Ch. 8 PPT The Endocrine and Metabolic Systems Student Copy

Page 1: Introduction

• Title: The Endocrine and Metabolic Systems

• Instructor: Mrs. Giomara McBee, PTA, MS, BS from Keiser University

Page 2: Objectives

• Describe interconnected nature of the endocrine system

• Identify primary and secondary endocrine disorders, hormonal imbalances, and red flags for physical therapists

• Understand etiology, treatment, and prognosis of diabetes mellitus types 1 and 2

• Recognize role of physical therapy for patients with diabetes mellitus

• Explain importance of fluid and electrolyte balance in metabolism

• Describe signs and symptoms of common endocrine and metabolic diseases

Page 3: Medical Terminology Ch. 11 (Endocrine)

• Acronyms:

  • Acr/o: Extremities

  • Aden/o: Gland

  • Calc/o: Calcium

  • Cortic/o: Outer layer

  • Crin/o: To secrete

  • Gluc/o: Glucose

  • Glyc/o: Sugar

  • Kal/I: Potassium

  • Natr/o: Sodium

  • Ophthalm/o: Eye

Page 4: Signs & Symptoms

• Exophthalmos:

  • Definition: Condition where the eyes protrude (e.g., in Graves' disease)

• Glycosuria: High glucose excreted in urine

• Polydipsia: Excessive thirst

• Hypercalcemia: High calcium levels in blood

• Hyperglycemia: High glucose levels in blood

• Hyperkalemia: High levels of potassium in blood

• Hypocalcemia: Low calcium levels in blood

• Hyponatremia: Low sodium levels in blood

Page 5: Endocrine System Overview

• Secretes hormones directly into the bloodstream

• Maintains homeostasis, which helps organisms adapt for survival

• Coordinates male and female reproductive systems

• Regulates optimal internal environment through life span

• Initiates adaptive responses to emergencies

• Influences reproductive and CNS differentiation in the fetus

• Stimulates growth and development during childhood

Page 6: Catecholamines

• Organic compounds involved in stress response

• Functions include:

  • Breaking down molecules (glycolysis)

  • Increasing heart muscle contraction, cardiac output, blood pressure, and blood glucose levels

  • Enhancing lipid breakdown

• Stressors leading to catecholamine release: exercise, thermal changes, emotional stress

• Related hormones: Adrenaline, Cortisol, Glucagon

Page 7: Metabolism: Anabolism & Catabolism

• Catabolism:

  • Breaks down complex molecules, releasing energy

  • Examples: Glycolysis, digestion of proteins into amino acids

• Anabolism:

  • Builds molecules necessary for bodily function, consuming energy

  • Examples: Bone development, muscle hypertrophy, lipogenesis, gluconeogenesis

Page 8: Controlling Metabolic Rate

• Diet: high-quality proteins, fats, carbohydrates, avoid processed foods

• Habits:

  • Limit alcohol, avoid smoking/substances

  • Regular sleep (minimum 7 hours), stress relief strategies

  • Stay hydrated and exercise regularly

• Uncontrollable factors: age, gender, genetics

Page 9: Anabolic vs. Catabolic Workouts

• Anabolic (Strength) Workouts:

  • Examples: Weight lifting, push-ups, squats

  • Initiates muscle repair and strengthening

• Catabolic (Endurance) Workouts:

  • Examples: Running, swimming, biking

  • Higher demand for oxygen and energy, burns glucose and fat

Page 10: Stress

• Display of stress management and session acknowledgment

Page 11: Hypothalamus Functions

• Primary visceral control of homeostasis

• Controls:

  • Blood pressure, heart rate, pupillary response

  • Emotional responses (pleasure, fear, rage, and sex drive)

  • Body temperature regulation

  • Food intake and hunger satisfaction

  • Water balance and thirst through ADH action

  • Sleep-wake cycle with light/dark stimuli

Page 12: Pituitary Gland Functions

• Anterior Pituitary Gland:

  • Hormones: Prolactin, Growth Hormone (HGH), TSH, Luteinizing Hormone, FSH, ACTH, MSH

• Posterior Pituitary Gland:

  • Hormones: Oxytocin, ADH (controls kidney tubule permeability to conserve water)

Page 13: Pituitary Hormone Targets

• Growth Hormone: Targets bones, muscles, organs

• Follicle-stimulating Hormone: Targets ovaries & testes

• Luteinizing Hormone: Targets ovaries & testes

• TSH: Targets thyroid gland

• ACTH: Targets adrenal cortex

• Prolactin: Targets mammary glands

• Oxytocin: Targets uterus & mammary glands

• Antidiuretic Hormone (ADH): Targets kidneys

Page 14: Thyroid and Parathyroid Functions

• Thyroid:

  • Regulates metabolic rate, protein synthesis

  • Releases T3 (triiodothyronine) and T4 (thyroxine)

  • Calcitonin lower calcium levels in blood

• Parathyroid:

  • Raises calcium levels via PTH, absorbs calcium through kidneys and GI tract

Page 15: Thyroid and Parathyroid Hormones

• Thyroid Hormones:

  • T4 & T3: Normal development and cellular metabolism

  • Calcitonin: Regulated by hypercalcemia for calcium storage

• Parathyroid Hormone (PTH):

  • Increases blood calcium in response to hypocalcemia

Page 16: Adrenal Gland

• Location: Above each kidney (outer cortex & inner medulla)

• Functions:

  • Produces corticosteroids for bodily functions, stress response, and electrolyte balance

  • Medulla produces epinephrine for increased heart rate and blood pressure during stress

Page 17: Adrenal Hormones and Functions

• Adrenal Cortex:

  • Androgens: Increases masculinity in ovaries and testes

  • Aldosterone: Sodium reabsorption in kidneys, potassium excretion

  • Cortisol: Influences metabolism, suppresses inflammation

• Adrenal Medulla:

  • Epinephrine: Increases heart rate, blood pressure

  • Norepinephrine: Causes vasoconstriction in various tissues

Page 18: Pancreas Functions

• Secretes insulin and glucagon, as well as digestive enzymes

• Contains Islets of Langerhans:

  • Alpha cells: Produce glucagon to increase blood sugar levels

  • Beta cells: Produce insulin to decrease blood sugar levels

Page 19: Pancreas Hormones and Regulation

• Glucagon:

  • Target: Liver

  • Function: Increases blood glucose via glycogen breakdown

  • Regulation: By hypoglycemia

• Insulin:

  • Target: All body systems

  • Function: Decreases blood glucose, aids in fat, protein, carbohydrate storage

  • Regulation: By hyperglycemia

Page 20: Endocrine Gland Dysfunction

• Hypopituitarism:

  • Decreased hormone secretion from anterior pituitary

  • Associated disorders: Dwarfism, delayed growth/puberty

  • Treatment: Hormonal replacement therapy

• Hyperpituitarism:

  • Excess hormonal secretion

  • Disorders: Gigantism, hirsutism

  • Treatment: Surgery, radiation, hormone suppression

Page 21: Hyperthyroidism: Graves’ Disease

• Excessive thyroid hormone secretion, mostly due to autoimmune disease

• Symptoms:

  • Tachycardia, increased metabolism leading to weight loss, nervousness

  • Negative nitrogen balance and nutritional deficiencies

Page 22: Hyperthyroidism Clinical Manifestations

• Enlargement of thyroid (goiter), heat intolerance, weight loss despite increased appetite

• Additional symptoms: excessive sweating, diarrhea, tremors, palpitations, dyspnea, exophthalmos

Page 23: Goiter

• Enlargement of thyroid gland due to iodine deficiency or inflammation

• Symptoms:

  • Neck swelling, breathing difficulties, dysphagia

• Treatment: Antithyroid medications, surgery, effective in most cases

Page 24: Hypothyroidism

• Deficiency in thyroid hormone causing decreased metabolism

• Symptoms: Weight gain, cold intolerance, fatigue

• Causes: Hashimoto's thyroiditis

• Treatment: Oral thyroid hormone replacement therapy

Page 25: Pathologies of Thyroid Gland

• Hypothyroidism:

  • Symptoms: Depression, fatigue, weight gain

  • Neuromuscular issues: Muscle weakness, paresthesia

• Hyperthyroidism:

  • Symptoms: Tremors, tachycardia, increased appetite, weight loss, insomnia

Page 26: Hyperparathyroidism

• Excessive PTH leading to calcium/phosphate/bone metabolism disruption

• Risks: Osteoporosis, fractures, kidney damage

• Treatment: Diuretics, medications, surgical removal if necessary

• PTA Implications: Minimize injury risk, adjust environments for safety

Page 27: Hypoparathyroidism

• Decreased PTH leading to low calcium, high phosphate

• Symptoms: Muscle spasms, tetany

• Treatment: Intravenous calcium for rapid serum elevation

Page 28: Pathologies of Parathyroid Gland

• Hypoparathyroidism:

  • Decreased bone resorption, hypocalcemia

  • Compromised breathing and potential arrhythmias

• Hyperparathyroidism:

  • Increased bone resorption, risks of fractures and renal damage

Page 29: Diabetes Mellitus Overview

• Chronic disorder marked by hyperglycemia, affects metabolism of carbs, fats, proteins

• Normal Blood Sugar Levels:

  • Fasting: <100 mg/dL

  • 2 hours after eating: <140 mg/dL

• Diabetes Diagnosis:

  • Fasting: >125 mg/dL

  • 2 hours post-meal: >200 mg/dL

Page 30: Type 1 Diabetes Mellitus

• Lack of insulin production by pancreas, often diagnosed in childhood

• Causes: Autoimmune destruction of beta cells

• Treatment: Exogenous insulin, nutritional management, possible insulin pump use

Page 31: Type 2 Diabetes Mellitus

• Common in those over 45; increasing incidence in children due to obesity

• Etiology: Insulin resistance and inadequate secretion

• Management: Diet, exercise, oral medications

Page 32: Diabetes Mellitus Types Characteristics

• Type 1 DM:

  • Abrupt onset, generally <25 years old, very little or no insulin

• Type 2 DM:

  • Gradual onset, generally >45 years old, variable insulin production

Page 33: Cardinal Signs of DM at Diagnosis

• Polyuria, polydipsia, polyphagia, blurred vision, glucosuria

Page 34: Complications of DM

• Atherosclerosis: due to chronic hyperglycemia

• Nephropathy: kidney damage from high glucose levels

• Charcot’s foot: risk due to peripheral neuropathy

Page 35: Musculoskeletal Problems

• Increased incidence of conditions such as carpal tunnel syndrome and Dupuytren’s contracture among DM patients

• Ulceration risks due to sensory loss

Page 36: Special Implications for PTA

• Ketoacidosis:

  • Results from insulin insufficiency; signs include ketone breath, dehydration

• Hypoglycemia:

  • Signs: Sweating, headache, shakiness; treatment with sugary drinks or candy

Page 37: Addison’s Disease

• Primary adrenal insufficiency: decreased cortisol and aldosterone production

• Symptoms: Weakness, low blood pressure, weight loss, increased pigmentation

• Treatment: Fluids, electrolytes, cortisol

Page 38: Cushing’s Syndrome

• Overactivity of the adrenal gland causing excess cortisol

• Symptoms: Hyperglycemia, obesity (“moon face”), mental changes

• Treatment: Variances, including radiation and glucocorticoids

Page 39: Pancreatic Cancer

• Extremely high mortality; can metastasize widely

• Risk factors: Tobacco, age

• Symptoms: Weight loss, jaundice

• Treatment focuses on symptom relief

Page 40: References

• Goodman's "Pathology for the Physical Therapist Assistant"

• Fremgen's "Medical Terminology: A Living Language"

• Giles' "PTA Exam: The Complete Study Guide"