Quiz 5A Flashcards
What is Exophthalmos
how to remember
Abnormal protrusion of the eyeball or eyeballs. Associated with HEAT intolerance.
(ex pat military guy will get bulged eyes since they’ve seen so much … and can’t stand heat from middle east)
What is Addison’s disease
What gland is effected?
(how to remember)
A disorder in which the adrenal glands don’t produce enough hormones (Adrenal insufficiency).
ADRENAL GLANDS
AD = ADrenal glands
What is Hashimoto’s disease
(how to remember)
What gland is effected?
Hashimoto’s disease is a condition in which your immune system attacks your THYROID, a small gland at the base of your neck below your Adam’s apple. … Inflammation from Hashimoto’s disease, also known as chronic lymphocytic thyroiditis, often leads to an UNDERactive thyroid gland (HYPOTHYROIDISM) so not enough thyroid gland hormones are produced.
(remember: Hash the neck, O = hypo … so hypothyroidism)
Thyroid (this is: Thyroiditis)
What is Grave’s disease
(how to remember)
What gland is effected?
Graves’ disease is a type of autoimmune problem that causes the thyroid gland to produce too much thyroid hormone, which is called HYPERTHYROIDISM. Graves’ disease is often the underlying cause of hyperthyroidism.
(remember: in my grave, stick my neck out to try and get out … hyperthyroid … hyperactive to try to get out of my grave … i’m in my grave cause I can’t breath)
Thyroid
Discuss the incidence and prevalence, etiology and risk factors, pathogenesis and clinical manifestations of:
OBESITY
Describe:
Incidence:
Prevalence:
Etiology:
Risk Factors:
Pathogenesis:
Clinical Manifestations:
Describe: Obesity is an excessive amount of fat in the body that contributes to many chronic diseases / early mortality / morbidity.
Incidence: It is becoming a PANDEMIC (affecting all people globally) … 300 million people worldwide. 2nd to cigarette smoking as leading cause of preventable death (500,000 deaths annually).
Prevalence: Obesity has doubled from 1980 to 2002, and TRIPLED among children. 40% of men and 45% of women are considered obese.
Etiology: Imbalance between energy intake and energy expenditure (more energy consumed / calories eaten). Inactivity and high processed foods (diet) are biggest contributors (EXERCISE AND DIET).
Risk Factors: Sedentary lifestyle, high glycemic diet (high sugar), genetic disorder, medications (food cravings increase), lifestyle / social factors.
Pathogenesis: Neuroendocrine dysfunction where genes get mutated by fat and impare CNS signaling causing food intake and body weight control issues. Also hormones play a role … stress may signal improper hormone control resulting in body fat accumulation. Maybe obese people have fewer ATP pumps in cells
Clinical Manifestations: Excess body fat :) Diabetes Mellitus (just diabetes), asthma, functional / mobility impairments, LE lymphodema, sleep apnea, atherosclerosis, HTN, CVD, CVA, Cancer, depression, binge eating, etc.
What is morbidity:
The condition of being diseased
What is bariatrics
Branch of medicine concerned with studying and managing obesity
What are 3 ways people measure obesity, and explain each:
1) BMI (body mass index)
- Considers height and weight
2) Waist circumference
- Measure circumference of waste in people with normal and overweight conditions (but it is not useful in extremely obese people to help predict morbidities).
3) Waist to hip ratio
- Measures fat stored in hips, waist, buttocks areas as predictor of morbidities
- Waist is above iliac crest, and hip is around greater trochanters.
What are the BMI ranges for:
- Underweight
- Normal
- Overweight
- Obese Class 1
- Obese Class 2
- Obese Class 3
Morbid obesity =
Underweight: <18.5 BMI Normal: 18.5-25.9 Overweight: 25-29.9 Obese Class 1: 30-34.9 Obese Class 2: 35-39.9 Obese Class 3: >40 Morbid = BMI greater than 40
Describe the medical role … and the physical therapist’s role in managing obesity.
MEDICAL:
- Diagnose (through BMI, waist to hip, etc.)
- Treatment through: surgery, weight loss, medications, behavioral and lifestyle changes
- Prognosis
PT:
- Prevention (exercise, diet, education)
- Treatment (Exercise program, movement/function after surgery)
1) What is the Endocrine System:
2) What could go wrong if endocrine system doesn’t work?
3) What are the glands in the endocrine system in each major body region:
4) T or F: Hormones could target specific organs, specific target cells, another endocrine gland, or the entire system wide?
5) Hormones are released into and travel in what?
1) The endocrine system is the collection of glands that make and secrete hormones directly into the circulatory system to be carried towards distant target organs/glands/cells. Like neurons carrying electrical action potentials to create change/movement in body, hormones do the same.
2) If your endocrine system isn’t healthy, then each hormone needed for homeostasis could become hyper or hypo active (or not work at all). You also might have problems developing during puberty, growing properly, getting pregnant, producing milk, giving birth, sexual arousal, insulin management, weak metabolism, or managing stress. You also might gain weight easily, have weak bones, or lack energy because too much sugar stays in your blood instead of moving into your cells where it’s needed for energy.
3)
BRAIN: pineal gland, hypothalamus, and pituitary gland
NECK: Thyroid and parathyroid glands
CHEST: Thymus is between your lungs
– KIDNEYS: Adrenals are on top of your kidneys
– PANCREAS: behind your stomach.
PELVIC: ovaries in a women, testes in a man.
4) TRUE
5) Bloodstream
What is a cascade:
A gland:
Target Cells:
Cascade: A chain of reactions from the release of a hormone. So hypothalamus releases a hormone to pituitary gland which sends a hormone to adrenal gland, etc. It sends hormone and cascades to trigger release of other hormones or events in body.
Gland: Anything that receives, makes, or secretes a hormone (pituitary, thyroid, pancreas, etc.)
Target Cells: A hormone can ONLY trigger a reaction in specific cells - target cells that have the correct RECEPTORS for those hormones.
Hormones are not just for feelings/emotions, sexual activity, etc.
What else do hormones do:
- Reproduction (birth contractions, milk production)
- Metabolism and energy balance
- Growth and development
- Body defenses
- General homeostasis
- Calcium regulation
- Fight and flight neurotransmitter releases
- Water, nutrient, and electrolyte balance in blood.
- *** Trigger the release of other hormones
1 and 2) Your body (brain) communicates to your body to do things (or stop doing things) via two routes. Explain
3) Which of all the glands is the MASTER GLAND
4) Which gland maintains and monitors for homeostasis, or is the COMMAND CENTER
5) What is role of hypothalamus
6) How do the hypothalamus and pituitary gland interact
7) T or F: The hypothalamus has both neural and endocrine functions?
1) Nervous system: sends super fast electrical signals to get body to move/act or do something (or stop doing something). ACTION POTENTIAL TRAVELS THROUGH NEURONS. They go fast, but don’t last long.
2) Endocrine system: This is a much SLOWER process of communication where hormones get released through blood stream. The hypothalamus will monitor what is going on in body (what hormones are too high or low), and then send signals (hormones) to PITUITARY gland which releases other hormones (cascade effect) and those go through blood stream to target cells or organ, or other gland, etc. This happens SLOWER, and thus takes longer to shut off (compared to nervous system), but the effect can last longer.
3) PITUITARY GLAND
4) Hypothalamus
5) The hypothalamus responds to a variety of signals from the internal and external environment including body temperature, hunger, feelings of being full up after eating, blood pressure and LEVELS of HORMONES in the circulation. It also responds to stress and controls our daily bodily rhythms such as the night-time secretion of melatonin from the pineal gland and the changes in cortisol (the stress hormone) and body temperature over a 24-hour period. The hypothalamus collects and combines this information and puts changes in place to correct any imbalances.
6) In some cases, the hypothalamus signals the pituitary gland to stimulate OR inhibit hormone production. Essentially, the pituitary acts after the hypothalamus prompts it. Hypothalamus sends signals down to pituitary via blood vessels (Hypothalamic-pituitary interface).
7) TRUE
Explain difference between POSITIVE feedback loop and NEGATIVE feedback loop:
T or F: there are good and bad positive feedback loops, and good and bad negative feedback loops.
** A positive feedback loop causes a self-amplifying cycle (reinforces or has it keep going) where a physiological change leads to even greater change in the SAME direction.
A negative feedback loop is a process in which the body senses a change, and activates mechanisms to reverse that change (turns it off).
TRUE
T or F: The endocrine system interacts with the nervous system constantly to maintain homeostasis?
Where do nervous system and endocrine system meet and interact?
TRUE (through the hypothalamus)
Hypothalamic-pituitary interface. Connection of blood vessels between the two glands where hormones are created and released / initiated.
Below is a list of the major glands. You need to list the:
- Where it is located in body
- Hormones
- Target Organ
- Function of each
PINEAL GLAND HYPOTHALMUS PITUITARY GLAND THYROID GLAND PARATHYROID GLAND THYMUS ADRENAL GLANDS PANCREAS OVARIES TESTES
** Review the drawing in your green binder for a break down of all of them
PINEAL GLAND: Mid brain
- Hormones: melatonin (Mid = Melatonin, M=M) - Target Organ: many - Function of each: Biological clock, sleep cycles
HYPOTHALAMUS: COMMAND CENTER. Monitors hormone levels in body and then sends signals / controls the release of the 2 hormones to posterior pituitary gland, and the 6 in anterior pituitary gland.
PITUITARY GLAND: Brain (anterior and post. lobe)
- Hormones: LOTS (see next slide) - Target Organ: many - Function of each:
THYROID GLAND: Neck
- Hormones: T3 (tri) and T4 (thyroxine), Calcitonin - Target Organ: liver - Function of each: METABOLISM
PARATHYROID GLAND: Neck
- Hormones: PTH - Target Organ: Bone, kidney, GI - Function of each: Calcification of bone (CALCIUM)
THYMUS: goes away after puberty (Hormone = thymosin)
ADRENAL GLANDS: Kidney
Cortex:
- Hormones: cortisol, aldosterone
- Target Organ: many
- Function of each: metabolism, electrolyte balance,
stress balance
Medulla:
- Hormones: adrenaline (epinephrine, NE, dopamine)
- Target Organ: widespread
- Function of each: fight or flight
PANCREAS: Stomach area
- Hormones: insulin, glucagon - Target Organ: liver - Function of each: glucose homeostasis
OVARIES: Women
- Hormones: estrogen, progesterone (and testosterone)
- Target Organ: many (mainly uterus and breast)
- Function of each: female characteristics / menstrual
cycle
TESTES: Men
- Hormones: testosterone - Target Organ: many - Function of each: male characteristics
** Review the drawing in your green binder for a break down of all of them
For Pituitary Gland:
1) How many lobes?
2) Does the pituitary gland PRODUCE the hormones, or hypothalamus?
3) Post. pituitary lobe is known for how many and what hormones (and what hormones do … and how to remember each)?
4) Ant. pituitary lobe is known for how many and what hormones (and what hormones do … and how to remember each)?
5) Acronym to remember ant. pit. hormones:
6) Know about the hormones in ant. and post. lobes, and how hyper and hypopituitarism would effect these.
1) Ant and Post lobe
2) ???? I think hypothalamus sends signal for pituitary gland to release the hormones it creates.
3) Oxytocin and ADH (vasopressin)
- Oxytocin: contraction of uterus / birth contractions (ox’s have birth)
- Vasopressin (ADH): anti-diuretic hormone (helps retain fluid)
4)
- Thyroid-stimulating hormone (TSH)
- Adrenocorticotrophic hormone (ACTH)
- Prolactin (PRL): Milk production (heather a pro at milking 5 kids)
- Growth hormone (GH): Growth / Cell division
- Follicle-stimulating hormone (FSH): ovulation / mentstration (fish for creation)
- Melanocyte-stimulating hormone (MSH)
- Luteinising hormone (LH): ovulation / mentstration
5) T - the - TSH A - anterior -ACTH P - pituitary - Prolactin G - gland - GH F - finds - FSH M - more - MSH (MORE than posterior) L - luteinising - LH
6) ok
1) Discuss the neuroendocrine response to stress.
1B) If homeostasis is impacted (STRESS) what two systems kick in.
2) Catecholamines are what: (how to remember)
3) Cortisol:
4) What are Endorphins and their role?
1) The concept of stress (mental, physical, spiritual, etc.) may influence immunity. During fight or flight, sympathetic system is aroused and causes medulla of adrenal gland to release catecholamines (epinephrine, NE) into blood stream (and ant. pituitary releases other hormones into blood stream). ACTH is released from Ant. pituitary gland … which travels or cascades to adrenal gland so the cortex can release Cortisol hormone to help with stress.
1B) Disruptions in homeostasis (ie, stress) place demands on the body that are met by the activation of 2 systems, the hypothalamic-pituitary-adrenal (HPA) axis and the sympathetic nervous system (SNS).
2) Catecholamines: Epinephrine, norepinephrine, and dopamine. Help with sympathetic nervous system flight or flight. (remember: cats are high stressed so epinephrine)
3) Cortisol: Hormone in adrenal cortex, triggered by ACTH hormone from ant. pituitary gland, and it regulates metabolism, elevates blood sugar levels, dampens inflammatory response in body, and STRESS
4) CNS releases endorphins which help elevate tolerance to pain during sympathetic response (or like when you exercise). When you exercise, your body releases chemicals called endorphins. These endorphins interact with the receptors in your brain that reduce your perception of pain. Endorphins also trigger a POSITIVE feeling in the body, similar to that of morphine.
Describe the musculoskeletal signs and symptoms of endocrine disease.
- Depends on whether there is hyper or hypo secretion of certain hormones, and which gland was effected.
- Growth and development of connective tissue is impacted by hormones and metabolic processes. So if hormone production / regulation is altered, so would connective tissue development.
- Muscle weakness, atrophy, myalgia (muscle pain), and fatigue that persist DESPITE REST is a s/s of early thyroid/parathyroid disease or diabetes.
- Carpal tunnel syndrome (median nerve impingment)
- Hand pain and stiffness
- Rheumatoid Arthritis is an indicator of underlying endocrine disease
- Excessive or delayed growth
T or F: hormones have a SLOWER effect (turning on and off) than neurotransmitter, but last longer
T or F: hormones may be localized in body, or system wide
T or F: hormones only target cells that have receptors for those hormones
The ____________ controls the function of endocrine organs by hormonal and neural pathways
Posterior pituitary gland releases 2 hormones (the rest are from anterior). What are those 2:
Tropic means: (how to remember)
ADH does what: (how to remember)
TRUE
True
True
Hypothalamus
2: Oxytocin and ADH (antidiuretic hormone … or vasopressin)
Tropic = stimulating (in tropics, you’ll get stimulated)
ADH: reabsorb water (water homeostasis) (remember: you take diuretics for CVD to flush excess fluid out to relieve pressure on heart. So anti-diuretic will help keep fluid in body). Water retention.
Describe each below for this condition with the endocrine glands:
Hyperpituitarism (it primarily results in what?)
Incidence:
Etiology:
Pathogenesis:
Clinical manifestations:
Medical Management:
About: oversecretion of one or more hormones produced by anterior lobe of pituitary gland … especially GH (resulting in acromegaly and giantism)
Incidence:
Etiology:
Pathogenesis:
Clinical manifestations:
Medical Management: Surgery or drug/medications to manage hormones
What are Primary and Secondary disorders of Endocrine glands:
Can glands be impacted iatrogenically
Primary: Dysfunction of the gland itself
Secondary: Dysfunction of an outside stimulus to the gland (other gland or cascade effects the downstream gland).
Iatrogenically: yes, from surgery
Name two OPPOSING conditions resulting in ANTERIOR pituitary gland disorder, and two conditions resulting in POSTERIOR pituitary gland disorder
ANTERIOR:
- Hyperpituitarism (oversecretion of GH leading to acromegaly and giantism)
- Hypopituitarism (decreased secretion of GH leading to dwarfism or Panhypopituitarism)
POSTERIOR:
- Diabetes Insipidus
- SIADH
Giantism =
Acromegaly = (how to remember)
Overgrowth of long bones usually in children (as a result of oversecretion of GH from ant. pituitary gland)
Increased bone THICKNESS and hypertrophy of soft tissues … usually in adults. Hypersecretion of GH in ant. pituitary gland. (Remember: acromion is a WIDE bone, not long)
1) Hypopituitaryism =
2) s/s of hypopituitaryism =
3) Panhypopituitaryism =
(how to remember)
4) Hypophysectomy =
Suffix of ectomy
1) Decreased or absent GH released/secreted by anterior pituitary gland … resulting in dwarfism
2) GH deficient, delayed puberty, short in stature
3) Caused by partial or total failure of all six pituitary hormones
(remember: put all hormones from ant. lobe in a pan =
fail)
4) Removal or destruction of pituitary gland by surgery or chemical agents
ectomy = cutting out
What is SIADH:
This is the opposite of:
Syndrome of Inappropriate Antidieuretic Hormone (SIADH) … associated with excessive release of ADH which disrupts fluid and electrolyte balance, resulting in water imbalance. So much ADH in system = A LOT of water RETENSION.
Diabetes incipidus (lots of water being urinated out)
1) What is a Diuretic:
2) What is anti-diuretic hormone
3) What is Vasopressin?
4) What is diabetes insipidus =
1) Drug to help pass urine or remove fluid from body (you’d use if you had major heart or HTN issues)
2) Does opposite of a diuretic - hypothalamus tells kidneys how much urine to conserve/keep. More water retention for homeostasis.
3) Vasopressin (ADH) is an anti-diuretic … to help with water retension
4) A disease in which the secretion of or response to the pituitary hormone ADH / VASOPRESSIN is impaired (NOT released), resulting in the production of very heavy/lots of dilute urine, often with dehydration and insatiable thirst.
Which gland disappears with age:
The thymus gland, located behind your sternum and between your lungs, is only active until puberty.
After puberty, the thymus starts to slowly shrink and become replaced by fat.
What is the gland that maintains homeostasis in body:
Place where endocrine and nervous system connect / interact:
Functions of this gland are to help regulate/control what in your body:
Hypothalamus
Hypothalamus
FUNCTIONS:
- MONITOR hormone levels in body, to determine if body needs more or less hormones, and to initiate the cascade effect to get those hormones out.
- Heart rate and blood pressure
- Body temperature
- Fluid and electrolyte balance, including thirst
- Appetite, metabolism, and body weight
- Reproductive functions (contraction, milk production)
- Glandular secretions of the stomach and intestines
- Production of substances that influence the pituitary gland to release hormones
- Sleep cycles
Endocrine pathology can be explained as what:
When a gland or glands don’t function properly and release too much or too little of their hormone (hyper / hyposecretion). Or, a gland doesn’t work at all. Or cascades don’t work properly. Or target cells with proper receptors are damaged.
If the sympathetic nervous system is aroused, what gland and hormone is triggered?
Why?
Adrenal gland (specifically the medulla)
To release Catecholamines: epinephrine, norepinephrine, dopamine
1) Is diabetes mellitus same as diabetes?
2) What is diabetes
3) Describe Type 1 diabetes
4) What is insulin and why does body need it. (read more on flashcard 50 below)
5) What is Type 2 diabetes
1) YES (synonymous)
2) Diabetes is TOO MUCH BLOOD SUGAR. It is a disease in which the body is unable to properly use and store glucose (a form of sugar). Glucose backs up in the bloodstream — causing one’s blood glucose (sometimes referred to as blood sugar) to rise too high.
3) Type 1 is usually GENETIC and found in children. Body just doesn’t produce insulin so person is inulin dependent. You need insulin injection since insulin doesn’t work properly in your body. IT IS AN AUTOIMMUNE disease where body attacks cells that produce insulin.
4) Insulin is a hormone produced by the pancreas to regulate how much sugar is in the blood. Insulin helps keeps your blood sugar level from getting too high (hyperglycemia) or too low (hypoglycemia). It helps sugar to LEAVE the blood stream and go get stored in cells (muscle, fat, etc. cells) to be converted to energy there. So insulin gets sugar out of bloodstream and to the cells to be converted into energy. Without insulin, cells cannot get and absorb sugar (glucose), which they need to produce energy.
5) Type II diabetes is usually found in adults over 40 years old who are overweight, and it is because the cells receptors to receive insulin start to break down. So blood sugar stays high, pancrease produces more, and then pancrease burns out. Basically the high amounts of sugars and carbs in body due to poor diet cause pancreas to have to produce more insulin, and it just can’t keep up, so you don’t have enough insulin for the amount of sugar in bloodstream, so you need insulin injections to compensate for the high levels of blood sugar.
If you had a ADH deficiency, it would lead to:
ADH promotes what:
So, SIADH is what:
SIADH can lead to what:
Diabetes insipidus (which is too much urine/fluid released … peeing a lot)
Water reabsorption (or retention)
TOO much of ADH hormone released, so lots of water reabsorbed and stays in body.
Water intoxication / swelling
What is Phenylketonuria (PKU):
What are s/s:
An inherited inability to metabolize phenylalanine that causes brain and nerve damage if untreated. TESTS of phenylalanine levels are done in NEWBORNS.
Phenylketonuria (commonly known as PKU) is an inherited disorder that increases the levels of a substance called phenylalanine in the blood. Phenylalanine is a building block of proteins (an amino acid) that is obtained through the diet. It is found in all proteins and in some artificial sweeteners. If PKU is not treated, phenylalanine can build up to harmful levels in the body, causing intellectual disability and other serious health problems.
s/s: Everything normal till a few months old, then Seizures, delayed development, behavioral problems, and psychiatric disorders are also common. BRAIN DAMAGE
What is Wilson’s disease
(how to remember)
s/s:
Wilson’s disease is a rare inherited disorder that causes COPPER to ACCUMULATE in your liver, brain and other vital organs. Most people with Wilson’s disease are diagnosed between the ages of 5 and 35, but it can affect younger and older people, as well.
IT IS A DEFECT in the metabolism of COPPER - so copper accumulates in liver, brain, blood
(Remember: WILSON from Cast Away was his “Dog” that he lost, and COPPER was our dog we lost).
s/s: Symptoms include swelling, fatigue, abdominal pain, and uncontrolled or poorly coordinated movements.
Describe the link between obesity and cancer
HIGH correlation between obesity and cancer
- Fat tissue (also called adipose tissue) produces excess amounts of estrogen, high levels of which have been associated with increased risks of breast, endometrial, ovarian, and some other cancers.
- High levels of insulin and IGF-1 may promote the development of colon, kidney, prostate, and endometrial cancers
- Many observational studies have provided consistent evidence that people who have LOWER weight gain during adulthood have lower risks of colon cancer, kidney cancer, and—for postmenopausal women—breast, endometrial, and ovarian cancers
Describe the general functions of metabolism
Metabolism is ALL the chemical processes to break down nutrients / food (the lipids, carbs, sugar molecules) into broken-down chemicals and then convert them into energy. Metabolism converts the fuel in the food we eat into the energy needed to power everything we do, from moving to thinking to growing.
Catabolism breaks molecules down, Anabolism builds molecules up needed to produce/convert energy.
Nutrition is the key to metabolism. The pathways of metabolism rely upon nutrients that they breakdown in order to produce energy. This energy in turn is required by the body to synthesize new proteins, nucleic acids (DNA, RNA) etc.
Explain why adipose tissue is considered an endocrine tissue
- Adipose tissue (body fat) is crucial for health. Along with fat cells, adipose tissue contains numerous nerve cells and blood vessels, storing and releasing energy to fuel the body and releasing important hormones vital to the body’s needs.
- Adipose tissue is now known to be a very important and active endocrine organ. It is well established that adipocytes (or fat cells) play a vital role in the storage and release of energy throughout the human body. More recently, the endocrine function of adipose has been discovered. In addition to adipocytes, adipose tissue contains numerous other cells that are able to produce certain hormones in response to signals from the rest of the organs throughout the body. Through the actions of these hormones, adipose tissue plays an important role in the regulation of glucose, cholesterol and the metabolism of sex hormones.
- A number of different hormones are released from adipose tissue and these are responsible for different functions within the body.
1) What is Hyperthyroidism
1A) What are the Thyroid hormones
2) What does Thyroid do?
3) Where is it? Can you feel it?
4) The most common cause of hyperthyroidism is an immune system disorder called:
5) What hormones does it produce
6) What causes Thyroid to not work properly
7) s/s of hyperthyroidism
8) What is a goiter
1) If you have hyperthyroidism, it means your thyroid is overactive and produces too much thyroid hormone which increases metabolism.
1A) Thyroid hormones, thyroxine (T4) and triiodothyronine (T3). The thyroid gland makes hormones that regulate the way the body uses energy. The thyroid gland uses iodine from food to make two thyroid hormones: thyroxine (T4) and triiodothyronine (T3). And Calcitonin
2) It releases hormones to regulate: body’s temperature, METABOLISM, and heartbeat.
The function of the thyroid gland is to take iodine, found in many foods, and convert it into thyroid hormones: thyroxine (T4) and triiodothyronine (T3). Thyroid cells are the only cells in the body which can absorb iodine. These cells combine iodine and the amino acid tyrosine to make T3 and T4.
3) It is just below your adams apple, in front of trachea, but if it is normal, you can’t feel it.
4) Graves’ disease (hyperthyroidism). It is increased T4 production (probably autoimmune disease). Your eyes bulge out, large goiter, heat intolerance, weight loss, increased appetite
5) T3, T4, and Calcitonin
6) It could be genetics, an autoimmune attack, pregnancy, stress, nutritional deficiencies, or toxins in the environment, but experts aren’t entirely sure. Or lack of TSH to be released from ant. pit. gland
7)
- Feeling nervous, anxious, or irritable
- Experiencing mood swings
- Feeling very tired or weak
- Sensitivity to heat
- An enlarged thyroid (goiter). This can make the base of your neck look swollen.
- Losing weight suddenly with no known cause (metabolism not working)
- Fast or irregular heartbeat or palpitations (pounding in your heart)
8) Goiter is an enlargement or swelling of the neck from the thyroid gland getting enlarged.
1) What is hypothyroidism
2) Is hypo or hyperthyroidism more common
3) s/s
4) Medical management
5) PT managemet
1) When the thyroid does not produce enough thyroid hormone, so it slows down metabolism
2) Hypothyroidism
3) s/s: brachycardia, fatigue, weight gain, lower metabolism, decrease in body heat production
4) Life long administration of synthetic thyroid drug
5) It correlates with fibromyalgia, chest pain, HTN, exercise intolerance
1) What is Thyroiditis:
2) Does it effect women or men more?
3) Most common type?
1) Thyroiditis: Inflammation of thyroid gland, hypothyroidism
2) Women much more than men
3) Hashimoto’s thyroiditis
What is Thyroid cancer:
What would you do if you found this through palpation?
Thyroid cancer: Cancer on thyroid gland, you’d feel hard (but painless) nodule at base of anterior neck.
Refer to physician immediately
1) What is Hyperparathyroidism
2) What hormone does parathyroid gland release, and what does it do?
3) s/s:
4) Two types of hyperparathyroidism occurs:
5) s/s:
6) What is hypercalcemia
1) Hyperparathyroidism is an excess of parathyroid hormone (PTH) in the bloodstream due to overactivity of one or more of the body’s four parathyroid glands. These glands are about the size of a grain of rice and are located in your neck by/on thyroid gland. It will disrupt CALCIUM and bone metabolism … one or more of the parathyroid glands causes overproduction of the PTH hormone, which will cause more calcium to go into blood, resulting in high levels of CALCIUM in the blood (hypercalcemia). Causes weak bones cause of oversecretion so bone can’t absorb it all.
2) The parathyroid glands produce parathyroid hormone (PTH), which helps maintain an appropriate balance of CALCIUM in the bloodstream and in tissues that depend on calcium for proper functioning.
3) s/s: fragile bones, kidney stones, and excessive urination
4) Two types of hyperparathyroidism exist. In PRIMARY hyperparathyroidism, an enlargement of one or more of the parathyroid glands causes overproduction of the PTH hormone, resulting in high levels of CALCIUM in the blood (hypercalcemia), which can cause a variety of health problems. Surgery is the most common treatment for primary hyperparathyroidism.
SECONDARY hyperparathyroidism occurs as a result of another disease that initially causes low levels of calcium in the body and over time, increased parathyroid hormone levels occur.
5) Fragile bones that easily fracture (osteoporosis) Kidney stones Excessive urination Abdominal pain Tiring easily or weakness Depression or forgetfulness Bone and joint pain Frequent complaints of illness with no apparent cause Nausea, vomiting or loss of appetite
6) Hypercalcemia: with too much PTH released, then too much CALCIUM goes through blood stream = hypercalcemia.
1) What is Hypoparathyroidism
1A) It causes what
2) How could you get hypoparathyroidism
3) s/s
4) Treatment
1) Diminished concentration of parathyroid hormone (PTH) in the blood, which causes deficiencies of CALCIUM and phosphorus compounds in the blood and results in muscular spasms (since muscles don’t have enough calcium to create contractions). Acute tetany is when you don’t have enough calcium to create the muscle contraction. Bones become weak.
1A) Hypocalcemia (too little Ca in body) … muscle spasms and weak bones.
2) The most common cause of hypoparathyroidism is injury to the parathyroid glands, such as during head and neck surgery. In other cases, it is present at birth or may be associated with an autoimmune disease. Could be iatrogenic too.
3) Symptoms of hypoparathyroidism may include tingling in the lips, fingers, and toes; dry hair, brittle nails, and dry, coarse skin; muscle cramps and pain in the face, hands, legs, and feet; cataracts; dental problems; memory loss, headaches, and muscle spasms.
4) Calcium carbonate and vitamin D supplements are the only currently approved treatment.
1) What is Adrenal Insufficiency
2) Another name for Adrenal Insufficeincy
3) This leads to or results in?
4) s/s
5) Cortisol is said to do dozens and dozens of things for the body, but the main ones are:
6) Primary and secondary causes of adrenal insufficiency
1) A disorder in which the adrenal glands don’t produce enough hormones. Hypofunction of the adrenal cortex who’s purpose is to help with metabolism, electrolyte balance, stress balance (producing cortisol and aldosterone).
2) Addison’s disease (AD=AD)
3) Not enough cortisol being released
4) The disease is characterized by weight loss, muscle weakness, fatigue, low blood pressure, and sometimes darkening of the skin in both exposed and non-exposed parts of the body
5)
- REDUCE STRESS
- helps maintain blood pressure and cardiovascular function;
- helps slow the immune systems inflammatory response;
- helps balance the effects of insulin in breaking down sugar for energy; and
- helps regulate the metabolism of proteins, carbohydrates, and fats.
6) Disorder or injury of the adrenal glands themselves (PRIMARY adrenal insufficiency) or to inadequate secretion of ACTH by the anterior pituitary gland (SECONDARY adrenal insufficiency).
Review this cycle of hormone transport through body, specifically with adrenal glands:
First, the hypothalamus sends “releasing hormones” to the pituitary gland. The pituitary responds by secreting other hormones that regulate growth, thyroid and adrenal function, and sex hormones such as estrogen and testosterone. One of the pituitarys main functions is to secrete ACTH (adrenocorticotropin), a hormone that stimulates the adrenal glands. When the adrenals receive the pituitarys signal in the form of ACTH, they respond by producing cortisol. Completing the cycle, cortisol then signals the pituitary to lower secretion of ACTH.
Does the cortex or medulla produce epinephrine and norepinephrine?
Does the cortex or medulla produce cortisol?
Medulla
Cortex
1) What is Adrenocortical Hyperfunction:
2) If too much cortisol is produced, it is called:
(how to remember)
3) Is Cushing’s disease and Cushing’s syndrome the same thing?
4) s/s
5) Oversecretion of ACTH =
1) Adrenocortical hyperfunction is a condition where there is an overproduction of hormones of the adrenal cortex. When cortisol is overproduced, it is called Cushing’s syndrome. When aldosterone is overproduced, it is called hyperaldosteronism
2) Cushing’s Syndrome (remember: It is “cushy” if you don’t have any stress)
3) Cushing disease is caused by a pituitary gland tumor (usually benign) that over-secretes the hormone ACTH, thus overstimulating the adrenal glands’ cortisol production. Cushing syndrome refers to the signs and symptoms associated with excess cortisol in the body, regardless of the cause. When too much cortisol is present in the body, it is called Cushing’s syndrome, regardless of the cause. Cortisol is made by the adrenal glands which are stimulated by ACTH, which is produced in pituitary gland. When the cause of the excess cortisol is excess ACTH made by a pituitary tumor, the condition is called “Cushing’s disease”.
4) obesity, hypertension, type 2 diabetes, easy bruisability, abdominal striae, and myopathy
5) Cushings disease
How does Insulin work:
Insulin is a hormone made by one of the body’s organs called the pancreas. Insulin helps your body take sugar in your blood (glucose) and deliver it to cells/muscles to convert into energy. It also helps your body store it in your muscles, fat cells, and liver to use later, when your body needs it.
After you eat, your blood sugar (glucose) rises. This rise in glucose triggers your pancreas to release insulin into the bloodstream. Insulin travels through the blood, picks up the glucose, and delivers it to your body’s cells. It tells the cells to open up and let the glucose in. It is the key. Once inside, the cells convert that glucose into energy or store it to use later.
Without insulin, your body can’t use or store glucose for energy. Instead, the glucose would just stay in your blood … leading to many issues/pathologies: diabetes, CVD, HTN, CAD, atherosclerosis.
What is high blood sugar:
Why is high blood sugar bad:
High blood sugar usually comes on slowly. It happens when you don’t have enough insulin in your body or ate too much sugar. High blood sugar can happen if you miss taking your diabetes medicine, eat too much, or don’t get enough exercise. Sometimes, medicines you take for other problems may cause high blood sugar.
Having too much sugar in the blood for long periods of time can cause serious health problems if it’s not treated. Hyperglycemia can damage the vessels that supply blood to vital organs, which can increase the risk of heart disease and stroke, kidney disease, vision problems, HTN, CVD, CAD, diabetes, and nerve problems in people with diabetes.
HIGH blood sugar can lead to atherosclerosis, and for the pancreas to over-produce insulin which eventually causes it to over-work and shut down (which then insulin is not created, and blood sugar goes even higher).
Most common type of endocrine cancer
Incidence:
Thyroid cancer
33,500 new cases per year
Define idiopathic
(how to remember)
Any disease or condition that arises spontaneously or for which the cause is unknown.
(the pathology is not known - because IDIOTS like me don’t understand Pathology :)
How can PT’s treat those with conditions of the endocrine system
- Observe s/s and refer to medical provider
- Don’t put too much stress on pt with exercise
- Hypoparathyroiditis means low Ca+ will create bone weakness and loss of muscle contractions
- Help prevent loss of ROM
- Palpate for nodules (thyroid)
- Stretch weak muscles
Define these:
Polyuria =
Polydipsia =
Nocturia =
Polyuria = many pee (large amounts of urine) Polydipsia = many THIRST (small amounts of urine / thirsty) Nocturia = peeing at night (have to wake up a lot to pee)
What is Methylmalonic acidemia:
how to remember
Methylmalonic acidemia is a disorder in which the body cannot break down certain proteins and fats. The result is a buildup of a substance called methylmalonic acid in the blood. This condition is passed down through families. It is one of several conditions called an “inborn error of metabolism.”
(methyl-olic = metabolic …. metabolism doesn’t work, can’t break down fats and protiens).
True or False: Does SIADH have anything to do with sodium levels in the body?
Yes, of course. High amounts of sodium require more water to help break it down. If you need water retention, you’ll release more ADH hormone … leading to SIADH.
Calcitonin does what:
PTH does what:
Calcitonin: A hormone secreted by the thyroid that has the effect of LOWERING blood calcium. Calcitonin lowers blood calcium levels by suppressing osteoclast activity in the bones and increasing the amount of calcium excreted in the urine.
PTH: When the calcium in our blood goes too low, the parathyroid glands make more PTH. Increased PTH causes the body to put more calcium into the blood. Increased PTH causes the bones to release their calcium into the blood.
Conn’s syndrome is associated with:
Cushings syndrome is associated with
Cushings disease is associated with:
Which one is associated with the dark pigmented skin:
Aldosterone (hyper) (russian people cause stress, twitch of face)
Cortisol (hyper)
ACTH (hyper)
Addison’s disease
What is Porphyrias:
Porphyria is a group of disorders caused by an overaccumulation of porphyrin which helps hemoglobin, the protein that carries oxygen in the blood.
Graves disease is from what:
Increase in T4, from hyperthyroidism, so it increases metabolism.
Explain difference between PTH and Calcitonin.
Are they opposites?
Calcitonin lowers blood calcium levels by storing calcium in bones. It will take too much calcium in the blood to the bones. Reduces calcium levels in blood.
When the calcium in our blood goes too low, the parathyroid glands make more PTH. Increased PTH causes the body to put more calcium into the blood. Increased PTH causes the bones to release their calcium into the blood.
PTH will sense if blood calcium levels are too low, and signal to create more … which will signal that the body needs more calcium. BUT, calcitonin only kicks in when blood calcium levels are too high, and it takes calcium TO the bones.
Yes, they are opposites.
Part of the brain that secrets tropic stimulating hormone (TSH)
Is TSH same as TH or Thyroid hormones?
Any hormones ending in “SH” means:
Anterior lobe of pituitary gland
NO
Stimulating hormone
An abnormal spasm of the facial muscles elicited by a light tap over the facial nerve above the mandibular angle adjacent to the ear lobe.
(How to remember)
Chevostek’s
Russians are “conn’s” and weird, and can’t be trusted - make funny face movements.
Hepatolenticular degeneration producing a defect in the metabolism of COPPER
Wilson’s disease
Just to remember that Wilson’s disease is about COPPER (“Wilson” from Cast away …. I lost my dog Copper)
Medical Steroids diabetes is often associated with hypercortisolism, a condition known as:
Cushing’s Syndrome
remember Cushing’s disease is from ACTH not cortisol
Term used to describe an enlarged thyroid gland
Goiter
Condition resulting from hypersecretion of aldosterone
Conn’s syndrome
A disorder of the posterior lobe of the pituitary secondary ADH deficiency
ADH surplus would be what condition/disorder:
Diabetes insipidus
ADH surplus would be SIADH
An iatrogenic cause of this condition includes accidental removal of glands during a thyroidectomy or anterior neck surgery
If you remove thyroid, you’d impact the parathyroid
Hypoparathyroidism
Chronic autoimmune thyroiditis
Hashimoto’s disease
An autosomal recessive disease resulting from a genetic defect in the metabolism of the amino acid, phenylalanine
PKU
An autoimmune disease that is the most common form of hyperthyroidism
Grave’s Disease
1st biggest endocrine “horse”
2nd biggest endocrine “horse”
Diabetes
Grave’s Disease (most common form of hyperthyroidism, and thyroid cancer is most common endocrine cancer)
Disease characterized by overgrowth of the long bones, and when usually does it occur in
Which one is thickening of bones, and when does it happen?
Giantism (Gigantism) … in children
Acromegaly … (in adults after epiphyseal plates close)
Intermittent tonic spasm of the voluntary muscles
Acute tetany
Proteins released by fat cells that act locally in an autocrine fashion and systemically as hormones
Adipokines
A condition of primary adrenal insufficiency with insufficient cortisol and aldosterone release
Addison’s Disease
Grave’s Disease =
Hyperirritability of facial nerve
Elevated body metabolism
Chvostek’s
Is Hashimoto’s autoimmune?
Is Grave’s disease autoimmune?
Yes
Yes
What does ACTH hormone do:
Adrenocorticotropic hormone (ACTH) is a hormone produced in the anterior pituitary gland in the brain. The function of ACTH is to regulate levels of the steroid hormone cortisol, which released from the adrenal gland.
Another name for ADH =
Vasopressin
Only cells in the body which can absorb iodine are:
Thyroid cells (T3 and T4 from Thyroid gland)
Explain cascade of how T4 or Calcitonin would be released
Ant. Pituitary gland would release TSH, which goes down to Thyroid gland, to release T3, T4, or Calcitonin …
Main gland associated with Metabolism " with calcium " with cortisol " with epinephrine " with oxitocin " with insulin " with ADH " with TSH " with T3 " with glucogon " with aldosterone " with testosterone
Thyroid parathyroid adrenal cortex adrenal medulla post. pit gland pancreas post. pit gland ant pit. gland thyroid pancreas adrenal cortex testes (and ovaries)
When cortisol is overproduced, it is called:
When aldosterone is overproduced, it is called:
Cushing’s syndrome
hyperaldosteronism
Hyperthyroidism disease =
It is a result of oversecretion of:
Graves Disease
T4
*** Adipose Tissue releases what hormones, which results in what:
Adiponectin, Leptin, Angiotensin
Obesity
*** What are the Metabolic diseases:
Wilson’s disease
Phenylketonuria
Porphorias
