Module 7
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| Hypothalamus, pineal body, pituitary, thyroid and parathyroid, thymus, adrenal gland, pancreas, ovary, testis, heart and kidneys | ||
| False. Slower onset and longer duration. | ||
| Yes. | ||
| The cortex and the medulla. Cortex: corticosteroids Medulla: Epinephrine (E) and norepinephrine (NE) | ||
| Thyroid: Calcitonin (CT) and thyroid hormone (TH) Parathyroid: (posterior surface) parathyroid hormone (PTH) Pancreas: Glucagon, Insulin and somatostatin | ||
| Pituitary. Primary fxn is to control other glands. It's secretion is controlled by the hypothalamus | ||
| Structurally and functionally. Anterior and posterior areas that each produce different hormones. | ||
| ADH (vasopressin): can increase re-absorption of water in kidney. Over-activation of this hormone could cause BP to go up. Also releases oxytocin | ||
| ACTH: which can stimulate the ADRENAL CORTEX to release ALDOSTERONE and CORTISOL TSH: stimulates THYROID to release T3 ad T4 to increase metabolic rate and calcitonin to inhibit osteoclast activity Also releases GH, LH and FSH | ||
| On top of both kidneys | ||
| Adrenaline, Sympathetic nervous system | ||
| ^ blood glucose levels, excretion of Ca++ and BP, suppresses inflammation. Stress, injury or serious infection can trigger its release. | ||
| YES! | ||
| Adrenal. Maintains fluid/electrolyte balance by reabsorbing NaCl and excreting K+. Increase is this hormone leads to preservation of water and increase in BP. Prolonged ^: hypokalemia and hypernatremia. | ||
| Renin-Angiotensin-Aldosterone system | ||
| Angiotensin 2 increases > this caused the pituitary to release ADH to preserve water and bring BP back up. The pituitary also releases ACTH that stimulates the release of aldosterone and blood volume goes up and blood vessels constrict and BP goes up | ||
| T4, T3: ^ metabolic rate, stimulate growth and development of cells Calcitonin: inhibits bone resorption Anterior pituitary | ||
| PTH increases blood Ca++ by removing it from your bones, limiting bone formation. | ||
| Islets of langerhans. Alpha: glucagon (increases blood glucose) Beta: insulin (lowers blood glucose) Delta: somatostatin, inhibits both glucagon and insulin | ||
| Low blood sugar triggers pancreas to release glucagon that will stimulate breakdown of glycogen to glucose to raise blood sugar. High blood sugar promotes insulin release from the pancreas to cause glucose uptake from blood to lower blood sugar. | ||
| -alteration in hormone release. -alteration in the stimulation or inhibitory response. -Defect in target tissue. | ||
| -blood supply to glands reduced -glands shrink or become fibrotic -decrease in hormone secretion | ||
| STRESS. catecholamines are from the adrenal gland due to stimulation of the SNS (fight or flight reponse) | ||
| **typically due to tumor, infarction, genetic disorders or trauma** hyper: oversecretion, esp GH, leads to gigantism, acromegaly hypo: dwarfism. | ||
| The mouth. 75% | ||
| Graves disease | ||
| nervousness, goiter, weight loss despite ^ appetite, tremors, protruding eyeballs, tachycardia, HTN, insomnia, arrhythmia | ||
| radioactive iodine, anti-thyroid meds, beta-blockers, and surgery | ||
| pts with I-131 (iodine) will be radioactve and precautions should be taken around children and pregnant women; monitor vitals, heat tolerance, musculoskeletal symptoms, fatigue, and dyspnea | ||
| Secondary. Your primary is impaired hormonal synthesis or release. Women | ||
| slowed speech and mental fxn, fatigue, proximal muscle weakness, cold intolerance, bradycardia, weight gain, retarded growth, decrease in DTRs | ||
| Synthetic thyroid hormone | ||
| musculoskeletal trigger points. skin breakdown, watch for chest pain and tachycardia with meds, improve tolerance to activity, rhabdomyolysis: disintegration of skeletal muscle with excretion of myoglobin in urine. | ||
| CUSHING'S SYNDROME: over secretion of CORTISOL, due to adrenal mass or excessive corticosteroid meds; usually women affected. CUSHING'S DISEASE: due to pituitary adenomas CONN'S DISEASE: aldosterone excess | ||
| Round face, protuberant abdomen, abnormal fat distribution, osteoporosis, muscles weakness, hyperglycemia, virilism in women, mental changes | ||
| Surgery or meds to suppress cortisol production PT: ^ susceptibility to infection, monitor vitals, WB bearing exercise and resistance training | ||
| Adrenal. Equal. It is idiopathic and autoimmune | ||
| Surgery, trauma, infection, pain, volume loss, hypoglycemia | ||
| CORTISOL: leads to decreased BP and hypoglycemia ALDOSTERONE: ^ Na excretion, dehydration, and hypotension Also see fatigue, weight loss can be given meds (hydrocortison and florinef together) | ||
| Diabetes mellitus Also includes Hyperglycemia, and a genetic link | ||
| Diabetes insipitus | ||
| Juvenile: type 1, autoimmune, little or no insulin production Adult: type 2, MORE COMMON, insulin resistance or diminished insulin production. | ||
| All type 1 | ||
| member of high risk ethnic group (hispanics), family history of it, HTN, HDL < 35 or triglycerides > 250, BMI>=27, age>45 | ||
| Hyperglycemia, irritability, fatigue and weakness, blurred vision, cuts/bruises slow to heal, numbness/tingling in hands and feet, polyuria, glycosuria | ||
| Neuropathy is most common. Charcot's foot can occur due to neuropathy | ||
| Hand stiffness: limited joint mobility, flexor tenosynovitis, dupuytren's contracture Atheroscerlosis: ^ fat metabolism and HTN Impaired wound healing | ||
| Glucose and ketones in urinalysis. Fasting glucose levels of >126 mg/dl on 2 occasions. Casual glucose of >200 on 2 occasions | ||
| Less than 7%. In poorly controlled diabetes it can be 8% or above. | ||
| Low fat diet, avoid simple carbs and alcohol, eat regular meals to control hyperglycemic surges. | ||
| 80-150 g/dL (up to 180 1-2 hours after a meal) | ||
| Rapid acting. Long acting | ||
| Sulfonylurease (^ insulin production) Metformin (glucophage): decrease glucose production but ^ insulin sensitivity. | ||
| TRUE | ||
| -diabetic ketoacidosis (DKA) -hyperglycemis, hyperosmolar, nontotic coma (HHNC) both blood glucose >300 -insulin shock (blood glucose <70) | ||
| Breath fast to blow off extra acid (respiratory alkalosis) | ||
| Insulin shock. DKA. DKA: type 1 HHNC: type 2 shock: both | ||
| -Morning for type 1. Avoid late night or during peak insulin. -Avoid strainging, high intensity, head below waist (retinopathy) -Hypoglycemic rxn | ||
| Fatigue, mental changes, osteoporosis, osteoarthritis, changes in hair, skin or body fat distribution, polyuria, polydipsia (excessive thirst), RA like signs and symptoms, myalgia (muscle pain) | ||
| Maintain fluid/electrolyte balance and acid-base balance. | ||
| Phenylketonuria Autosomal recessive disease where a diet restriction of phenylalanine is required. | ||
| Copper. it is a progressive disease, autosomal recessive trait | ||
| Kayser-Fleischer ring around the iris, cirrhosis of the liver, degeneration of the brain and unsteady gait Tx: vit B6 and other meds to promote excretion of copper | ||
| -50. Also 13% of US white men affected. -Menopause: 54% postmenopausal white women are osteopenic and 30% are osteporotic | ||
| OsteoBlasts (B for Build) OsteoClasts (C for...idk just remember B) Build: during childhood, teen and young adult years; when you consume enough calcium and vit D LoseL Older adult; when you do not consume enough calcium and vit D | ||
| No the spine/vertebral body. With osteoporosis you see decreased bone mass resulting in porous bones more easily fractured | ||
| Female, increasing age, thin, small boned, caucasian, family Hx of fractures or osteoporosis, abnormal menstrual hx, eating disorder, lactose intolerant, digestion disorders, poorly controlled diabetes, RA, thyroid or parathyroid disorders | ||
| Inactive, low calcium, low vit D or sun exposure, few fruits and veggies, excessive alcohol, current/former smoker, lots of caffeine (uh-oh!) | ||
| Eat a healthy diet and have sun exposure | ||
| -3 or more servings of milk/dairy foods; fortified food, dairy, fatty seafood; 10-15 minutes of sun a day. -5 or more servings of vegetables and fruits; potassium, magnesium, zinc and copper; vit K and C | ||
| Those who are lactose intolerant or allergic to milk, those avoiding milk/dairy foods, on a strict weight loss diet, over 50 y/o with little milk or sun, those on long term steroid therapy | ||
| Maintain active life style. Regular weight bearing aerobic type exercises: 30 min 3X a week; Strength training 20 min 2X a week; balance and stretching 3X weekly | ||
| Strength training | ||
| Most common fracture is the vertebral bodies and the flexion in a crunch could cause a fracture. | ||
| Get bone mineral density (BMD) test. | ||
| False, not lordosis, kyphosis | ||
| Avoid harmful habits: smoking, heavy drinking, strict diets, heavy caffeine, diets with low calcium and vit D, inactive lifestyle | ||
| Calcium/vit D, hormone replacement therapy, biphosphonates, calcitonin, PTH | ||
| Fosomax and Actonel. They bind permanently to the surfaces of bone and slow down OSTEOCLASTS to allow OSTEOBLASTS to work more effectively. | ||
| VDR (vit D receptor maybe?). 2 forms 2 copies of the more efficient gene gives high bone density, 2 of the less efficient give somewhat weaker bones. | ||
| -Twisting the spine, excessive flexion of the spine or high impact activities. -Avoid spinal mobilizations and manipulations | ||
| False, you must continue exercise or the benefits on bone density are lost quickly | ||
| -Osteomalacia -Osteopenia (less severe than osteoporosis btwn 1-2.5 SD below bone density of normal adult) | ||
| OstoePOROSIS: decreased bone density (2.5 SD below bone density of normal adult.) OsteoPETROSIS: increased bone density | ||
| Dietary deficiencies, malabsorption problems, gastrectomy, chronic renal failure, inadequate vit D, hyperparathyroidism | ||
| Bone pain, tenderness, possible muscle weakness, possible bowing of legs, softened vertebrae compress and can lead to thoracic kyphosis | ||
| Correct underlying cause; supplement diet; control pain, optimize fxn (be careful they fracture easy) | ||
| Excessive octeoclastic bone resorption followed by excessive bone formation from osteoblasts that results in bone that architecturally unsound. can lead to bone pain and skeletal fragility. | ||
| Enalrged cranium, not face; impaired hearing, bowed femurs and tibias, kyphosis, pain and tenderness, (possible clavicle deformities) | ||
| Meds: biphosphonates and calcitonin Fractures managed; hearing aids for hearing loss; watch for hypercalcemia; encourage adequate fluid intake ; optimize function | ||
| Abdominal obesity, HTN, insulin resistance, pro-thrombotic state, pro-inflammatory state, atherogenic dyslipidemia (blood fat disorders) | ||
| Apple shape: central obesity | ||
| Coronary heart disease and other diseases related to plaque buildups in artery walls and type 2 diabetes | ||
| Stop smoking, reduce LDL cholesterol, BP and glucose levels Weight loss to desirable weight; increase physical activity and healthy eating |
