losing 20% can still be survivable for a healthy individual.

94
Q

At what percentage of blood volume loss does survival become very difficult?

A

Around 40%

Rapid blood loss beyond this point typically leads to poor outcomes.

95
Q

What role does the spleen play during blood loss?

A

It serves as a storage for extra hemoglobin and red blood cells that can be released into circulation

This is part of the body’s compensatory mechanisms during hemorrhage.

96
Q

What is the primary function of the kidneys in response to low blood pressure?

A

To retain fluid and electrolytes to increase blood volume

This response is aimed at normalizing blood pressure.

97
Q

What is the significance of a failing heart’s filling pressure increase?

A

It helps compensate for the heart’s reduced ability to pump effectively

This is part of the body’s strategy to maintain necessary cardiac output.

98
Q

What is the purpose of medications like Digoxin and Milrinone?

A

To assist in increasing cardiac output in patients with heart failure

They provide temporary support but are not cures.

99
Q

What does the Black Compensation Curve represent?

A

It illustrates a failing heart’s inability to reach the required cardiac output level

Points on this curve indicate worsening conditions over time.

100
Q

What is the role of diuretics in chronic heart failure management?

A

To prevent the kidneys from retaining excessive fluid that could worsen heart function

They help manage fluid overload and maintain a safer blood pressure.

101
Q

True or False: Blood pressure is a reliable substitute for measuring cardiac output.

A

False

While blood pressure is useful, it does not provide a complete picture of cardiac health.

102
Q

What does the Edwards FlowTrac monitor?

A

Pulse pressure variation to assess cardiac function

It is an algorithm-based tool that may not significantly enhance clinical assessments.

103
Q

What is the critical output level required for a young, healthy individual to survive?

A

Approximately five liters of blood per minute

This is essential for maintaining necessary organ perfusion.

A&P II (Spring 2025) (7 decks)

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