Unit 1: Endocrine Disorders Flashcards
1
Q
These 2 organs will act upon eachother and are responsible for for important hormones that control various physio. processes….
A
- Hypothalamus
- Pituitary
2
Q
Small gland below the thalamus that coordinates BOTH the ANS AND activity of the Pituitary
A
Hypothalamus
3
Q
Hypothalamus coordinates 2 things:
A
- ANS
- Activity of the Pituitary
4
Q
Small, pea-shaped structure loc’d w/in the sella turcica @ the base of the brain
A
Pituitary gland
5
Q
Hormones and terms:
Hormone-releasing
vs.
Hormone-inhibiting
A
Hormone-releasing==> INCs that hormone
Hormone-inhibiting ==> DECs that hormone
6
Q
Growth hormone-releasing hormone==>
GHRH
A
INCs GH release
7
Q
Growth-hormone inhibitory hormone
GHIH
A
DECs GH release
8
Q
Gonadotropin-releasing hormone
GnRH
INCs what
A
INCs LH and FSH
9
Q
Thyrotropin-releasing hormone
TRH
INCs what
A
INCs TSH
10
Q
Corticotropin-releasing hormone
CRH
INCs what
A
INCs ACTH release
11
Q
Prolactin-inhibitory factor
PIF
DECs what
A
Pr release
(Prolactin)
12
Q
Hypothalamic hormones and their effects :
A
see pic
13
Q
Anterior Lobe, Pituitary
Hormones
Target Tissue
Made by
A
see pic
14
Q
Ant. Pit. Hormone
Growth Hormone
Target—>
Made by—>
A
Target== bone/muscle
Made by== Somatotrophs
15
Q
Ant. Pit. Hormone
Leutinizing Hormone LH
Target tissue==
Made by==
A
Target== Gonads
Made by== gonadotrophs
16
Q
Ant. Pit Hormone
Follicle Stimulating Hormone FSH
Target==
Made by==
A
Target== gonads
Made by== gonadotrophs
17
Q
Ant. Pit. Hormone
Thyroid Stimulating Hormone TSH
Target==
Made by==
A
Target== thyroid
made by== thyrotrophs
18
Q
Ant. Pit. Hormone
AdrenoCorticoTropic Hormone ACTH
target==
made by==
A
Target == adrenals
Made by== corticotrophs
19
Q
Ant. Pit. Hormone
Prolactin PRL
Target==
Made by==
A
target== breast tissue
Made by== Lactotrophs
20
Q
Ant. Pit. hormone release is DRIVEN BY:
A
Hypothalamic hormones
21
Q
Growth Hormone Actions
2:
A
- INC linear growth and mm mass
- DEC body fat
22
Q
Growth Hormone
Medically-approved uses
CHILDREN
A
- GH deficiency
- chronic kidney dis.
- Turner Syndrome
- Prader-Willi syndrome
23
Q
Growth Hormone
Med-approved uses
ADULTS
A
- GH deficiency
- mm wasting from HIV
- short bowel syndrome
24
Q
GH has potential for abuse T/F?
A
TRUE!!!!!!
25
ANTERIOR PITUITARY HORMONES
6:
Get Lost For They Are Passed
1. G: Growth Hormone
2. L: Leutinizing hormone
3. F: Follicle Stimulating Hormone
4. T: Thyroid Stimulating Hormone
5. A: AdrenoCorticoTropic Hormone
6. P: Prolactin
26
Posterior Lobe Pituitary Hormones
2:
1. Antidiuretic ADH
2. Oxytocin "Bonding Hormone"
27
Post. Pit. Hormone
Antidiuretic
**think alcohol**
**ACTION**
* Action==\>
* INCs **reabsorption of water from kidney**
* **Fun Fact:** alcohol INHIBITS ADH ==\> BLOCKS water reabsorption
28
Post. Pit. Hormone
## Footnote
**Oxytocin**
**Bonding hormone**
**"give yourself a hug"**
**ACTION**
* **Action**:
* stimulates **uterine contractions**
* stimulates **ejection of milk from mammary glands**
* **== "let down" response**
29
Thyroid Gland
## Footnote
**LOCATION:**
Anterior Neck
30
**Thyroid Gland** in Ant. Neck
## Footnote
**Produces 2 hormones:**
1. Thyroxine **T3**
2. Triiodothyronine **T4**
31
**T3 and T4 produced by the Thyroid Gland**
**acted on by this Ant. Pit. Hormone**
TSH
Thyroid Stimulating Hormone
32
**Cellular effects of Thyroid Gland (prod's T3 and T4)**
INCs **cellular metabolism** in **body tissues**
33
**Body effects of Thyroid Gland (prod's T3 and T4)**
regulate **body heath (thermogenesis)** and **metabolism**
34
Possible **Dysfunctions** of **Thyroid Gland**
## Footnote
**2:**
1. HypOthyroidism= **underactive thyroid hormones**
2. HypERthyroidism= **overactive thyroid hormones**
35
HypERthyroidism
## Footnote
**PRIMARY CAUSES:**
* Graves Disease
* Autoimmune Dis.
* Adenoma/Carcinoma
36
HypERthyroidism
## Footnote
**SECONDARY CAUSES:**
* Induced by **excessive Hypothalamic OR Pituitary stimulation**
37
HypOthyroidism
## Footnote
**PRIMARY CAUSES:**
* Genetic deficiency of **hormone synthesis**
* **Hashimoto's**
* Thyroiditis (autoimmune)
* Cretinism in **childhood**
38
HypOthyroidism
**SECONDARY CAUSES**
* Hypothalamic OR Pituitary **deficiencies**
39
SYMPTOMS: **Compare and Contrast**
## Footnote
**HypERthyroidism vs. HypOthyroidism**
LOTS OF OPPOSITES!!!
40
**Compare and Contrast: Hyperthyroidism vs. HypOthyroidism**
**HYPERTHYROIDISM SYMPTOMS:**
* **TACHYCARDIA**
* MM wasting
* Wt. loss
* Heat intolerance
* Insomnia
* Exophthalmos (bulging eyes) GRAVES
* Nervousness
* INCd appetite
* Diarrhea
* Oligomenorrhea
* Goiter
41
**Compare and Contrast: Hyperthyroidism vs. HypOthyroidism**
**HYPOTHYROIDISM SYMPTOMS:**
* **BRADYCARDIO (think hypO, slOw HR)**
* Weakness
* Wt. GAIN (adults)
* COLD intolerance
* Sleepiness
* Facial edema
* lethargy
* anorexia
* Constipation
* Menorrhagia (heavy, painful)
* Dry, coarse skin
42
Medical Mgmt Thyroid disorders
## Footnote
**Hyperthyroidism: 2 forms of medical mgmt**
1. **Radioactive Iodine**
2. **Beta Blockers**
43
Medical mgmt thyroid disorders
## Footnote
**Hyperthyroidism: Radioactive Iodine....WHY?**
* Ablate thyroid tissue
* **reduces SIZE of thyroid== LESS T3 T4**
44
Medical mgmt of thyroid disorders
## Footnote
**Hyperthyroidism: Beta Blockers....WHY?**
* Tx of **cardiovascular effects (TACHYCARDIA) of hypERthyroidism**
45
Medical mgmt of thyroid disorders
## Footnote
**HYPOTHYROIDISM: what is the purpose of this medical mgmt?**
Pharmacologic **replacement** of **missing thyroid hormones**
**\***since hypO means **not producing enough**
* **Levothyroxine: ex. Synthroid == T4 synthetic**
46
PT considerations in **Thyroid Disease:**
## Footnote
**THESE conditions may be MORE common**
**and Examples:**
**MSK conditions**
* Adhesive capsulitis== MOST COMMON
* Trigger finger
* Dupytren's contracture
* CTS
47
PT considerations for Thyroid Disease
## Footnote
**Another possible condition for the LONG TERM:**
**Peripheral Neuropathy**
* MM wasting, balance problems
48
PT Considerations for Thyroid Disease
## Footnote
**How might you screen these patients given the more common conditions they experience?**
* Hand & wrist screening
* Frozen shoulder screening
* **UQS \*\*\*\***
49
How can you remember **Adrenal Glands?**
Party Hat on the **Kidneys!!!**
50
What is the **Location** of the **Adrenal Glands?**
Superior Pole of the **Kidney**
51
The **Cortex** of the **Adrenal Glands produces what?**
\*REMEMBER **"CORT" and CORTICOIDS**
* GlucoCORTicoids
* MineraloCORTicoids
* Sex **steroids**
52
The **Medulla** of the **Adrenal Glands produces what?**
## Footnote
**\*think FIGHT or FLIGHT**
THIS IS YOUR **FIGHT OR FLIGHT responses!!!**
* Epi
* NorEpi
53
**Cellular Effects of Adrenal Glands**
A LOT!!!
54
Possible **Dysfunctions** of the **Adrenal Glands**
1. Adrenal **Insufficiency**
2. Adrenal **Crisis**
55
Adrenal Glands
**Cortex vs. Medulla**
see pics
56
Adrenal **Corti**
Acted on by what hormone?
Think **Adrenal**
ACTH
**AdrenoCorticoTropic Hormone**
57
Adrenal Corti secretes **Glucocorticoids**
## Footnote
**This produces what?**
* Cortisol
* **"Cortisol from Cortex"**
58
Adrenal Corti secretes **Mineralocorticoids**
## Footnote
**This produces what ?**
**Aldosterone**
59
3rd Hormone the **Adrenal Corti produce?**
Sm. amts of Sex Steroids
60
Phys. of **Glucocorticoids**
## Footnote
**aka Steroids**
**ACTIONS:**
* Regulate **glucose metabolism**
* Anti-inflammatory
* Immunosuppressive props
* **Enhance ability** to handle **Stress**
* **RENAL ACTIONS**
* ****Abnormal lvls (\>)---\> **mood & behavior changes**
* ****INC **sodium & water reabsorption**
* Impair ability of the kidneys to excrete a **water load**
61
Phys. of **Glucocorticoids**
## Footnote
**THERAPEUTIC USES:**
* CONTROL **inflammation**
* Suppress **immune response**
* **Cortisol:** lvls rise slowly t/o morning hours and PEAK ~8AM
* Circadian Rhythm
* Released in response to **stressful stimuli**
* ****trauma, infection, hemorrhage, temp extremes, food and water deprivation, perceived pyschological stress, pandemics, **PT school**
62
Adverse Effects: **Glucocorticoids**
## Footnote
**Long Term Use=====**
**Adrenocortical Suppression\*\*\***
63
Adverse effects: **Glucocorticoids**
**Long term use leads to Adrenocortical Suppression**
**RESULTS OF THIS:**
* HypOglycemia
* Dehydration
* Wt. loss
* Disorientation
* weak/fatigue
* dizziness
* OH
* MM aches
* nausea, vomiting, diarrhea
* **tanning of the skin that may be patchy (skin creases, mouth) OR entire body**
64
Adverse Effects: **Glucocorticoids**
## Footnote
**Long term use may ALSO lead to:**
Drug-induced Cushing's Syndrome
65
Adverse Effects: **Glucocorticoids**
## Footnote
**Drug-induced Cushing's Syndrome**
**As a result of this:**
* Moon face
* Fat deposition, obesity in **trunk**
* **MM wasting in the extremities**
* Hirsutism (hair growth)
* **HTN**
* **GLU intolerance**
* **Osteoporosis**
* **Breakdown of supporting tissues---ESP muscle**
* Bone loss--aseptic necrosis
66
Adrenal Cortex--**Mineralocorticoids**
## Footnote
**MAIN MINERALOCORTICOID:**
ALDOSTERONE
67
Adrenal cortex: **Mineralocorticoids**
**ALDOSTERONE**
**ACTIONS:**
* Controls **electrolyte & fluid lvls**
* ****INCs **reabsorption** of **sodium** from **renal tubules**
* **"**Where **salt** GOES, **water** FOLLOWS"
* INHIBITS **potassium reabsorption**
68
Three **Stimuli for Release of ALDOSTERONE (mineralocorticoid)**
1. INCd **Angiotensin II**
2. INCd **Plasma Potassium**
3. DECd **Plasma Sodium**
69
Stimulus for Release of **Aldosterone**
**\*INCd Angiotensin II**
**FUNCTION of this:**
Vaso**constriction;** Maintains **BP**
70
Stimulus for Release of **Aldosterone**
## Footnote
**\*INCd Plasma Potassium**
**FUNCTION of this:**
INHIBITS K+ reabsorption
71
Stimulus for Release of **Aldosterone**
## Footnote
**\*DECd Plasma Sodium**
**FUNCTION of this:**
ENHANCES Na+ reabsorption
72
What should you remember about **Adrenal Meduli and the hormones it produces??**
FIGHT OR FLIGHT RESPONSE HORMONES!!!
73
Adrenal **Meduli** secretes 2 hormones:
FIGHT OR FLIGHT!!!!
1. Epi
2. NorEpi
74
Adrenal Meduli and release of **Epi and NorEpi**
## Footnote
**helps prepare body for what ?**
Sudden physical activity
FIGHT OR FLIGHT RESPONSE
75
The release of Epi and NorEpi **from Adrenal Meduli is controlled by:**
**Sympathetic Division of ANS**
76
Adrenal Medulla: **FIGHT OR FLIGHT RESPONSE**
**Human Body and Organ Responses:**
see pics
77
Considerations for PTs in **Adrenal Disease**
Pts on **chronic adrenal steroid tx will present w/ 2 things:**
1. **MM wasting** bc glucocorticoids are **catabolic**
2. **Bone loss** bc glucocorticoids **impair** **bone metabolism**
78
Considerations for PTs in **Adrenal Disease**
## Footnote
**PT goals:**
* INC mm strength
* REDUCE DEconditioning, promote mobility
* REDUCE bone loss w/ WB exercises
79
Considerations for PTs in **Adrenal Disease**
## Footnote
**PT Considerations & Precautions:**
* Careful not to place **too much load on mm's/joints**
* **Deconditioning**
* **MONITOR BP bc mineralocorticoids & glucocorticoids can INC BP \*\*\*\***
* Beware of **infection signs bc glucocorticoids are immunosuppressive**
80
Parathyroid Glands
## Footnote
**LOCATION?**
**Embedded in Thyroid**
81
Parathyroid Glands produce 2 hormones:
1. **Parathyroid Hormone (PTH)**
2. **Calcitonin**
82
I say **Parathyroid.......**YOU SAY.........
**CALCITONIN AND Ca+ CONCENTRATION!!!!!**
83
**Cellular/Body Effect** of Parathyroid Glands:
* modify **calcium concentration** in serum
* **regulated by _serum calcium lvl_**
84
2 Possible **Dysfunctions** w/ **Parathyroid Glands:**
* 1. HypERparathyroidism
* **OVERactive PTH**
* 2. HypOparathyroidism
* **UNDERactive PTH**
85
Parathyroid Glands:
## Footnote
**Calcium Regulation**
**Nrml Concentration=====**
Nrml conc. Ca+ in blood == **9.4mg/100mL**
86
Parathyroid Glands:
## Footnote
**Calcium Regulation**
**nrml==9.4mg/100mL**
**IF plasma calcium falls BELOW 6.0mg/100mL======**
* Pt will develop **tetanic mm convulsions**
* **this stimulates PTH RELEASE**
* **INCs plasma calcium by causing REABSORPTION of calcium from bone, GI tract**
87
Parathyroid Glands
## Footnote
**Calcium Regulation**
**Nrml==9.4mg/100mL**
**IF lvls are GREATER than 12.0mg/100mL=======**
* Pt develops **DECd nervous function, sluggishness and lethargy and possible coma**
* ****Stimulates **CALCITONIN Release**
* **hormone that DECs plasma calcium by causing calcium to deposit in bone**
88
In a nutshell.....
## Footnote
**If plasma calcium lvls fall BELOW 6.0mg/100mL**
**Stimulates.......**
**Parathyroid hormone** release
INCs plasma calcium
89
In a nutshell.....
**If plasma calcium lvls are GREATER than 12.0mg/100mL**
**Stimulates-------**
**Calcitonin Release**
**DECs plasma calcium**
90
