1.6.15 - Endocrine Cases

Question 1

addisons disease

Answer 1

adrenal insufficiency

Question 2

tests is suspect adrenal insufficiency

Answer 2

basal plasma cortisol

ACTH level

Question 3

low cortisol and high ACTH

Answer 3

addisons

normal or low cortisol - adrenal fatigue - subclinical addisons

Question 4

ACTH stimulation test

Answer 4

cosyntropin IV and measure preinjection

30 and 60 minute cortisol

don’t rise - addisons

Question 5

5 S’s

Answer 5

for adrenal insufficiency

-salt, sugar, steroids, support, search

Question 6

arterial supply to adrenal gland

Answer 6

superior, middle, inferior suprarenal arteries

Question 7

venous drainage of adrenal glands

Answer 7

suprarenal veins

Question 8

lymphatic drainage of adrenals

Answer 8

para-aortic nodes

driven by motion of resp diaphragm**

to thoracic inlet back to heart

Question 9

autonomics for adrenal

Answer 9

T8-T10

Question 10

SD for adrenals

Answer 10

flexed segment - T/L junction

Question 11

OPP for adrenals

Answer 11

lympatics - resp diaphragm

sympathetics T6-L2

PS - OA, AA, C2, temporal, occiput

cranial

ventral abdominal release

fascial restriction of adrenal

champmans

Question 12

anterior chapmans for adrenals

Answer 12

2-2.5 inches above and 1 inch lateral to umbilicus

Question 13

posterior chapmans for adrenals

Answer 13

intertransverse space between T11 and T12 bilaterally

Question 14

sympathetics to adrenals

Answer 14

T6-L2

Question 15

labs for hypothyroid

Answer 15

TSH, T4, and T3

Question 16

TSH increase

T4 decrease

Answer 16

primary hypothyroid

Question 17

TSH decrease

T4 decrease

Answer 17

central hypothyroid

Question 18

TSH elevated

T4 normal

Answer 18

subclinical hypothyroid

Question 19

arterial to thyroid

Answer 19

superior and inferior thyroid arteries

Question 20

levothyroxine

Answer 20

T4

tx of hypoT

Question 21

repeat TSH

Answer 21

every 6 weeks until thyroid function stabilized

Question 22

venous drainage thyroid

Answer 22

superior, middle, inferior thyroid veins

Question 23

thyroid lymph drainage

Answer 23

prelaryngeal, pretracheal, paratracheal nodes

motion of respiratory diaphragm**

to thoracic inlet to heart

Question 24

symapthetics to thyroid

Answer 24

T1
contributions from superior, middle, and inferior cervical ganglia - 1st rib

sympathetics are vasomotor

Question 25

OPP for thyroid

Answer 25

lymphatics sympathetics - T1 - flexed - compensatory extensions T3-4 cervical spine cranial - hypothalamic pituitary axis

Question 26

elevated 1st rib

Answer 26

thyroid dysfunction inferior cervical ganglion

Question 27

anterior chapmans reflex thyroid

Answer 27

ICS between 2 and 3 rib close to sternum bilaterally

Question 28

posterior chapmans reflex thyroid

Answer 28

over transverse T2

Question 29

sympathetics to thyroid

Answer 29

vasomotor

Question 30

metabolic syndrome

Answer 30

constellation of altered function -abdominal obesity, dyslipidemia, HTN, insulin resistance path of thyroid, adrenal, pancreas, liver, kidney

Question 31

aterial to pancreas

Answer 31

superior and inferior pancreaticoduodenal arteries

Question 32

venous from pancreas

Answer 32

superior and inferior pancreaticoduodenal veins | -portal system

Question 33

lymph pancreas

Answer 33

pancreaticosplenic and preaortic nodes

Question 34

sympathetics to adrenals

Answer 34

vasomotor also - stimulation causes E and NE secretion

Question 35

sympathetics to pancreas

Answer 35

T6-9 vasomotor

Question 36

PS to pancras

Answer 36

vagus | -secretomotor

Question 37

PS stimulation of pancreas

Answer 37

insulin, bicarb, somatostatin, glucagon release

Question 38

liver function

Answer 38

metabolize, detoxify, inactivate substances store - carbs, lipids, vit, min activate hormones - T4 to T3 synthesize albumin, glucose, cholesterol, phospholipids

Question 39

arterial to liver

Answer 39

hepatic artery

Question 40

venous liver

Answer 40

portal system | -hepatic vein

Question 41

lymph liver

Answer 41

nodes above and below diaphragm

Question 42

liver sympathetics

Answer 42

T6-9 stimulate breakdown of glycogen to glucose

Question 43

PS to liver

Answer 43

vagus | -decrease glycogen breakdown

Question 44

arterial to kidney

Answer 44

renal arteries

Question 45

kidney venous

Answer 45

renal veins

Question 46

lymph kidney

Answer 46

renal vein to drain toward lateral aortic nodes

Question 47

sympathetics for kidney

Answer 47

T10-L1 vasomotor

Question 48

flexed segment at TL junction

Answer 48

kidney SD

Question 49

sympathetics to kidney effects

Answer 49

vasoconstriction Na reabsorption prox tub renin secretion increased fluid retention and increased BP

Question 50

OPP for kidney

Answer 50

lymph autonomics myofacial/osseous restrictions in area chapmans