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EndocrineJaz > Physiology and Anatomy > Flashcards

Physiology and Anatomy Flashcards

1
Q

4 chemical types of hormones

A

modified amino acids
steroid
peptide
protein

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2
Q

example of a protein hormone

A

insulin

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3
Q

modified amino acid acids eg from __+__

examples __+__

A

tyrosine and tyramine

adrenaline, T3 and T4

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4
Q

examples of steroid hormones

A

cortisol, progesterone, testosterone

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5
Q

examples of peptide hormones

A

ACTH oxytocin ADH

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6
Q

6 main hormones from anterior pituitary

It releases ___ chemical type hormones

A

ACTH, GH, FSH, LH, prolactin, TSH

peptide/protein

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7
Q

intermediate pituitary hormone

A

MSH

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8
Q

posterior pituitary hormones

A

ADH/vasopressin

oxytocin

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9
Q

pineal gland hormone

and its target

A

melatonin

hypothalamus

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10
Q

Zollinger Ellison syndrome is a tumour of the ___ that releases ___

A

pancreas/duodenum

gastrin

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11
Q

definition of autocrine

A

acts on the same cell

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12
Q

definition of paracrine

A

acts on other cells within that organ/tissue

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13
Q

definition of endocrine

A

enters circulation to act on distant cells

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14
Q

hormones act at __ concns over a ___ distance with ___ receptors and __ potency

A

low concns
large distance
specific receptors
high potency

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15
Q

3 hormones involved in homeostasis short term during exercise and their function

A

glucagon - gluconeogenesis and glucose release
cortisol - enhance metabolic use of glucose
adrenaline - prevent hypoK+

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16
Q

4 hormones involved in long term effect of exercise for normal growth

A

GH
insulin
IGF-1
sex hormones

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17
Q

insulin has antagonistic actions to __+__

A

adrenaline and glucagon

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18
Q

amine hormones: ___ converted to adrenaline it is then ___ and then released in response to ___ = ___ - is highly hydrophilic and so travels ___ in plasma

A 
tyrosine
stored pre-synthed in vesicles
Ca2+ in cell
exocytosis
free in plasma
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19
Q

peptide and protein hormones:

precursor (synthed at __) >____>hormone>____>___dependent exocytosis>highly hydrophilic so travels ___

A 
rER
proteolytic steps by convertases
stored pre-synthed in vesicles
Ca2+
free in plasma
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20
Q

steroid hormones:
__+__ stimulated > __ uptake > converted into ___ (rate limiting step) > steroid hormone which is ___ and released>is ___ and so 90% travels bound in blood

A 
intracellular ligand and receptor
cholesterol uptake
pregnenolone
not stored
hydrophobic
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21
Q

carrier proteins provide a ___ for hormones and increase ___ and so maintains a ___ concn

A

reservoir
t1/2
relatively constant

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22
Q

3 specific carrier proteins

A

CBG - binds cortisol
TBG - binds T4
SSBG - bind sex steroid hormones

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23
Q

general carrier proteins (2)

A

albumin (steroids and thyroxine)

transthyretin (thyroxine and some steroids)

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24
Q

5 factors that the control of hormone levels depend on

A 
rate of secretion
negative feedback
neuroendocrine
circadian rhythm
rate of elimination
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25
Q

t1/2 of amine, peptide/protein and steroid+thyroid hormones

A

amine - seconds
p+p = minutes
s+t = hours-days (due to carrier protein binding)

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26
Q

GPCR are the receptors for __+___ hormones eg.

A

amines and some peptides

adrenaline, glucagon, CRH,ATII, GRH, TRH, malatonin

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27
Q

ATII/GRH/TRH to GPCR => __>__/__

A

Gq
IP3
PKC

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28
Q

adrenaline, glucagon CRH to GPCR =>__>__>___>phosporylation

A

Gs
increase cAMP
PKA

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29
Q

melatonin to GPCR => __>__>__

A

Gi
decrease cAMP
decrease PKA

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30
Q

type of receptor for protein and peptide hormones

A

receptor kinase on cell surface

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31
Q

type of receptor that is for insulin

A

receptor kinase on cell surface

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32
Q

insulin binds to ___ (receptor) to cause ____ which recruits ___ notably ___

A

receptor kinase
autophosphorylation of intracellular tyrosine residues
adapter proteins - ISR1

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33
Q

Class 1 nuclear receptors are activated by __ hormones
in inactive form are found in ___ bound to __
then bound to and move to __ to ___ genes

A 
steroid
cytoplasm
inhibitory HSPs
nucleus
transactivate/repress genes
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34
Q

Class 2 nuclear receptors activated by __

are found in the __ always

A

lipids

nucleus

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35
Q

Hybrid nuclear receptors are activated by ___

A

T3 and others

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36
Q

exocrine pancreas is made of __ cells

A

acinar

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37
Q

pancreatic islet cells and their % they contribute to its composition

A

alpha (10-20%)
beta (60-80%)
𝛿 (5%)
PP (<1%)

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38
Q

glucagon is produced by __ cells in the __

A

alpha

pancreas

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39
Q

somatostatin is produced by __ cells in the pancreas

A

𝛿

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40
Q

Insulin production:
synthed in __ of beta cells as a ____>cleaved to leave signal peptide + __>insulin + ___ (used to measure insulin release)

A

rER
larger single chain preproinsulin
proinsulin
C peptide

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41
Q

biochemistry of insulin =

A

2 polypeptide chains linked by disulfide bonds

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42
Q

glucose enters beta cells by ___ >___ phosphorylates > increase __>increase __concn> inhibits ___> increase intracellular __ depolarises cell membrane> __ open > increase __ > __ fuse with cell membrane and insulin is released

A 
GLUT2
glucokinase
metabolism of glucose
ATP
KATP channel
K+
voltage-gated Ca2+ channels
intracelular Ca2+
vesicles
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43
Q

release of insulin is ___ as 5% are in ____ then the rest are in ____ which need to be acted upon before release

A

biphasic
RRP (readily releasable pool)
reserve pool

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44
Q

2 proteins in KATP channels

is a __ structured channel

A

inward rectifier - KIR6 - pore subunit
sulfonylurea receptor - SUR1 - regulatory subunit
octomeric

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45
Q

3 things that regulate KATP channels
___ inhibits by binding to __
directly inhibited by ___ on ___
stimulated extracellularly by ___ on ___ to inhibit insulin release

A

intracellular ATP KIR6
sulfonylurea drugs SUR1
diazoxide on SUR1

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46
Q

neonatal diabetes is caused by __ mutation causing __ of KATP channels
Rx =

A

KIR6.2
overactivity
sulfonylureas

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47
Q

inhibiting mutations on __/__ can cause congenital hyperinsulinaemia
Rx =

A

SUR1/KIR6.2

diazoxide

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48
Q

diencephalon = __+__

A

thalamus and hypothalamus

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49
Q

infundibulum connects __ to __

A

hypothalamus to pituitary

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50
Q

pituitary gland lies in the ___ in the __ in the ___ bone

A

pituitary fossa
sella turcica
sphenoid

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51
Q

temporal side of vision is seen on the ___ retina

A

nasal

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52
Q

nasal side of vision is seen on the ___ retina

A

temporal

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53
Q

inbetween retina and optic chiasm in visual pathway =

A

optic canal

54
Q

between optic chiasm and thalamus synapse in the visual pathway

A

optic tract

55
Q

pituitary lies __ to the optic chiasm

A

inferior

56
Q

the ___ optic canals cross sides at the optic chiasm

A

nasal (from temporal light rays ->nasal retina)

57
Q

nasal light rays > ___ retina > ___ optic canal and tract

A

temporal

ipsilateral

58
Q

temporal light rays > ___ retina > ___optic canal > ___ > ___ optic tract

A

nasal
ipsilateral
optic chiasm
contralateral

59
Q

pituitary tumour can cause this visual defect because it compresses the optic chiasm

A

bitemporal hemianopia

60
Q

most common Sx approach to the pituitary

A

transsphenoidal (via nasal cavities and sphenoid sinus - surgically # the nasal septum)

61
Q

nasal conchae bones =

A

sup and middle from ethmoid

inferior = its own bone

62
Q

roof of nasal cavity made from

A

cribriform plate of ethmoid bone

63
Q

superior part of nasal septum is made from

A

perpendicular plate of ethmoid bone

64
Q

inferior nasal septum is made from

A

vomer

65
Q

4 paranasal sinuses=

A

ethmoid air cells
sphenoid
maxillary
frontal

66
Q

paranasal sinuses drain through __ to __

A

ostia

nasal cavities

67
Q

adherent to the internal aspects of all the cranial vault bones

A

dura mater

68
Q

pituitary lies inferior to ___ (dura mater)

A

diaphragm sella

69
Q

tentorium cerebelli =

A

dura mater over the cerebellum with central gap for the brainstem

70
Q

below dura mater in middle cranial fossa that are susceptible to damage by a pituitary tumour =

A

CN II, III IV, V, VI

dural venous sinuses

71
Q

dural venous sinuses =

A

venous channels in dura mater that drain most of the blood from the cranial cavity to the internal jugular veins

72
Q

___ pass through the cavernous sinuses

A

internal carotid arteries

73
Q

cavernous sinuses lie ___ to pituitary

A

lateral (on both sides

74
Q

intercavernous sinus connects ___ lies ___ to pituitary

A

R+L cavernous sinuses

anterior

75
Q

8 structures at risk in pituitary Sx

A 
CN III
CN IV
CN V
CN VI
optic chiasm
cavernous sinus
ICA
dura mater
76
Q

functions of CNIII (3)

A

motor to 4/6 occular muscles
constrictor pupillae
elevates upper eyelid

77
Q

damage to CN III causes

A

eye movement problems

dilated pupil

78
Q

CN IV function

A

moves eye up and down

79
Q

CNV functions (2)

A

facial sensory

muscles of mastication motor

80
Q

CNVI function

A

lateral rectus motor supply - abducts eyeball

81
Q

Thyroid lobes attach to __+__+__

A

trachea
thyroid cartilage
cricoid cartilage

82
Q

isthmus of thyroid lies anterior to __+__ tracheal cartilages

A

2nd and 3rd

83
Q

pyramidal lobe of thyroid is present in __% of population
usually originates from the __ lobe
most attach to __ but may extend to __

A

28-55%
Left
thyroid cartilage
hyoid bone

84
Q

embryology - thyroid starts as an ___ at the junction between __+__ (___ in adults)

A

epithelial proliferation

ant and post tongue (foramen caecum)

85
Q

embryology:

thyroid migrates inferiorly but still attached to tongue by ___

A

thyroglossal duct

86
Q

thyroid reaches its final destination by ___ gestation

A

wk7

87
Q

__/___ can be found anywhere along the migratory pathway of the thyroid

A

thyroglossal duct cysts

ectopic thyroid tissue

88
Q

platysma is supplied by __ as it is a ___

A

CNVII

muscle of facial expression

89
Q

thyroid lies at ___ with ___ in superficial fascia anteriorly

A

C7

platysma muscle

90
Q

prevertebral (deep) fascia is located __ to thyroid and contains ___+__

A

posteriorly
cervical vertebrae
postural neck muscles

91
Q

investing (deep) fascia encloses ___ +__+__

A

all other neck fascial compartments
sternocleidomastoid
trapezius

92
Q

carotid sheaths contents

A

IJV
CNX
deep cervical lymph nodes
common>ICA

93
Q

pretracheal (deep)fascia encloses ++++_

A 
strap muscles
thyroid
trachea
oesophagus
recurrent laryngeal nerve
94
Q

___ lies between pretracheal and prevertebral fascia

A

retropharyngeal space

95
Q

attachments (3) of the sternocleidomastoid

A

manubrium
medial clavicle
mastoid process of temporal bone

96
Q

___ nerve supply to sternocleidomastoid and trapezius it lies ___

A

CNXI

in between them

97
Q

___ lies anterior to sternocleidomastoid and drains to the EJV

A

anterior jugular vein

98
Q

__+__ lie posterior to sternocleidomastoid

A

trapezius

External jugular vein

99
Q

EJV drains to the ___

A

subclavian vein

100
Q

descending part of trapezius attaches to

A

occipital bone
spine of scapula
lateral clavicle

101
Q

superior thyroid artery is a branch from _

A

ECA

102
Q

inferior thyroid arteries are branches from __

A

subclavian arteries

103
Q

superior middle and inferior thyroid veins drain to __

A

IJV

104
Q

lymphatics of the thyroid (4)

A

superior and inferior deep cervical nodes
pretracheal
paratracheal

105
Q

CNX connects with ___ at brain >___>carotid sheath

A

medulla oblongata

jugular foramen

106
Q

somatic branches of CNX in neck =

A

superior and right recurrent laryngeal nerve

107
Q

the route of the Right recurrent laryngeal n. in the chest

A

lateral right aspect of trachea
posterior to right lung root
onto oesophagus

108
Q

right laryngeal recurs under the ___
left under the ___
both pass __ to the thyroid

A

right = subclavian artery
left = aortic arch
posterior

109
Q

contents of carotid sheath lateral to medial

A

IJV > CNX>common carotid

110
Q

3 strap muscles =

A

omohyoid
sternohyoid
thyrohyoid

111
Q

attaches the intermediate tendon of omohyoid to the clavicle

A

fascial sling

112
Q

collar incision goes through the __+__

A

skin

platysma

113
Q

unilateral recurrent laryngeal nerve injury results in:

bilateral results in :

A 
uni = hoarse/weak voice and weak cough
bi = aphonia and can't close rima glottis to produce a cough
114
Q

__+__ have cytokine receptors linked to tyrosine kinase activity

A

prolactin and GH

115
Q

accuracy of measuring levels of hormones depends on (6)

A 
main = rate of secretion
pattern of secretion
carrier proteins
interfering agents
t1/2
absolute concns
116
Q

___ is measured to assess GH levels because GH -> __ = ___ formed

A

IGF-1
liver
IGF-1

117
Q

time to measure levels of testosterone as this is when they are highest

A

9am

118
Q

prolactin secretion is under tonic inhibition by

A

hypothalamic dopamine

119
Q

physiological causes (3) of hyperprolactinaemia

A

pregnancy
lactation
nipple stimulation

120
Q

pathological causes of hyperprolactinaemia (7)

A 
prolactinomas
dopamine antagonists
CKD
hypophysitis
ovarian dermoids
hypernephroma
bronchogenic carcinoma
121
Q

95% of CAH is caused by deficiencies in __/___

A

21-hydroxylase

CYP21A2

122
Q

CAH hormone effects

A

increased aldosterone and cortisol

decerased androgens

123
Q

if suspect hormone excess = ___test

if deficiency = ___ test

A 
excess = suppression
deficiency = stimulation
124
Q

stimulation test for cortisol deficiency =

A

synacthen

125
Q

suppression test for cortisol excess =

A

dexamethasone

126
Q

70% of Cushings is caused by

A

tumour from ant pit corticotroph cells - Pituitary Cushing’s

127
Q

if suspect Cushings Ix = screening ___ => formal diagnostic test ____

A

1mg overnight dexamethasone suppression test

low dose dexamethasone suppression test

128
Q

If ACTH decreased in dexamethasone suppression test =

A

likely an adrenal cause

129
Q

If ACTH increased in dexamethasone suppression test =

A

still need to distinguish if is Cushing’s syndrome or ectopic ACTH

130
Q

If increase in cortisol and ACTH on CRH test = ___ source => ___ (Ix)

A

pituitary

MRI pituitary

131
Q

Ix used to lateralise a pituitary tumour pre Sx

A

inferior petrosal sinus sampling

EndocrineJaz (15 decks)

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