Mosby’s PATHOLOGY Lesson 7.1 Objectives for Massage Therapists Discuss anatomic structures and physiologic processes related to the endocrine system. Outline the glandular sources of major hormones, as well as their primary effects. Define diseases of the pituitary gland and list appropriate massage considerations. Chapter 7 Endocrine Pathologies Copyright © 2010, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. Copyright © 2010, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. 2 Endocrine System Overview Effects of the Endocrine System Regulatory system Regulates activity of Regulates growth Responsible for helping maintain homeostasis smooth/cardiac and development Regulates Works with nervous system to coordinate muscle and some Regulates functioning of all body systems glands reproductive processes Uses hormones to communicate Regulates chemical Participates in composition and circadian rhythms volume of fluids Alters metabolism Copyright © 2010, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. Copyright © 2010, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. 3 4 Types of Glands Types of Glands (cont'd.) Exocrine glands Endocrine (ductless) glands Sudoriferous : secretes perspiration Adrenals Sebaceous: secretes oil Gonads Ceruminous : secretes earwax Pancreas (islets) Digestive: secrete enzymes Parathyroids Mucous: secrete mucous Mucous: secrete mucous Pineal Pituitary Thyroid Copyright © 2010, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. Copyright © 2010, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. 5 6 Location of Endocrine Glands Pituitary Hormones ACTH, Adrenocorticotrophic hormone LH, luteinizing hormone ADH, antidiuretic hormone PRL, prolactin FSH, follicle -stimulating hormone TSH, thyroid -stimulating hormone From Salvo S: Massage therapy: principles and practice, ed 3, St. Louis, 2007, Saunders. GH, growth hormone From Herlihy B, Maebuis NK: The human body in health and illness, ed 3, Philadelphia, 2007, Saunders. Copyright © 2010, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. Copyright © 2010, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. 7 8 Diseases of the Pituitary Hyperpituitarism Hyperpituitarism Overproduction of pituitary hormones (especially ATCH and GH) causing overstimulation of target Giantism endocrine glands Acromegaly Giantism : GH overproduction occurring during Hypopituitarism childhood Dwarfism Acromegaly : GH overproduction occurring during adulthood Diabetes insipidus Jt. Mobs are omitted or cautiously applied Copyright © 2010, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. Copyright © 2010, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. 9 10 Giantism Acromegaly Form of hyperpituitarism Form of hyperpituitarism causing accelerated causing enlargement of growth due to hands, feet and face with overproduction of GH jaw protrusion due to before onset of puberty overproduction of GH after onset of puberty Jt. Mobs are omitted or cautiously applied Jt. mobs are omitted or cautiously applied Courtesy Dr. Edmund Beard. In Thibodeau GA: Anatomy and physiology, St. Louis, 1987, Mosby College Publishing. A, from Cooke RA, Stewart B: Colour atlas of anatomical pathology, ed 3, Sydney, 2004, Churchill Livingstone. Copyright © 2010, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. Copyright © 2010, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. 11 12 Hypopituitarism Dwarfism Underproduction of pituitary hormones causing Form of hypopituitarism lack of stimulation of target endocrine glands; causing short stature disease manifestations are directly related to resulting from the particular hormone shortage underproduction of GH in Adjust massage according to client vitality childhood (lighter pressure, reduced time); reduce No massage considerations pressure over areas of decreased bone density From Brashear HR, Raney RB: Handbook of orthopaedic surgery, ed 10, St. Louis, 1986, Mosby. Copyright © 2010, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. Copyright © 2010, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. 13 14 Diabetes Insipidus Lesson 7.2 Objectives List diseases of the thyroid gland and outline Condition caused by ADH insufficiently appropriate massage considerations. Adjust massage according to client vitality Name diseases of the parathyroids and state massage considerations. Identify diseases of the pancreas and list appropriate massage considerations. Copyright © 2010, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. Copyright © 2010, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. 15 16 Lesson 7.2 Objectives (cont ’d.) Diseases of the Thyroid List causes, signs and symptoms, and Goiter interventions for hyperglycemia and hypoglycemia. Graves disease Cretinism Define adrenal cortex diseases and list Cretinism appropriate massage considerations. Myxedema Copyright © 2010, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. Copyright © 2010, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. 17 18 Goiter Graves Disease Condition of Enlargement of the thyroid gland hyperthyroidism resulting in a goiter, anxiety and Avoid throat region (local fatigue, overheating, hand contraindication) tremors, eyeball protrusion Reduce treatment time to 30 min if client is fatigued; avoid throat From Seidel H: Mosby ’s guide to physical examination, ed 4, St. Louis, 1999, Mosby. Copyright © 2010, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. Copyright © 2010, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. 19 20 Cretinism Myxedema Condition of Condition of severe or hypothyroidism occurring long -standing in fetal life or early infancy hypothyroidism in adulthood resulting in mental adulthood retardation (if untreated) Adjust massage according to client vitality (lighter Relaxing massage is pressure, reduced indicated treatment time) From Seidel H: Mosby ’s guide to physical examination, ed 5, From Schneeberg NE: Essentials of clinical endocrinology, St. Louis, 2003, Mosby. St. Louis, 1970, Mosby. Copyright © 2010, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. Copyright © 2010, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. 21 22 Diseases of the Parathyroids Hyperparathyroidism Hyperparathyroidism Condition of PTH overproduction Hypoparathyroidism characterized by muscle weakness, fatigue, and hypertension Adjust massage according to client vitality (lighter pressure, reduced treatment time); jt. mobs are omitted or cautiously applied; reduce pressure over areas of decreased bone density Copyright © 2010, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. Copyright © 2010, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. 23 24 Hypoparathyroidism Diabetes Mellitus Condition of diminished parathyroid gland Group of disorders characterized by elevated function leading to hypocalcemia (low blood blood glucose levels due to: calcium levels) Insufficient insulin Adjust massage according to client vitality Resistance to insulin by cells (lighter pressure, reduced treatment time); Both reduce pressure over areas of decreased bone Types are type I, type II, and gestational density diabetes Diabetics must monitor and maintain their blood sugar in a healthy range Copyright © 2010, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. Copyright © 2010, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. 25 26 Diabetes Mellitus, Type I Diabetes Mellitus, Type I (cont'd.) Lack of insulin Hypoglycemia Condition of reduced blood glucose levels Regular injections of insulin needed Major cause in diabetics is overdose of prescribed insulin; second major cause is eating too little food Three P ’s: polyuria , Can occur with all types of diabetics, but more polydipsia , polyphagia common in type I May lead to insulin shock Massage considerations same as type II Can be fatal Offer a source of sugar such as regular soda From Potter PA, Perry AG: Fundamentals of nursing, ed 4, St. Louis, 1997, Mosby. Copyright © 2010, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. Copyright © 2010, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. 27 28 Diabetes Mellitus, Type II Diabetes Mellitus, Type II (cont'd.) Body cells resistant to insulin Hyperglycemia Related to central obesity and Condition of high blood glucose levels sedentary lifestyle; strong Major cause in diabetics is too much food, missed genetic link also exists dose of medication, too little insulin or oral diabetic medication, or too little exercise S/S similar to type I May lead to diabetic coma Can be controlled by regular Can be fatal exercise and maintaining Can be fatal healthy weight Offer water or sugar -free beverage and suggest a glucose level check From Damjanov I: Pathology for the health -related professions, ed 2, Philadelphia, 2000, WB Saunders. Copyright © 2010, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. Copyright © 2010, 2006 by Mosby, Inc., an affiliate of Elsevier Inc. All rights