Thyroid Function Considerations for patient care

Question 1

What is the function of the thyroid

Answer 1

• works on almost every cell in the body
• speeds up cell processes: hyperfunction and increases function of other cells
• increases basal metabolic rate
• works by secreting two metabolically active hormones: T4, T3
• thyroid secretion regulated by anterior pituitary gland

Question 2

What is the thyroid important for

Answer 2

• overall growth esp. in children
• fat and carbohydrate metabolism
• respiratory rate
• GI mobility
• CNS
• sleep
• sexual function

Question 3

thyroid function effects on the cardiovascular function

Answer 3

• decerases systemic vascular resistance e
• increases: heart rate, left ventricular contractility, blood volume

Question 4

What is the thyroid role in blood pressure

with hyperthyroidism

Answer 4

• hyperthyroidism assoicated with arteial stiffness despite a decrease in systemic vascular resistance
• can cause HTN, esp. in older adults with atherrosclerosis
• treatment: B-blockers, treatment of hyperthyroidism

Question 5

What is the thyroid function with blood pressure: hypothyroidism

Answer 5

• tends to result in diastolic HTN
• treatment: treatment for hypothyroidism

Question 6

what is the thryoid function on muscle function

Answer 6

• slight increase in thyroid hormone: stronger muscle contraction
• large increase: protein catabolism = tremor, weakness, myopathy
• decrease in thyroid hormone: takes a while to generate contraction: slower muscle contraction, slower relaxation (EMG = repetitive discharge)
• decrease = cramping, ataxia, hyporeflexia, nystagmus, tremor

Question 7

What are common causes of hypothyroidism

Answer 7

• congential autoimmune disorder such as hashimoto thryoiditis
• thyoid ablation – surgery or radiation
  inceased TSH levels with deceased T3/T4

Question 8

What are common signs and symptoms of hypothyroidism

Answer 8

• weight gain
• cold intolerance
• fatigue
• myxedema: non-pitting, boggy edema: not good venous return
• increased LDL cholesterol; aterriosclerosis, CAD, HTN
• increased risk of stroke

Question 9

PT considerations with hypothyroidism

Answer 9

• can begin exercise once thyroid replacement initiated
• will have had execise intolerance, fatigue, weakness
• rhabdomyolysis possible with exercise
• common assoicated problems that may benefit from PT: arthritis, carpal tunnel, fibromyalgia

Question 10

Hyperthyroidism: causes

Answer 10

• most common cause = autoimmne (grave’s disease)
• Thyrotoxicosis: increased levels of thyroid hormones

Question 11

Neuromuscular signs and sympoms of hyperthyroidism

Answer 11

• proximal muscle weakness, tremor
• impaired coordinaion or balance
• myasthenia gavis: more likely overtime to have this

Question 12

What are PT considerations with hyperthyroidism

Answer 12

• monitor vital signs and exercise responses: tachycarrdia, dyspnea
• increased caution if known heart disease: arrythmia, angina

Question 13

What are the treatments for hyperthyroidims

Answer 13

• antithyroid drugs: beta blockers
• radioactive iodine: reduces function
• surgery

last two will increase the rick of hypofunction

Question 14

What have studies demonstrated with hyperthyroiodism and new onset A-fib

Answer 14

• increased risk of ischemic stroke clustering during the initial phase of presentation
• indicates need for early use of anticoagulation therapy in patients with hyperthyroidism and AF