Thyroid Function Considerations for patient care Flashcards
What is the function of the thyroid
- works on almost every cell in the body
- speeds up cell processes: hyperfunction and increases function of other cells
- increases basal metabolic rate
- works by secreting two metabolically active hormones: T4, T3
- thyroid secretion regulated by anterior pituitary gland
What is the thyroid important for
- overall growth esp. in children
- fat and carbohydrate metabolism
- respiratory rrate
- GI mobility
- CNS
- sleep
- sexual function
thyroid function effects on the cardiovascular function
- decerases systemic vascular resistance e
- increases: heart rate, left ventricular contractility, blood volume
What is the thyroid role in blood pressure
with hyperthyroidism
- hyperthyroidism assoicated with arteial stiffness despite a decrease in systemic vascular resistance
- can cause HTN, esp. in older adults with atherrosclerosis
- treatment: B-blockers, treatment of hyperthyroidism
What is the thyroid function with blood pressure: hypothyroidism
- tends to result in diastolic HTN
- treatment: treatment for hypothyroidism
what is the thryoid function on muscle function
- slight increase in thyroid hormone: stronger muscle contraction
- large increase: protein catabolism = tremor, weakness, myopathy
- decrease in thyroid hormone: takes a while to generate contraction: slower muscle contraction, slower relaxation (EMG = repetitive discharge)
- decrease = cramping, ataxia, hyporeflexia, nystagmus, tremor
What are common causes of hypothyroidism
- congential autoimmune disorder such as hashimoto thryoiditis
- thyoid ablation – surgery or radiation
inceased TSH levels with deceased T3/T4
What are common signs and symptoms of hypothyroidism
- weight gain
- cold intolerance
- fatigue
- myxedema: non-pitting, boggy edema: not good venous return
- increased LDL cholesterol; aterriosclerosis, CAD, HTN
- increased risk of stroke
PT considerations with hypothyroidism
- can begin exercise once thyroid replacement initiated
- will have had execise intolerance, fatigue, weakness
- rhabdomyolysis possible with exercise
- common assoicated problems that may benefit from PT: arthritis, carpal tunnel, fibromyalgia
Hyperthyroidism: causes
- most common cause = autoimmne (grave’s disease)
- Thyrotoxicosis: increased levels of thyroid hormones
Neuromuscular signs and sympoms of hyperthyroidism
- proximal muscle weakness, tremor
- impaired coordinaion or balance
- myasthenia gavis: more likely overtime to have this
What are PT considerations with hyperthyroidism
- monitor vital signs and exercise responses: tachycarrdia, dyspnea
- increased caution if known heart disease: arrythmia, angina
What are the treatments for hyperthyroidims
- antithyroid drugs: beta blockers
- radioactive iodine: reduces function
- surgery
last two will increase the rick of hypofunction
What have studies demonstrated with hyperthyroiodism and new onset A-fib
- increased risk of ischemic stroke clustering during the initial phase of presentation
- indicates need for early use of anticoagulation therapy in patients with hyperthyroidism and AF