Assessment of the Endocrine Sys

Question 1

Hypothalamus - neuroendocrine func - affect glands; act on pit which then acts on something; biggest regulatory gland within sys
Pit - ant and post
Thyroid and parathyroid - neck
Adrenal - top kidneys
Pancreas - diabetes; upper abd
Testes and ovaries

Answer 1

Various glands with the endocrine sys

Question 2

Endocrine glands secretes certain hormones - huge regulatory; helps maintain homeostasis
Secreted hormones are transported via blood to the target tissues: other glands or other target tissues
Whole cycle releasing hormones which act on other things - another gland or tissue
Endocrine system works with the nervous system to control overall body function and regulation including: - affects everything
Endocrine sys and hormones work on - feedback loop; hormonal cycles in sys - feedback

Answer 2

Overview endocrine sys

Question 3

Metabolism
Nutrition
Elimination
Temperature
Fluid and electrolyte balance
Growth
Reproduction

Answer 3

Endocrine system works with the nervous system to control overall body function and regulation including: - affects everything

Question 4

initial stimulating and releases certain hormones that then stimulate ant pit; produces ADH (vasopressin) and oxytocin - catecholomines: stored in post pit;
Corticotropin-releasing hormone: CRH (cause ant pit release ACTH/corticotropin which then acts on adrenal gland), thyrotropin-releasing hormone: TRH (acts on TSH and acts on thyroid to release T3/4), gonadotropin-releasing hormone: GnRH, growthing hormone releasing hormone: GHRH, growth hormone inhibit hormone: somatostatin GHIH, prolactin-inhibity hormone: PIH, melanocyte-inhibiting hormone: MIH hormones act on ant pit to do something

Answer 4

Hypo

Question 5

Adrenocorticotropic hormone: ACTH/corticotropin which then acts on adrenal gland, Thyroid-stimulating hormone: TSH and acts on thyroid to release T3/4, Luteinizing hormone: LH and Follicle-stimulating hormone: FSH work on gonads, prolactin - mammary glands to produce breast milk, growth hormone: GH - abnormalities with ant pit this is one of them and if increased going cause overgrowth bone and soft tissue; melanocyte-stimulating hormone: MSH - production melanin and increase pigment

Answer 5

Ant pit

Question 6

stores from hypo vasopressin (antidiuretic hormone: ADH) and oxytocin

Answer 6

Post pit

Question 7

triiodothyronine: T3, thyroxine: T4, Calcitonin

Answer 7

Thyroid

Question 8

Parathyroid hormone (PTH) - regulates Ca

Answer 8

Parathyroid

Question 9

steroids, glucocorticoids (cortisol), mineralocorticoids (aldosterone)

Answer 9

Adrenal cortex -

Question 10

Catecholamines (epi and nor epi)

Answer 10

Adrenal medulla -

Question 11

estrogen, progesterone

Answer 11

Ovary -

Question 12

testosterone

Answer 12

Testes -

Question 13

insulin, glucagon, somatostatin; endocrine gland and exocrine funcs - digestive enzymes secrete and empty into bowel; islets of Langerhans and 3 diff types cells: alpha - glucagon, beta - insulin (also helps store and metabolize proteins and fats), delta - somatostatin

Answer 13

Pancreas -

Question 14

Target tissue: thryoid
Actions: stimulates synthesis and release of thyroid hormone

Answer 14

TSH -

Question 15

Target tissue: adrenal cortex
Actions: stimulates synthesis and release of corticosteroids and adrenocortical growth

Answer 15

ACTH -

Question 16

Target tissue: ovary, testis; gonads
Actions: stimulates ovulation, progesterone and testosterone secretion

Answer 16

LH; Leydig cell-stimulating hormone in males -

Question 17

Target tissue: ovary, testis; gonads
Actions: stimulates estrogen secretion and follicle maturation; stimulates spermatogenesis

Answer 17

FSH; Sertoli cell-stimulating hormone in males -

Question 18

Target tissue: mammary glands
Actions: breast milk production

Answer 18

PRL -

Question 19

Target tissue: bone and soft tissue
Actions: promotes growth

Answer 19

GH -

Question 20

Target tissue: melanocytes
Actions: promotes pigmentation

Answer 20

MSH -

Question 21

Target tissue: kidney
Actions: promotes water reabsorption - body to hold onto water; retention of fluid/water reabsorption in kidneys

Answer 21

Vasopressin/ADH

Question 22

Target tissue: uterus and mammary glands
Actions: stimulates uterine contractions and ejection of breast milk

Answer 22

Oxytocin

Question 23

Decreased glucose tolerance
Decreased general metabolism
Decreased antidiuretic hormone (ADH) production
Decreased ovarian production of estrogen - older female pats

Answer 23

Endocrine changes with aging

Question 24

Weight becomes greater than ideal - harder keep within norm range
Elevated fasting and random blood glucose levels
Slow wound healing due to higher BG
Frequent yeast infections due to higher BG
Polydipsia due to higher BG; very thirsty
Polyuria due to higher BG; peeing a lot

Answer 24

Decreased glucose tolerance

Question 25

Less tolerant of cold Increased weight gain Decreased appetite Decreased heart rate and blood pressure - VS slowing down

Answer 25

Decreased general metabolism

Question 26

Body cannot reabsorb the fluid, more urine and more dilute; cannot concentrate when fluid intake is low - why older pops at great risk for dehydration - do need to hold onto water not able to because not have as much ADH to tell kidneys that low on fluid keep fluid in Urine is more dilute and may not concentrate when fluid intake is low Patient is at greater risk for dehydration

Answer 26

Decreased antidiuretic hormone (ADH) production

Question 27

Bone density decreases - func estrogen: Ca in bones and bone density up; with less estrogen; likely for bones for leak Ca/get rid Ca Skin is thinner, drier, and at greater risk for injury Perineal and vaginal tissues become lot drier, and the risk for cystitis/bladder infections/UTI increases

Answer 27

Decreased ovarian production of estrogen - older female pats

Question 28

Patient history Physical assessment that could indicate endocrine alterations - notice; all indicate something diff; clues if abnormality Psychosocial assessment Lab assessment Imaging assessment Other diagnostic assessment

Answer 28

Assessment methods

Question 29

Age and gender for baseline Nutritional history Family history and genetic risk - Imp assess Current complaints - health problems

Answer 29

Patient history

Question 30

Abnormalities in endocrine sys see nutritionally wise so if increase wanting drink and peeing lot indicates possibly diabetes; low adrenal func low Na level so Na craving; certain cravings for N/V, abdominal pain, increase or decrease in food or fluid intake, changes in weight - abnormality in GH may have increased weight gain - high levels corticosteroids/steroids and adrenal gland hyperfunctioning causes retention fluid and increase fat deposit which increases weight, dietary deficiencies All types things give clues if having issues

Answer 30

Nutritional history

Question 31

include changes in energy level - thyroid issue, elimination, sexual and reproductive functions - look at if issue with gonadotropins, physical appearance - GH issue

Answer 31

Current complaints - health problems

Question 32

Prominent forehead or jaw - abnormalities in GH Round or puffy face - retention fluid - alterations/high levels adrenal Dull or flat expression Exophthalmos (protruding eyeballs and retracted upper eyelids) - thyroid Vitiligo (patchy areas of pigment loss with increased pigmentation at the edges) - low adrenal func Check the trunk for any abnormalities in chest size and symmetry - adrenal/GH Striae (reddish purple “stretch marks”) - adrenal Hirsutism (excessive growth of body hair) - GH Palpate thyroid to enlargement - goiters/enlargement of thyroid gland imp assessment to

Answer 32

Physical assessment that could indicate endocrine alterations - notice; all indicate something diff; clues if abnormality

Question 33

Abnormalities in hormone can affect stress and anxiety so need to assess that

Answer 33

Psychosocial assessment

Question 34

Assays Provocative/suppression tests Urine tests Tests for glucose

Answer 34

Lab assessment

Question 35

Measures the level of a specific hormone in the blood or other body fluids Often times due blood; also do urine and saliva

Answer 35

Assays

Question 36

Specific to endocrine abnormalities; whole - feedback loop endocrine funcs base release one Provocative tests: give a stimulus for a gland to see if the gland responds; give something that know stimulate gland to work and see if responds and if not something wrong with gland Suppression tests: drugs or substances given that would normally suppress a hormone then lab work done; know have - feedback effect and see how gland responds Have serial blood draws - do baseline level of hormone, give stimulate/suppress, serial blood draws for hormone levels Look at with adrenal func: cortisol stimulating tests - see how adrenal gland reacts when given cortisol

Answer 36

Provocative/suppression tests

Question 37

Typically done by 24 hour urine collection to give a better picture of endocrine function Can test for hormone levels but vary in course day in what going on in body so typ do 24 hour urines because better pic of endocrine gland checking

Answer 37

Urine tests

Question 38

Tests for the function of the islet cells of the pancreas (beta) Ex. fasting glucose (short term glucose), glucose tolerance test (short term glucose), glycosylated hemoglobin (HgA1C - long term picture)

Answer 38

Tests for glucose

Question 39

X-rays: MRI: CT: Ultrasound:

Answer 39

Imaging assessment

Question 40

evaluate bony pocket where pituitary gland rests; pit gland sitting in base skull and looking at that

Answer 40

X-rays:

Question 41

best method to evaluate pituitary gland; typ for pit gland

Answer 41

MRI:

Question 42

evaluate adrenal glands, ovaries and pancreas

Answer 42

CT:

Question 43

evaluate thyroid (often), parathyroid (often), ovaries and testes

Answer 43

Ultrasound:

Question 44

Needle biopsy for thyroid nodules - done quite often esp if concerned about cancers

Answer 44

Other diagnostic assessment