Parathyroid Flashcards
Body Ca2+ levels are regulated mainly by three hormones;??
Body Ca2+ levels are regulated mainly by three hormones; parathyroid hormone (PTH), Vitamin D and calcitonin.
Ca2+ in essential metabolic activities including
neuromuscular excitability,
excitation-contraction coupling in muscle,
stimulus-secretion coupling,
maintenance of cellular tight junctions,
blood clotting,
and structural and functional integrity of bone and teeth
Parathyroid hormone related peptide (PTHrp), plays a role in
Pendochrondral bone growth,
resorbing aveolar bone to allow normal tooth development and eruption
maintaining elevated Ca2+ levels in fetal circulation during pregnancy and
mobilization of Ca2+ in mammary gland for secretion in milk during lactation.
(CaSR)
Parathyroid gland chief cell release of PTH is regulated by a Ca-sensing receptor (CaSR)
role of Active Vit. D3
Active Vit. D3 supresses PTH synthesis and stimulates CaSR synthesis.
PTH and its effect on the bones
BONE
PTH stimulates bone osteoblasts to increase growth & metabolic activity
PTH stimulates bone resorption and releases calcium & phosphate into blood
PTH and its effect on the kidney
PTH increases reabsorption of calcium & reduces reabsorption of phosphate
Stimulates synthesis of Vitamin D3
Inhibits resorption of Na+ and bicarbonate in the proximal tubule and stimulates a Na+-H+ exchanger
PTH and its effect on the INTESTINE
INTESTINE
Increases calcium and phosphate reabsorption via vitamin D
fast exchange vs slow exchange of calcium
fast: calcium moves from the labile pool in bone fluid to the plasma
slow: calcium moves from sstable pool in the mineralized bone to the plasma
calcitonin is secreted by
Calcitonin is a peptide hormone secreted by the parafollicular or “C” cells of the thyroid gland
calcitonin function
Calcitonin acts on bone osteoclasts to reduce bone resorption.
Net result of its action is a decline in plasma calcium & phosphate
Calcitonin appears to have no physiological role in the regulation of plasma Ca2+ in humans.
T/F
T
Increased PTH
CAUSES
Increased PTH
Resulting in mobilization of bone Ca2+ & PO4-, increased renal phosphate excretion & Ca retention and increased Vitamin D3 synthesis
Primary hyperparathyroidism
hypercalcemia, hypophosphatemia, hypercalciuria and renal calculi (renal stones) Usually has no clinical expression in bone
Long-term secondary hyperparathyroidism
renal failure generated hyperphosphatemia and hypocalcemia
is associated with accelerated bone resorption