endocrinology:-it is the study of endocrine glands their secretion /hormones produces ,physiological action action &abnormalities
hormones-it is the chemical substance secreted from endocrines which behaves like messenger and alter cell activities.
\
endocrine:-
glands which secretes hormone where the target organ is at distance.
eg:-LH,-ant.pituitary
target-gonads.
paracrines:-secretes local hormones ,where target organ is not at distance /adjacent.
classification:-
1)steroid hormones-aldosterone,testosterone,
2)protein hormone-insulin -requires 2nd messenger like cyclic AMP or calcium.
3)amine-thyroxine
thyroid gland:-
located in front of trachea as shield .
2 pairs of parathyroid are present .
made up of millions of follicles
-when it is active cells are columnar and secretes .
-highly vascularized.
stores hormon within gland .
Hormone produced:-thyroxine ,triiodo thyroxine,tetraiodo thyroxine,calcitonin
thyroxine biosynthesis:-
step1-iodide trapping :-iodides which comes from GIT enters to the follicular cells through the capillaries,it is influenced by TSH secreted gland formed the ant.pituitary gland .
step2-oxidation of iodide to iodine:-peroxidase.
step 3:-iodination of thyroxine :-at 3rd position iodine is attached which form monoiodothyroxine
at 5th position -1 more iodine attaches to give diiodothyronine .
step4-coupling:-
MIT+DIT-------T3
DIT+DIT------T4
physiological action :-
calorigenic action:-
increases BMR(normal -40kcal/m2/hr
therefore it is used as weight reducing agent
-hyperthyroidism ,cretinism
Role in growth development and tissue differentiation ;-
in absence of thyroxine the milestones in the growth & development of the infant is delay (crawling,walking,talking)
-in tissue differentiation calcification of cartiliage and converting of cartiliage to bone -occurs in presence of T4.
myelination of the nerve fibers and formation of synapses occurs in the presense of thyroxine .
-thyroxine along with growth hormone decides the personality of the individual-they work together-synergistic action of growth hormone.
effect on metabolism.
1)-carbohydrate metabolism:it is hyperglycemic action
-glycogenolysis &increases the absorption inGIT of glucose .
2)protein metabolism:-it is catabolic in action ,when there increases in T4 -
anabolic when decrease in T4.
3)lipid metabolism:-breakdown of fat ,helps in weight loss.
Effect on individual system:-
1)blood:-thyroxine is necessary for erythropoiesis
2)increased heart rate ,increase in stroke volume therefore cardiac out put also increases.
-systolic BP increases & diastolic BP decreases doe to vasodilation.
3)respiratory system:-if BMR increases Respiration increases.
4)GIT:-Helps in absorption of glucose.
-incase of hypothyroidism -constipation,hyperthyroidism-diarrhea
5)CNS:-myelination of nerve fiber ,T4 is necessary
-T4 decreases-cretinism
-development of synapse occurs in the presence of T4
-in reproduction system -if T4 decreases -leads to
amenorrhea /oligomenorrhea:irregular menstruation in female
infertility in female
in pregnancy for synthesis of milk ,T4 is require .
-skin-skin becomes rough &dry in absence of T4 leads to toad skin -slightly yellowish due to deposition of mucopolysaccharides -oedematous.
abnormalities.:-
hypothyroidism-cretinism-in infants
-myxoedema-adults.
2)hyperthyroidism-grave's disease
3)hypo/hyperthyroidism-goitre
cretinism:-
it is caused by hypothyroidism in foetal condition as wel as afte birth.
symptoms-physical,mental,sexual growth retardation.
-milestone in the growth and development is delayed.
-idiotic behaviour.
-poor reflexes.
-IQ is low .
-saliva dripping ,slurry speech,brachycardia.
Myxedema-
it is caused by hypothyroidism in adults.
1)oedematous skin due to deposition of mucopolysar,
-yellowish because of excess of canolene deposition
-non pitting oedema.
2)idiotic behaviour.
3)poor reflexes.
4)IQ is low
5)saliva dipping,slurry speech.
6)brachycardia.
difference between Dwarf and cretinism.
dwarf:-deficiency of growth hormone
unable to withstand hot weather.
physical retardation
propionate
TSH is more secreted by anterior pituatory gland gland shown no respose.
cretinism:-deficiency of T4
physical,mental,sexual retardation
dipropionate
Graves disease/exophthalmos/Thyrotoxic:-
caused by hyperthyroidism in adults
symptoms:-
protrusion of eyeball because of retroocular deposition of mucopolysaccharides.
-hyperplasia-increase in cell NO.
-hypertrophy -increase in cell size.
-fine tremors-excess of thyroxine is catabolic which gives breakdown of protein
-IQ is normal.
-reflexes are exaggerated
-trachy cardia
TSH is secreted more
Thyroid stimuliting immunoglobulin doesn't show - ve feedback .
goitre;-
non inflammatory non malignant enlargement of gland is called goitre
caused by hypo&hyper thyroidism.
1)simple goitre _deficiency of iodine
2)nodular goitre-some ares of gland shown nodules
-due to hyperthyroidism.
3)toxic goiter -similar to thyrotoxicosis
#thyroid function test:-
test to asses function of thyroid gland.
1)TSH concentration-in hypothyroidism increases
- in hyperthyroidism increases
2)T3,T4 -in hypo...decreases.
-in hyper....-increases.
3)BMR (40)- in hypo.... -low(20)
-in hyper......-high (70)
4)cholesterol- in hypo....-increase
in hyper .....-decreased
#hormonal regulation of ionic ca++in the serum:-
1)calcium in the form of calcium phosphate in bones and teeth which accounts for 1100gms
2)calcium in combined form -calcium-oxalate or carbonate or bicarbonate
3)the ionic calcium in the serum is maintained 9 to 11 mg/100ml blood
it is maintained by 3 hormones
-para thyroid hormone
-calcitonin
-1,25 dihydroxycholecalciferol (vit D3 active form)
4)importance of ionic calcium in serum.
-necessary for blood coagulation ,for muscle contration,transmission of impulse at NMJ .
-rhythemicity of heart.
-in protein hormones calcium acts 2nd messenger.
parathyroid hormone:-
secreted from parathyroid
-hypercalcemia in action
-hormone is released when ionic calcium becomes less than 9 in 100ml blood.
physiological action;-
1)action on bones:-demineralization
-osteoclastic activity increases.
-therefore circulation ionic ca is increased.
2)action on kidney-reabsorption of calcium in renal tubule is increases
-loss of phosphate in urine.
-conversion of vitD3 to active vit D3
3)action on intestine :-vit D3 helps in synthesis of carrier protein for absorption of calcium.
there fore all these methods increase the calcium upto 11 mg%
Calcitonin:-
secretion -thyroid gland
-hypocalcemic effect
-hormone is released when ionic calcium level goes beyond more than 11mg/100mlof blood
physiological action-
i)action on bones -remineralization of bone.
-osteoblastic activities increase
-in circulatory ionic calcium is decreased
ii)action on kidney-reabsorption of calcium in renal tubule decreases
-phosphate reabsorption increases
-conversion of inactive vitD3+active vitD3 is decreased
iii)action on intestine:-decreased synthesis of carrier protein -therefore decreased absorption of calcium
there fore calcium level decreases upto 9 mgm%
3)vitamin D3:-
during sunlight -vitD3 synthesised in skin
furthermore process occurs in liver ,finally active vit D3 is formed in kidney
-physiological action:-
1)synthesis carrier protein necessary for absorption of calcium in intestine from dietary source .
Abnormalities:-
1)hypoparathyroidism-tetany-cause:- decreased secretion of PTH
-calcium decrease below 6mg/100ml
symptoms
-spasm of muscle
1)laryngeal stridor -spasm of L muscle(respiration with crowing sound)
2)Accoucher hand /obstetrician's hand-
-wrist flexed &extended fingers like that of obstetricians hand
-spasm of muscle of forearm
2)chvostek's sign -it is is tapping at the angle of jaw
-shows facial muscle spasm.
4)trousseau's sign-carpopedal spasm
-when sphygmomanometer cuff is applied to arm
tendency toward tetany:-
whenever the calcium level is reduced Mg is also reduced while phosphate ,bicarbonate increases.
2)hyperparathyroidism-osteitis fibrosa cystica
cuase-increase in secretion of parathyroid hormone
-calcium level increases beyond 11mg/100ml.
-symptom -multiple cyst in bone because of excessive demineralisation.
-bones becomes fragile &prone for fracture
-excess of calcium in circulation lead to its deposition in soft tissue ,walls of blood vessels
#cerebrospinal fluid:-
present in cerebral ventricles subarachnoid space central canal of spinal cord
-transparent clear fluid without RBC and platelet and few WBC are present.
-no bile pigment
-protein is contain very less 13mg(in blood 6-8 mg)
cholesterol content is less
secretion :-ependymal cells of choroid plexus of lateral ventricle and 3rd ventricle.
circulation:-starts from lateral ventricle it transported to 3rd ventricle
|
Through aqueduct of sylvius
|
4 th ventricle
|
subarachnoid space & central canal of spinal cord
absorption :_arachnoid villi
normal value :-150 ml
if it greater 150 ml intracranial pressure increases(N.V =60-100 MM of H20)
function:-1)act as shock absorbers because of water cushion
2)weight of the brain is not but because of buoency.
3)it provides nutrition O2 to areas of brain where blood doesnt supply.
4)excretory waste are removed and drained in to CSF.
5)maintains intracranial pressure 6)lumbar puncture
CSF:-water-99.13%
solid-.87%-organic-protein sugar-urea,uric acid ,creatinine
-inorganic-NA ,potassium,calcium,chlorides
hormones-it is the chemical substance secreted from endocrines which behaves like messenger and alter cell activities.
\
endocrine:-
glands which secretes hormone where the target organ is at distance.
eg:-LH,-ant.pituitary
target-gonads.
paracrines:-secretes local hormones ,where target organ is not at distance /adjacent.
classification:-
1)steroid hormones-aldosterone,testosterone,
2)protein hormone-insulin -requires 2nd messenger like cyclic AMP or calcium.
3)amine-thyroxine
thyroid gland:-
located in front of trachea as shield .
2 pairs of parathyroid are present .
made up of millions of follicles
-when it is active cells are columnar and secretes .
-highly vascularized.
stores hormon within gland .
Hormone produced:-thyroxine ,triiodo thyroxine,tetraiodo thyroxine,calcitonin
thyroxine biosynthesis:-
step1-iodide trapping :-iodides which comes from GIT enters to the follicular cells through the capillaries,it is influenced by TSH secreted gland formed the ant.pituitary gland .
step2-oxidation of iodide to iodine:-peroxidase.
step 3:-iodination of thyroxine :-at 3rd position iodine is attached which form monoiodothyroxine
at 5th position -1 more iodine attaches to give diiodothyronine .
step4-coupling:-
MIT+DIT-------T3
DIT+DIT------T4
physiological action :-
calorigenic action:-
increases BMR(normal -40kcal/m2/hr
therefore it is used as weight reducing agent
-hyperthyroidism ,cretinism
Role in growth development and tissue differentiation ;-
in absence of thyroxine the milestones in the growth & development of the infant is delay (crawling,walking,talking)
-in tissue differentiation calcification of cartiliage and converting of cartiliage to bone -occurs in presence of T4.
myelination of the nerve fibers and formation of synapses occurs in the presense of thyroxine .
-thyroxine along with growth hormone decides the personality of the individual-they work together-synergistic action of growth hormone.
effect on metabolism.
1)-carbohydrate metabolism:it is hyperglycemic action
-glycogenolysis &increases the absorption inGIT of glucose .
2)protein metabolism:-it is catabolic in action ,when there increases in T4 -
anabolic when decrease in T4.
3)lipid metabolism:-breakdown of fat ,helps in weight loss.
Effect on individual system:-
1)blood:-thyroxine is necessary for erythropoiesis
2)increased heart rate ,increase in stroke volume therefore cardiac out put also increases.
-systolic BP increases & diastolic BP decreases doe to vasodilation.
3)respiratory system:-if BMR increases Respiration increases.
4)GIT:-Helps in absorption of glucose.
-incase of hypothyroidism -constipation,hyperthyroidism-diarrhea
5)CNS:-myelination of nerve fiber ,T4 is necessary
-T4 decreases-cretinism
-development of synapse occurs in the presence of T4
-in reproduction system -if T4 decreases -leads to
amenorrhea /oligomenorrhea:irregular menstruation in female
infertility in female
in pregnancy for synthesis of milk ,T4 is require .
-skin-skin becomes rough &dry in absence of T4 leads to toad skin -slightly yellowish due to deposition of mucopolysaccharides -oedematous.
abnormalities.:-
hypothyroidism-cretinism-in infants
-myxoedema-adults.
2)hyperthyroidism-grave's disease
3)hypo/hyperthyroidism-goitre
cretinism:-
it is caused by hypothyroidism in foetal condition as wel as afte birth.
symptoms-physical,mental,sexual growth retardation.
-milestone in the growth and development is delayed.
-idiotic behaviour.
-poor reflexes.
-IQ is low .
-saliva dripping ,slurry speech,brachycardia.
Myxedema-
it is caused by hypothyroidism in adults.
1)oedematous skin due to deposition of mucopolysar,
-yellowish because of excess of canolene deposition
-non pitting oedema.
2)idiotic behaviour.
3)poor reflexes.
4)IQ is low
5)saliva dipping,slurry speech.
6)brachycardia.
difference between Dwarf and cretinism.
dwarf:-deficiency of growth hormone
unable to withstand hot weather.
physical retardation
propionate
TSH is more secreted by anterior pituatory gland gland shown no respose.
cretinism:-deficiency of T4
physical,mental,sexual retardation
dipropionate
Graves disease/exophthalmos/Thyrotoxic:-
caused by hyperthyroidism in adults
symptoms:-
protrusion of eyeball because of retroocular deposition of mucopolysaccharides.
-hyperplasia-increase in cell NO.
-hypertrophy -increase in cell size.
-fine tremors-excess of thyroxine is catabolic which gives breakdown of protein
-IQ is normal.
-reflexes are exaggerated
-trachy cardia
TSH is secreted more
Thyroid stimuliting immunoglobulin doesn't show - ve feedback .
goitre;-
non inflammatory non malignant enlargement of gland is called goitre
caused by hypo&hyper thyroidism.
1)simple goitre _deficiency of iodine
2)nodular goitre-some ares of gland shown nodules
-due to hyperthyroidism.
3)toxic goiter -similar to thyrotoxicosis
#thyroid function test:-
test to asses function of thyroid gland.
1)TSH concentration-in hypothyroidism increases
- in hyperthyroidism increases
2)T3,T4 -in hypo...decreases.
-in hyper....-increases.
3)BMR (40)- in hypo.... -low(20)
-in hyper......-high (70)
4)cholesterol- in hypo....-increase
in hyper .....-decreased
#hormonal regulation of ionic ca++in the serum:-
1)calcium in the form of calcium phosphate in bones and teeth which accounts for 1100gms
2)calcium in combined form -calcium-oxalate or carbonate or bicarbonate
3)the ionic calcium in the serum is maintained 9 to 11 mg/100ml blood
it is maintained by 3 hormones
-para thyroid hormone
-calcitonin
-1,25 dihydroxycholecalciferol (vit D3 active form)
4)importance of ionic calcium in serum.
-necessary for blood coagulation ,for muscle contration,transmission of impulse at NMJ .
-rhythemicity of heart.
-in protein hormones calcium acts 2nd messenger.
parathyroid hormone:-
secreted from parathyroid
-hypercalcemia in action
-hormone is released when ionic calcium becomes less than 9 in 100ml blood.
physiological action;-
1)action on bones:-demineralization
-osteoclastic activity increases.
-therefore circulation ionic ca is increased.
2)action on kidney-reabsorption of calcium in renal tubule is increases
-loss of phosphate in urine.
-conversion of vitD3 to active vit D3
3)action on intestine :-vit D3 helps in synthesis of carrier protein for absorption of calcium.
there fore all these methods increase the calcium upto 11 mg%
Calcitonin:-
secretion -thyroid gland
-hypocalcemic effect
-hormone is released when ionic calcium level goes beyond more than 11mg/100mlof blood
physiological action-
i)action on bones -remineralization of bone.
-osteoblastic activities increase
-in circulatory ionic calcium is decreased
ii)action on kidney-reabsorption of calcium in renal tubule decreases
-phosphate reabsorption increases
-conversion of inactive vitD3+active vitD3 is decreased
iii)action on intestine:-decreased synthesis of carrier protein -therefore decreased absorption of calcium
there fore calcium level decreases upto 9 mgm%
3)vitamin D3:-
during sunlight -vitD3 synthesised in skin
furthermore process occurs in liver ,finally active vit D3 is formed in kidney
-physiological action:-
1)synthesis carrier protein necessary for absorption of calcium in intestine from dietary source .
Abnormalities:-
1)hypoparathyroidism-tetany-cause:- decreased secretion of PTH
-calcium decrease below 6mg/100ml
symptoms
-spasm of muscle
1)laryngeal stridor -spasm of L muscle(respiration with crowing sound)
2)Accoucher hand /obstetrician's hand-
-wrist flexed &extended fingers like that of obstetricians hand
-spasm of muscle of forearm
2)chvostek's sign -it is is tapping at the angle of jaw
-shows facial muscle spasm.
4)trousseau's sign-carpopedal spasm
-when sphygmomanometer cuff is applied to arm
tendency toward tetany:-
whenever the calcium level is reduced Mg is also reduced while phosphate ,bicarbonate increases.
2)hyperparathyroidism-osteitis fibrosa cystica
cuase-increase in secretion of parathyroid hormone
-calcium level increases beyond 11mg/100ml.
-symptom -multiple cyst in bone because of excessive demineralisation.
-bones becomes fragile &prone for fracture
-excess of calcium in circulation lead to its deposition in soft tissue ,walls of blood vessels
#cerebrospinal fluid:-
present in cerebral ventricles subarachnoid space central canal of spinal cord
-transparent clear fluid without RBC and platelet and few WBC are present.
-no bile pigment
-protein is contain very less 13mg(in blood 6-8 mg)
cholesterol content is less
secretion :-ependymal cells of choroid plexus of lateral ventricle and 3rd ventricle.
circulation:-starts from lateral ventricle it transported to 3rd ventricle
|
Through aqueduct of sylvius
|
4 th ventricle
|
subarachnoid space & central canal of spinal cord
absorption :_arachnoid villi
normal value :-150 ml
if it greater 150 ml intracranial pressure increases(N.V =60-100 MM of H20)
function:-1)act as shock absorbers because of water cushion
2)weight of the brain is not but because of buoency.
3)it provides nutrition O2 to areas of brain where blood doesnt supply.
4)excretory waste are removed and drained in to CSF.
5)maintains intracranial pressure 6)lumbar puncture
CSF:-water-99.13%
solid-.87%-organic-protein sugar-urea,uric acid ,creatinine
-inorganic-NA ,potassium,calcium,chlorides
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