This document summarizes various endocrine disorders including dwarfism, acromegaly, hyperthyroidism, hypothyroidism, Cushing's syndrome, and tetany. It discusses the causes, signs and symptoms, and investigations for each condition. Dwarfism can be caused by growth hormone deficiency or panhypopituitarism. Acromegaly is characterized by enlarged extremities and is caused by excess growth hormone secretion in adults. Hyperthyroidism often results from Graves' disease and causes symptoms like increased sweating and heart rate. Hypothyroidism in children leads to cretinism and in adults leads to myxedema. Cushing's syndrome is characterized by obesity and is caused by excess cort
Thyroid hormone (The Guyton and Hall physiology)Maryam Fida
THYROID HORMONE
Location:
The thyroid gland located below the larynx on each side of and anterior to the trachea.
Largest Endocrine Hormone
Secretion:
secretes:
1. thyroxine (T4)
2. triiodothyronine (T3)
3. Also secretes calcitonin (an important hormone for calcium metabolism)
Cell: Thyrotopes
secretion is controlled by thyroid-stimulating hormone (TSH) from the anterior pituitary gland.
93% T4 & 7% T3
T4→T3 in tissues
Qualitatively same
Differ in Rapidity & Intensity of action.
T3 is 4 times more potent than T4, but decrease conc. In blood & decrease half life.
T3 and T4 combine mainly with thyroxine-binding globulin.
More than 90% of Thyroid hormone that binds with cellular receptors is T3.
T4
No effect for 2-3 days after injection
Long Latent Period.
Activity peaks in 10-12 days & ↓↓ with a half life of 15 days.
In some cases it takes 6 weeks-2 months.
T3
4 times rapid
Latent Period 6-12 hours
Peak in 2-3 days
Composed of large numbers of closed follicles filled with colloid and lined with cuboidal epithelial cells that secrete into the interior of the follicles
The major component of colloid is the large glycoprotein Thyroglobulin contains the thyroid hormones within its molecule.
50mg/year, 1mg/week
Ingested iodine in the form of iodides
Iodides ingested orally are absorbed from GIT
⅕ removed from the blood by thyroid cells for synthesis of hormones; rest excreted through kidneys.
Basal membrane of thyroid cells has an active pump to push iodides to interior (Iodine Pump).
Normally 30% more conc. Inside
Max. active 250% more conc. Inside
The rate of Iodine trapping is influenced by conc. of TSH
TSH stimulates and hypophysectomy greatly diminishes the activity of the iodide pump in thyroid cells.
Hormones of pancreas (The Guyton and Hall physiology Maryam Fida (o-1827))Maryam Fida
Pancreas is composed of two major types of tissues.
1. The Acini: which secrete digestive juices into the duodenum.
2. The islets of Langerhans: Contain three major types of cells INSULINMetabolized by the enzyme Insulinase (present mainly in the liver, kidneys and muscles).
Insulin is a small protein, it is composed of two amino acid chains connected to each otherby disulfide linkages. When the two amino acid chainsare split apart, the functional activity of the insulinmolecule is lost.
Insulin is synthesized in the beta cells.
Diabetes Mellitus
Thyroid hormone (The Guyton and Hall physiology)Maryam Fida
THYROID HORMONE
Location:
The thyroid gland located below the larynx on each side of and anterior to the trachea.
Largest Endocrine Hormone
Secretion:
secretes:
1. thyroxine (T4)
2. triiodothyronine (T3)
3. Also secretes calcitonin (an important hormone for calcium metabolism)
Cell: Thyrotopes
secretion is controlled by thyroid-stimulating hormone (TSH) from the anterior pituitary gland.
93% T4 & 7% T3
T4→T3 in tissues
Qualitatively same
Differ in Rapidity & Intensity of action.
T3 is 4 times more potent than T4, but decrease conc. In blood & decrease half life.
T3 and T4 combine mainly with thyroxine-binding globulin.
More than 90% of Thyroid hormone that binds with cellular receptors is T3.
T4
No effect for 2-3 days after injection
Long Latent Period.
Activity peaks in 10-12 days & ↓↓ with a half life of 15 days.
In some cases it takes 6 weeks-2 months.
T3
4 times rapid
Latent Period 6-12 hours
Peak in 2-3 days
Composed of large numbers of closed follicles filled with colloid and lined with cuboidal epithelial cells that secrete into the interior of the follicles
The major component of colloid is the large glycoprotein Thyroglobulin contains the thyroid hormones within its molecule.
50mg/year, 1mg/week
Ingested iodine in the form of iodides
Iodides ingested orally are absorbed from GIT
⅕ removed from the blood by thyroid cells for synthesis of hormones; rest excreted through kidneys.
Basal membrane of thyroid cells has an active pump to push iodides to interior (Iodine Pump).
Normally 30% more conc. Inside
Max. active 250% more conc. Inside
The rate of Iodine trapping is influenced by conc. of TSH
TSH stimulates and hypophysectomy greatly diminishes the activity of the iodide pump in thyroid cells.
Hormones of pancreas (The Guyton and Hall physiology Maryam Fida (o-1827))Maryam Fida
Pancreas is composed of two major types of tissues.
1. The Acini: which secrete digestive juices into the duodenum.
2. The islets of Langerhans: Contain three major types of cells INSULINMetabolized by the enzyme Insulinase (present mainly in the liver, kidneys and muscles).
Insulin is a small protein, it is composed of two amino acid chains connected to each otherby disulfide linkages. When the two amino acid chainsare split apart, the functional activity of the insulinmolecule is lost.
Insulin is synthesized in the beta cells.
Diabetes Mellitus
enlists and the description of the different descending tracts of the CNS. cortico spinal tract, cortico bulbar tract, extra pyramidal and pyramiddal tracts, homunculus, vestibulospinal tract, reticulo spinal tracts, tectospinal tract, autonomic tract, uppermotor neuron lesion, lower motor neuron lesion, spinal cord injury, brown sequard syndrome. spinal cord infection, degenerative disorders of spinal cord,
this is a content on adrenal medulla made by myself. Here i tried to bring out the whole system in a short note. i hope it would be helpfull for someone.
Cervical spine trauma and spinal cord injuries by Dr Shamavu Gabriel.pptxGabriel Shamavu
PAEDIATRICS TRAUMA ADVANCED LIFE SUPPORT PRESENTATION
Cervical spine trauma and spinal cord injuries
Prepared by Dr GABRIEL KAKURU SHAMAVU, Resident in Paediatrics and child health at Kampala International University Teaching Hospital. With Mentorship of Professor Yamile Arias Ortiz. Tutor of the course of "Paediatrics Emergencies and life support". Mars 2022
enlists and the description of the different descending tracts of the CNS. cortico spinal tract, cortico bulbar tract, extra pyramidal and pyramiddal tracts, homunculus, vestibulospinal tract, reticulo spinal tracts, tectospinal tract, autonomic tract, uppermotor neuron lesion, lower motor neuron lesion, spinal cord injury, brown sequard syndrome. spinal cord infection, degenerative disorders of spinal cord,
this is a content on adrenal medulla made by myself. Here i tried to bring out the whole system in a short note. i hope it would be helpfull for someone.
Cervical spine trauma and spinal cord injuries by Dr Shamavu Gabriel.pptxGabriel Shamavu
PAEDIATRICS TRAUMA ADVANCED LIFE SUPPORT PRESENTATION
Cervical spine trauma and spinal cord injuries
Prepared by Dr GABRIEL KAKURU SHAMAVU, Resident in Paediatrics and child health at Kampala International University Teaching Hospital. With Mentorship of Professor Yamile Arias Ortiz. Tutor of the course of "Paediatrics Emergencies and life support". Mars 2022
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Degeneration & regeneration of nerve fiber.ppt by Dr. PANDIAN M.Pandian M
INTRODUCTION
CLASSIFICATION OF NERVE INJURIES
INJURY OF THE NERVE CELL BODY
INJURY OF THE NERVE CELL PROCESS
CHANGES IN THE DISTAL SEGMENT OF THE AXON
CHANGES IN THE PROXIMAL SEGMENT OF THE AXON
CHANGES IN THE NERVE CELL BODY
RECOVERY OF THE NEURONS FOLLOWING INJURY
REGENERATION OF AXONS IN THE PERIPHERAL NERVES
REGENERATION OF AXONS IN THE CNS
COMPOSITION
BLOOD CELLS
PLASMA
SERUM
FUNCTIONS
NUTRITIVE FUNCTION
RESPIRATORY FUNCTION
EXCRETORY FUNCTION
TRANSPORT OF HORMONES AND ENZYMES
REGULATION OF WATER BALANCE
REGULATION OF ACID-BASE BALANCE
REGULATION OF BODY TEMPERATURE
STORAGE FUNCTION
DEFENSIVE FUNCTION
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Anti ulcer drugs and their Advance pharmacology ||
Anti-ulcer drugs are medications used to prevent and treat ulcers in the stomach and upper part of the small intestine (duodenal ulcers). These ulcers are often caused by an imbalance between stomach acid and the mucosal lining, which protects the stomach lining.
||Scope: Overview of various classes of anti-ulcer drugs, their mechanisms of action, indications, side effects, and clinical considerations.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
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Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
3. • Dwarfism.
• Dwarfism is a pituitary disorder in children,
characterized by the stunted growth.
• Hypoactivity of anterior pituitary
• It Dwarfism may be due to endocrinal or non-
endocrinal causes.
• Endocrinal causes of dwarfism are:
• Growth hormone deficiency (pituitary dwarf),
• Panhypopituitarism,
• Hypothyroid dwarf and Cushing’s syndrome
4. •Non-endocrinal causes of dwarfism
include:
•Familial dwarfism,
•Achondroplasia,
•Nutritional (malnutrition or malabsorption),
•Chromosomal abnormalities, e.g. Turner’s
syndrome and
•Psychological dwarfism (Kasper–Hauser’s
syndrome).
5. • Causes:-
• Reduction in GH secretion in infancy or early childhood Causes dwarfism.
• It occurs because of the following reasons:
• Tumor of chromophobes: It is a non-functioning tumor, which
compresses and destroys the normal cells secreting GH.
• It is the most common cause for hyposecretion of GH, leading to
dwarfism
ii. Deficiency of GH-releasing hormone secreted by hypothalamus
iii. Deficiency of somatomedin C
iv. Atrophy or degeneration of acidophilic cells in the anterior
pituitary
• Panhypopituitarism: In this condition, there is reduction in the secretion
of all the hormones of anterior pituitary gland.
6. • II. Signs and symptoms:-
• Stunted skeletal growth
• The proportions of different parts of the body are almost
normal.
• Reproductive function is not affected, if there is if there is
only GH deficiency.
• During panhypopituitarism, the dwarfs do not obtain puberty
due to the deficiency of gonadotropic hormones.
7.
8. • Acromegaly is the disorder characterized by the
enlargement, thickening and broadening of bones,
particularly in the extremities of the body.
• Acro – Peripheral part
• Megaly – Enlargement
• Causes:-
• Acromegaly is due to hypersecretion of GH in adults
• after the fusion of epiphysis with shaft of the bone.
• Hypersecretion of GH is because of tumor of acidophil
cells in the anterior pituitary.
9. •II. Signs and symptoms:-
i. Acromegalic or gorilla face: Face with rough
features such as protrusion of supraorbital ridges,
broadening of nose, thickening of lips, thickening and
wrinkles formation on forehead and prognathism
(protrusion of lower jaw)
ii. Enlargement of hands and feet
iii. Kyphosis (extreme curvature of upper back –thoracic
spine)iv. Thickening of scalp. Scalp is also thrown into
folds or wrinkles like bulldog scalp
v. Overgrowth of body hair
10. vi. Enlargement of visceral organs such as lungs,
thymus, heart, liver and spleen
vii. Hyperactivity of thyroid, parathyroid and adrenal
glands
viii. Hyperglycemia and glucosuria, resulting in
diabetes mellitus
ix. Hypertension
x. Headache
xi.Visual disturbance (bitemporal hemianopia)
11.
12. • Hyperthyroidism - Increased secretion of thyroid hormones is called
hyperthyroidism.
•
• Causes of Hyperthyroidism:-
• Graves’ disease or toxic goitre or thyrotoxicosis is the most common
cause of hyperthyroidism.
• It is an autoimmune disease
• The thyroid-stimulating antibodies (TSAb) against the TSH
receptors, also called long acting thyroid stimulator.
• These antibodies bind to TSH receptors and mimic TSH action on
thyroid growth and hormone synthesis.
• The entire thyroid gland undergoes hyperplasia as a result of
autoimmune stimulation.
13. • Signs and Symptoms of Hyperthyroidism:-
• Exophthalmos
• Toxic goiter
• Intolerance to heat
• Due to increased BMR caused by excess of thyroxine
• Increased sweating due to vasodilatation
• Decreased body weight due to fat mobilization
• Diarrhea due to increased motility of GI tract
• Muscular weakness because of excess protein catabolism
• Nervousness, extreme fatigue, inability to sleep, mild tremor in the
hands and psychoneurotic symptoms such as hyperexcitability.
• Extreme anxiety or worry.
• Oligomenorrhea or amenorrhea & Tachycardia and atrial fibrillation
14. • Investigations:-
• Both T3 and T4 plasma levels are elevated.
• TSH is low or may become undetectable.
• 131 I Uptake is increased, i.e. > 35% at 5 h.
• TRs antibodies may be increased > 7 U/1, (N = <
7U/l).
• Serum cholesterol is less.
• ECG shows tachycardia and arrhythmia.
• Ultrasonography of thyroid gland shows diffuse goitre.
15.
16. • Cretinism
• Cretinism is the hypothyroidism in children, characterized
by stunted growth.
• Also known as infantile hypothyroidism
• Causes for cretinism:-
• Cretinism occurs due to congenital absence of thyroid gland,
genetic disorder or lack of iodine in the diet.
• A newborn baby with thyroid deficiency may appear normal
at the time of birth because thyroxine might have been
supplied from mother.
• Unless treated immediately, the baby will be mentally
retarded permanently.
17. • Features of cretinism:-
• Sluggish movements and croaking sound while crying.
• Stunted growth
• The tongue becomes so big that it hangs down with
dripping of saliva.
• The big tongue obstructs swallowing and breathing.
• Guttural breathing that may sometimes choke the
baby.
20. Characteristic features:-
• Deficiency of GH causes retardation of growth in all parts of the body
proportionately.
• Consequently, a pituitary dwarf with a chronological age of 20 years has the
body structure like that of a normal child of 7–10 years of age.
Thus, a pituitary dwarf has following features
• Shortness of stature,
• Normal mental activity,
• Plumpness (fatness),
• Immature faces,
• Delicate extremities and
• Sexual maturity does not occur when associated with the gonadotropin
deficiency.
21. • Infantile hypothyroidism (cretinism).
• It occurs when thyroid deficiency occurs during first year of life
• Its characterized by mental retardation, marked retardation of growth,
• Delayed milestones of development, pot belly, protruding tongue, flat
nose, dry skin and sparse hairs.
• Radiograph of bone shows delayed bone age.
• At adolescence, hypothyroidism is characterized by short stature,
• Poor performance at school, delayed puberty and Sexual maturation.
• Other features of adult hypothyroidism are present to variable degree.
• Treatment:- should be prompt otherwise, mental deficiency will
persist.
22.
23. I. Myxedema (HYPOTHYROIDISM)
• Myxedema is the hypothyroidism in adults,
• Characterized by generalized edematous appearance.
• Hypothyroidism leads to myxedema in adults and cretinism in children.
• Causes for myxedema:-
• Myxedema occurs due to diseases of thyroid gland, genetic disorder or iodine
deficiency.
• In addition, it is also caused by deficiency of thyroid-stimulating hormone or
thyrotropin-releasing hormone.
• Common cause of myxedema is the autoimmune disease called Hashimoto’s
thyroiditis,
• Its common in late middle-aged women
• In most of the patients, it starts with glandular inflammation called thyroiditis
caused by autoimmune antibodies.
• Later it leads to destruction of the glands.
24. II. Signs and symptoms of myxedema:-
• Typical feature of this disorder is an edematous appearance
throughout the body.
• It is associated with the following symptoms:
1. Swelling of the face
2. Bagginess under the eyes
3. Non-pitting type of edema,
4. Atherosclerosis
5. Cold intolerance.
6. Depressed hair growth
7. Scaliness of the skin
8. Constipation
25. Investigations:-
•Serum T3 and T4 levels low
•Serum TSH levels high in primary and low in
secondary hypothyroidism
•Serum cholesterol high
•Peripheral blood film macrocytic anaemia
•Photomotogram—delayed ankle jerk.
26.
27. •Attitude of hand in carpopedal spasm includes:
i. Flexion at wrist joint
ii. Flexion at metacarpophalangeal joints
•Extension at interphalangeal joints
•Adduction of thumb.
28. • TETANY
• Tetany refers to a clinical condition resulting from
increased neuromuscular excitability.
• Hypocalcemia causes neuromuscular
hyperexcitability, resulting in hypocalcemic tetany.
• Normally, tetany occurs when plasma calcium level
falls below 6 mg/dL from its normal value of 9.4
mg/dL.
29. • Causes:-
• Causes of tetany include:
• Hypocalcaemia - Extracellular calcium plays an
important role in membrane integrity and excitability.
• Hypomagnesaemia - also causes tetany, because
magnesium ions are also associated with
neuromuscular irritability.
• Alkalosis - which reduces ionic calcium, can also
produce tetany.
30. • Mainly three hormones regulate Blood calcium level
• Parathormone
• 1,25- dihydroxycholecalciferol (Calcitriol) – Thyroid
gland
• Calcitonin
• Source of Calcium – whole milk, low fat milk,
cheese, other dairy products, vegetables, other
substances such as meat, egg, grains etc.
31.
32. • Cushing syndrome is a disorder characterized by obesity.
• Causes:-
• Cushing syndrome is due to the hypersecretion of
glucocorticoids, particularly cortisol.
• It may be either due to pituitary origin or due to adrenal
origin.
• If it is due to pituitary origin, it is known as Cushing disease.
• If it is due to adrenal origin, it is called Cushing syndrome.
• Generally, these two terms are used interchangeably.
33. • Signs and Symptoms:-
• Moon face
• Torso
• Buffalo hump
• Pot belly
• Purple striae
• Thinning of skin and
• Poor wound healing.
34. • Tests for Cushing Syndrome
• i. Observation of external features
• ii. Determination of blood sugar and cortisol levels
• iii. Analysis of urine for 17-hydroxysteroids.
• Treatment for Cushing Syndrome
• Treatment depends upon the cause of the disease.
• Treatment may include cortisol-inhibiting drugs, surgical
removal of pituitary or adrenal tumor, radiation or
chemotherapy.
35.
36. • Goiter in Hypothyroidism – Non-toxic Goiter
• Non-toxic goiter is the enlargement of thyroid gland
without increase in hormone secretion.
• It is also called hypothyroid goiter
37. • It is classified into two types:-
a. Endemic colloid goiter – caused by iodine deficiency
b. Idiopathic non-toxic goiter - due to unknown
Cause
• Thyroid hormone have two major effects
• To increase BMR
• To stimulate growth in children
• On CNS – very essential for development & maintenance of normal
functioning of CNS.
38. Action of TH are:-
•On CVS – HR & Force of contraction increases
•On RS – thyroxine increases rate and force of
resp. indirectly.
39. Referred :-
• Text book of Medical Physiology
• Guyton, 13th edition,
• Text book of Medical Physiology
• Indu khurana,
• Text book of Medical Physiology
• Vander’s
• Text book of Medical Physiology
• Sembulingam &
• LPR