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PATHO FINAL (new material)
Terms in this set (76)
How do physical and mechanical barriers contribute to defense mechanisms?
Physical barriers made up of tightly associated epithelial cells of skin & of linigs of GI, GU, & respiratory tracts will prevent entry of pathogens. Lower temp of skin & acidic pH of skin + stomach are also barriers that inhibit microbes. Mechanical barriers are coughing, sneezing, vomiting, etc, which keep pathogens out of the body.
What is the normal bacterial flora? What is its role in defense?
Normal bacterial flora is the flora we get from our mothers and it can be found in our gut, respiratory tract, and skin. Normal gut flora plays a huge role in our first defense (innate immunity) as it facilitates digestion and prevents pathogen colonization, defending our body from opportunistic infection and keeping the majority of our immune system healthy.
Why are innate immunity and inflammation described as "nonspecific"?
They are nonspecific because they protect against all antigens, not just specific ones.
Describe the basic steps in acute inflammation.
At the site of tissue injury, arterioles constrict briefly. They then dilate, increasing blood flow to the area. Increased microvascular pressure and increased vasopermeability cause movement of plasma, proteins, and blood cells into the interstitial spaces, leading to tissue edema. Neutrophils and then macrophages are attracted to the site where they adhere to the endothelial cells, become actively phagocytic (eat antigens), and release many chemical mediators (like histamine) that enhance the inflammatory process. The injured endothelium stimulates the adherence of platelets and activation of the clotting cascade. As inflammation and clotting subside, fibrin is deposited and tissue repair begins.
What are the benefits of inflammation? Explain tolerance (central and peripheral), is it a good thing?
Inflammation is a vital part of the immune system's response to injury and infection. It is the body's way of signaling the immune system to heal and repair damaged tissue, as well as defend itself against foreign invaders.
Central tolerance is the main way the immune system learns to discriminate self from non-self.
Peripheral tolerance is key to preventing over-reactivity of the immune system to various environmental entities.
What are the three most important products of the complement system?
1. opsonin: important for the opsonization of pathogens in order to increase their likelihood of phagocytosis. Opsonization is an immune process that uses opsonins to tag foreign pathogens for elimination by phagocytes.
2. anaphylatoxin: complement peptides that are produced as part of the activation of the complement system -- Causes the mast cell to release histamine which will cause vasodilation
3. C5b: forms a membrane attack complex that damages bacteria
How is the coagulation cascade activated? How is it related to the plasma kinin cascade?
The coagulation cascade is activated by either the intrinsic pathway where there is damage to the blood vessel or the extrinsic pathway where there is blood vessel injury and blood leaks out of the vessel and into the tissue.
This relates to the plasma kinin cascade because the kinin system is another plasma system that must activate along with the complement system and clotting system in order to initiate the acute inflammatory response. For example, bradykinin is an inflammatory mediator that stimulates pain and has histamine-like effects like increased vascular permeability.
What factors control the plasma protein systems of inflammation?
1. complement system (complement factors)
2. clotting system (Hageman factor or Factor XII)
3. kinin system (Hageman factor or Factor XII)
What are cytokines? How do cytokines promote inflammation?
They are chemical mediators produced by macrophages that regulate the body's response to disease and inflammation.
What products do the mast cells release during inflammation, and what are their effects?
This process known as mast cell degranulation is triggered in response to cellular injury. When cells become injured, mast cells release chemical mediators such as histamine, bradykinin, and leukotrienes.
Histamine causes dilation of blood vessels and increases vessel permeability to allow macrophages and leukocytes to pass through the vessel wall to the site of injury.
Bradykinin relaxes the arterial smooth muscle to cause vasodilation and increases blood flow to the site of injury. It also has a role in nerve endings to increase the sensation of pain.
Leukotrienes have significant effects in the lungs to cause bronchoconstriction and increase the production of mucus, typically in response to an allergen.
What phagocytic cell types are involved in the acute inflammatory response? What is the role of each?
Acute inflammation mainly involves neutrophils (a type of phagocyte). These WBC are the "first responders" against invading pathogens. Chemotaxis attracts neutrophils to the site of infection/injury, which then leave the blood vessels to start phagocytizing pathogens. If neutrophils remain at high levels after the wanted response, they can start to eat their own body.
Macrophages are also part of acute inflammatory responses, however, they are more related to chronic inflammation. These WBC also phagocytize. They also release cytokines to attract more immune cells to the area and cells for repair.
What are the four steps in the process of phagocytosis?
1. phagocyte activation - inflammatory mediators stimulate the activation of phagocytes
2. chemotaxis - the phagocytes move toward the distressed area in response to a chemical stimulant
3. attachment - the phagocyte attaches itself to the intended pathogen to be eliminated via unenhanced (innate recognition) or enhanced (through use of the IgG antibody) attachment.
4. ingestion - subsequently, the phagocyte engulfs the pathogen and transfers it into a phagosome. Upon fusing with a lysosome, the pathogen's cellular proteins are broken down through acidification within the vesicle, thus killing the organism.
Describe how acute inflammation differs from chronic inflammation. What characteristics do they share?
Acute inflammation lasts for about 8-14 days while chronic inflammtion lasts two weeks or longer. Sometimes, an unsuccessful acute inflammatory resonse occurs before chronic inflammation occurs. Both of these types of inflammation are part of the secondary line of defense.
Define acquired immunity. Distinguish between innate and acquired immunity.
Acquired immunity, also known as adaptive immunity, is continually developed throughout one's lifetime and is specific to a certain pathogen. As one's body encounters a pathogen, the body adapts and acquires antibodies for that specific antigen. When the body encounters that pathogen again, it has the immune cells to recognize it and begin the process of eliminating it. This is different from innate immunity because one is born with their innate immunity and it is nonspecific to the pathogens it encounters.
Distinguish between humoral and cell-mediated immunity.
In humoral immunity responses, B Cells produce antibodies after being activated by free antigens present in body fluids.
In cell-mediated immunity responses, T cells attack infected body cells that display the antigens of pathogens on their surface.
What are the differences among antigens, immunogens, and haptens?
Antigens are markers on cells that trigger the production of antibodies.
Immunogens are substances that produce an immune response.
Haptens are small molecules that when combined with a larger carrier can elicit antibody production.
All immunogens are antigens but not all antigens may be immunogens because there are normal antigens used in everyday homeostatic processes.
What are the major functions of antibodies?
opsonize bacteria (for enhanced phagocytosis), neutralize viruses (igG), activate complement (igM and igG), sensitize mast cells (igE)
What is the difference between the secretory and systemic immune systems?
- Innate: Eosinophils, leukocytes, compliments, neutrophils, pattern proteins
- Adaptive: Antibodies, activated B-cells, Antibody producing B-cells, T-cells
Both: Macrophages, Dendritic cells, Mast cell, Basophil, Leukocyte
- Innate: Mechanisms that appear immediately or within hours of exposure to an antigen; At birth; Ex. Skin, chemicals in the body, immune cells, chemical properties of an antigen.
- Adaptive: Acquired immunity that has been introduced into the body by way of the previous infection or immunization/inoculation; immune memory; activated when innate fails; antigen-specific response; more complex.
What are the different types of T cells, and what function does each have?
T cells play an important role in the adaptive immune system. The different types of T cells include helper T cells and cytotoxic T cells.
Helper T cells (CD4+) recognize antigens and cause cytokines to be released, this activates macrophages, initiates inflammation, and activates T and B lymphocytes (specifically in proliferation and differentiation).
Cytotoxic T cells (CD8+), also known as killer T cells or cytolytic T lymphocytes, kill infected cells.
What is the role of T-helper cells?
T-helper cells are essential in the immune system. They produce cytokines used to mediate the immune response. By activating B cells, antibodies and macrophages help destroy microbes. Cytotoxic T cells are also activated, which kill affected cells. The cytokines produced also help in the proliferation and differentiation of lymphocytes into T and B lymphocytes.
List two typical complications of urinary tract obstruction, and briefly describe them.
Acute cystitis - An inflammation of the bladder, which is often the result of chronic UTI or patients who are given too many foley catheters. The inflammation is the result of uropathogenic microorganisms E. coli (most common) and S. saprophyticus (2nd most common). They damage the mucosa and over time will cause the bladder walls to die. Repeated infection over time can alter the cells and tissue which could develop into bladder cancer.
Sepsis (shock) - Untreated urinary tract infections may spread to the kidney, causing more pain and illness and lead to sepsis. Often called urosepsis, sepsis caused by a UTI is the body's often deadly response to the infection caused by blockage or obstruction.
How do kidney stones form? What do nurses monitor when patients develop kidney stones and what is the most important reason they actually form?
Kidney stones (also known as urinary stones or renal calculi) are masses of crystals, protein, or other substances that commonly cause obstructions in the urinary tract. They can be formed in the kidneys, ureters, or urinary bladder. Environmental factors can contribute to the formation of kidney stones (age, sex, race, geographic location because it influences the fluid intake and dietary patterns of patients or seasonal factors, fluid intake, diet and occupation).
The MOST important factor in the formation of urinary stones is urine pH. An alkaline pH favors the crystallization of calcium- and phosphate-containing stones, whereas and acidic urine pH promotes uric acid or cystine stones
When patients develop kidney stones, nurses should monitor their pain level, bladder distention, signs of infection (fever, chills, increased WBC count), hematuria (blood) in urine, and bowel sounds. Overall they need to be monitoring fluid and managing urinary elimination.
What is prostate hyperplasia and how does it change the health of males?
nonmalignant enlargement of the prostate -- can cause frequent urination, trouble starting to urinate, weak stream, inability to urinate, or loss of bladder control.
Why is cystitis more common in women?
Cystitis (infection of the bladder) is more common in women probably because the anus is closer to the urethra in women and because women have a shorter urethra than men
What is interstitial cystitis?
When cystitis occurs, this is referring to inflammation within the bladder. It is the most common site of UTIs and most often due to infections of E. coli or staph saprophyticus. Some things that can occur inside the organ include sloughing of the mucosa with ulcer formation, and it can lead to bladder wall necrosis in the most severe cases.
Explain urinary tract infections impact on the health of the elderly. What kind of pain result from a UTI, explain.
Urinary tract infections in adult men can be related to prostate issues. Men 73 years and older have a higher incidence of UTIs. Advanced age may cause the patient to lack mobility, increasing their risk for a UTI. Older adults may also manifest confusion as a presenting symptom of a UTI. The pain that results from a UTI would be dysuria, urgency, frequency, and possible blood in the urine.
What is the nurse's role in carrying for someone with incontinence, explain in detail.
The nurse's role is to identify causes, create treatment plans, and support the patient despite the humiliation or depression that may accompany them with the failing organs with age. That could be using urinary catheters that collect into a bottle or helping them after colostomy has taken place to rid of their collected stool. Nurses can empower patients to be adherent to all aspects of their care and lead them to better health
How do the medications prescribed for detrusor muscle issues work?
They work by augmenting the excitatory neurotransmitter (acetylcholine) actions at the detrusor neuroeffector junction
Always treat detrusor muscle overactivity with alpha-blockers
Explain overactive bladder and underactive bladder. Why do they occur?
Overactive bladder is the frequent urge to urinate because of the over-contraction before the bladder is full.
The underactive bladder is the reduced strength of detrusor muscles, resulting in prolonged urination or failure to urinate. They occur because of the abnormal functions of the detrusor muscles caused by neurogenic, myogenic, and aging.
Explain how diabetes can affect urinary health.
High blood glucose levels can promote bacterial growth which can raise the risk of urinary tract infections or thrush developing.
How do calculi form and what is the treatment?
Calculi form in kidneys, ureters, or the urinary bladder when high amounts of minerals build up and the body has a hard time breaking them down.
Also can occur when there is too much urine in the bladder because the urine will become more alkaline.
We can wait for the patient to pass it themself, which will be painful (might have to give opioids for pain), or have the stones be broken down with lithotripsy. This uses shock waves with high-frequency ultrasound to penetrate soft tissue and break up the stones.
What are the most common pathogens causing UTIs and what are the manifestations of a UTI?
E coli. and Staphylococcus saprophyticus are the most common pathogens.
- strong, persistent urge to urinate
- burning sensation when urinating
- passing frequent, small amounts of urine
- urine that appears cloudy
- urine that appears red, bright pink, or cola-colored (a sign of blood in the urine)
Would you place a catheter in a patient with a urinary tract infection, why or why not? Explain.
Anyone with a long-term urinary catheter is at risk of developing a urinary tract infection. Using a catheter can introduce bacteria into the bladder and cause a UTI. So using a catheter in a patient who has a UTI could make the infection worse, which could lead to serious complications like sepsis.
Explain the lab values you would look for to assess someone's bladder health.
A urinalysis can be used to determine if someone has a UTI.
Presence of nitrate or leukocyte esterase in the urine could indicate an infection
How do you care for someone with a urinary tract infection, explain.
- Antibiotics should be taken as directed
- They should drink extra water and other fluids (avoid drinks that are carbonated or have caffeine)
- They should try to urinate often
- To relieve pain, take a hot bath, or lay a heating pad (set on low) over your lower belly or genital area
What is a post-void residual and why would healthcare providers want to monitor it?
A post void residual is when there is urine left in the urinary bladder after urination. Post void residual can indicate urinary incontinence. This could indicate issues with the detrusor muscle, for example if the muscle is hyperreflexive, it will prevent patients from being able to fully void because it contracts too much and closes off the urethral opening. In worst case scenarios urine sitting in the bladder can potentially have bacteria in it which can lead to acute cystitis (infection of the bladder). It is important to monitor this to prevent onset of additional medications and to see if a urinary catheter needs to be placed.
What is overactive bladder, explain. What is the treatment?
Overactive bladder is a problem with bladder function that causes the sudden need to urinate. It happens mostly in women but may occur in men. Aging, an enlarged prostate, and diabetes are all risk factors. The urge to urinate may be difficult to control and lead to the involuntary loss of urine (incontinence).
Treatments such as pelvic floor muscle exercises, medications (alpha-blockers), and nerve stimulation can reduce or eliminate symptoms.
Explain stress incontinence in both males and females.
An involuntary release of urine due to increases in abdominal pressure associated with actions like coughing. This affects females over the age of 60 and males who have had prostate surgery.
Explain how the environment changes urinary health.
Environmental changes such as increased salt intake into your diet can cause high blood pressure which is damaging to blood vessels. In the long-term, it can cause kidney impairment, kidney stones and affect one's urinary health. Other changes such as being exposed to non-sterile areas and being infected with bacteria and viruses can damage one's urinary health by having UTI, acute cystitis, pyelonephritis, etc.
What is the major structural difference between the cortex and medulla of the kidney?
renal medulla: The inner-most region of the kidney, arranged into pyramid-like structures, that consists of the bulk of nephron structure.
renal cortex: The outer region of the kidney, between the renal capsule and the renal medulla. Consists of a space that contains blood vessels that connect to the nephrons.
What is the function of the nephron?
The nephron consists of the renal corpuscle and renal tubule. Its functions include the regulation of water and soluble substances in the blood by filtering the blood, reabsorbing nutrients, and excreting the rest as urine. This function helps to maintain homeostasis of the blood volume and blood pressure.
Why are proteins not filtered at the glomerulus?
The oncotic pressure on glomerular capillaries is one of the forces that resist filtration. Because large and negatively charged proteins have a low permeability, they cannot filtrate easily to the Bowman's capsule.
When the kidneys are damaged, protein leaks through the damaged filters and is removed from the body in the urine, along with the waste products.
Where is pain from the ureters referred?
Pain from the ureters might be felt in the retroperitoneal space. In other words, the pain might be felt in the lower abdomen or back area.
How do the bladder and urethra function in urine regulation?
The bladder temporarily holds the urine until it gets full. Baroreceptors will sense that the bladder is full and send signals to the brain that the bladder is full. Intrinsic and extrinsic muscles will relax and urine will go through the urethra and out.
What is autoregulation in the kidney? What other regulatory mechanisms are at work in renal function?
Kidneys are vital organs that filter waste from blood; therefore, kidneys rely on blood flow to perform their function. Autoregulation in the kidney controls the muscle cells of the arterioles that supply the glomerulus. Depending on blood pressure, the muscle cells will respond by causing vasoconstriction or vasodilation in order to maintain a consistent rate of blood flow to the glomeruli. This helps the body maintain a steady glomerular filtration rate (GFR).
The kidneys are also an essential organ that regulates the concentration of water, electrolytes, and acid-base balance. These are all regulated by the reabsorption as the filtrate travels through the loop of Henle.
Outline the process of glomerular filtration.
Glomerular filtration is the first step in making urine. It is the process that your kidneys use to filter excess fluid and waste products out of the blood into the urine collecting tubules of the kidney, so they may be eliminated from your body.
Proximal convoluted tubule -> nephron loop -> distal convoluted tuble -> collecting duct -> minor calyx -> major calyx -> renal pelvis -> ureter -> urinary bladder -> urethra -> external urethral opening
What types of absorption/reabsorption take place in the proximal tubule, the loops of Henle, and the distal tubule?
In the proximal tubule, Na+ is the majority of what is reabsorbed, though glucose, K+, amino acids, bicarbonate, urea, and water are also reabsorbed here.
In the Loop of Henle, Na+ is reabsorbed in the ascending loop.
In the distal tubule, reabsorption of H2O takes place with the help of ADH. Reabsorption of Na+, K+, H+, NH3, and urea takes place in the distal tubule as well.
What hormones are activated or synthesized by the kidney?
The hormones that are synthesized by the kidneys are erythropoietin, calcitriol (vitamin D), and renin.
Erythropoietin stimulates the production of red blood cells in bone marrow. Vitamin D is important for the absorption of calcium in the intestine, and renin is a key component of the RAAS system (by interacting with angiotensinogen and producing angiotensin I).
How does pyelonephritis differ from cystitis?
Pyelonephritis is the infection of the renal pelvis and parenchyma of the kidney.
Cystitis is the infection of the bladder.
What is glomerulonephritis? List two types.
inflammation of glomeruli and capillaries
There is acute and chronic. The acute develops suddenly
What immune mechanisms are operative in glomerulonephritis?
The immune mechanisms that are operative in glomerulonephritis are inflammation and activation of molecular mediators. The presence of an antibody, such as IgA, causes the glomerulus to become inflamed. Mesangial cells then become activated, which lead to the release of cytokines and chemokines. Cytokines and chemokines bring in and control the actions of immune cells at the site of inflammation, such as T-cells, B-cells. This aggregation leads to the clogging of the glomeruli.
Why is edema present in individuals with nephrotic syndrome?
Because the kidney is injured and cannot get rid of waste and excess fluid in the body. The kidney passes too much protein in the urine leading to severe proteinuria and hypoalbuminemia. Albumin in the blood contributes to the oncotic pressure in the blood vessels. With the severe loss of albumin in the blood due to the damaged nephron, the oncotic pressure is severely decreased, leading fluid to escape from the blood vessel. The fluid escaping the blood vessels causes the edema.
What mechanisms cause prerenal acute renal failure?
Severe blood loss and low blood pressure related to major cardiac or abdominal surgery, severe infection (sepsis), or injury.
Medicines can also interfere with the blood supply to the kidneys.
How does intrarenal acute renal failure differ from postrenal failure?
Intrarenal acute renal failure (aka intrinsic acute kidney injury or AKI) occurs when direct damage to the kidneys causes a sudden loss in kidney function. The treatment of intrinsic acute kidney injury includes identifying and correcting the cause of the kidney injury.
Postrenal acute kidney injury, occurs when an obstruction in the urinary tract below the kidneys causes waste to build up in the kidneys. It is not as common as AKI or acute tubular necrosis.
Briefly describe the causes of anemia, cardiovascular disease, and bone and neurologic changes associated with chronic renal failure.
Anemia: To get bone marrow to make red blood cells, the kidneys make a hormone called erythropoietin, or EPO. When the kidneys are damaged, they may not make enough EPO. Without enough EPO, the bone marrow does not make enough red blood cells, and you have anemia.
Cardiovascular disease: Damaged kidneys may release too much renin, which can lead to high blood pressure. High blood pressure increases the risk of heart attack, congestive heart failure, and stroke.
Bone: When kidneys do not function properly, extra parathyroid hormone is released in the blood to move calcium from inside the bones into the blood. Chronic kidney disease causes mineral and bone disorder because the kidneys do not properly balance the mineral levels in the body.
Neuro: Common neurological complications in CKD include stroke, cognitive dysfunction, encephalopathy, peripheral and autonomic neuropathies.
Explain the difference between Immunoglobulin A Nephropathy and Nephrotic Syndrome.
IgA nephropathy is a chronic kidney disease. It progresses over 10 to 20 years, and it can lead to end-stage renal disease. It is caused by deposits of the protein immunoglobulin A (IgA) inside the filters (glomeruli) in the kidney.
Nephrotic syndrome is a kidney disorder that causes your body to pass too much protein in your urine. Nephrotic syndrome is usually caused by damage to the clusters of small blood vessels in your kidneys that filter waste and excess water from your blood.
How do you monitor kidney function as a nurse, explain.
As a nurse:
- monitor urine output
- check GFR (glomerular filtration rate): a blood test that checks how well your kidneys are filtering your blood
- check albumin levels through a urine test: albumin is a protein that can pass into the urine when the kidneys are damaged
- check BUN levels
- check creatinine levels
- Don't just give antibiotics! Get a urine culture first!
Explain what is found in a normal UA.
- Color: Light yellow to deep amber (normal hydration).
- Turbidity (Cloudiness): Clear (free from blood, WBC's, fat and other sediments)
- Protein: Less than 20mg/dL (normal). Proteinuria is a common indicator of kidney disease.
- pH: 4.5 to 8 (balanced H+ concentration in blood).
- Specific Gravity: 1.005 to 1.03 (normal 'concentration ability' of kidney).
- Urobilinogen: up to 1 mg/dL (normal, indicator for liver conditions or hematopoiesis/blood production)
- Glucose: Negative (normal, indicator for diabetes)
- Ketones: Negative (normal, indicator for carbohydrate metabolism)
- Hemoglobin: Negative (normal, indicator for blood in urine)
- Bilirubin: Negative (normal, indicator for liver disorders)
- Nitrite: Negative (normal, indicator for UTIs)
- Leukocyte esterase: Negative (normal, indicator for UTIs)
Explain aging and the changes in stress hormones.
As we age, our glands will not perform as well. The general changes include altered secretory responses, altered metabolism of hormones, and altered levels of circulating hormones. There is an overall significant loss of function. As an example, the posterior pituitary will not only decrease in size, but it will not release as much ADH. ADH is released when the body feels that it needs to retain water. This happens when the body has low pressure/volume in its system. As one ages, this mechanism of maintaining homeostasis is more difficult to achieve.
What are the hormones associated with stress in humans and explain what each one does.
- Cortisol: Secreted by the adrenal cortex, increases sugars (glucose) in the bloodstream, causes the brain to utilize more glucose
- Epinephrine (adrenaline): secreted by the adrenal medulla, stimulates the fight or flight response, charges the liver up to make glucose (not good for diabetes patients), greatest role in fuel metabolism
- Norepinephrine: also secreted by the adrenal medulla. Increases heart rate and blood pressure, helps to increase blood glucose levels so that the body has enough energy in fight or flight situations
What is the pathophysiology of Type I diabetes.
Type 1 diabetes is inherited and then triggered by something in our environments. The environmental trigger leads to antibody production and T-cells attack the beta cells, thus leading to a decrease in insulin production, an increase in blood glucose and cells begin to starve, causing beta cells in the pancreas to be destroyed, which is caused by autoimmunity.
Explain the difference between Type I and Type II diabetes.
Type I and Type II diabetes are two variations of Diabetes Mellitus, which is characterized by chronic high blood glucose levels (hyperglycemia). Insulin is produced by beta cells in the pancreas. If there is no insulin present, glucose can build up in the blood.
Type I diabetes is due to insufficient insulin secretion. Those with type I diabetes are initially not making enough insulin and eventually stop making insulin altogether.
Type II diabetes is due to deficiancy of insulin secreation and insulin resistance. Those with type II diabetes make insulin, however, the body is not responding to it, meaning that the insulin is not interacting with the cells, and glucose is not able to get into the cells.
What is gestational diabetes? What is the risk to the mother and the fetus, explain.
Gestational diabetes is a type of diabetes mellitus that occurs during pregnancy. Hyperglycemia during pregnancy can result in fetal and maternal complications. The condition resolves after childbirth.
What is the liver's role in stress?
Under stress, the liver helps by producing extra blood sugar in order to help the body get a boost of energy. This helps to provide the body with more energy to use for any problems that it may be having.
Explain each gland mentioned in week 12's lectures and explain what each one does and what substance they make (if any).
Parathyroid: there are 4 glands, they produce parathyroid hormone (PTH) which plays a key role in the regulation of calcium levels in the blood and bone
Thyroid: T3, T4: metabolism calcitonin: reduces Ca+ in the blood & thyroid stimulating hormone. Hormones regulate the body's metabolic rate controlling heart, muscle and digestive function, brain development and bone maintenance. Its correct functioning depends on a good supply of iodine from the diet.
Thymus: assists in WBC maturation, secretes thymosin, a hormone necessary for T cell development and production (T-cells help fight disease). The thymus is special in that, unlike most organs, it is at its largest in children. Once you reach puberty, the thymus starts to slowly shrink
Pancreas: makes digestive enzymes and produces insulin and glucagon to control glucose
Adrenal: SNS: controls cortisol, adrenaline, and water balance (glucocorticoids)
What are the stressors that alter endocrine health?
Some of the factors that affect endocrine organs include puberty, aging, pregnancy, the environment, genetics, and certain diseases and medications, including naturopathic medicine, herbal supplements, and prescription medicines such as opioids or steroids.
During times of stress, the hypothalamus, a collection of nuclei that connects the brain and the endocrine system, signals the pituitary gland to produce a hormone, which in turn signals the adrenal glands, located above the kidneys, to increase the production of cortisol.
Explain acromegaly and what is the treatment?
Acromegaly is a disease caused by changes in hormone secretion. It causes facial deformation including increased frontal bossing, brow furrow, thickening of the lips, loss of oval facial features, and parathyroid hypertrophy. It can be treated with surgery or medications such as lanreotide and bromcriptne
How would you treat someone with a change in breathing pattern, explain your role as a nurse.
- Check airways for choking or blockage
- Raise the head of the bed and place the patient in a position for maximum breathing pattern
- Encourage slow deep breaths
- Check respiratory rate
- Advocate for oxygen supplementation (stay away from high concentrations of oxygen with COPD patients).
What is meant by negative-feedback regulation of hormone release?
Hormone production and release are primarily controlled by negative feedback. In negative feedback systems, a stimulus causes the release of a substance whose effects then inhibit further release. In this way, the concentration of hormones in blood is maintained within a narrow range. This type of feedback brings things back to normal whenever they start to become too extreme.
What is the relationship between the hypothalamus and the pituitary?
The hypothalamus links the nervous and endocrine systems by way of the pituitary gland. Its function is to secrete releasing hormones and inhibiting hormones that stimulate or inhibit production of hormones in the anterior pituitary.
What is the action of antidiuretic hormone (ADH)?
Antidiuretic hormone is used to regulate water excretion from the kidneys. More antidiuretic hormone means more water is being reabsorbed and less urine produced.
How does the anterior pituitary regulate the thyroid gland?
Thyroid-releasing hormone (TRH) from the hypothalamus stimulates TSH from the pituitary, which stimulates thyroid hormone release. As blood concentrations of thyroid hormones increase, they inhibit both TSH and TRH, leading to "shutdown" of thyroid epithelial cells.
What is the most potent naturally occurring glucocorticoid, and how is its secretion related to that of adrenocorticotropic hormone (ACTH)?
Cortisol is the most important naturally occurring glucocorticoid secreted by the adrenal gland.
ACTH is made in the pituitary gland in response to the release of another hormone, called corticotropin-releasing hormone (CRH), by the hypothalamus. In turn, the adrenal glands then make cortisol, which helps your body manage stress.
How does aldosterone influence fluid and electrolyte balance?
Aldosterone is a mineralocorticoid that is secreted by the adrenal cortex and is secreted in response to hemodynamic changes as part of the RAAS system (renin-angiotensin-aldosterone). The RAAS system is stimulated by a decreased blood pressure and low serum sodium levels. Aldosterone increases retention of sodium which would increase fluid/blood volume since water follows sodium. While aldosterone is saving sodium, potassium is being excreted from the body through urination.
What are catecholamines? How do hormones and cholesterol become excreted from the body or disabled?
Catecholamines are hormones released by the adrenal gland when the body is under stress and the sympathetic system is activated. These include norepinephrine and epinephrine. Once released they will cause the body to go in fight-or-flight modes such as increasing the heart rate and blood pressure. Cholesterol is synthesized into steroid hormones and after finishing their function, they will be excreted by the kidneys or metabolized by the liver. If they are metabolized in the liver, the liver will inactivate the hormone and the hormone will undergo renal excretion.
Explain why glucagon is important and why must you know what it does for the management of a diabetic.
Glucagon is secreted by pancreatic alpha cells and is released when blood glucose decreases (makes glucose levels rise). Moreover, glucagon helps your liver break down the food you eat to make glucose. This can help the body if it's in a situation like hypoglycemia (which makes people dizzy, sluggish).
This is important for the management of diabetes because diabetics are not able to produce enough insulin for the uptake of glucose. If glucagon levels are high and insulin levels are low, this could be dangerous and cause hyperglycemia.
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