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What is the endocrine system?
all those organs that secrete their cellular products (hormones) directly into the bloodstream
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What produces effects on tissues?
- hormones
- chemical substance which changes the physiology of the specific cell on which it acts
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What type of glands have secretions that reach epithelial surfaces?
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What is an endocrine gland?
- no ducts
- secrete hormones which are carried by the blood to the body parts on which they will act
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The ulitmate control of the endocrine glands come largely from what?
hypothalamus
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What gland is found in the sella turnica of the sphenoid bone and has 2 lobes?
pituitary gland
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What is the ant lobe of the pituitary gland called?
- adenohypophysis
- master gland of the body
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What hormones does the ant pituitary (adenohypophysis) secrete?
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What is the post pituitary called?
neurohypophysis
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What does the post pituitary (neurohypophysis) secrete?
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What does the thyroid gland secrete?
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What does the parathyroid gland secrete?
parahormone
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What does the thymus secrete?
production of anytibodies by lymph structures so it is considered a lymph organ
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What does the adrenal gland secrete?
- 2 parts:
- cortex- steriods, and some sex hormones
- medulla- epinephrine, nor-epinephrine
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What does the pancrease secrete?
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What do the ovaries secrete?
estrogen and progesterone
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What do the testes secrete?
testosterone
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What does the pineal gland secrete?
- sleep-wake cycle
- melatonin
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adrenocorticotropic hormone (ACTH)
stimulates production of steriods by adrenal gland
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growth hormone (GH)
promotes growth
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thyroid stimulating hormone (TSH)
production of thryoid hormones
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follicle stimulating hormone (FSH)
maturation of ovaries
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interstitial cell stimulating hormone (ICSH)
testes
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lutenizing hormone (LH)
causes ovulation
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prolactin
secretion of breast milk
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hypothalamus hormones
act on ant pituitary to release or inhibit specific hormones
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antidiuretic hormones (ADH)
- conservation of body water
- decreases urine output
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oxytocin
smooth m contraction in breast to aid in milk ejection, and uterine contractions
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thyroxine
increase rate of metabolism
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thyrocalcitonin
decreases calcium in blood
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parathyroid hormone (parahormone)
- metabolism of calcium and phosphorus
- increases calcium in blood
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glucocorticoids (hydrocortisone) <-steriods
cortex
inhibits inflammatory response
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epinephrine/nor-epinephrine
medulla
- regulates BP
- fight or flight
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insulin
- utilization of glucose
- decreased blood sugar
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glucagon
increases blood sugar
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estrogen
- female sex characteristics
- menstrual cycle, pregnancy
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progesterone
maintenance of pregnancy
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human chorionic gonadotropin (HCG)
placenta
maintains progesterone production in pregnancy (otherwise miscarriage)
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testosterone
male sex characteristics
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What are 2 diseases of the pituitary gland?
- giantism/acromegaly
- diabetes insipidus
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What are 2 diseases of the thyroid gland?
- hashimotos disease (hypothyroidism)
- graves disease (hyperthyroidism)
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What are 2 diseases of the parathyroid?
- hypoparathyroidism
- hyperparathyroidism
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What are 2 diseases of the adrenal gland?
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What disease is caused by excessive growth hormones in the ant pituitary (adenoma)?
giantism (kids) acromegaly (adults)
- rapid increase in height of children
- enlarged hands and coarse facial features in adults
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What disease is caused by trauma or a neoplasm of the post pituitary gland? (decreased ADH)
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What is hashimotos disease?
- decreased activity
- intolerance to cold
- dry hair and skin
- myxedema
- women more commonly affected
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What is myxedema?
- cretinism hypo thyroid from birth
- puffy face, hands, and feet
- large tongue
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What is graves disease?
- increased thyroid hormone
- neoplasm
- tremors
- nervousness
- emotional instability
- heat intolerance
- rapid heart beat
- weight loss
- enlarged thyroid
- exopthalamus
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What is caused by decreased blood calcium, trauma, or surgery?
hypoparapthyroidism
- tetany (stiffness/pain)
- convulsions
- decreased calcium
- mild tingling hands/feet
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What is caused by increased calcium, or carcinomas?
hyperparathyroidism
- increased breakdown of bones - pathologic fracture
- increased absorption of calcium -> kidney stones
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What is addisons disease?
- decreased adrenocortical hormones
- idiopathic
- tuberculosis
- increased skin pigmentation
- tiredness
- intestinal complaints
- hypotension
- hypoglycemia
- loss of body hair
- depression
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What is cushings syndrome?
- excess corticosteriods
- steroid therapy
- obesity of face (moon face)
- easy bruising
- hypertension
- increased body hair
- m weakness
- acne
- psychosis
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What type of pancreas disease is marked by a lack of insulin; none is produced by pancreas?
type 1 insulin dependent diabetes mellitus (IDDM)
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What type of pancreas disease is marked by the body producing insulin but it is not being used properly?
type 2 noninsulin dependent diabetes mellitus (NIDDM)
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What is the normal blood sugar levels?
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What are some complications of diabetes we see in therapy?
- atherosclerosis
- vascular disease
- microangiopathy (damage to tiny blood vessels..eyes, kidneys)
- neuropathy
- increased susceptibility to infection
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What is the PT intervention for diabetes?
- prevention/pt education
- ther-ex
- sterile whirlpool
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What are the symptoms of a hypoglycemic attack?
- insulin shock
- shallow breathing
- perspiration
- light headed
- coma
- glucose (give OJ, candy)
- tell pt to reduce insulin or increase carbs before therapy
- keep fruit juice, sugars ready during exers
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What are the symptoms of hyperglycemia?
- diabetic coma/ketoacidosis
- too much sugar in system, not enough insulin
- deep, labored breathing
- skin, tongue dry
- fruity smell of breath
- drowsy
- coma
- need insulin
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What are he warning signs of IDDM?
- Constant urination
- Abnormal thirst
- Unusual hunger
- The rapid loss of weight
- Irritability
- Obvius weakness and fatigue
- Nausea and vomiting
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What are the warning signs of NIDDM?
- Drowsiness
- Itching
- A family history of DM
- Blurred vision
- Excessive weight
- Tingling/numbness, pain in extremities
- Easy fatigue
- Skin infection, slow healing of cuts and scratches, esp on feet
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What are some common causes of hypoglycemia/insulin reactions?
- poor timing of meals or snacks
- extra exercise without additional food
- too much insulin
- alcohol consumption
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What are some symptoms of hypoglycemia/insulin reactions?
- shakiness
- nervousness
- sweating
- dizziness
- weakness
- irritability
- hunger
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What are some common causes of hyperglycemia/high blood glucose?
- increased amt of food
- decreased amt of exercise
- not enough insulin or too much, resulting in rebound
- poor timing of insulin injections in relation to meal times
- illness, infection, or stress
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What are some symptoms of hyperglycemia/high blood glucose?
- excessive urination
- thirst
- hunger
- drowsiness
- weakeness
- unexplained weight loss
- slow healing cuts
- blurred vision
- dry itchy skin
- vaginal itching
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What are some common causes of ketoacidosis?
- not enough insulin plus illness, infection, or stress
- pt failure to take insulin
- failure to test urine or blood for glucose and to treat high glucose levels
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WHat are some symptoms of ketoacidosis?
- same as high blood glucose plus:
- nausea
- vomiting
- abdominal pain
- rapid shallow breathing
- coma
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What is a dependent rubor test?
- test to check for circulation
- LEs in a dependent position; push on toenail bed and it turns pale, let go and it pinkens back up
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The likeihood and severity of peripheral arterial disease in diabetic pts increase with what?
- age
- duration of diabetes
- cigarette smoking and other tobacco use
- hypertension
- hypercholesterolemia and hypertriglyceridemia
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What is the primary symptom of peripheral arterial disease?
- intermittent claudication
- narrowing or occulsion of an artery or arteries in the lower abdomen and/or the lower limbs
- oxygen demand of affect exercised leg mm exceed the arterial supply resulting in lactic acid accumulation and pain
- pt exeriences leg ache or pain when walking, esp uphill, that promtly subsides when he or she stops and rests
2nd to angina pectoris as the most common presenting symptom of occulsive artery disease
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What is charcots joints?
- result from neuropathic changes in and around the articulations of the foot
- normal proprioception and afferent sensoryinput deteriorate, leading to abnormal gait patterns and inability to perceive the resulting mechanical stresses
- minor fractures, which would normally cause pain, occur but go unnoticed by the diabetic resulting in abnormal joint stress and destruction
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What is mal perforant?
ulcers develop under bony prominences- typically under the first or second metatarsal head
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