1
Q
“Homeostasis is the ability to respond and maintain stability __________ and _______ during rapid changes of conditions in the ______ and _________ environment” by Walter ________.
A
physiologically, psychologically, internal, and external
2
Q
_______ _________ is used to combat changes in homeostasis
A
Negative Feedback
3
Q
________ feedback is like a thermostat. It has a set point and it goes on and _____
A
negative, off
4
Q
__________ feedback is like childbearing, it has stronger and _________ contractions
Another example could be the AC in the car because it ______.
A
positive, stronger
blasts
5
Q
Negative Feedback in Blood Glucose
- Candy bar (_______)
- ___ cells in the pancreas are the ______.
- Insulin _____ to decrease the _____
- Continuation means _______ in glucose
- Glucose sensor ___ cells recognize decrease and start the process over.
A
- Glucose
- Beta, Sensor
- Increase, glucose
- decrease
- Beta
6
Q
Examples of physical stress
A
bacteria, surgery, growth
7
Q
“State manifested by symptoms that arise from coordinated activation at neuroendocrine and immune systems”
A
Stress, by H Selye
8
Q
Which systems affect acute stress?
A
nervous, immune system and hormones
9
Q
________ detects stress and can go 1 of 3 ways .
A
Hypothalamus
10
Q
Hypothalamus detects stress and directs it to the brain stem, then the ____ ______ detects stress
A
Locus Coeruleus
11
Q
Hypothalamus detects stress and directs it to the brain stem, then ____ is activated, producing ___, turning on the ___ nervous systems
A
LC, NE, autonomic
12
Q
the Hypothalamus detects stress and directs it to the brain stem, then that is the ______ system
A
Sympathetic nervous
13
Q
From the Locus Coeruleus, there is a release of ___________ that activates the _____ nervous system, beginnings _____ or _____
A
neurepinephrine, autonomic, flight, fight
14
Q
From the pituitary gland comes ______ which activates the _______ gland
A
ACTH (Adrenocorticotropic hormone), adrenal
15
Q
Once the adrenal gland is activated, the _____ cortex of the pituitary gland releases ______, a stress hormone that gives energy
A
outer, cortisol
16
Q
Once the adrenal gland is activated, the ____/medulla releases _______/_____ to balance energy.
A
Inner, epinephrine, norepinephrine
17
Q
Cortisol stops releasing when the stress is _____ _____.
A
over came
18
Q
The ______ stress system is an example of negative feedback
A
pituitary
19
Q
The RAS causes ______ and muscle _____.
A
Arousal, tension
20
Q
The Locus Courelius and the pituitary gland respond as apart of the ________ system
A
limbic
21
Q
___________ is the ability to respond to challenges of physical or psychological homeostasis and return to a balanced state.
A
adaptation
22
Q
A. R. E.
A
Alarm, Resistance, Exhaustion/recovery
23
Q
Alarm
A
Sympathetic nervous system response
24
Q
Resistance
A
Fight against
25
Exhaustion/ Recovery
disease/chronic disease/ healing
26
stressor-> ______->release of epinephrine/norepinephrine->_____->exhaustion/recovery
alarm, resistance
27
Ex. of endogenous stress
genetic depression
28
Ex. of exogenous stress
temperature, finances
29
Eustress
mild controlled stress
30
Distress
severe uncontrolled stress
31
Locus Coeruleus is Located in the ______ ______.
Has neurons that produce __________________
Central Integrating Site for ____ response for to
stress
The LC-NE system has _____ pathways to
the _______, the _____ system, the ________, and _____ ______.
brain stem,
neurepinephrine,
ANS,
afferent,
hypothalamus, the limbic system, the
hippocampus, and cerebral cortex
32
breakdown of glucose
_____ excess stored
glucagon ____ takes it out when in need of it
________ breaks it down into glycogen or glucose
__________ is the formation of glucose in non carb form
glycogen, hormone, glycogenolysis, gluconeogenesis
33
_______ is the balance of heat gain and loss to maintain normal core body temperature
thermoregulation
34
____________ is the thermal control center
hypothalamus
35
the hypothalamus receives temperature from peripheral ________________ in the body to bring the body temperature back to normal
thermoreceptors
36
How to maintain an accurate core body temperature
- rectal temperature
- esophagus
- pulmonary artery catheter
- urinary catheter temperature
37
How to maintain an accurate body surface temperature
- oral
- axillary
- tympanic
38
Core body temperature
97-99.5 degrees Fahrenheit
39
Temperature changes during ___ hours, and after female ______
24, ovulation
40
Exercise or the ______ change temperature
environment
41
Sweat or _____ change body temperature
shiver
42
vasoconstriction symptoms
shiver, increase temperature
43
vasodialation symptoms
sweat, decrease temperature
44
Heat is produced from _________ tissue and insulated by ____.
muscle, fat
45
Change in temperature adjust by being picked up by the ____ and alerts the ____ and _____.
thalamus, CNS, PNS
46
_________ binds blood flow to the core
vasoconstrictions
47
________ muscles contract to keep blood inside
pilomotor
48
______ keeps temperature to the core
huddling
49
______ produces heat from the muscles
shivering
50
_________ release produces metabolic hear
epinephrine
51
the ______ produces long term heat (survival situation)
thyorid
52
__________ moves heat from the core to the peripheral
vasodilation
53
apart of vasodialation is ________ which evaporates heat
sweat
54
metabolism is the ____ _______ production for heat
main, hormonal
55
Heat loss happens where
at the skins surface
56
____ is the lose of heat through air
radiation
57
radiation happens when the environment around is ___ than the internal temperature
cooler
58
_______ coming in contact with an object cooler than body core temperature
conduction
59
______ like a draft causing cool air
convection
60
_______ is water on skin converting into water vapor
evaporation
61
Fever aka ____ is elevation in body temperature
Pyrexia
62
Pyrexia is caused by ____
Pyrogen
63
exogenous example of external cause of fever is _____
, bacteria
64
______ example internal cause of fever is bacteria getting into ____
endogenous, tissue
65
Once bacteria gets into tissue and causes fever, a _______ _______ is released and produces a ______ causing the ______ to move the core body temp up, causing a fever and down, causing shivering.
pyrogenic cytokine, prostaglandin, hypothalamus
66
_______ fever returns to normal once every 24 hours
intermittent
67
______ temperature doesn't go back to normal but varies a degree or two in either direction
remittant
68
_______/______ temp is above normal very little variation
sustained/continuous
69
________ one or more episodes of fever lasting days with one or more days of normal temperature between episodes
recurrent
70
Prodome
head ache fatigue and malaise and pain
71
chills
uncomfortable shaking
72
flush
cutaneous vasodilation and headaches
73
defervescence
initiation of sweating
74
fever in older people causes
confusion
75
fever can cause
anorexia, malaria, arthralgia, and fatigue
76
Glucose is ______
energy
77
_________ is stored excess in the liver and muscles
glycogen
78
________ is a hormone from the pancreas that brings glycogen out of storage
glucagon
79
_________ breaks down glycogen into glucose to use it for energy
glycogenolysis
80
__________ is a new production of glucose using fats, amino acids, and protein to get glucose
gluconeogenesis
81
_______ is in the adrenal, in side the medulla. It is epinephrine and norepinephrine
Catecholamine
82
_____ stimulate alpha 1 and 2, and beta 1 and 2
catecholamines
83
The SNS triggers which alpha/beta receptor______ which increases glycogenolysis, smooth muscle contraction in the blood vessels and causes hypertension
Alpha 1
84
________ causes renin release, hypertension, and holding onto water
Alpha 2
85
Which alpha/beta receptor______ causes lipolysis, fat break down, increased heart rate, and increased heart contraction
Beta 1
86
Which alpha/beta receptor______ increases hepatic glucogenesis, glycogenolysis, and bronchodialation
Beta 2
87
when stressed, the GI, GU, and immune system get paused by ________
cortisol
88
the SNS response to stress goes to the ________ ____
brain stem
89
The endocrine system response goes to the _____ ______
pituitary gland
90
the third stress response of the body goes to the _______
muscles
91
cortisol comes form the ______ of the ____ _______
cortex, adrenal, gland
92
Cortisol promotes:
glycogenesis in the liver
93
cortisol suppreses:
the immune sysem
94
Cortisol allows _______ availability
glucose
95
Cortisol causes _____ in limbs
lipolysis
96
Cortisol makes adipose deposits around the _____ _______ and ________
face, neck, and abdomin
97
Endocrine stress response begins in the ________, and then ____ is released, and stimulates the ________ gland, which releases ______ and stimulates the ______ ______, and then _____ is secreted.
hypothalamus, CRF, Pituitary, ATCH, adrenal cortex, cortisol
98
Factors impacting ability to adapt to stress
- age
- time
- health status
- nutrition
- sleep/wake cycle
- psychosocial factors
- coping mechanisms
- genetics
99
______ means having a sense of control of your environment and understanding purpose in life to better deal with stress
Hardiness
100
Pathophysiological changes due to effect of chronic stress are:
- physical signs
- psychological
- increase cortisol
101
_______ is a chronic activation of a stress response from experiencing a life threatening event
PTSD
102
Example of a catastrophic event causing PTSD
Weather, crashes, terrorists, rape, or abuse
103
Symptoms of PTSD
Intrusion, avoidance, and hyper arousal
104
______ of PTSD is flash back, nightmares, and terror
intrusion
105
_______ of PTSD is emotionally numb, survivor's guilt
avoidance
106
__________ of PTSD is anger, irritability, and depression
hyperarousal
107
Nonpharmalogical ways to relieve stress
- debriefing
- counseling
- relaxation
- massage
- music therapy
- biofeedback
- imagery
- other
108
_______ are chemical messengers
Hormones
109
Hormones affect
- growth development
- sex differentiation
- metabolism
- adapting to environment
110
_______ means hormones flow through the blood
endocrine
111
______ means hormones incite local effects
paracrine/autocrine
112
Some receptors are on the surface and thus need a _________ messenger to help act
second
113
A single hormone can exert various effects in different tissues (T/F)
True
114
A single function can be regulated by one hormone (T/F)
False, several hormones
115
Some hormones are produced at _____
night
116
Some hormones are ______
cyclical
117
Some hormones act slower because they have to _______ to a protein
bind
118
Some hormones break down ______ than others
quicker
119
Hormones have lots of _____ feedback
negative
120
Peptides and ______ come together to form larger proteins and hormones
proteins
121
Steroids are cholesterol based. an example is _______
cortisol
122
Paracrine means
near by
123
Endocrine means
to travel
124
Autocrine means
Beta cell releasing endocrine, acting on self.
125
The ________ binds with a receptor to bring about a biological event
agonist
126
The _______ blocks the activity of the agonist and does so by binding with a receptor
antagonist
127
The _____ and _______ system control physiological processes
nervous and endocrine
128
the hypothalamus links the ____ to the endocrine system
SNS
129
If you have stress, a cold, or fatigue, the __________ picks up on it
The _______ releasing hormone activates the _____ _______
_____ _______ hormone is released
activating the _______ gland to produce T3 and T4 and releases it to the target organs
hypothalamus
Thyrotropin releasing hormone, anterior pituitary
thyroid stimulating hormone
Thyroid gland
130
Oxytocin and ADH are transported through axons to the ______ _______ and into the blood stream
posterior pituitary
131
______ raises blood pressure
renin
132
The ______ pituitary is glandular, while the _______ pituitary is nervous
anterior, posterior
133
The thyroid releases releasing hormones through ______ vessels, then to the hypothalamus then to the ______ pituitary then to the target organs
portal, anterior
134
If a disorder originates in the target Gland (thyroid, liver, adrenal) it is a ____ Disorder
Primary
135
If the target gland is normal, but the disorder stems from the stimulating hormone/releasing factors from pituitary gland, it is a _______Disorder
Secondary
136
If the hypothalamus is causing the disorder, it is a ______ Disorder
tertiary
137
_________/_______ are catecholamines
norepinephrine, and epinephrine
138
________ is a glucocorticoid
cortisol
139
_________ is a mineralocorticoid
aldosterone
140
______ causes the shift from angiotensin I into angiotensin II, causing the release of aldosterone
renin
141
Cortisol converts glucose into
energy
142
When aldosterone is released, ______ and ______ increase
Sodium and water
143
Sugar is a
glucocorticoid
144
Salt is a
mineralocorticoid
145
Sex is an
androgen
146
_________ _______ ________ is insufficient production of the target organ ADRENAL gland
Primary Adrenal Insufficiency
147
________ Disease is the immune system attacking itself
Addison's
148
The problem in Primary Adrenal Insufficiency is a _______ cortical hormone and ACTH is too _____ to make up for the decrease in cortisol
decrease, high
149
Signs/symptoms of Primary Adrenal Insufficiency are
Anorexia, weight loss, fatigue, nausea, diarrhea, arthalgia, abdominal pain, hyperkalemia, and hyponatremia
150
in Primary Adrenal Insufficiency the low cortisol leads to _____ glucose to hypoglycemia to _____ aldosterone and then to low ______ and _____ levels and high K+
low, low, Na+ and H2O
(decrease in cortisol leads to decrease in hormones)
151
Treatment for Primary Adrenal Insufficiency
History and Physical
Hormone treatment
monitor electrolytes
monitor meals + activity
152
______ _______ ______ Is the pituitary not getting signal to adrenal gland sufficiently
Secondary Adrenal Insufficiency
153
Causes of Secondary Adrenal Gland insuffiencey
Hypopituitarism and rapid withdrawal from glucocorticoids
154
Problems in Secondary Adrenal Gland insufficiency
no releasing factor from the pituitary
155
_______ ______ _____ Is life threatening, the combination of Addison's disease AND stress, and it is an adrenal gland problem.
Acute Adrenal Crisis
156
Symptoms of Acute Adrenal Crisis
weakness, hypertension, dehydration, vascular collapse
157
Treatment for Acute Adrenal Crisis
salt replacement
sugar replacement
steroid replacement
support of physiological function
search for/treat underlying condition
monitor electrolytes + physical conditions
158
_______ _______ is linked to hypercortisolism (excess glucocorticoid)
Cushing's syndrome
159
Cushing's syndrome symptoms
moon face
buffalo hump
excess sex hormones
altered fat metabolism
altered glucose metabolism
increased facial hair
thinning scalp hair
160
Cushing's syndrome diagnoses
24 hour cortisol excretion in urine
ATCH level
MRI/CT of head
161
Treatment for Cushing's syndrome
Block steroids with Ketoconazole
radiation to tumor
help immune system before hand (prophylaxis)
Monitor electrolytes + physical findings
162
Growth hormone comes from the _____ ________
anterior pituitary
163
GH is necessary for growth in
children
164
GH increases ____ size
cell
165
GH is responsible for ___ ______ transport across the cell membrane
amino acid
166
GH controls the rate at which a cell uses ___ ______
fatty acids
167
GH causes a _____ of using carbs
decrease
168
a lack of GH in adults causes
hypopituitarism
169
an excess of GH in adults causes
acromegaly (overgrowth in cartilage, small bones keep growing, enlarged tongue, sleep apnea)
170
Treatment for GH dysfunction
correct metabolism
reduce mass
watch for physical changes
171
Thyroid gland is responsible for the
metabolism
172
The thyroid gland produces ___ and ____ made from iodine and salt
T3 (increases metabolism) and T4
173
Physiological effects of the thyroid gland
metabolic
cardiovascular
gastrointestinal
neuromuscular
infant brain development
174
Hypothyroidism indicates a ____- metabolism
low
175
Hypothyroidism symptoms
cold
hair loss
dry skin
brittle nails
fatigue
slow mental process
anorexia + weight gain
constipation
bradycardia
176
Congenital means
at birth
177
Congenital Hypothyroidism leads to _____ disabilities
intellectual
178
Diagnoses of congenital hypothyroidism is ____ amounts of T3 and T4 meaning high
TRH
179
Treatment of Congenital Hypothyroidism
Synthetic hormone treatment, monitor growth and development,
monitor thyroid levels
180
Primary Hypothyroidism is caused by
thyroid destruction
thyroidectomy
meds consumption/iodine
181
Secondary Hypothyroidism is caused by
impaired pituitary function
182
Tertiary Hypothyroidism is caused by
impaired hypothalamus function
183
Hashimoto's Thyroiditis is an ________ Disorder
autoimmune
184
Hashimoto's Thyroiditis symptoms
BMR
mental sluggish
brachycardia
Dry skin
weight gain
cold intolerance
185
Treatment for Hashimoto's Thyroiditis
physical and TH exam
186
Myxedematous Coma is caused by the
worsening of hypothyroidism
187
Myxedematous Coma can be
life threatening
cause cardio vascular collapse
hypoventilation and hypothermia
188
Myxedematous Coma causes three things...
1. CO2 retention
2. electrolitic
3. Hypothermia
189
Myxedematous Coma treatment
electrolyte correction
ventilation support
correct hypothermia
correct thyroid imbalance
monitor VS
190
Symptoms of hyperthyroidism
intolerance to heat
extreme weight loss
muscle wasting
diarrhea
tachycardia
BP increase
facial flushing, bulging eyes
tremors
191
Thyrotoxicosis is the
hyperactivity of a gland
192
symptoms of Thyrotoxicosis are
increase in BMR
tachycardia
hot
thin + silky hair and skin
restless/anxiety
exophthalmos (bulging eyes)
193
Thyrotoxicosis treatment
reduce thyroid level
antithyroid drugs
beta androgen blocking drugs
194
Thyroid storm
extreme thyrotoxicosis
195
Most common cause of hyperthyroidism is
Grave's Disease
196
Symptoms of grave's disease
goiter (enlarged thyroid)
exopthalmos
onset 20-40yr old women
autoimmune disease
tremmors
weightloss
tachycardia
197
Thyroid storm comes from
undiagnosed/untreated hyperthyroidism
198
Do not use ______ to treat THYROID storm
asprin
199
Parathyroid hormone regulates ____ levels
calcium
200
Hyposecretion of parathyroid hormone means
low serum calcium
201
Hyposecretion of serum calcium symptoms
tetany (muscle spams) and seizures
202
Hypersecretion of serum calcium symptoms
arrhythmias and muscle bone weakness and kidney stones (renal calculi)
203
_____ is a protein hormone that comes from the _______ pituitary gland
Prolactin, anterior
204
Prolactin causes
milk production
mammary glands
reproduction
205
Stimulated nipples during breastfeeding causes production of ________
prolactin
206
Prolactin is produced by stimulation of the ______ and then _____ ________
hypothalamus, anterior pituitary
207
Hyperprolactinemia in women causes
Amenorrea
Galactorrhea (excessive milk)
208
Hyperprolactinemia in men causes
decrease sex drive
breast enlargement (gynecomastia)
209
Gonodadtropins in women stimulate
overis and ovulation
by follicle stimulation
210
Gonodadtropins in men stimulate
testes and testosterone
by follicle stimulation
211
2 post pituitary hormone
ADH and Oxytocin
212
Oxytocinin causes
labor contractions and milk ejection
213
ADH stands for
Antidiuretic hormone
214
Antidiuretic causes fluids to be held in (T/F)
True
215
Osmolarity =
concentration
216
ADH effects the kidneys to hold/eject water
hold
217
High volume of water means _____ blood pressure
Low
218
Diabetes Insipidus affected by the hypothalamus means deficient from _____, is due to head trauma, infection, and tumors
ADH
219
Diabetes Insipidus affected by kidneys means _____ response from kidneys (nephrogenic)
no
220
Signs/symptoms of Diabetes Insipidus
- excessive output of urine
- dehydration/thirst
- fever
221
Diagnostic/Lab for Diabetes Insipidus
- 24 hour urine output
- measure ADH
- urine osmolality, serum osmolality
222
Treatment for Diabetes Insipidus
- desmopressin acetate (fixes hormone ADH)
223
Low serum Osmolality means a _____ urine osmolality
High
224
Tx for Diabetes Insipidus
Desmoporessin (because it helps produce ADH)
Nursing 115
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