NUR 631 Topic 5 DQ 1

Sample Answer for NUR 631 Topic 5 DQ 1 Included After Question

Select two of the following discussion questions for your discussion response. Indicate which questions you have chosen using the format displayed in the “Discussion Forum Sample.”

  1. As with all disorders, it is essential to determine the root cause of endocrine disorders. What are primary, secondary, and tertiary disorders? Compare the differences among primary, secondary, and tertiary forms of hyposecretion and hypersecretion.
  2. The hypothalamic-pituitary system is the main controlling factor for normal endocrine function. What are some of the common ways for this finely balanced system to become unstable?
  3. Explain how the circadian rhythm is related to cortisol secretion from the adrenal cortex. What factors cause disturbances in this system?

A Sample Answer For the Assignment: NUR 631 Topic 5 DQ 1

Title: NUR 631 Topic 5 DQ 1

Q2: The hypothalamic-pituitary system is the main controlling factor for normal endocrine function. What are some of the common ways for this finely balanced system to become unstable?

The hypothalamic-pituitary system is the main controlling factor for normal endocrine functions. There are many opportunities for this finely balanced system to become unstable. For example, the pituitary stalk works with the pituitary gland by releasing all necessary hormones for balance, growth, and stimulation/functions. When the pituitary gland and hypothalamus becomes unstable, it can affect hormonal and temperature regulation, endocrine functions, changes in mood, and can even cause electrolyte imbalances. The hypothalamus/pituitary gland system work together to release hormones such as leutenizing hormone (LH), follicule-stimulating (FSH), adrenocorticotrophic hormone (ACTH), anti-diuretic hormone (ADH), thyrotropin releasing hormone (TRH), growth hormone (GH), and growth-hormone releasing hormone (GHRH), together the balances of these hormones affect growth, fluid balance, the reproductive system, and renal function (McCance et.al, 2019).

One of the ways that this system can become unstable is the growth of a pituitary tumor or lesion that can affect pituitary and hypothalamus functions. A pituitary tumor or lesion can cause an absence of, hypo, or hypersecretion of hormones, dysregulating the endocrine system. Other syndromes include diabetes insipidus (DI) and syndrome of inappropriate anti-diuretic hormone (SIADH). DI and and SIADH lead to imbalances of sodium in the circulatory system. In DI, there is an insufficiency of ADH, symptoms include polyuria (excessive urination) and excessive thirst (polydipsia), this can stem from a hypothalamic or renal standpoint (McCance et.al, 2019). Other methods of imbalance can happen when there are not enough growth hormones being released during or before puberty. Hypopituitarism and hyperpituitarism (primary adenoma) are other imbalances that can affect the endocrine system and lead to drastic changes in hormonal regulation.

Q3: Explain how the circadium rhythm is related to cortisol secretion from the adrenal cortex. What factors cause disturbances in this system?

The primary function of the circadian rhythm is to balance our natural sleep-wake cycle, it is sensitive to changes in light, environment, temperature, sleeping habits. The driving factor behind the circadian rhythm is cortisol, the cortisol awakening response (CAR) occurs daily in the hours upon wakening. According to a sleep study by Babilon et.al, cortisol levels in the morning hours are influenced by environmental factors such as lighting conditions and are at the highest levels during this time of day (2022). Cortisol is supposed to awaken us and provide a boost to get the day started. Cortisol is released from the adrenal cortex and regulated by the hypothalamic-pituitary axis (HPA), it is a stress hormone and is gradually supposed to decrease throughout the day upon awakening (Babilon et.al, 2022). 

At night while we are asleep, cortisol levels rise again slowly, reaching peak levels in the morning. Together this balances out our circadian rhythm. Sleeping habits, stress, and lighting control can cause disturbances in the circadian rhythm. For example, shift workers who can only sleep in the day because they work at night can run on high levels of cortisol constantly which over time can cause stress on the body. Poor sleep habits such as pulling all-nighters or only sleeping a few hours can also throw the system off balance. Lighting is another factor in circadian rhythm dysregulation, for example using a device that emits bright lighting before going to sleep can trick the HPA into thinking it is still daylight, this affects cortisol and melatonin levels throughout time. According to Babilon et.al, light therapy has shown a significant increase in fixing sleep-wake cycles and in stabilizing natural cortisol levels (2022).

References:

Babilon, S., Myland, P., Klabes, J., Simon, J., & Khanh, T. Q. (2022). Study protocol for measuring the impact of (quasi-)monochromatic light on post-awakening cortisol secretion under controlled laboratory conditions. PloS One17(5), e0267659. https://doi-org.lopes.idm.oclc.org/10.1371/journal.pone.0267659

McCance, K. L., Huether, S. E., Brashers, V. L., Rote, N. S. (2019). Pathophysiology: The biologic basis for disease in adults and children (Eighth ed.). Elsevier.

A Sample Answer 2 For the Assignment: NUR 631 Topic 5 DQ 1

Title: NUR 631 Topic 5 DQ 1

The hypothalamic-pituitary system is the main controlling factor for normal endocrine function. What are some of the common ways for this finely balanced system to become unstable?

The hypothalamic-pituitary axis is the basis for the central integration of the neurologic and endocrine systems. It forms what is known as the neuroendocrine system. The neuroendocrine system plays a role in a number of bodily functions including thyroid, adrenal, and reproductive functions. One of the most common causes of disruption of the hypothamic-pituitary axis is interruption of the pituitary stalk which is caused by lesions, rupture after head injury, surgical transection, or tumor. When this occurs, there is an absence of hypothalamic releasing or inhibiting hormones causing a variety of manifestations that will clinically present as pituitary disease. Chronic stress can lead to changes in both ADH and oxytocin release causing significant effects on body fluids, electrolytes, cognitive, emotional, and behavioral responses to stress.

Tumors, pulmonary disorders, central nervous system disorders, as well as surgical interventions and medications are known to cause syndrome of inappropriate antidiuretic hormone secretion (SIADH) secretion. The symptoms of SIADH are caused by the enhanced renal water retention. Symptoms include dilutional hyponatremia, hypervolemia, and weight gain. Diabetes insipidus is caused by an insufficiency of ADH. This is caused by lesions of the hypothalamus, pituitary stalk, or posterior pituitary that interferes with ADH synthesis, transport, or release. Nephrogenic DI is caused by the renal system’s inadequate response to ADH. DI leads to the inability to concentrate urine. Symptoms include diuresis of large volumes of dilute urine, increased plasma osmolalaity, continuous thirst, and polydipsia (McCance, 2019). 

Explain how the circadian rhythm is related to cortisol secretion from the adrenal cortex. What factors cause disturbances in this system?

Circadian rhythm is the periodic pattern that takes about 24hrs. It is where light-dark cycles synchronize biological functions with the environment. The circadian system synchronizes physiology and behaviors so that the body acts like a finely tuned clock. The suprachiasmatic nucleus (SCN) of the hypothalamus functions as the clock master. The SCN aligns the 24hrs rhythm with the body’s systems including other brain regions and peripheral tissues. Identical clock oscillators to the SCN are located in peripheral tissues such as the GI tract, liver, muscle, adipose tissue, and cardiovascular tissue.

These clocks regulate multiple bodily functions. At night, it induces sleep and anabolic functions such as immune function and hormone release. In the daytime, they induce wakefulness and catabolic functions such as metabolism and physical activity. One of the most important hormones in this process is cortisol. Cortisol affects nearly all cells of the body. Circadian rhythm is crucial to physical and mental well-being. Disturbance of the circadian rhythm leads to negative physiological, psychological, and clinical implications.

Cortisol rhythmicity is influenced by factors such as sleep, season, and stress factors such as mental, psychological, or physical status. Plasma cortisol levels are impacted by stress factors, especially during the “fight or flight” response (Azmi, et. al, 2020).

McCance, K., Huether, S., Brashers, V., Rote, N. (2019). Pathophysiology: The Biologic Basis for Disease in Adult and Children (8th ed.). Elsevier. 

Azmi, N., Juliana, N., Azmani, S., Effendy, N., Abu, I., Teng, N., Das, S. (2020) Cortisol on circadian rhythm and its effect on cardiovascular system. International Journal of Environmental Research and Public Health 18(2), 676. https://doi.org/10.3390/ijerph18020676