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kelenjar partiroid-endokrinologi

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buat yang mau bikin tugas mata kuliah endokrinologi. semoga bermanfaat

buat yang mau bikin tugas mata kuliah endokrinologi. semoga bermanfaat


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  • 1. THE PARATHYROID GLAND
  • 2. Parathyroid Gland
    • 4 small glands located on the dorsal side of the thyroid gland
    • essential for life
    • produces parathyroid hormone
    • responsible for monitoring plasma Ca 2+
  • 3. Anatomy & Location of Parathyroid Gland
  • 4. PARATHYROID HORMONE
  • 5. Parathyroid Hormone (PTH)
    • a peptide hormone that increases plasma Ca 2+
    • causes increase in plasma Ca 2+ by:
    • Mobilization of Ca 2+ from bone
    • Enhancing renal reabsorption
    • Increasing intestinal absorption (indirect)
  • 6. Regulation of PTH release by Plasma Ca 2+ Levels
    • PTH is released by chief cells in the parathyroid gland.
    • Chief cells contain receptors for Ca 2+
    • A decrease in plasma Ca 2+ levels mediates the release of PTH
    • Conversely, hypercalcemia inhibits PTH release
  • 7. Physiologic Anatomy of the Parathyroid Gland
  • 8. Effect of Parathyroid Hormone on Calcium and Phosphate Concentrations in the ECF
  • 9. The rise in calcium concentration is caused by two Effects
        • 1. an effect of PTH to increase calcium and phosphate absorption from the bone
    • 2. a rapid effect of PTH to decrease the excretion of calcium by the kidneys
        • - Parathyroid Hormone Increased Calcium and Phosphate Absorption from the Bone
    • - Rapid Phase of Calcium and Phosphate Absorption – Osteolysis
    • - Slow Phase of Bone Absorption and Calcium Phosphate Release – Activation of the Osteoclasts
    • - Parathyroid Hormone Decreases Calcium Excretion and Increase Phosphate Excretion in the Kidneys
    • - Parathyroid Hormone Increases Intestinal absorption of Calcium and Phosphate
    • - Cyclic Adenosine Monophosphate Mediates the Effects of Parathyroid Hormone
  • 10.
        • ACTIONS OF PTH ON TARGET ORGANS
    • 1. BONES OR SKELETON
    • Calcium and Phosphate absorption from bones
    • a. Rapid Phase – osteolysis
    • b. Slow Phase – activation of osteoclasts
            • 1. immediate activation of osteoclasts that are already formed
    • 2. formation of new osteoclasts from osteoprogenator cells
    • 2 . INTESTINES
        • Enhances both Ca and PO4 absorption from the intestines by increasing formation of 1, 25 dihydroxycholecalciferol from vitamin
    • 3. KIDNEYS
    • a. Increased renal tubular reabsorption of calcium in the distal tubules and collecting ducts
    • b. diminished proximal tubular reabsorption of PO4
  • 11. EFFECTS OF PTH ON TARGET ORGANS
    • 1 . Blood Calcium and Phosphate
        • a. Hypercalcemia
    • b. Hypophosphatemia
    • 2. Urine
    • a. Hypocalciuria
    • b. Hyperphosphatemia - phosphaturic
  • 12. Control of Parathyroid Hormone Secretion
  • 13. CALCITONIN
        • Peptide hormone secreted by the thyroid gland that tends to decrease plasma calcium concentration.
        • Two ways:
    • 1. decrease absorptive activities of the osteoclasts and the osteocytic effect of the osteocytic membrane – immediate effect
    • 2. decrease formation of new osteoclasts – more prolonged effect
    Increased Plasma Calcium Concentration Stimulates Calcitonin Secretion Calcitonin Has a Weak Effect on Plasma Calcium Concentration in Adult Human
  • 14. SUMMARY OF CONTROL OF CALCIUM ION CONCENTRATION
    • 1. Buffer Function of the Exchangeable Calcium in Bones - the First Line of Defense
    • 2. Hormonal Control of Calcium ion concentration – the Second Line of Defense
    • a. PTH
    • b. Calcitonin
  • 15. PARATHYROID HORMONE and BONE DISEASE
    • 1. Hypoparathryroidism
    • a. Tetany – Calcium concentration is 6-7 mg% - Larygospasm
    • Signs of Latent Tetany
            • 1. Chvostek’s sign
    • 2. Trousseau’s sign
    • b. Impairment of blood clotting
  • 16.  
  • 17.
        • 2. Hyperparathyroidism
          • a. Bone Disease
          • - broken bones
          • - Cystic bone disease – Osteitis Fibrosa Cystica or Von Recklinghausen’s Disease
        • b. Effects of Hypercalcemia
        • 1. Rise of calcium to 12-15 mg%
        • - depression of central and peripheral nervous system
        • - muscular weakness, constipation, abdominal pain, peptic ulcer, lack of appetite, depressed relaxation of the heart during diastole
  • 18.
        • 2. Formation of kidney stones
        • 3. Parathyroid hormone poisoning and metastatic calcification- 17 mg% Calcium
          • alveoli of the lungs – tubules of kidneys
          • thyroid gland – walls of the arteries
          • stomach mucosa
  • 19. BONE DISEASES
    • Rickets – Vitamin D Deficiency
        • - occurs mainly in children
    • - results from calcium or phosphate deficiency in the ECF caused by lack of VitaminD
    • - develops tetany
  • 20.
    • Osteomalacia – “Adult Rickets”
        • - deficiency of both vitamin D and calcium occurs as aresult of steatorrhea (failure to absorb fat) because vitamin D is fat soluble
    • - “Renal rickets” is a type of osteomalacia that results from kidney damage
        • Osteoporosis – Decreased Bone Matrix
        • - the most common of all bone disease in adults especially in old age
    • - results from diminished bone matrix rather than poor bone calcification
  • 21.
        • Causes:
        • a. lack of physical stress on the bones due to inactivity
        • b. malnutrition – sufficient protein matrix cannot be formed
        • c. lack of vitamin C – necessary for secretion of intercellular substances
        • d. postmenopausal lack of estrogen secretion – estrogen have osteoblast-stimulating activity
        • e. old age – diminished growth hormone
        • f. Cushing’s syndrome – massive glucocorticoids cause decreased deposition of protein thus depressing osteoblastic activity