Lesson 10 Endocrine+ Neuro Flashcards by Chun Wing Wong

Endocrine glands secrete to where?

To blood

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Insulin vs glucagon

Insulin dcrease level of blood sugar by uptaking glucose to cell

Glucagon increase blood sugar level by breaking down glycogen in liver

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Endocrine hormone-thyroid, parathyroid

Thyroid-thyroxine
Regulate metabolism

Thyroid-calcitonin
Inhibit release of calcium from the bone

Parathyroid-parathyroid hormone
Stimulate the release of calcium from bone

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Adrenal cortex-epinephrine

Epinephrine-stimulate fight or flight response
(Adrenaline)

Cortisol-stress response

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Adrenal medulla

Glucocorticoids- cortisol
Stress response

Aldosterone
Regulate level of sodium content in the blood

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Pineal gland-melatonin

Melatonin: sleep cycle and reproductive cycle

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Alteration of hormonal regulation

Dysfunction of endocrine gland
Elevated or deoressed hormone level
Secretory cell not able to produce, obtain, convert hormone precursors
Increased hormone degradation

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Anterior pituitary glands
Hypopituitarism 垂體機能減退

Cause：head trauma, infections
Mechanism： diminished hormone secretion by pituitary glands causing dwarfism, premature ageing

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Anterior pituitary-hyperpituitarism

Mechanism: cause by a benign, slow growing pituitary adrenoma

S/s headache, fatigue, muscle weakness

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Hypersecretion of growth hormone-Acromegaly, gigantism

Acromegaly( after adult)
Enlarged feet& hand
Thick lips
Enlarged facial features
Jutting突顯 forehead and jaw

Gigantism( when adolescent)
Grow in height and girth
Large hand and feet
Prominent jaw and forehead

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Posterior pituitary- antidiuretic hormone

Syndrome of inappropriate antidiuretic hormone

Hypersecretion-less urine
Manifestation: hyponatemia 低鈉血症

Hyposecretion： diabetes insipidus
Polyuria+ polydipsia
Partially or totally not able to concentrate urine
Reason: inadequate ADH

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Thyroid glands secreting route(TRH)

TRH-) TSH thru blood-) t3 t4( increase metabolism)

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Hyperthyroidism

Cause thyrotoxicosis( excessive output of thyroid hormone)
s/s:
Nervousness
Rapid pulse
Heat intolerance(hot)
Exothalmos(眼突）
Increase appetite
Cardiac dysrhymias
Enlarged thyroid glance

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Cause of hyperthyrodism

Shock
Stress
Infection
Excessive ingestion of thyroid hormone
Excessive iodine intake
Thyroid cancer

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Hypothyrodism

Inadequate thyroid hormone
Affects body functions and may have myxedema(黏液水腫）
Cause： autoimmune thyroiditis
Treatment of hyperthyroidism
Thyrodectomy （切咗甲狀腺
Radiation to head or neck cancer

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Parathyroid hormones uses

Stimulate the secretion of calcium from the bones

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Hyperparathyroidism
S/s?

Hypoparathyroidism

Primary: Excess secretion of parathyroid hormone
Secondary: leads to chronic disease

Hypoparathyroidism: abnormally low PTH

Diabetes what type?

Type 1( genetic factor)
Insulin deficit (destruction of pancreatic beta cell)

Type 2( mature onset)
Based on decreased effectiveness of insulin or deficit of insulin

Adrenal cortex( on kidney)
What disease?

Cushing disease
Excessive anterior pituitary secretion of ACTH

Cushing syndrome( adrenal glands)d
Excessive level of cortisol

Adrenocortical hypofunction

Hyperaldosteronism
Too much aldosterone produced by adrenal glands
—) hypokalemia
—) hydrogen ion excretion increase
—) alkalosis

Hypersecretion of androgen& estrogen
Feminisation/ virilization

Cushing syndrome
Cause?

Excessive adrenocortical or corticosteroid

S/s
Moon face
Buffalo hump
Truncal obesity
Skin is fragile
bruising / striae at lower abdomen
Increase facial hair

Addison’s disease

Opposite of cushing syndrome
Deficit of corticosteroid

S/s
Weight loss
Muscle weakness
Anorexia
Low BP
Sodium low
Potassium high
Confusion
Apathy

Drugs in endocrine system

Corticosteroid
Suppress inflammation, allergic reactions

E.g.prednisolone
Decrease inflammation-x) leukocyte, lysosomal
From severe inflammation, immunosuppression, neoplasm

Dexamethasone
For cerebral edema

Neurological
Two system?

central nervous system(CNS)
Peripheral nervous system(PNS)

Level of consciousness
1.
2.
3.
What test to do?

Confusion
Disorientation
Loss of consciousness
—)motionless but may have response
Glascow coma scale

Neurological dysfunction

Sensory deficit眼耳口鼻 Aphasia Seizure—） excessive amount of neuron in brain

Brain death

If yes then terminate medical intervention Definition: stopped brain function( included brain stem+ cortex) No brain stem reflex Nil spontaneous respiration

Traumatic brain injury

Trauma to brain leads to physical, intellectual, emotional, social changes 50% is car accident 21% is fall

Two type of brain trauma

Blunt trauma( closed) Head strikes hard surface Dura remain intact Open trauma Injury breaks the dura Expose cranial content to the environment Cause focal injury( single location injury to pain)

Spinal cord trauma Definition

Vertebral injury Fracture( simple, compressed, comminuted 粉碎) Most common locstion： 1，2，4-7 Hyperflexion, hyperextension, compression

Brain tumor

Taking up spaces and cause increased intracranial pressue Benign/ malignant tumors Inflammation

Vascular血管 disorder — transcient ischemic attack

Temporary localized reduction of blood flow in the brain . Recover within 24hrs Cause: atherosclerosis/ small embolus Remain conscious Short period of impaired function 1. Muscle weakness of arm and legs 2. visual disturbances 3. Numbness 4. Transient aphasia 5. Confusion

Cerebralvascular accident

Stroke is infarction of brain tissue=lack of blood Total occlusion of cerebral blood vessel by atheroma/ embolus will cause ischemia缺血—）tissue necrosis Rupture of cerebral vessel-x) hemorrhage and increase ICP

3 types of stroke

Ischemic stroke缺血性中風 1. Occlusion of atery by athersclerosis Most common Cause gradual narrowing of arterial lumen（plaque or thrombus） 2. Embolus Stuck in cerebral artery Emboli can be air, tumors, infection 3. Intracerebral hemorrhage （hemorrhagic stroke） Cause by rupture of cerebral artery More severe, destructive CVA Affect large area of brain Greater increase of intracranial pressure with hemorrhage

Diagnosis for CVA, s/s

Test: speech, level of consciousness, motor ability, eye movement S/s of stroke Depend on the location of obstruction, size of artery involved Flaccid paralysis軟癱 Muscle weakness Sensory loss of leg Confusion Loss of problem solving skills Personality change

Infection meningtis 腦膜炎

Microorganism reach the brain via blood Meningococcus

Seizure Generalized seizure

Gemerslized seizure Last 5-10 seconds Brief loss of awareness Transient facial movement-twitch of eyelids, lip-macking Tonic-clonic seizure( 2min) Tonic-arms bend Clonic- extension of body Partial seizure Simple partial/ focal seizure arise from a single area of damage Manifested by repeated motor activityy

Parkinson’s disease

Progressive degeneration disorder Motor function affected Degenerative change in basal nuclei

S/s of parkinson

Early signs: Fatigue, muscle weakness, muscle aching Change in facial expression Obvious sign: tremor in hands, pill-rolling hands 震 Latw stage： motor impair, bradykinesia

Dementia

Progressive chronic disease Impair cognitive: language, logical thinking, judgement MMSS, MoCA test

Drug for neuro

Anti-parkinson drugs Benztropine Balance neurotransmitter Reduce parkinsonian symptoms Anti-convulson Inhibit spread of seizure activity by altering ion transport Also can for dysrhymias