Week 8- Endocrine and Metabolic System *didn't finish Flashcards
The endocrine system and the nervous system control and integrate body function to maintain ______________
Homeostasis
The endocrine system sends its messages in the form of hormones via the ____________
Bloodstream
Five general functions of the endocrine system
-Differentiation of the reproductive and central nervous system of the developing fetus
-Stimulation of sequential growth and development during childhood and adolescence
-Coordination of the male and female reproductive systems
-Maintenance of optimal internal environment throughout the life span
-Initiation of corrective and adaptive responses when emergency demands occur
______________ , the main integrative center for the endocrine and autonomic nervous systems, controls the function of endocrine organs by neural and hormonal pathways
Hypothalamus
In addition to hormonal and neural controls, a ________________ system (simple or complex) regulates the endocrine system
Negative feedback
SLIDE 7, 8, 9
_____________ can be classified as an endocrine gland, because it secretes several hormones responsible for metabolism, hunger, vasoconstriction, and cellular growth and development
Adipose tissue
Hormones released by adipose tissue
Adiponectin
Leptin
Dysfunctions of the endocrine system are classified as _____________or ____________
HYPOfunction
HYPERfunction
Endocrine system, together with the immune system and the nervous system, mounts an integrated response to stressors
Psychoneuroimmunology
Catecholamines
Epinephrine
Norepinephrine
Dopamine
Catecholamines produce a _____________ response
Fight-or-flight
SLIDE 11- cortisol (look at table 11.2)
Other hormones produced through neuroendocrine response to stress
Endorphins
GH
Prolactin
Testosterone
True or false: Exact effects of aging on the endocrine system are clear
False
(not clear)
Failure of homeostasis basis of age-associated ___________ in physiologic performance on the endocrine system
Declines
Equilibrium concentrations of the principal hormones necessary to maintain homeostasis are not necessarily altered with age, but what may differ as we get older is ______________ , which points to changes in regulatory control
The way we achieve equilibrium hormone levels
True or false: Only subtle changes occur in the pituitary, adrenal, and thyroid function
True
True or false: Changes in glucose homeostasis, reproductive function, and calcium metabolism are less apparent
False
(more apparent)
Suggests that cells are programmed to function only for a given time
Neuroendocrine theory of aging
Example of neuroendocrine theory of aging
Menopause (result of programmed changes in reproductive system)
Clients with a variety of endocrine and metabolic disorders report symptoms of ___________, _________, and occasionally ____________
Fatigue
Muscle weakness
Muscle or bone pain
The lack of progress in therapy should signal to the therapist the possibility of a ____________ of musculoskeletal symptoms
Systemic origin
SLIDE 16
________________ can be an indicator of an underlying endocrine disease
Rheumatoid arthritis
True or false: Muscle weakness, atrophy, myalgia, and fatigue that persist despite rest may be early manifestations of thyroid or parathyroid disease, acromegaly, diabetes, Cushing syndrome, or osteomalacia
True
_____________ resulting from __________ nerve impairment at the wrist is a common finding in people with certain endocrine and metabolic conditions such as acromegaly, diabetes, pregnancy, and hypothyroidism
Carpal tunnel syndrome (CTS)
Median
In endocrine disorders, CTS is frequently _________ , which is one characteristic that may distinguish it from overuse syndromes and other causes of CTS
Bilateral
___________ , __________ , and ___________ (joint stiffness) of the small joints of the hand may occur with endocrine and metabolic diseases
Hand stiffness
Hand pain
Arthralgias
Flexor tenosynovitis with stiffness is a common finding in persons with _______________
Hypothyroidism
Anterior lobe disorders of pituitary gland
HYPERpituitarism
HYPOpituitarism
Hyperpituitarism
Orthopedic considerations
Acromegaly
Skeletal manifestations, such as __________ of the hands and _____________ of the spine, may develop with hyperpituitarism
Arthritis
Osteoarthritis
CTS is seen in up to ____% of people with acromegaly
50
About _________ of individuals with acromegaly have thoracic or lumbar back pain
Half
True or false: Therapist may be called on to provide a program that promotes maximum joint mobility, muscle strength, and functional skills
True
Excessive secretion of growth hormone after normal completion of body growth
Acromegaly
Anyone with acromegaly should be screened for __________, ____________, and ____________
Weakness
Changes in joint mobility
Poor exercise tolerance
Primary hormones produced by the thyroid
Thyroxine (T4)
Triiodothyronine (T3)
Calcitonin
Both _____ and ______ regulate the metabolic rate of the body and increase protein synthesis
T3
T4
____________ has a weak physiologic effect on calcium and phosphorus balance in the body
Calcitonin
Thyroid function is regulated by…
-Hypothalamus
-Pituitary feedback controls
-Intrinsic regulator mechanism within the gland
True or false: Disorders of the thyroid gland may be functional abnormalities leading to hyperfunction or hypofunction of the gland or anatomic abnormalities such as thyroiditis, goiter, and tumor
True
Alterations in thyroid function produce changes in…
Nails
Hair
Skin
Eyes
GI tract
Respiratory tract
Heart and blood vessels
Nervous tissue
Bone
Muscle
True or false: Women do not notice disturbances in mood and menstrual cycles
False
(they do notice lol)
Both hyperthyroidism and hypothyroidism can adversely affect _____________
Cardiac funciton
SLIDE 28- Table 40.19
Creates a generalized elevation of body metabolism, the effects of which are manifested in almost every system
Hyperthyroidism
The most common for (85% of cases) of hyperthyroidism
Graves disease
Regarding Graves disease, the autoimmune condition increases ______ production
T4
True or false: Hyperthyroidism affects women more than men (4:1)
True
Acute episode of thyroid over activity
Thyroid storm
Functional abnormalities of thyroid gland
Hyperthyroidism
Hypothyroidism
Anatomic abnormalities of thyroid gland
Goiter
Thyroiditis
Thyroid cancer
About _____ % of people with Graves disease have circulating autoantibodies called __________ that react against thyroglobulin (precursor for thyroid hormones)
-95
-Thyroid-stimulating immunoglobulins (TSIs)
TSIs react against a component of the thyroid cell membranes, _________ enlargement of the thyroid gland and secretion of __________ thyroid hormone
Stimulating
Excess
Hyperthyroidism results with increased __________ nervous system activity and __________ deficiency
Sympathetic
Nutritional
Mild symmetric enlargement of the thyroid (goiter), nervousness, heat intolerance, weight loss despite increased appetite, sweating, diarrhea, tremor, and palpitations
Hyperthyroidism
Hyperthyroidism may induce…
-Atrial fibrillation
-Precipitate congestive heart failure
-Increase the risk of underlying CAD for myocardial infarction
Forward displacement of the eyeballs associated with thyroid disease
Exophthalmos
True or false: PT is recommended for someone with exophthalmos
False
(not recommended until after endocrine system is solved)
Inflammation that involves the peri-articular structures, including the tendons, ligaments, and joint capsule
Peri-arthritis
True or false: Peri-arthritis can be be unilateral or bilateral
True
Proximal muscle weakness (most marked in the pelvic girdle and thigh muscles) accompanied by muscle atrophy
Myopathy
Respiratory muscle weakness can present as _________
Dyspnea
True or false: There is a way to prevent Graves disease
False
(no way)
Lab tests for hyperthyroidism
TSH and antithyroid antibodies
_______ is positive in almost all people with Graves disease
TSI
Three major forms of therapy for hyperthyroidism
-Antithyroid medication
-Radioactive iodine (RAI)
-Surgery
True or false: Lifelong follow-up for patients with hyperthyroidism is recommended because many remissions are not permanent
True
True or false: If PT sees unusual swelling, enlargement with or without symptoms of pain, tenderness, hoarseness, or dysphagia (difficulty swallowing), a medical referral is required
True
True or false: Hyperthyroidism is associated with exercise tolerance and increased exercise capacity, although the exact relationship is unknown
False
(intolerance, decreased exercise capacity)
Results in a generalized slowed body metabolism (basal metabolic rate)
Hypothyroidism
These types are involved in hypothyroidism
-Type I / primary (hormone deficient)
-Type II / secondary (hormones resistant)
True or false: Hypothyroidism is more prevalent in men than women
False
(more prevalent in women than in med)
SLIDE 37-44
______ parathyroid glands are located on the posterior surface of each lobe of the thyroid gland
Two
Parathyroid glands secrete _____, which regulates _______ and ________ metabolism
PTH
Calcium
Phosphorus
PTC exerts its effect by the following…
-Increasing the release of calcium and phosphate from the bone (bone demineralization)
-Increasing the absorption of calcium and excretion of phosphate by the kidneys
-Promoting calcium absorption in the GI tract
SLIDE 48 ,49
Over-activity of one or more of the four parathyroid glands that disrupts calcium, phosphate, and bone metabolism
Hyperparathyroidism
True or false: Regarding hyperparathyroidism, women are affected more than men (2:1), usually after age 60 years (postmenopausal)
True
SLIDES 51-57
______________ are two small glands located on the upper part of each kidney
Adrenals
Two relatively discrete parts of each adrenal gland
-Outer cortex
-Inner medulla
The outer cortex of the adrenal gland is responsible for the secretion of…
-Mineralocorticoids (steroid hormones that regulate fluid and mineral balance)
-Glucocorticoids (steroid hormones responsible for controlling the metabolism of glucose)
-Androgens (sex hormones)
The centrally located adrenal medulla is derived from neural tissue and secretes __________and ___________, which exert widespread effects on vascular tone, the heart, and the nervous system and affect glucose metabolism
Epinephrine
Norepinephrine
Together, the adrenal _______ and ________ are major factors in the body’s response to ________
Cortex
Medulla
Stress
SLIDE 61-62
Disorders of the adrenal gland
-Primary Adrenal Insufficiency (Addison Disease)
-Secondary Adrenal Insufficiency
-Adrenocortical Hyperfunction (Cushing syndrome and Conn syndrome)
Insufficient cortisol release from the adrenal glands causing a wide range of problems
Primary adrenal insufficiency (Addison Disease)
Regarding Addison Disease, most causes occurred as a complication of tuberculosis, but now most cases are considered ___________ or ____________
Idiopathic
Autoimmune
True or false: Other causes of Addison Disease include bilateral adrenalectomy, adrenal hemorrhage or infarction, radiation to the adrenal glands, malignant adrenal neoplasm, infections, and medications
True
SLIDE 65-71
Examples of adrenocortical hyperfunction
-Cushing syndrome
-Conn syndrome or aldosteronism
An excess of cortisol in the body
Hypercorticolism
REST OF SLIDE 73
__________ has a key role in glucose metabolism and a lesser part in protein, carbohydrate, and fat metabolism
Cortisol
True or false: Cortisol also helps maintain blood pressure and cardiovascular function while reducing the body’s inflammatory responses
True
Hypercortisolism resulting from adrenal gland oversecretion or from hyperphysiologic doses of corticosteroid medications
Cushing syndrome
When the hypercortisolism results from oversecretion of ACTH from the pituitary (usually due to an anterior pituitary tumor)
Cushing disease
Occurs when conditions such as depression, alcoholism, estrogen therapy, or eating disorders cause changes like those of Cushing syndrome
Pseudo-Cushing syndrome
SLIDE 76-77
Therapists are more likely to treat people who have developed medication-induced ______________ (exogenous steroid administration)
Cushing syndrome
Cushing syndrome occurs after individuals have received large doses of _________ (also known as hydrocortisone) or _________
Cortisol
Cortisol derivatives
Occurs when an adrenal lesion results in hypersecretion of aldosterone
Conn syndrome
The major cause of primary aldosteronism is a benign, aldosterone-secreting tumor called ______________
Aldosteronoma
________________ also can occur as a consequence of pathologic lesions that stimulate the adrenal gland to increase production of aldosterone
Secondary hyperadolsteronism
Aldosterone affects the tubular reabsorption of ________ and _________ and the excretion of _________ and _________ ions in the renal tubular epithelial cells
Sodium
Water
Potassium
Hydrogen
An excess of aldosterone enhances ________ reabsorption by the _________
Sodium
Kidneys
