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What is the endocrine system formed by?

Ductless glands that produce hormones



the endocrine system works in isolation


Works in tandem with the nervous system


What is the result of the endocrine system working together with the nervous system?

Endocrine works in tandem with the nervous system to regulate:
Water and salt balance
Response to stress
Sexual reproduction


Name the nine glands of the endocrine system + the one named in some sources only

Pituitary (hypophysis)
Anterior and posterior lobes
Pancreas (Islets of Langerhans)

+ Thymus


Name the 3 types of hormones in the endocrine system (based on their location and effect). Briefly explain how each works.

- autocrine hormones have effect on the releasing gland itself
- paracrine hormones function regionally
- endocrine hormones function at distance


True / False

The endocrine system works with the same speed as the nervous system.

Slower to respond, and takes longer to act, than the nervous system


Name the 5 glands that are solely endocrine

Pituitary, thyroid, parathyroids, adrenals, pineal


What's the hormone produced by the pineal gland?



Where is the control center of the endocrine system?



Explain the controlling role of the Hypothalamus

Hypothalamus controls pituitary function, so has enormous indirect effect on others glands.

- Hypothalamus can synthesize and release hormones from axon terminals directly into bloodstream
- Neurons can also have a hormone-secreting function – example, Ach, which is classified as both neurohormone and neurotransmitter – facilitates release of both


Name the three glands that are not solely endocrine.

Pancreas, ovaries, and testes are not solely endocrine


What endocrine gland is involved in the immune system, as well?

Thymus– important in T-cell production


Explain the field of Psychoneuroimmunology

Multiple feedback systems in place to keep hormones at normal levels.

Interfaces between endocrine-nervous-immunologic systems has given rise to field of psychoneuroimmunology (PNI) – interactive biologic signaling


Does age and sex have any effect over the endocrine glands?

Age-related changes in endocrine function are highly variable and sex-dependent (example: menopause)
Glands undergo tissue change with age, variable effect on function


When would you start thinking about endocrine screening in the context of PT (other than Init. Eval.)?

With patients/clients who do not respond predictably to treatment


What neuromusculoskeletal signs and symptoms may be associated with endocrine dysfunction?

- s/s associated with RA
- muscle weakness
- muscle atrophy
- myalgia
- fatigue
- synovial fluid changes
- periartheritis
- adhesive capsulitis (diabetes)
- Chondrocalcinosis
- Spondyloarthropathy
- OA
- hand stiffness
- arthralgia


What systemic signs and symptoms may be associated with endocrine dysfunction?

- excessive or delayed growth
- polydipsia
- polyuria
- mental changes (nervousness, confusion, depression)
- changes in hair (quality and distribution)
- changes in skin pigmentation
- changes in vitals (elevated temp., HR, BP)
- heart palpitations
- increased perspiration
- Kussmaul's respiration (deep, rapid breathing)
-dehydration or excessive retention of body water


Why does the endocrine system produce so many neuromuscular and systemic changes?

Because connective tissue growth and development are influenced/controlled by hormones and metabolic processes, alterations in those processes may produce neuromuscular or systemic changes


How does muscle weakness, myalgia, and fatigue relate with the endocrine system?

May signal thyroid or parathyroid disease
Acromegaly, diabetes, Cushing’s syndrome, osteomalacia

Painless proximal muscle weakness – may not be restored when underlying endocrine function is addressed


How does CTS relate with the endocrine system?

Soft tissue changes at wrist secondary to hormone changes, thickening of transverse carpal ligament, gout

CTS has multiple causes (Table 11-2, p. 412, G&S) – repetitive motion and occupational factors usually bring the problem to light


What are the neuromusculoskeletal causes of CTS?

- amyloydosis
- sequelae of medical or surgical procedures
- thumb arthritis
- cervical disc lesion
- cervical spondylosis
Spondyloarthropathy and osteoarthritis
Associated with excess iron deposition in tissues (bronze diabetes, iron storage disease), DM, acromegaly ochronosis (discolored body tissues)

- congenital anatomic differences
- cumulative trauma disorder
- peripheral neuropathy
- poor posture (associated with TOS)
- repetitive strain injury

- tendenitis
(Periarthritis and Calcific Tendinitis, especially at the shoulder. If cause is an underlying endocrine dysfunction, PT will not be effective)

- trigger points
- tenosynovitis
Hand stiffness and pain, often with CTS and flexor tenosynovitis

- wrist trauma (Colle's fx)


What are the systemic causes of CTS?

- alcohol
- arthritis
- benign tumors
- leukemia
- liver disease
- medication
oral contraceptives
- multiple myeloma
- obesity
- pregnancy
- scleroderma
- hemochromatosis
- vitamin deficiency (especially B6)


What are the endocrine causes of CTS?

- acromegaly
- diabetes mellitus
- hormonal imbalance
- hyperparathyroidism
- hyperthyroidism (Grave's disease)
- hypocalcemia
- hypothyroidism

- gout
Chondrocalcinosis (deposit of calcium salts)
Pseudogout – gout-like symptoms
5-10% of people with this disorder have underlying endocrine disease


What neuromuscular and musculoskeletal signs and symptoms may be associated with endocrine dysfunction?​

Periarthritis and Calcific Tendinitis, especially at the shoulder ​
If cause is an underlying endocrine dysfunction, PT will not be effective​

Chondrocalcinosis (deposit of calcium salts)​
Pseudogout – gout-like symptoms​
5-10% of people with this disorder have underlying endocrine disease​

Spondyloarthropathy and osteoarthritis​
Associated with excess iron deposition in tissues (bronze diabetes, iron storage disease), DM, acromegaly ochronosis (discolored body tissues)​

Hand stiffness and pain, often with CTS and flexor tenosynovitis


What are the two classification​s of Endocrine Pathophysiology?

Primary (dysfunction of the gland)​

Secondary (caused by an external stimulus, but may be iatrogenic, such as a surgical removal)​

will result in over- or under-production of hormone​


What is the function of Hypothalamus-Pituitary system​?

What makes the connection between the two?

Integration of neurologic and endocrine system​

Connected by pituitary stalk​


What is the role of Hypothalamus?

Synthesizes and releases hormones that regulate gland secretion​


What are the two parts of the Pituitary?

Anterior portion​
Posterior portion​


Name 9 hormones released by the Anterior Pituitary gland and briefly describe their role.

ACTH- affects adrenal gland​
Cortisol and androgenic steroids​

Melanocyte-stimulating hormone (MSH)​
Melanin and lipotropin release; makes skin darker​

GH- affects muscle, bone and liver​
Regulates growth, fat metabolism; in liver produces IGF’s that act like insulin hence insulin like growth factors​

Prolactin- affects breasts​
Milk production​

TSH- affects thyroid gland​
Increase thyroid hormone and Iodine uptake​

LH- Ovarian (ovaries) and Leydig (testicles) cells​
Ovulation and progesterone; Spermatogenesis, testosterone​

FSH- Ovarian and Leydig cells​
Follicle maturation, estrogen; Spermatogenesis​

β-Lipotropin- Adipose cells​
Fat breakdown and release of fatty acids​

β-Endorphins- Brain and spinal cord​
Analgesia; Body temperature​


Name two Pathologies of the anterior lobe of the Pituitary and decide if each is caused by hyper or hypo hormonal secretion.

Acromegaly (hyperpituitarism)
Increased release of GH- typically tumor of pituitary​

Hypopituitarism (dwarfism, non-genetic)​
Decreased secretion by anterior pituitary, may see partial/total failure of ACTS, TSH, LS, FSH, HGH, prolactin​