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Questions and Answers
Which of these is NOT a possible cause of hypothyroidism?
Which of these is NOT a possible cause of hypothyroidism?
What is the effect of hypothyroidism on the cardiovascular system?
What is the effect of hypothyroidism on the cardiovascular system?
Which of these is NOT a musculoskeletal effect of hypothyroidism?
Which of these is NOT a musculoskeletal effect of hypothyroidism?
What is the typical pattern of thyroid hormone levels in hypothyroidism?
What is the typical pattern of thyroid hormone levels in hypothyroidism?
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How does hypothyroidism affect neurological function?
How does hypothyroidism affect neurological function?
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What is the primary treatment for hypothyroidism?
What is the primary treatment for hypothyroidism?
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What is the relationship between hypothyroidism and fibromyalgia syndrome (FMS)?
What is the relationship between hypothyroidism and fibromyalgia syndrome (FMS)?
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What is the recommended approach to exercise for individuals with hypothyroidism?
What is the recommended approach to exercise for individuals with hypothyroidism?
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What is the primary mechanism by which hormones travel throughout the body?
What is the primary mechanism by which hormones travel throughout the body?
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Which of the following is NOT a primary function of the endocrine system?
Which of the following is NOT a primary function of the endocrine system?
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The endocrine system plays a crucial role in the development of which of the following during fetal development?
The endocrine system plays a crucial role in the development of which of the following during fetal development?
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Which of these is a major function of the endocrine system related to the internal body environment?
Which of these is a major function of the endocrine system related to the internal body environment?
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Which of the following glands is NOT part of the endocrine system?
Which of the following glands is NOT part of the endocrine system?
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Which hormone, released by the pituitary gland, contributes to fluid retention by the kidneys?
Which hormone, released by the pituitary gland, contributes to fluid retention by the kidneys?
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What is a common physiological response to stress that involves the release of catecholamines?
What is a common physiological response to stress that involves the release of catecholamines?
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What is the primary function of cortisol when released from the adrenal cortex during the stress response?
What is the primary function of cortisol when released from the adrenal cortex during the stress response?
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Which of the following is a common musculoskeletal manifestation of endocrine disorders?
Which of the following is a common musculoskeletal manifestation of endocrine disorders?
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Which of the following hormones is NOT secreted by the anterior lobe of the pituitary gland?
Which of the following hormones is NOT secreted by the anterior lobe of the pituitary gland?
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A patient presents with headaches, visual disturbances, and endocrine abnormalities. These symptoms are MOST indicative of what condition?
A patient presents with headaches, visual disturbances, and endocrine abnormalities. These symptoms are MOST indicative of what condition?
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What condition is a result of excessive growth hormone (HGH) secretion in adults?
What condition is a result of excessive growth hormone (HGH) secretion in adults?
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Which of the following is a characteristic sign of Cushing's disease due to excessive cortisol?
Which of the following is a characteristic sign of Cushing's disease due to excessive cortisol?
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Which condition is characterized by symptoms including amenorrhea, gynecomastia, and decreased libido?
Which condition is characterized by symptoms including amenorrhea, gynecomastia, and decreased libido?
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Why is early ambulation and exercise encouraged post-surgery for hyperpituitarism?
Why is early ambulation and exercise encouraged post-surgery for hyperpituitarism?
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What is a significant cause of acquired hypopituitarism?
What is a significant cause of acquired hypopituitarism?
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A deficiency in growth hormone (HGH) in children can lead to which of the following conditions?
A deficiency in growth hormone (HGH) in children can lead to which of the following conditions?
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Which of the following best describes the symptoms associated with hypopituitarism?
Which of the following best describes the symptoms associated with hypopituitarism?
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If a child has a congenital growth hormone (HGH) deficiency, what is a typical physical manifestation?
If a child has a congenital growth hormone (HGH) deficiency, what is a typical physical manifestation?
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Which of the following is a medical treatment option for hyperpituitarism?
Which of the following is a medical treatment option for hyperpituitarism?
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What is a potential cause of secondary adrenal insufficiency?
What is a potential cause of secondary adrenal insufficiency?
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Which of the following are symptoms commonly associated with Cushing Syndrome?
Which of the following are symptoms commonly associated with Cushing Syndrome?
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How does the body respond to increased temperature and humidity in a pool environment according to the content?
How does the body respond to increased temperature and humidity in a pool environment according to the content?
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What is a treatment approach for secondary adrenal insufficiency?
What is a treatment approach for secondary adrenal insufficiency?
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Which adverse effect is NOT associated with corticosteroid treatment in Cushing Syndrome?
Which adverse effect is NOT associated with corticosteroid treatment in Cushing Syndrome?
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What is a common symptom associated with hyperthyroidism?
What is a common symptom associated with hyperthyroidism?
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Which hormone is primarily deficient in diabetes insipidus?
Which hormone is primarily deficient in diabetes insipidus?
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Which physical therapy implication may be observed in a patient with hypopituitarism?
Which physical therapy implication may be observed in a patient with hypopituitarism?
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What condition is associated with increased secretion of ADH leading to water retention?
What condition is associated with increased secretion of ADH leading to water retention?
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What is one of the main treatments for hyperthyroidism?
What is one of the main treatments for hyperthyroidism?
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Which symptom would NOT typically be associated with gonadotropin deficiency in hypopituitarism?
Which symptom would NOT typically be associated with gonadotropin deficiency in hypopituitarism?
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What hormonal treatment is essential for patients with hypopituitarism?
What hormonal treatment is essential for patients with hypopituitarism?
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What is a potential complication of untreated SIADH?
What is a potential complication of untreated SIADH?
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Which of the following tests is NOT typically performed for hypopituitary disorders?
Which of the following tests is NOT typically performed for hypopituitary disorders?
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What is a common effect of hyperthyroidism on physical performance?
What is a common effect of hyperthyroidism on physical performance?
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What is the primary hormone deficiency observed in hypoparathyroidism?
What is the primary hormone deficiency observed in hypoparathyroidism?
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Which electrolyte imbalance is primarily associated with hypoparathyroidism?
Which electrolyte imbalance is primarily associated with hypoparathyroidism?
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Which of the following is a common diagnosis method for hypoparathyroidism?
Which of the following is a common diagnosis method for hypoparathyroidism?
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What is the most common cause of iatrogenic hypoparathyroidism?
What is the most common cause of iatrogenic hypoparathyroidism?
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In Addison disease, which hormone is primarily deficient that leads to hypotension?
In Addison disease, which hormone is primarily deficient that leads to hypotension?
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What symptom may be observed due to adrenal insufficiency in Addison disease?
What symptom may be observed due to adrenal insufficiency in Addison disease?
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Which of the following treatments is typically necessary for managing Addison disease?
Which of the following treatments is typically necessary for managing Addison disease?
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What is a serious potential complication of untreated Addison disease?
What is a serious potential complication of untreated Addison disease?
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Which of the following effects is associated with the adrenal medulla's secretion of epinephrine?
Which of the following effects is associated with the adrenal medulla's secretion of epinephrine?
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What is a common systemic effect of hypoparathyroidism related to the respiratory system?
What is a common systemic effect of hypoparathyroidism related to the respiratory system?
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Flashcards
Endocrine System
Endocrine System
A group of glands that produce and secrete hormones into the bloodstream. Hormones act as chemical messengers, affecting various bodily functions.
Hormones
Hormones
Chemical messengers produced by glands in the endocrine system. They travel through the bloodstream to target organs and regulate their functions.
Pituitary Gland
Pituitary Gland
A gland located in the brain that secretes hormones that control other glands in the endocrine system. Also plays a role in growth, metabolism, and reproduction.
Parathyroid Glands
Parathyroid Glands
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Adrenal Glands
Adrenal Glands
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Hypothyroidism
Hypothyroidism
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Type I Hypothyroidism
Type I Hypothyroidism
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Type II Hypothyroidism
Type II Hypothyroidism
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Slowed Digestion in Hypothyroidism
Slowed Digestion in Hypothyroidism
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Proximal Hip Weakness in Hypothyroidism
Proximal Hip Weakness in Hypothyroidism
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Myalgia in Hypothyroidism
Myalgia in Hypothyroidism
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Increased Bone Density in Hypothyroidism
Increased Bone Density in Hypothyroidism
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Carpal Tunnel Syndrome in Hypothyroidism
Carpal Tunnel Syndrome in Hypothyroidism
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Central adiposity
Central adiposity
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Insulin resistance
Insulin resistance
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Hypopituitarism
Hypopituitarism
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Amenorrhea
Amenorrhea
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Syndrome of Inappropriate Antidiuretic Hormone Secretion (SIADH)
Syndrome of Inappropriate Antidiuretic Hormone Secretion (SIADH)
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Thyroxine (T4)
Thyroxine (T4)
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Graves Disease
Graves Disease
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Exophthalmos
Exophthalmos
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Periarthritis
Periarthritis
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Antithyroid medication
Antithyroid medication
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Body's response to heat/humidity
Body's response to heat/humidity
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Secondary Adrenal Insufficiency
Secondary Adrenal Insufficiency
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Cushing Syndrome
Cushing Syndrome
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Muscle breakdown in Cushing Syndrome
Muscle breakdown in Cushing Syndrome
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Corticosteroid Side Effects
Corticosteroid Side Effects
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Hypoparathyroidism
Hypoparathyroidism
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Iatrogenic Hypoparathyroidism
Iatrogenic Hypoparathyroidism
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CNS effects of Hypoparathyroidism
CNS effects of Hypoparathyroidism
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Musculoskeletal effects of Hypoparathyroidism
Musculoskeletal effects of Hypoparathyroidism
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Cardiac effects of Hypoparathyroidism
Cardiac effects of Hypoparathyroidism
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Hypoparathyroidism Diagnosis
Hypoparathyroidism Diagnosis
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Emergency Treatment for Tetany
Emergency Treatment for Tetany
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Endocrine Dysfunction
Endocrine Dysfunction
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Hypoparathyroidism Treatment
Hypoparathyroidism Treatment
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Adrenal Cortex
Adrenal Cortex
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Neuroendocrine Response to Stress
Neuroendocrine Response to Stress
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Adrenal Medulla
Adrenal Medulla
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Catecholamines
Catecholamines
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Cortisol
Cortisol
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Anterior Lobe (Adenohypophysis)
Anterior Lobe (Adenohypophysis)
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Posterior Lobe (Neurohypophysis)
Posterior Lobe (Neurohypophysis)
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Pituitary Tumors (Adenomas)
Pituitary Tumors (Adenomas)
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Acromegaly
Acromegaly
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Cushing’s disease
Cushing’s disease
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Prolactin Excess
Prolactin Excess
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HGH Deficiency
HGH Deficiency
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LH/FSH Deficiency
LH/FSH Deficiency
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Study Notes
Endocrine System Overview
- Comprised of numerous glands that synthesize hormones
- Hormones travel through bloodstream to target organs, affecting function
- The endocrine system is responsible for:
- Fetus development (reproductive system and CNS)
- Growth and development (childhood/adolescence)
- Reproductive system coordination
- Maintaining internal environment
- Responding to emergency situations
Primary Function
- Secretion of hormones
Glands
- Pituitary
- Thyroid
- Parathyroid
- Adrenal
- Pancreas
- Pineal
- Thymus
- Ovaries/Testes
Endocrine System Overview
- A diagram displays the location of the major glands in the body.
- The hypothalamus and pituitary gland are central to the endocrine system.
Endocrine Glands: Secretion, Target, and Action
- Information is presented in a table format outlining various glands, their hormones, and their targets, along with the basic actions of those hormones.
Endocrine Dysfunction
- Dysfunction causes alterations in the musculoskeletal system.
- Results from hyperfunction or hypofunction.
Neuroendocrine Response to Stress
- Immune and endocrine systems are intimately related.
- Stress increases activation of the sympathetic nervous system, triggering the adrenal glands to release catecholamines.
- The pituitary gland releases ADH, prolactin, GH, and ACTH.
Neuroendocrine Response to Stress(exercise, emotional stress, changes in body temperature)
- Cortisol, released from the adrenal cortex, regulates proteins, carbohydrates, and lipids to increase blood glucose.
- Inhibits fibroblast proliferation (poor wound healing, increased infection risk).
- Helps with the fight or flight response.
- Reduces inflammation.
Pituitary Gland
- Master gland
- Anterior lobe (Adenohypophysis): Secretes ACTH, TSH, LH, FSH, HGH, Prolactin
- Posterior lobe (Neurohypophysis): Stores ADH and oxytocin
Pituitary Tumors (Adenomas)
- Signs/symptoms include headaches, increased ICP, decreased drainage from the 3rd ventricle.
- Visual disturbances: optic chiasm, bilateral temporal hemianopsia.
- Endocrine abnormalities (can be present)
Anterior Pituitary Gland Disorders
- HGH → acromegaly (adults): Excessive growth (often benign tumor):
- Overgrowth of long bones
- Hypertrophy of soft tissues
- Widened joint spaces (children can grow to >7ft)
- Increased jaw bone, hand/foot size in adults
- ACTH → Cushing's disease: Symptoms include muscle wasting, osteopenia, moon face, easy bruising, abdominal striae, acne, 5:1 women to men, childbearing years, obesity, glucose intolerance.
Prolactin
- High prolactin levels can result in amenorrhea, gynecomastia, lactation, decreased libido, and impotence in both men and women.
HYPERpituitarism Medical/Surgical Treatment
- Benign tumors: surgery and/or radiation.
- Medications to decrease or stunt hormone production.
HYPERpituitarism Physical Therapy Implications
- Ambulation/exercise encouraged 24 hrs post-op.
- Monitor for changes in consciousness/vision, pulse, blood pressure (indicative of increased ICP—report).
- Observe for meningitis symptoms (headache, irritability, neck rigidity).
HYPOPituitarism
- Diminished secretion (>70%) by the anterior lobe.
- Etiology: congenital, surgery/medication/radiation, postpartum hemorrhage, anorexia, anemia, or GI dysfunction.
- Gradual onset of symptoms and signs.
HYPOPituitarism (cont.)
- HGH→decreased growth and delayed puberty
- Impaired cartilage, skeletal bone and muscle growth
- Skin has affected fatty production for energy
- LH (Luteinizing Hormone)/FSH→sexual/reproductive disorders.
HYPOPituitarism – Signs and Symptoms
- Fatigue, muscle weakness, weight loss, poor appetite, joint stiffness, low blood pressure, headaches, erectile dysfunction, irregular menstruation, delayed growth in children.
Congenital HGH Deficiency
- Normal birth length
- Height curve drops by 1-2 years of age
- Normal intelligence, obesity, delayed skeletal maturation, delayed puberty, and shortness.
- HGH replacement therapy (daily or during growth periods)
Acquired HGH Deficiency
- Tumor or treatment for tumor
- ? increased cardiac disease
- Central adiposity
- Insulin resistance
- Poor lipid profile
HYPOPituitary Disease: Gonadotropin deficiency
- Amenorrhea, breast atrophy, testicular atrophy, diminished libido, minimal pubic/axillary hair, hypothermia, hypotension, and hypoglycemia.
HYPOPituitary Disorders: Tests & Measures
- Blood work (cortisol, prolactin, thyroxine TSH, testosterone, estrogen, LH/FSH, HGH)
- MRI of hypothalamus/pituitary
- Radiographs of hands in children
HYPOPituitary Disease Medical Treatment
- Removal of causative factor (surgical tumor removal)
- Lifelong hormone replacement therapy
- Steroids (replace adrenal hormones)
- Synthroid (correct TSH loss)
- Sex hormones
- Growth hormones
HYPOPituitarism – Implications for Physical Therapy
- May observe weakness, fatigue, lethargy, apathy, and orthostatic hypotension.
- Prevent infections.
- Impaired vision (bilateral hemianopia) possible
Posterior Pituitary Lobe Disorders
- Diabetes Insipidus: Rare; caused by damage to hypothalamus or posterior pituitary.
- Antidiuretic hormone (ADH) deficiency → kidneys don't reabsorb enough water.
- Copious diluted urine (dehydration, dizziness, fatigue, polydipsia, etc.)
- Treatment: ADH replacement.
- Syndrome of Inappropriate Antidiuretic Hormone Secretion (SIADH): Increased ADH secretion→ increased water retention (hyponatremia).
- Signs: lethargy, weakness, coma
- Treatment: Correct sodium balance (surgery/chemo/radiation if tumor), restrict fluid intake, diuretics.
Thyroid Gland
- Located inferior to larynx
- Secretes thyroxine (T4) and triiodothyronine (T3), calcitonin
- Regulates basal metabolism, enhances fat, promotes growth and development; regulates electrolyte, protein exchange
Thyroid Disorders
- More prevalent in women 4:1
- Affect many body systems (nails, hair, eyes, GI tract, lungs, heart, nervous tissue, bones, muscles)
HYPERthyroidism
- Graves Disease: Autoimmune disease.
- Enlargement of thyroid and increased secretion.
- Accounts for 85% of hyperthyroidism cases.
- Typically between 20-40 years old; predominantly women (4:1).
- Can occur during pregnancy.
- Symptoms (Hyperthyroidism): Increased thyroid size (goiter), heat intolerance, weight loss, sweating, tremor, tachycardia, irritability, poor concentration, diarrhea, mood swings, exophthalmos (eye protrusion)
- Diagnosis: Decreased/normal TSH, elevated T3/T4, increased radioactive iodine uptake
- Treatment: Medication to inhibit synthesis, radioactive iodine (RAI) treatment (followed by thyroid medication), surgery.
- Hyperthyroidism and Exercise: Associated with exercise intolerance and reduced capacity; proximal muscle weakness. Graves disease muscle weakness/myopathy.
- Can worsen existing heart conditions, leading to atrial fibrillation and worsening angina pectoris, and increasing risk of myocardial infarction.
- MS Signs and Symptoms (Hyperthyroidism): Periarthritis (tendons, ligaments, joint capsule, ROM, pain), Calcification in joints (limited ROM "hard end feel"), proximal muscle weakness, and decreased coordination
HYPOthyroidism
- Decreased thyroid hormones → slow metabolism
- Causes: Autoimmune (Hashimoto's thyroiditis), surgery affecting thyroid, overmedication for hyperthyroidism, diet, congenital
- More prevalent in women (30-60 years)
- Type I (hormone deficient): Caused by loss of thyroid tissue
- Type II (hormone resistant): Result from pituitary gland failure to produce adequate TSH
- Pathology: Thyroid tissue destruction → decreased thyroid hormone secretion → increased TSH secretion from anterior pituitary.
- Symptoms (Hypothyroidism): Slowed metabolism (decreased GI tract mobility, weight gain), bradycardia, slowed neurological functioning (slow speech, decreased short-term memory, headache, cerebellar ataxia, mood changes), increased cholesterol/triglycerides, anemia.
- Musculoskeletal Effects (Hypothyroidism): Proximal hip weakness, myalgia, stiffness in small joints, paresthesia without objective findings, joint edema, increased bone density, carpal tunnel
- Diagnosis: Elevated TSH, normal/low T3/T4, elevated CPK-MB
- Treatment: Synthetic thyroid hormones (Synthroid)
- Prognosis: Untreated hypothyroidism can lead to severe CAD, increased triglycerides/cholesterol.
- Hypothyroidism and Physical Therapy: Correlation with fibromyalgia syndrome (FMS) continues investigation. Thyroid dysfunction commonly seen with rheumatoid arthritis in women. Increased activity/exercise helpful for constipation secondary slowed metabolism/decreased peristalsis.
Thyroid Cancer
- Rare, usually slow-growing
- More prevalent in women (20-60 years old).
- Risk factors include low iodine, radiation exposure.
- Types: Papillary carcinoma (develops in one lobe and spreads to lymph nodes), Follicular carcinoma (spreads to lungs and bones).
- Treatment: Surgery, radioactive iodine, chemotherapy, radiation
Parathyroid Glands
- Two glands on each lobe of thyroid.
- Secrete parathyroid hormone (PTH) to manage calcium levels.
- If blood calcium levels are low, PTH causes the bones to release calcium and/or increase calcium absorption from the GI tract.
HYPERparathyroidism
- Too much PTH is produced, causing hypercalcemia (high calcium levels).
- Causes: Benign tumor in the glands (most common).
- Symptoms (mild hypercalcemia): Thirst, frequent urination, HTN, heartburn, mental confusion, kidney stones, and joint pain
- Secondary HYPERparathyroidism: Caused by low blood calcium levels, stimulating parathyroid glands to produce more PTH; often low vitamin D or kidney disease.
- Diagnosis: PTH measurement, electrolyte measurement, X-ray of bones.
- Treatment: Parathyroidectomy, IV hydration to lower calcium levels.
- Physical Therapy Implications: Early ambulation is essential as weight-bearing speeds up recalcification of bones. Use of light ankle weights or light weight-resistance can accomplish similar results.
HYPOparathyroidism
- Decreased secretion of parathyroid hormone (PTH) results in hypocalcemia (low calcium levels).
- Increased phosphate, tetany (muscle spasms), reduced bone reabsorption.
- Causes: Iatrogenic (most common); accidental removal during surgery (especially thyroidectomy or neck surgery), hypovolemia, infarction of parathyroid, scar tissue, tumor, or low vitamin D.
- Symptoms: Irritable, anxiety, agitation, increased osteoclast activity, spasms (esp. resp. muscle), and dysrhythmias.
- Diagnosis: Electrolyte evaluation, decreased PTH
- Treatment: Emergency IV calcium; Vitamin D supplementation, airway management, medications
- Late results: Potential for cataracts, basal ganglia calcification, and respiratory issues, potentially leading to death.
Adrenal Gland
- Located above each kidney
- Outer cortex:
- Mineralocorticoids (Aldosterone): regulates blood pressure by managing sodium and potassium.
- Reabsorption of sodium
- Excretion of potassium
- Glucocorticoids (Cortisol): metabolism, responses to stress, and reduces inflammation.
- Androgens (sex hormones) (testosterone, estrogen, progesterone)
- Mineralocorticoids (Aldosterone): regulates blood pressure by managing sodium and potassium.
- Inner medulla: Catecholamines (Epinephrine):
- Increased heart rate
- Increased heart contractility
- Increased blood pressure through vasoconstriction
- Increased blood glucose
Adrenal Insufficiency
-
Primary Adrenal Insufficiency (Addison's Disease): Insufficient corticosteroid production.
- Causes: TB complication, autoimmune, radiation, neoplasm, or infections
- Risk factors: Surgery, pregnancy, trauma, infections
- Pathogenesis: Drop in production of aldosterone, poor coordination etc. and of cortisol
- Hypoglycemia: weakness, hypotension, nausea, emotional lability, paranoia
- Increased skin pigmintation on extensor surfaces
- Diagnosis: Cortisol levels
- Treatment: Corticosteroids
- Prognosis: Untreated → fatal
- **Physical Therapy Implications: **Aquatic therapy may be contraindicated; heat/humidity increases cortisol need.
-
**Secondary Adrenal Insufficiency: **Causes: tumors, rapid tapering of corticosteroids, symptoms: arthralgia, myalgia, tendon calcification; treatment: replacement ACTH, manage fluid/electrolyte balance
Cushing Syndrome
- High levels of cortisol.
- Causes: Adrenal gland tumor, high-dose steroid treatments.
- Effects: Loss of amino acids (protein) → stretch marks, decreased wound healing, thin skin, muscle weakness, osteoporosis, fractures, Cushingoid face, increased weight, hair growth, buffalo hump
- **Physical Therapy Implications: **Adverse effects from corticosteroid treatment (sleep/mood changes, GI irritation, hyperglycemia, fluid retention).
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Description
This quiz tests your knowledge on hypothyroidism and the endocrine system. It covers key concepts including causes, effects on the cardiovascular and musculoskeletal systems, and treatment options. Assess your understanding of hormone functions and the role of the endocrine system during fetal development.