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look. Okay, I make it half six. So let's get started. It's quickly. I do that. Everybody. Welcome to the atrial healthcare. Uh, serious. That's our session on endocrine anatomy. It's going to talk by the wonderful Muir E. I hope I got her year, right. I should probably double check what year she was before I stuck it on this slide. I think your fourth year on Humira. Yeah. Yeah. Ah, yes. Result. Um, yes. So wonderful, Mary. And this was one. Uh, I couldn't really find a picture of you not in scrubs and a mask, but I think that's probably in part for covert set that wonderful Mary. Some housekeeping just had to make most session. Do feel free to take notes. He's really even if you just take very basic notes. This is a really good way to help. Still things your memory on improve your learning. Ask questions. The more you participating more active, you are in a session that's again proven to show proven that you will get better attention on learn mawr. Finally, if you enjoy any particular bits and you want to find out more police over it, email on or just ask questions or email, and we can send for the resources to you to further you're learning. That's my email address. I'm sure the majority of you know all of you have got metal ready, But feel free to email me if you have questions or any particular things you want more information on because follow instagram and on Facebook, both of the atrial healthcare. And I'm doing my best to try and be better at running both of them. I'm not very good at it there with me, fairly. These and sessions we have currently this is our sessions up until the end of March in yellow is our nutrition session that's supposed to be a couple weeks ago. Unfortunately, Speaker wasn't available due to the last minute problems, but, well, hopefully gonna put that in a bit later on, we'll keep people updated on that. So this actually is our first session off 2022. There's going to clinical cases in a couple weeks time that will be discussed basic talking about some patient presentations and teaching for those that we have some bone and ask me for a couple times on. Then it's a little health so should be some good sessions. Pleased to come along to them. And was that? I will hand over to Mary Joe on to share your slides. Please get a second when my team doesn't teams doesn't stop lagging that one. I could put your face on it. That's a good start. I think it looks like I love everyone and I give me a couple of seconds. Teo, you might need to stop sharing yours to let me see your mind. Yeah. Slide already. Okay, let me start sharing for just a second. Then it was working earlier, and then I just decided that power point is gonna be a pain in my butt. Here we go. There we go. I see. Right that. See if this works now. Fab. Okay, it's working. Okay. Yes, that's excellent. Over to you. Thank you very much. If you see me looking on my corner, it's with my nose around on the left hand side. So that's why I'm looking slight. The left. But welcome to the session in under current anatomy for the city that haven't been to any of these sessions before. My name is my theory. I did a session a while ago now and he goes back in July or August. Um, Andi, we covered a little bit about bones skeleton, but this time we're going. It'll end of crime on all things hormones related. Yeah, I am 1/4 year medical student, but the London A Queen Mary University. I have a B, S c and biomed. Also, Saint John Volunteer, as is pretty much everyone doing this doing this Siris eso I hope you find this useful, as always, pop messages in the chat Friday. I think you might need to read them out to me because there's an interaction in this pile point. So hopefully you guys are involved in thank you very much and learn a lot from this. So we'll kick things off. Okay, Die on me today. Teams. Okay, right. So the learning outcomes from today we'll quickly union overview of what the role of the endocrine system is well chopped through. It's actually how I slept. The up is through the different organs. Now the endocrine system has a lot of organs involved. We'll chat a bit about the hypothalamus and the pituitary gland, but the thyroids parathyroids kind creates that urinal grinds and the ovaries and testies. These are broadly speaking, the key things you need to know about. But as a as as like Freddy has said, make notes, don't expect to learn everything right away. We understand this is to give you a little bit of a taste. Er, I tried to make this a simple as I can, but not to sound really patronizing on give you a flavor of what endocrinology is all about and hopefully get you interested in it as well. So we'll kick things off with the overview section. So what is the end there? Crime systems role. So the end of current system essentially uses chemical signaling on the role of this chemical signaling. I guess it's to communicate and facilitate communication between different parts of the body, and then doing so allows home your status to be maintained. If you don't know what home your Stasis is, it probably the word that is associated with the crazy? It's the word associated with chemical reaction. It's the idea of keeping the body in a state of balance. In a state of a dynamic equilibrium where things can essentially saying balance, you might get things shifting of it to the left it a bit to the right of this balance. But ultimately it will allow this balance to be maintained on. And this is really important. Allows us to conserve energy so that we can then use that energy when we need it. It allows us to maintain a wide variety of body functions. This could be helping us grow. This has helped us developed. This can help with things, even just the basic things, like maintaining your blood sugar, making sure that you have the right amount of sugar going through your bloods. Um, so that you know, if you don't get really hungry, increases the level of blood sugar on you. Don't feel as hungry decreases the level of flushing it sold. There's various different ways that this this endocrine system work. So I think it's quite ambulated body system. It's got some huge importance, but not many people care about. It is much and so there are no ducks and occurring that it's standard resistant, which is made of glands and essentially where there are some debts. But the majority of this is run by hormones, and these hormones essentially secreted into the blood on get transported around the body in that respect, all kind of there. Some nervous system impact. But on the whole, it's mostly run by these hormone chemicals. Beach happens, wanted everywhere on the body by the second surgery system. So that's how that works. And as I said earlier that you saw on the previous two sides before that, there are a wide range of organs that are involved in this undercurrent system, and they are skeptics throughout the body. So, unlike, perhaps, let's take the cardiovascular system. Yes, the blood is technically everywhere, but it's the heart. Well, they're especially just a vicious the lungs. This is with encompassing a wide range, different organs that from your head to toes like so it's it's big in that respect. And and, as I said earlier, the main undercard in gloves that will be focusing on the pancreatitis, hypothalamus, pituitary gland, the adrenal glands, parathyroids cetera. But before we go into that, the key concept that you need to understand is it's negative feedback loop. So I've promised that on the Internet, which hopefully explains the idea of a negative feedback loop very, very simply so if Let me get my laser pointer. Are you? So you've got this person here who is absolutely freezing, so their body temperature is too low. So in all that her, I guess, maintain their body temperature. It increases because the body is shivering in this case, right? And so, by shivering, you're using your muscles. You're producing energy keeps the nicer Well, happy days. This person is now happy. Other things That money, for example happen is your brain signals you to put jacket on. Right, So you put your jacket on, it's warm. But then you know you you start to overheat at times and therefore in order to maintain that balance so that you end up if you don't overheat, you start to think what you need to call down a bit. So you might take that jacket off or you might sweat, and that maintains his body temperature. So the idea is, in a way, with a negative feedback, like it stops. You go from one extreme and stops your phrasing the other extreme, and tries to keep you in this kind of area here with Sometimes you're not developing this when somebody and overlapping that way. You know, if you're in the sunny weather in Australia right now, you might be sweating you about stuff. And that's okay, because that's how your body essentially responds to the extreme temperature. Or you might be like actually, I really want some somewhere with a conditioning's used. Also, if you run into the nearest shopping mall or whatever O'Neill, time to decide. You know you're freezing and you go into Is that question for me? Okay, it's on. If it if it's cold, then you're you're trying to run into the nearest place with water in it. So there's different ways that can work. But the idea related feedback loop, because this energy, if there's too much of one thing, you try and do the opposite to make it go down. And there's too much of one other thing. You try and increase the other things go up. So that was kind of essentially what that concept is that you understand it a bit more. We talk about hormones in a minute. Let me get rid of this later point. Okay, so let's talk about this with this. All right? Let's talk about the hypothalamus in the pituitary gland. So in this case you can see that the hypothalamus and the trick is located. So it's just under the base of the brain. This green structure here is highlighted. Angry. It's the hypothalamus. That's what we'll talk a little bit more about your back to me in a second. So this is second. So this is the hypothalamus here on the patootie grand right here. So we're going to talk about the hypothalamus first. This is located pretty much directly under the brain. On the idea is it secretes hormones that essentially they don't directly impact body functions. They indirectly. So they're kind of like the first messenger, these hormones that are released from the hypothalamus and then the government effect that Patricia glands and then go and secret hormones, which then the's homeowners then affect the organ. So it's kind of like the Kickstarter in a real a race. It's that first runner, um, that is running with the battle on have to pass the first doctor across to the next. You're alert. That's essentially what the hyper the hypothalamus in the hypersaline Coleman's do. And as we said earlier, ultimately home your status is the idea of keeping everything in a dynamic balance. But how does the hypothalamus no one to release these hormones was? Quite simply, it is your brain signaling everything that you everything in your environment accidents, stimulus, the cold weather, the warmer than life. We took that concept from the previous light. You know, your body temperature is sensed by receptors in your skin, and it's freezing, so it signals to your brain, too. Then, you know, make you put a coat one in a similar way. They're stimulus outside and also inside your body once they're detected. Your nervous system that's magical. Start basically signals to your brain that you need to release some hormones in the heart from the hypothalamus to then kind of kick off. This cascade of hormones and reactions don't care, so that the body function that is desired is performed, and we'll explain that a little bit more in detail when you get the context. But so essentially that hard with calories in the hope of the long acting form, it's exit, the first battle carrying really race runner. So I have that makes sense, and then you've got the pictures you gone. So this sits in the cellar testicle, which sound, which basically is Latin for the Turkish shadow. Now, if you, Maggie, cast your mind back to this family bones and we looked at their bones of the skull. Does Family Point is like this but fly shaped bone in your skull? And it connects all the different brands of the skull together, and it's It's sort of like in the middle. If you have a cross section of my head, it's kind of like in there and in there. Basically, if you had store line three, you can google it that later on, it's actually that's where the pituitary gland sits. This kind of images basically show you that this is the seller testicle here, and that's that's very good bone overall, that's your pituitary gland. Now the patrol got to spit into your anterior, which is this kind of gold ish brown color on the posterior pituitary images. Pinkish color Celeste about the anterior pituitary. This is the biggest part of this problem or important posterior pituitary, because the hormones that come from the hypothalamus here essentially backed on the anterior pituitary gland to then release further home. It's so this is the okay. The first read, a race runner is running from the hypothalamus, passes the bathroom across to the anterior pituitary gland, and that releases another whole bit. So that's come about the second. Read a race right now, if you like. Now, this is now essentially the anterior pituitary or the pituitary gland, and the hypothalamus connected via pituitary stalk on a little bit about that later. But the main thing to know is that the hormones from the hypothalamus end to the anterior pituitary gland through a blood circulate three little systems. There's a little correction system of blood vessels here that's called the Hope oh physiolo system. So that basically means that blood connects the hypothalamus on the anterior pituitary gland. And that's how those hormones travel as pretty much it does everyone else. But the reason I'm saying that is because the posterior got a slight difference. So this infundibular stork actually contains um, nerves and axons. So that's how the hypothalamus continue communicates with the posterior pituitary gland. That was the key difference. You need to know. So the anterior pituitary gland has a connection with the hypothalamus fire bloods system, whereas the posterior pituitary is connected by essentially in stock. But nerves is how they communicate the antipathy 100. Patricia around the reason why that's important. It secretes more hormones, and they won't focus more on those. But we will talk about the two main hormones associated with the posterior pituitary gland. Soup s So that's those are the two key bits that I don't want to quite here. Now, we're gonna go on some very complicated and, um so this that this looks complicated, but I promise you, it's really not that bad. Ignore the median eminence bit. Don't worry about that. So this is like the hypothalamus. We're going to make it very simple. And these are some nerves in the hypothalamus or cells in the hypothalamus. There's different cell types that release different tires. Informants. So these are your hypothalamus hope. Hope for thalamic comment. We'll go through the one by one. Don't worry about the abbreviations. As they said, it's not something for you to take away too much. And don't get too overwhelmed by this just to give you a broad idea of how these popular like. So there's a group of cells here in your hypothalamus that release the gonadotropin releasing homework. That's G N orange. This acts on a group of cells in the anterior pituitary is up in the anterior pituitary gland. That release and this wrist. These cells release FSH, the follicle stimulating hormone, and LH, which is luteinizing hormone. You may have had these hormones before, when we talked about if you talked about this in school, I think you might have done already depends on your age. But you would have heard about this in uh, when they took about the reproductive system. But the menstrual cycle and the Varian cycle and how the ovary matures. And you know, if if it's not for the egg is fatter, you're slightly over. Insulin of the toward the egg isn't maturing and the follicle, and if it then you know all that kind of stuff where it gets first lies of dozen, you know, menstrual cycle, so very quick thing. But this is this pathway is associated with all things you have, sexual development and ovary test is, and we'll talk more about that in detail. But that's what this pathway is now. When I said, we'll talk a bit about negative feedback, but oats will talk about about negative feedback. Treat the end of this light, but that's what this pathways that's gonna have a trip and releasing hormone, FSH and LH, which acts on the going ads. And then we'll talk about later. But the going nuts then released they're in hormones, too. Um, this one, this lately apartment here is associated with quarters. Also, this is the corticotropic releasing hormone, the axon cells in the anterior pituitary gland again, which which then produces adrenocortical terrific releasing hormone well and adrenal go traffic home and sorry on. So it's all kind of similar names, but don't worry too much. That's on the adrenal cortex, which then also releases a hormone so you can quantity. There's a real memory is going on hormone. One comes in the hypothalamus for my toe comes in the interior structure gone home when three comes from a different set of Walgreens. Here in this, this green one is the thyroid was, This is oh, you get is long. There's a lot of wrong names here to bear with me. When I tried pronounced, this's the fire and trophic releasing hormone that then released that acts on the thyroid stimulating hormone, which then causes thyroid hormones to be produced. That's again another pathway over. It's like 123. Prolactin is interesting ones that this is known for breastfeeding and associate it with milk production in women that are that have just given recently. Giving bear for that helps with the development of breast you pregnancy so they can accommodate for the increased space needed to store the milk. So that's what prolactin is for. This is prolactin releasing hormone, which stimulates the production of productive from the anterior pituitary gland, and that stimulates the memory. Glanced. Isn't she developed now? Dopamine. Can you see there's a negative simple here, So no dopamine essentially inhibits this whole process, so it inhibits prolactin release. So prolactin releasing hormone increases that dopamine decreases. That similar kind of anything happens here is also this is the growth hormone releasing hormone surprise price and the which stimulates growth hormone to be released, which then acts pretty much on various parts of the body. Liver is one of them, but pretty much everywhere, and ultimately as the names that suggests it helps with you growing, and this you can see here like dopamine inhibits product in somatostatin inhibits growth hormone. That's, um, guess the subways of an example of a negative feedback Where, rather than you kind of having the product inhibiting the main starting point, you have another hormone inhibiting the main starting point. But in these cycles here, if I was still, let's just pick one. Let's pick this. Let's pick the thyroid hormone That's been really easiest to talk. And so he had it releases fire at home, and we're gonna call that Ti hates right? So you've got the fire, a terrific releasing hormone produced by the hypothalamus, which then acts on the Ampyra. Treat your gland cells to produce tired, thyroid stimulating hormone, which acts on the thyroid to produce thyroid home now thyroid hormone, then technically can negatively in hib it the production of TSH. So it stops the anterior should Really the arrow should kind of go here. Really? Let's just draw it here. That might be better. Yeah, so actually negatively packs the anterior Patricia plants. Then you get decrease in TSH production. The same thing also have been. So this is that the thyroid hormone can then also negatively inhibits the hypothalamus on then stop trh being released. So the idea is this end product that kind of would be in this little bit here. These end products that produced for by the governor's by the adrenal cortex by the thyroid and so on. All of these three products can essentially negatively inhibit the anterior pituitary gland on the hypothalamus to kind of maintain that balance in that home. Your Stasis because we don't want too much of these hormones and we don't want to little of the media. I hope that makes some sense again. Don't get too overwhelmed by this. There's a lot of hormone pathways, and once you kind of write them out a couple times, they get into your head quite usually. But just remember that it's kind of like a three step at the moment process. The hypothalamus in print out is usually the first step second anterior pituitary gland, and the third step is a target organ, which often can release another hormone that sometimes it does. No, uh, as you would have seen, for example, remember again, it doesn't really release anyone, would. But that's the key overall concept now in the poster project, Uganda's We said Robin it being home is that secreted in this case into the blood stream which don't act here. Instead, you've got a slightly different concept going on. So you've got these know these new These were, like, technically, new risk your E to resell. So these neuro security three cells isn't really some like some salt chemical signaling via the nerve. So it's, um, more like nervous input into that which that acts on the posterior pituitary gland, which doors these hormones. So these hormones 80 hate of oxytocin, I really important hormones, too often like he did say that the answer truthfully is gonna be coming into play more. But this is the transfer me to talk to you about the cost of a true true planted here. So there is two hormones that you need to essentially. No. The first one is anti dot all righty hormone or also known as a vase. The person what that does is essentially helps with act on the kidney and therefore retains water. So when you feel dehydrated on you find that your pees a lot darker, and that's because a D hate is partly playing a role in that it helps retain the water, making your urine darker, you know, if you add water to it, let's say, um, some food coloring unit is that the color gets lighter after a while, and that's pretty much why. So if you've got in this any of use if you're taking. If you add more food dye and there's less water than you, the coloring is darker. In some ways, I guess it's the easiest way to the means to describe it. But a D. H basically helps retain the water, making your urine darker. You need more water. You feel dehydrated. You want a story you don't know. Lose more by sweating or by going to the toilet more. That's essentially what a T H does. Oxytocin is known for being on hormone associated with pregnancy and labor so you can actually prescribe. Oxytocin is a medication on the label would, and it helps induce you to run into contractions to allow the lady to push out the fetus to become the newborn. So that's essentially what those two other architects is also associated things like maternal bonding. It's also known for things that lactation and breastfeeding and that kind of stuff So maybe there's a involvement you could probably research. There's actually I don't know, but maybe oxytocin could be used. Could be looked into with regards to things like postnatal depression, which is when some some people call it baby Blues. But it's more seriously the baby blues. When mothers are Some others are, you know, most of depression up. Giving birth on that is common on some baby oxidation could be used to nose, but it's definitely used on the labor would help induce contractions. So that's that. Hopefully, that makes sense. Is that any questions so far? I know that's a bit of a quite a lot of information is I'll take some questions now Friday if we got anything. No, that's good. Okay, I heard that makes sense. But essentially everything else questions, please also test me. Okay, right, try. But yeah, he's actually like it's a real a rice three stages. That's the main thing is no. This is. We'll go over this constant again and again and again throughout the different organs that we'll talk about, so we'll jump straight through to the thyroid. There's going to be some interaction now, so it's not you know if you get things wrong, that's fine. There's no you know, there's no terribly wrong on, so it's just to get an idea. See what your brain can think about and when we have, I talk you through some key concept, so we'll talk about thyroid gland for So here is the thyroid gland on, and you can. You can see it here. It's not the best around, but essentially, it's one of the largest, and the current glands in the body is just below the larynx, which is an area of the throat. And it's in front of the trachea, which is your windpipe. So it should be like you can kind of be a little bit. You shouldn't really be able to feel it too much because that means it's enlarged. But it's just like in this area, way often do at clinical examination, where you have to try and feel it while someone's goal. Pink water. It's a bit tricky, but you often feel it in patients that have a bigger thyroid, and we'll talk about that later. So let's quickly run over again. So you have we said this really Ray, So really raise number one runner number one, I guess, is thyrotropin. Releasing hormone comes from your hypothalamus acts on the anterior pituitary gland here, as we said that both located in the base of the brain, this causes thyroid stimulating hormone to be released, which is kind of encompass by this red arrow, which then acts on the thyroid gland to release fire at home. It's as we've said here. The blue Arrow is indicate that the thyroid hormones can they're negatively inhibit the production and release of Trh and TSH. So that's that home and pathway now Teeth Re and T four essentially the two main types of thyroid home, and how they differ is basically a number of I A dean's attached to them. It's just the structure, but what? The key thing you need to know, I guess, really is. T three is more active. T four is the store version, so often T four is broken down into T three. Basically, if you need active viral home, and that's how that is used. So it's good to have some store, and it's good to have some available and active and ready to go. Um, so that is that mean but for, you know, does anyone know what the thyroid is needed for such a fibroid woman's and needed for? I'm gonna give it a minute, Freddie. You can tell me if someone had is an answer in the chat about what the Viagra didn't need it for. Well, do you think I'm told? The delay is about 20 seconds, so wait 20 actually. Hear you. Yeah, if I can. For me, it's i e. I always hate that lifestyle. Have this, like, delay that I'm getting. Anyone has the guess. So far, we have growth. Gross. Okay, I guess. Yeah, I guess. Yeah, it's on the over and got the, um, physician was, like, Definitely Tabal is a muscle. The biggest one. Yeah. So the metabolism is the key. One is indirectly related to girlfriend development and other things and thyroid hormones. The key thing is, with this, I could put you put a sonogram, and then it had a function of money, so yeah, it's metabolism. If you've heard of basal metabolic rate, some people be like, Oh, my God. I have a high BMR BMR lose weight quickly. I break down food quickly. Some people might say Oh, I have a low b m r A problem with quicker. And you know, that kind of thing that off hand comment is often, you know, sometimes it's true. Sometimes it's not. It depends if they have an actual clinical diagnosis, and they have their parrot hormone levels checked. But yes, the century firing hormones run the show is the how quickly you break down foods and how quickly you're able to obtain energy from that. So that's what the fire it is essentially mainly full. So if we quickly kind of think of it in a clinical context, if you have now that we said that, Okay, so, you know, if you have lots of thyroid hormone, you're probably gonna have a higher basil metabolic rate and have more metabolism. If you have a low thyroid levels, then your thyroid hormone levels you're gonna have a low metabolic rate. I'll give you a minute or two to have a thing about this. What symptoms would you expect to see in the patient that has hypothyroidism? Is that low, high, low thyroid hormone levels? If we say they've got a low basal metabolic rate, what kind of things would you think the patient might come in and present with while you're waiting for us? That it's a nice question here for you. Uh, okay, so they say there is a t three and a T full. What happened to t two and t. One good, actually, Tito, quite important. So not to get into too much of the details of this but t one and T two and needed to essentially produce t three and t four on. So the idea is, is that the terrorist immolating hormone on I, A Dean kind of worked so far is not essentially stimulates the production in secretion of t three and t four s, o t three and t four actually produced by t one and T two. It sounds, and that's just how it works it. So you either have one t two and one ti one combined to make t three or two teachers to combine them. 84 on. So that's that they are essentially the constituents that I needed to produce t three and t 4% is about a question on it. Yeah, and simply ran practical. So yeah, it's a It's a fair question office the T one t t. So they are important and in other parts of the body. So we're lot of these things. It tends to be named in order of which one we found first. So if they found the first fired hormone T one t one when we found to to write, that's t two. In this case, it adds up in other parts of body, gets weird and confusing. Yeah, I think the numbers in this case is well, is directly related to the number by a Dean Atoms. Oh, I know how much I didn't I've got associated with it. So I think it's because from what I remember in my see days so they don't touch about they don't actually touch from the limits. And I don't think I remember learning in Bible. They did a whole like module in endocrinology and they said like, Yeah, I think I think it's to do with number wrong doings. I think you're right. I think so. But so you got quite a few articles. They all popped it once show, you know, to what happens with hypothyroidism. We've got stunted growth cause, Yeah, Tylenol cold all the time weight gain and no appetite. Fatigue. Okay, low energy slash lethargy for ti delayed puberty or slow growth. Yeah, lots of lots of, um, which is far. So yeah, I just put down three. Weight gain is the most obvious one. Fatigue, which you will talk about muscle weakness because, yeah, as you said, like, if you think about it, if you don't have enough metabolism, you're not getting enough energy to do anything so absolutely right. Lack of growth. Yes. It doesn't affect your sexual development, but also yet actually think that muscle weakness Just feeling tired after everything you feel like a snail. It's basically the best way to describe it. So with that in mind, what would you think about hyperthyroidism? I'll give you another 10 or 15 seconds to answer this and think about sides incentives. And this is on the word. What sign or what you feel Well, that's going on. You might give a better answer that time to breathe us. This one. What effect does idea have on the hormone? But I think the answer basically constituent part, isn't it? Yeah. So, yeah, it's essential for the structure of the hormone. Yeah, that's basically, I think so. I mean, there's a whole There's a step by step process by thyroid hormone production on one of the key steps is idea in trapping eso. Idea is, is actually is trapped in the thyroid to ensure that it then needed to produce thought the T one t do t three t four. So, yeah, there's no other reason other than it's needed for production. Something ridiculous like 90 is like 95 or 98% of the idea in your body has taken up by your thyroid, which is thinking I was You just read my mind. I was thinking, I don't think there's any one of the body that uses ideas. Much is the thyroid gland, so that correlates. I have not. I don't remember anywhere else. Go. Yeah, they we use tide into it, so it's quite it's quite effective in terms of like, if you're wanting to know, for example, tile, get the thyroid with some radiation, you can use radioactive idea very, very effectively because nowhere else is going to use it, but not great. If you accidentally drink a bunch of radioactivity, get the labs, your science expires. You do at school. Don't do that, but yeah, cool. Let's see anyone going on. Since for the hydro, it is a good artist. Here again, let's go from the light. Latest one. I put twitching, swelling of the neck, hired nous weakness, weight loss and mood swings. We've got unusual weight loss. Yeah, you know I love that. Yes. Twitching, swelling. Oh, it's on us soil. Put it twice, but yeah. Twitching, swelling in neck. Tiredness, weakness, weight loss, mood swings, hyperactivity, irritability. It's a good word. Restless, It's somnia. And then, uh, shaky Fast palpitations, weight loss, high appetite and hot. Absolutely. Yeah, yeah, you know, spot on pretty much the the fact that the person whoever said like, unusual know what you mean. It's the unexpected weight loss. So when a patient comes in and they said, You know, one of the classic screening red flag signs that we worry about is weight last for obvious reasons. You know it's associated Think what counts are in severe infection, big, big, roaring conditions. But it's unexpected weight loss and one of the things you often ask whether you're a GPA, any doctor on the words, you know, Have you had any weight loss that isn't expected, you know, stuff that like three times, But you haven't. Have you made any changes in your diet? You've been exercising mawr. Have you been trying to lose weight? Those kind of questions are really important to ask, because ultimately that helps the time. And what kind of paint? What picture it, paint a picture, Really? Because of the difference between someone you know take doing lots of exercise to lose a couple of key those because they're a bit overweight or trying to get fit because fast acting use resolution in large as, oh, whether they've lost weight unintentionally not changed anything? Yeah, they might have lost a bit of happen. It's high, but not, You know, there's no eating, that they've lost a lot weight and that that impacts how you paint that impacts exactly what you think about patient. You know, if I I would be more worried about someone that is, you know, has had a lump in this in their neck on They have come in with three months. Sister E off lost about fears. Will run over 15 20 kg, has lost appetite, is feeling tired on Well, you know, those gotten kind of thing makes you think over the thyroid cancer. Is that a a lymphoma where it's someone has gone? Yeah, I lost a bit of weight, but I've actually been doing a lot of exercise, and, you know, um, so it's that's in. That's not that's not worry s. Oh, yeah, that's brilliant. What goes? Five work. So, yes, I've got here Tachycardia, which is fast heart rate and rhythm. Ear is abnormal part rhythm, palpitations, anxiety or IT ability and large thyroid. So you should be able to feel the thyroid. You can't really feel it much now, but if it's swollen, so good on, that's probably because there could be assist. It could be cancer. It could be because it just might be a benign tumor on, you know, the fire control for many, many reasons. So that's yeah, I'm really good answers guys was on. So let's move on to the parathyroids. So unsurprisingly, they're located. If this is your thyroid gland there essentially located. So here, here, here and here. Now you Usually they're most people have for a party. There are very numbers, but four is a good answer to have. They're located on the posterior surface of the thyroid gland to the superior, which means that the top to the inferior, which is the bottom you can see it better here and here, here and here. Um, this gives you a little bit more enough to meet the fire. A glance of this middle connection point of the forward is the isthmus on that you could see here. And I see like this is when the larynx is tricky. As we said earlier, the higher it is kind of sitting on in front of your trapezius below your larynx in the neck. So about some easy stuff. Parents are worried. As I said, most people are four. It's responsible for calcium home your status. What I mean by that is we send home you stay since he's balance the balance of calcium levels in your bloodstream. So, actually, before we talk about that, let's go back quickly to the thyroid because I forgot to mention that one other hormone that the fire a gun releases its calcitonin so calcitonin is responsible. Too rude. Use calcium levels in your blood allows in doing basically how that works is in order to reduce the calcium mild levels in your blood. Calcitonin acts on the kidneys to excrete more to get rid of more in your in it. Also, it basically works on the bone so the bones absorb more counting where your parathyroid hormones and this works. Also in county homeostasis is on the opposite way to catatonia. So whereas calcitonin helps excrete calcium and get rid of calcium, this allows county calcium to be retained. Eso You know, calcium something receptors in different. Your parathyroid glands are there to detect when calcium levels are going up or down now. Obviously when they go below a certain point, active stimulates these receptors because the parathyroid hormone to be released by chief cells which is one of the cell types in the parathyroids I won't talk about the others. This is the main when you need to know on doing so allows calcium to be retained. This convened, done by, for example, breaking down bone. So you stimulate cell types in the bone there, called osteoclasts that help break down bone. You can retain calcium in the kidneys and prevented them going into the urine. Um, you know, it helps increase gastro G i calcium absorption. So when you eat food, some of your foods contain calcium. Does that by it Helps with activation of vitamin D, which helps calcium absorption for anyone moneys off a darker skin color or in a crappy countries like the UK, where we have rubbish about sunlight. Take a vitamin D supplement. Great for your immune system. Also is known to help with covered if you have covered as well. So what did wise You take it before you get over it because it helped with your immune system. Mitterand. These great don't take too much, but a small amount is didn't do any harm on Yeah, that's basically how that works. So calcitonin from the thyroid decreases calcium iron levels rose parathyroid hormone from the parathyroid gland increases calcium levels. So with this in mind, why do we need to make take calcium? What is cow's e? Um, used for in your body? I'll give you a chance to have Think about it and answer. I have three potential answers, but probably loads more that, um, sure you'll come up with is one that I have that you will get while you're waiting for answers on that one. The question here, if you go back a slide to your eso. What is the catecholamine effect that you have at the bottom here? Uh, okay. Okay. Okay. S tested. You like it? Someone has tested me. I'm trying to remember now I have a feeling it's to do with it. China. I have a feeling is to do with, like, the sympathetic nervous system and stuff. But I'm, you know, to show let me have everything about it. That's what he means, Uh, already taken me. Think. Now it's kind of a consistent those again. Yeah, I have a Yeah, I'm just trying to hold on System. Yes. Sorry. It is. Yeah. The idea is, I think, indirectly affects your nervous system, your fight or flight system. So your catacholamines a responsible for your adrenaline or journal, which we talk about later. Fowleri hormones. A quite big, powerful hormones. There's a reason why this kind of going slightly off topic, but it helps you understand why That why it says that it increases the catecholamine effect. So if you know anyone, but it's got low thyroid, especially low firing hormones. I'm not that high, but anyone that's Hypo Thyroid often gets free prescriptions because the impact of the having low thyroid hormones affects everything. They're more likely to have things like diabetes and heart conditions and weight problems like there's lots of different knock on effects of the thyroid gland. So you know the idea of you being your body is already slow if you have low thyroid hormone levels, if it's too if you got too high, then I suspect that probably kicks in. Sort of probably makes that adrenaline act worse and makes everything faster. So, like adrenaline, for example, is it catecholamine, which we'll talk about a bit later? That's part of the sympathetic nervous system, and it's released when you have five a flight to help kind of give you that boost of energy that you need. It's used, you know, when you feel scared. You satisfied. I just feel nervous, stressed. That's when Catacholamines kind of come into play and make you start doing things that quick about your heart rate goes faster, your breathing rate increases and you know that kind of links in again with the effects of hyperthyroidism. So imagine it kind of links in in that respect. I don't know that for long connection, but I imagine the fired hormones probably indirectly affect your levels of catacholamines, which ultimately cause things like increase in heart rate make you sweat more that kind of stuff. I have that kind of Once you quit. I think that is that about right. So got some answers here to your calcium question. Why is cancer important? And the answers reads like a petty flu effort who have got makes up teeth and bones mix up to even bones. Synthesis of bone relating regulates muscle contractions and then calcium help maintain strong bones, which definitely pretty fluid. I think 50 for the Advair is working. Okay, you will know that. And I forgot that so bad Me forgetting that I'm not just wanted my petty fluid goes I which we were. But, you know, we've just put some Ky was in here bones, obvious teeth, great muscle Contraction is a big one. Calcium iron is essentially the thing that drives that process. It's also needed indirectly to think like coagulation are receiving must to do with probably more the things like allowing the clotting factors to help do the things that produce tell you basically, when you cut yourself to help reduce the court, essentially, that stops you from bleeding further metabolism. It generally speaking, accent loads of cells. It has a lot of different functions, but the key one I wanted to know it was muscle contraction on also, yet bones and teeth teeth. Bad me for for getting that. But well done, guys. That's a good answer, right? Let's move on to the pain creates. No. Yes, you were on the pancreas. So pancreas is a big one in the sense that it's kind of got two main functions. So we'll talk about the exocrine function. Works when I'm exocrine function worse. So the exocrine function is about enzymes and digestion. The pancreas in size of the enzymes in the inactive form, which is called zymogen is. And this is so that essentially, if you because if you to create these enzymes and the Activelle, it's gonna cause the pancreas to digest itself. Eso to afford that. We have this in Activelle, so this is trypsinogen and kind of trips in the two examples. These enzyme then later activated and they get released. That's a by the cells. Wherever next principles are in the in the pancreas, through these ducks in the pancreas and into the small intestine and endurance on, pick out about sees. You know, it's kind of if I sneeze, I apologize. I want to get into this whole intestine. It gets it gets activated, Um on. That's the key thing to note here. So again, we don't want the activities in the pancreas to prevent digestion. We'll have activated in the small intestines and can carry on breaking down foods and pancreas. Also secretes bicarbonate home from the doctor cells. And that's to help if you I don't know if you I think you had a lecture on the digestive system. But in case you haven't and you've not been around for that long with atrial healthcare and the stomach essentially is probably the first mean, if you might, it's the esophagus. Get to the stomach, which has all your food in it on the acid, and naturally, that acid and food will end up. Some of it will end up in the intestine, so I mean, the food does that the some of the acid will end up in the intestine, and you don't want that there because the enzymes that are secreted by the parent Prius into the small intestine don't work as well in a in an in an acidic environment where as you need the alkaline so higher PH environment to work. So we want to neutralize the acid. That's why these bicarbonate loans and release and someone on such the main thing thing Exocrine function of the pancreas is controlled. Surprise, surprise by hormones. So you got various home. Is that gastric? Holy sister kind in there and so on. These hormones are secreted by the stomach and on pancreas. So the stomach on Judean Um, so these again. So, like, even though these are we're not talking about the stomach, we're not talking about the Judean. I mean response to the endocrine system. They're not the main organs. They have some, we'd like to say, a secondary underground function where they are releasing hormones, Um, in. So I have just bear that in mind. No everything. Even though it's not necessarily part of the endocrine system, there is some sort of endocrine function in the stomach. There is some sort of endocrine system function in the in the small intestine. So that's something to know once they're released anyway. So these ones, they're released into the intestine. There are enzymes and other molecules in the small intestine. Essentially, Cleve a section or break cut off a section off this trypsinogen and comb It drips and to make them active on but allows them to essentially do their function, which is to break down the food that is in your small intestine. So hopefully that makes sense, and we'll then talk about allergies. There's an ambulance, uh, or police. Then we haven't endocrine function with the pancreas, so the this endocrine function is related. Teo The set This cell types called the Group of Cells, could be islets of lying your hands. Now the islands of Langerhans essentially clusters of cells that have that have unending grown function in the pancreas that release and hormones of the pancreas. So these islets of lying your hands of different cell types in these different sometimes produce the Roman times. The homeowners listed on the slide simple, easy question that hopefully most of you be able to answer what condition is associate it with, uh, I guess low levels or insulin or not, being able to respond to into it and therefore causing my blood sugars to basically accumulate in your blood. And it's not great and has multiple multiple. Uh, I guess not. Con effects is a result on kinetic all of Utah. I mean, it was also partly increasing numbers do to the obesity epidemic that we're in at as a country. Does anyone know condition is linked to insulin? Show someone will. Friday. You could tell me the answer when it comes up. Dobby days, Diabetes? Yeah, diabetes. And there are diabetes. Actually, this one. Diabetes vytis, diabetes insipidus Type one diabetes type two diabetes is late onset diabetes and minerals that gestational diabetes. Here. There's many different types of diabetes, but ultimately, I think one is a way of your breast here on the Internet. Um, produced type to somebody could be a mixed. You could also get mixed picture of the two. To be fair and talk to you is when the time your body kind of becomes desensitized and your cells don't respond as much to the insulin, you kind of want to come tolerant to it. But again, you can kind of have a mixed picture in both on one or the other on. There's loads of interesting research going on about diabetes, especially with this obesity epidemic was going on. The number of people that are overweight obese is rising in the UK, especially in younger age groups, and certain borrows, especially in London. You can Google this and you can have a read about this. How do you recommend you do if you're interested in some sort of local health issues? But yeah, it's it's important to have a thing about it. It's a condition that's coming up more. It's basically becoming more and more prevalent, so it's worth reading about. But yeah, so it's. Actually there's different cell types of like that in the islands of Langerhans that release different moment, so the alpha cells secrete glucagon. So when the glucoses gone look going is released, it at essentially increase the glucose in blood wires. On the other hand, you have beater cells that release insulin and that helps reduce blood glucose levels. You have felt this out that that secrete some after statin, which can, which kind of have the role, I guess balancing again the insulin and glucagon levels it can regulate the Alfred Beat ourselves, and then you also have PPO or camera cells, and they secrete pancreatic. Call you pets. I don't worry about that, but the main wants to really these three into England, gone in a somatic static. That's kind of a regulator. A hormone Help Maintain the balance. Um, on your balance is sugar reveler kind of stuff just to see if anyone have any knowledge. If you have Diaby, if you're worried that someone has diabetes or think someone has diabetes, whether it's type one attempted of the matter, I'm not particularly for us. But what kind of symptoms do you think they might present with? If they have, you know, if they have diabetes needs a shameless plug. If I'm sure, go to our middle. The captain. You can see our session of diabetes from back in August. Oh, yeah, I forgot that you guys do. Let's see you for anyone if anyone that was there or if people just have common knowledge. To be fair, what kind of signs of symptoms are associated with diabetes? Best time because it's going to take what I'm going to read a question from earlier about saving because you're not going to like this question. Uh, is that where is it? What is pseudo pseudo hypoparathyroidism fighters, Freddie, that Who do you know? What was that again? Para five. So I've got a guest raked out of his name that it's hypoparathyroidism, but people think isn't hypoparathyroidism. I mean, I've heard of like, there's a B c, I think was like army secondary and tertiary hyperpara authorities. Um, but pseudo hyper parathyroid is pseudo pseudo. So sooner would be something that looks like hyper parathyroidism but isn't. Well, then, I guess Sudafed it was okay. It was like this. This whole life is to this, um last I was, like, something very rare on And, um yeah, I was going to say like, it sounds like so hyper ponies. Low parathyroid whole day. Um, pseudo pseudo gonna have to google. Let's hold off. That's what we figure that one out question about diabetic symptoms. We have polyuria. We have first tiredness and weight loss, loss of weight needing to go. We a lot. Good answer. Yes. Anemia. Okay. Not so sure Now I can't. You mean? I think the nationals I just feel like you start to have a direct impact on your bleeding and, like, I'm pretty sure it does. Slow down that. So I guess they I wouldn't I wouldn't say that. I understand why that might be coming from, but probably not anemia. And that I am different. Polyuria polydipsia fatigue, more urination. I think I want to put urination earlier on and then put morula nation frequent urination, blurred vision and fruity smelling breath. Oh, yeah, Someone went the ketosis, uh, frequent urination, cuts and wounds, not healing guest. So that one that one is Yeah, that's probably more than they need less. So, uh, policy, What they say is like, if there's a major, I mean, but then major bleed is just gonna impact everyone the same way you're going to get any any, regardless whether you have diabetes also. Yeah, increased first, then politics. See, and polyphagia Holly Fadia. Yeah. Is that increase hunger? Well, maybe I was increased hunger, isn't it? Think I I don't think diabetes necessarily makes you more hungry, but I guess if I think you want the extremes while like you got drops, if you especially your problem that you have to be cathed when you can have, like, you know, if you've not taken if you taking your medicine regularly, but you haven't eaten in a while. Your sugars can drops, I guess. In that respect you. Can you worry that if someone has low sugar loves his diabetic, but the quickest thing? I guess it's an emergency situation, but I wouldn't use the word polyphagia eso Pseudo pseudo hypoparathyroidism is a rare disease. Um according to the National Institute of Health and Genetic and Red Diseases. It says that it's an inherited condition that causes around face and short hand bones. It's genetically related to pseudohypoparathyroidism science symptoms and similar. However, people with pseudo pseudo hypoparathyroidism do not show resistance. The parathyroid woman, whereas pseudohypoparathyroidism Asians are resistant. Okay, yes, so they're so it's a similar condition to Pseudohypoparathyroidism, but it's not resistant to power that riddle bit. It's the answer to walk soon as you have probably sounds like you're going to get in the tone twisted. But Google it on. I think you'll understand that when you read it, and I hope that answers that question. We can go on to the next bit. Let's talk about the adrenal glands now let me get my notes up again. So I know where I am. Okay? Say, ah, there's your adrenal glands. That's all trying. Get upper, middle shaped, uh, undercurrent glands. Sit on top of your kidneys on deal. Talk about it in two layers. So the adrenal cortex is the outermost layer of your adrenal glands. Kind of. You can imagine. It's sort this out of the way that you can really see on the top Russian capsule that covers it. But it's the out. Um, the outer layer to chelate is the dream of brands. Now you can spit it out earlier into three layers. Um, let me get a pen. Yes. All right. So, yeah, you got these three m three layers, but make up the outer layer. So this is the outermost layer of the other labs. Let's put those are that's number one laying number two and number three. So your glomerulosa layer release is a type of I guess hormone or yeah, you're talking full moon Could mineralocorticoid. And the key example that's released aldosterone now aldosterone is part of the system. Which is that Ross system already? Don't you? Ah, a a s. That's the Renan and you tension out all story in systems, a little bit of extra information. But ultimately, this system is important to maintain your BP. So essentially aldosterone is released in order to increase your BP. How does it do that while it acts on certain parts of tribulus system in the kidneys? So the tribulus system wasn't it was the cold, very less, which is responsible for ultimately producing urine. The aldosterone acts on different parts of the system. In order to increase the reabsorption of sodium ions, increase the excretion of potassium and hydra nines. You hear the following phrase quite a bit, which is rare for sodium goes. Water follows. So if you're retaining, if your blood pressure's low and if you're increasing, really ultimately increasing reabsorption of sodium in the blood from the urine to the blood. Wherever sodium sodium moves from the urine to blood, your water also moves from your in the blood so it increases the amount blood. Whole human level helps bring your BP back up again. It's why do you know if you're feeling dehydrated? Your blood pressure's lower. You drink the better ones. That helps bring your BP back up again. Um, so that's kind of how to give you an idea of how that works in just very basic terms. But yeah, it's entering. This is theosophy. It is part of this brass system. Don't worry about it too much for that meet the second day if he like. That's how our dust around works on the next. But I get is there's only a physical artery, which is responsible for producing glucocorticoids in particular. Let's come back quarters off. Does anyone know anything about court it or what's what's called it all most commonly known as well, what what kind of forget What function is it related to of it? Answer that. Meanwhile, I'll give you another lovely question. I think, from the same the same source as a pseudo pseudo hyper parathyroidism. Uh, what are your thoughts on the Byetta mal aji of the dream? Oh, I think it's an abomination to combine Latin and Greek in a name. Okay, so just just tea help you out so that basically your adrenal glands have two different names. They are the adrenal glands, which means like above kidney on the pararenal plans, which means around. And so pararenal is sort of what they tend to be called by surgeons and then add renal by, like everyone who's know a very weirdly knee surgeon or in anatomy, I thought, Why do I feel that pararenal is such an American thing? Super idea. A renal is accurate. Is that that would be Greek on Greek, as opposed to a Latin on Greek, you know, who cares? A super A renal. Apparently suparenalis. The Merina is another one. Yeah, correct. Greek on Greek, which is what we're after. Well, I'm in. I don't want to have a school that they're trying to get a thing that sits on top of the kidneys because ultimately, we know what you're talking about. And that was it. I see. Yeah, it's Yeah. You know, I've been let's start government petition to call it Kidney House because, quite frankly, you know, yes. Because of stress, which I think is what you're feeling right now with these questions increase in the blood stream. Yeah. Uh huh. The primary stress hormone and it increases sugars. Yeah. So, essentially, cortisone on it has a diurnal rhythm. If anyone's ever heard of that, which means that it's higher in the day. If you wake up and then goes down drop addict on, then the whole thing starts again. But ultimately it's known as the stress hormone. The idea is kind of helped too indirectly, kind of links to that whole fight or flight response in the sense that you know when you are a bit stressed. Increase by increasing cortisol levels ultimately helps do things like increasing really busy of blood sugar, which then can be distributed where it needs to go on. Go get your body gives you a body more energy to deal with. Whatever is the source of that stress. So, yeah, fab work there. So let's re once the last bit. So the last areas Arizona Reticularis, which produced under genes, which basically sex hormones. So DHEA is dehydroepiandrosterone. Spare the mouth and androstenedione. Ultimately, these are precursor hormones, or what 100 dress. Dinner down is a pre course of testosterone, which is one of the male sex hormones. But I think a little bit cells are released. Yeah, maybe, but it's mostly men turned. Yeah, basically, these are just sex hormones. Don't worry about them too much. They ultimately we'll talk about the more important ones. But these touches that for you, too dot just to help you remember. Those are the three, I guess made it hormones or three main layers of the cortex. The best way I remember. It's a weird way. Remember you. So the kidney is associate it with something called the Glomerular. Filtration rate is down Bridge Simple acronym. This G f er It basically allows you to determine kidney function to see how well the kidney is doing its thing, which is both during the blood and excreting things into the urine. So g f r so, Yeah, GFO helps you remember the order in which these days go? Uh, just a way I remember it if you need to, but we'll move on. And the inner layer of the adrenal gland or the super renal handle the Powerade or gland or the kidney hats is your adrenal Vidalia that produces your Captain Colon. So we asked about catacholamines. Oh, yeah, I was right. Right. So you have adrenalin or journal in on a Z. You are where they're associated with the sympathetic nervous system. Eso The idea is that your fight or flight response and also kind of associated with the price of that existed. So let's think about it. Adrenaline, right? Nor done a jenaline if you have released in the fight or flight response if you're less. The classic textbook example is there's a bear in the forest and you've seen a bear, and it's about to come and get you and you're about to run away or fight it wherever you choose to do. It's your choice on Well, how does your body physically room to stress in that? In that kind of situation or any similar situation, you know what happens? What happens to your body organs? What does it what do they do? How do you respond to stress? Because that basically links to what? The function of the adrenalin in your German also gonna give you some time to talk about your answers? How does how does your body reactor fight or flight response? What does it do? I'm gonna tap? Yeah, we'll give people something. Any questions. In the meantime, Freddie, is there another one about it symbology and stuff that I have no idea what you're doing. Okay. You doing okay on my language? I mean, I did not study luck in or Greek. I mean, not like we're going option, but that was an option. It didn't study it. Feel this one is once a med school that, like some people, stay Latin, had an advantage. But the advantage in Los Yeah, she does, you know. Yeah, I remember that. Being used for, like, four weeks. Um, yeah. So here's some answers for you. You've got a lot of adrenaline is released. Pupils dilate and increased breathing rate. Increased heart rate on anything I'm looking for. Yeah. Age your fight or fly. Yeah, Pretty much so. Things that people dilation, increased heart rate, increased breathing rate. Gives you kind of that extra, I guess. Boost, if you have, like, okay, run or fight. Yeah, it's actually what's interesting our system is known for and the power acting, but that's excess. Then there's no need for rest, and I just but well, you won't worry about that. So essentially, that's the overview of the adrenal gland. So you've got your cortex, which is made up a commercial oh, so particular to articular wrists and then you're in a layer of the adrenal gland. Is your medulla, which produces you catacholamines so last bit before we end on any answering your own question that people have because we're for that we have the garnet. So yours, basically your sex audience. And now we talked about a little bit. I won't go into much detail about sort of the menstrual cycle. Weren't going to much about the to be of this kind of stuff because we're just gonna focus on the hormone aspect. So in the mail, you have best, even in the female, you have the ovaries. But let's talk about the males first. So, um, in both the men, we're going to go to the reason test is the main part of the main function is to produce steroid homers, 100 genes, the sex. All right, hold on. The TESTIES produces androgens that allow the development off any secondary sexual characteristics. This could be like, uh, body hair helps with the development of things like your deeper voice and a man on on other changes. There's SEC sexual development, and you've also, as you'd imagine in a man testosterone is also relevant, is by himself production on. If you can't remember, we had the hypothalamus releases G N R H, which they're releases, LH and FSH that ultimately plays into Rome. Here, that's that kind of change that goes down this bit here. So that is the main part. The testosterone is the most the key part of Ambidrin in males, and that stimulates the development of these primary sex organs. It also stimulates, and we talked about the development of the secondary sexual characteristics such as hair growth and so on. S So that's the key. Bits in the man grows in the female and the ovaries produce these hormone the Andrews and it's Easter gyn and progesterone here as well, you know, similar kind of again. It's just pretty much always to carbon copy, but obviously in the woman, it's different. So development of secondary sexual characteristics such a Z development of the memory bands or breast development technically really talking about development of the eggs on the their unfertilized and the whole menstrual cycle process is relevant here. Fat distribution as well. There's various different parts and bits and pieces of these hormones do, but that's just to give you an overview. Progesterone is a is a important hormone in the second half of the menstrual cycle, where, as I probably say that the stream is more so before, because progesterone is released by the Corpus Luteum after ovulation during the second half, and it kind of prepared. It's the lining of the uterus so that if the egg fertilized, then implants and someone that you can look up the each the cycle later. I mean, if we were, if you're really talking about, we talk about for hours, but I'm not going to. We're mainly trying to give you an overview of the endocrine system, but as we said, there's progesterone usually drops off if there is no first litigation. But if it's pregnancy occurs and progesterone levels tend to stabilize its own. But again, this process is more complicated and lies a lot detail that puts into this so we won't talk about it too much. But that's the idea here. So you can imagine that if you have low levels of sex hormones, you might have delayed puberty. So you know a female might not get a period on time. The male might know, um, puberty on time. Either you might get lack of body hair or breast development is slow. You can get the opposite kind of thing where you might have increased levels of Eastern in a man, for whatever reason. Or you might get this really interesting medical conditions that claimed felt a syndrome where you have to exercise in a while chromosome where you kind of get a mixed picture in terms of sexual characteristics. So there's loads of interesting things there as well that you can have a read about in your in time. But I just to kind of give you an overview. I have pretty much not anything else to say. Um, let's discard my ink animations. I I have stopped doing my screen. I hope so. Hopefully that is not good. Okay, I hope that makes sense. Uh, and I hope that answered a lot of kind of a lot of this, gives you an overview of the undercurrent system and gives you things to think about things to read about and to understand. So the clinical picture at 7 30 So I'm happy to take questions. I tried to finish it early so that you guys can have a nice evening. And also just to answer any questions that you might have. I don't want to spend an hour and a half talking about too much, but we've got just over an hour, so but worked out Well, questions. I'm gonna teach back link again. Yeah, please. And oh, someone has said Okay, of course. There are no surprise. Josh is after your question about pseudo pseudo have pro. Uh um I'm watching it. Catecholamine effective t four. Is that it? Sensitized beta receptors. I appreciate your question on. That's a great question. Something I've never actually covered in meds. I have just said the greatest question. I think this is a question I asked 1000 times. And oh, what What? How the hell do you remember all this? You know, so and the crying is one of those things. I actually really And so I did have modeling in surgery on. The thing I did was, you know, back in, like, when your primary school, you do the thing. Where is that look? Was it read? Look, cover right and check. And And you do that for spelling? You basically do that for all of the pathways, because there's not too much into thinking you kind of just learned one at a time. A lot of it is, I said. It's like a three step things of the hypothalamus releases a hormone number one, which acts on the anterior pituitary gland, which releases hormone number two, which acts on Inter Organ Union, which often releases Home number three and has Effexor effect impact. Then you'll just have to add any inhibitory stuff. It's often the same skeleton over and over again, which kind of gives you the basic stuff with a nice, easy one where it doesn't have too much into thinking with other things. So maybe start off, for example, with I would say, maybe like, Let's take let's take like the cortisol pathway, that's a nice one. It's a nice, easy one to start off with. Start off with that and that's like the basic one. Then take it a bit hot. Go to another, harder one, I would say. Maybe didn't Thyroid hormone next? Because you've got some interesting effects then and just keep building up on I would say probably the most. Uh huh, um, complicated. One would be the LH FSH stuff because you have to think about it in the context. It's really in a woman is well with the whole minister cycle and how the levels Mary and how those parts of our release fashion and so on. Those extra levels of the just start with the basics know how each of the homeowners orders works and gradually build up the information. But the idea is repetition. And doing that kind of writing over and over again and checking yourself over and over again is the best way of doing it and spacing out that learning is always useful and the other to the nipple. Don't bite away the things everything. Anything. Med school, nursing school, pyramid school, whatever healthcare you want to go into whatever healthcare you're in, you can't just go. I'm going to just run off and learn everything in one big go because you'll have a You'll either fail or you have a mental breakdown cry and give up. You've got to sort of take it a little bit of time chip away, and actually, these things do build up like the knowledge builds over time to take it your own pace. Just do it slowly and hopefully things like this do help give you an advantage because now you've heard a lot of this stuff, and then the next time around, I'll remember a little bit about that little bit on the next little bit on the next little bit. The last time is always terrifying. This I apologize, Guys, it doesn't feel like the craziest thing you here, Josh. Half the question yourself. The bunch of questions we'll ignore just is questions for the It's good questions. Do you like, you know, oxidized. Interesting cause I remember actually had a couple years back, and it was about so, uh, the potential theories about labor and stuff, one of one of the big things oxytocin. So I don't think it's important. It's an important 100 to be aware off more minutes, and I think it does a wonderful the fact that we can let you just give you a fake oxytocin, and it does the same thing as the oxytocin. You make beautiful hormone. There's no, actually, I don't think they're fully understood how it works, but they know that it's important, and it does is it's one of the key factors in, like get in labor, so everything is important. What's my favorite endocrinologist? I don't know. I think my hormone just to go out when it's like who changes and I wake up I was repeated pitching. I always remember to treat your adenoma, which isn't really kind years. And under current condition is the Patriciu can't because I wanna be where it sits in that in the cellar traffic of bone telecaster of this one I'm going to easy to remember because, like the the nerves that basically innovate your eyes, they're they're in the compresses and you get this loss of the outer half of vision on both eyes or what they call it bitemporal hemianopsia on the loss of the outer fields of the is easy to remember that one and it often comes up a lot of exams. And maybe that's why you're quite like it because you be on everything and it will be See if you have a counter of the maturity gun than actually everything's going to increase and there's gonna be are the problems. So it's quite easy to remember. Um, I don't know. I don't have a, uh I guess. Yeah, I always get I guess my least I wrote for cooking because I was confused about Cushing's syndrome questions, disease and Cushing's syndrome. Being like this kitchens interim, if I remember correctly, is one that's where it comes it because it is a result of a condition that something like pituitary have no more because she's diseases directly related. I always get those mixed up, so I say That's my least favorite someone mentioned Tennis center Isn't that tries to me so turn A syndrome is inactive. Second x Yes. Okay. So, effectively, you're a person is born with two X chromosomes interna syndrome. One of them is partially or fully faulty. So you end up with effect of the presentation similar to single Ex Uh, what else? We got it here. That's hormone hormone side. That one mg favorite least there. And the crime will ignore Josh constructions. Eyes known his love home. And what are your thoughts? I think that comes down to What is your definition of love really extension in what kind of situation doing patient? Who do you play? Excellent question. I because of coated, I didn't get in a current placement. However, I'm about to go. I will go on to geriatric. So that's older individuals that it's useful to know labor. Ward's had been on label wards. Oxytocin has been prescribed many a time, so that's one hormone you hit. Like general practice is off is a key ones you that you don't think about it is I endocrine problem. But diabetes is pretty much everywhere you go, even though I'm currently on old age psychiatry, and at the moment we have quite a few. Like I've met patient today, for example, who has diabetes in the background. But it's always important to consider that and same thing in yeah, pretty much just in general, like endocrine is one of the month, but I think it's forgotten. But you just have to remember. Diabetes is one of the biggest conditions that's in the UK right now. Part of it, if we're talking long term conditions, it's just everywhere trying to come in. Every specialty will have something to do with diabetes on it. No matter what you're looking at, you have any crying in this age and like you know, every classically associates you know, Type two diabetes, obesity and older age. Well, you know, as we said, Type one diabetes is in gestational diabetes, the diabetes your pregnancies, I think, and that in the community. Just general risk, especially because I go to medical school use London Obesity is a big problem in the thunder, and diabetes is a big problem in East London. Um, I was like, Yes, sometimes, I guess in a me you might see that's when my endocrine is often relevant in any sense that you get the acute hormone crisis issues that happen like adrenal crisis. There's things you can look into about that on day after get managed in hospital. I guess the other thing to know is like, for example, adrenaline. And yeah, I guess you put my think of yes. So adrenaline is a hormone it's used to treat in many conditions. Is an effect, right? Yeah, exactly. Anaphylaxis character. There you go. So you're using a hormone to treat things and then acute setting so any it's important we you get caught. It is a syndrome first data all the time. So your auto injectors are EpiPen's important. What kind of questions You getting this content in exams? Is it like a lower body in medical school exams? You get like we have pictures and Arizonans Queen Mary. Anyway, I'm sure I don't know about you guys. Don't feel like you must take where you get, like, a picture of someone if they present with ex wife is dead, and then you have to work out what condition they have. And it's often like, Oh, they have a goiter. No. Okay, but this this got this mismatch in this condition. And this is the time, the symptoms, that you have a picture of someone and it's like, Okay, it could be probably Hashimoto's thyroiditis. So, you know, there's like that's That's one way they do the classic things like this is a patient presented with these salaries and list them rather and show you a picture on there. Be like, this is their blood results. And then it has the TSH and T r T H levels. And they're three t four levels. And so you can get blood test or is interpretation questions? You can get pictures of signs and symptoms. You can get just general questions like Okay, this patient is on this. This this and this. They've been diagnosed owner. This patient had to came into the hospital to the GP with this and they have been diagnosed with this. What? How much what would you prescribe? And then you say what medications are like if a hypothyroidism, you give them levothyroxine, which is essentially like a supplement version of thyroid hormone. And that's yeah, that's a yes. It comes up. Diabetes again always crops up diabetes management and the different types of drugs. Because there's lows. Different medications that can be used to treat diabetes will not cure it, but managed get. You often get tested on that. What class of drug is this? And then you have to work out what caused a drug metformin years or examine time. There's a lot of different diabetic drugs, and so it's not quite like a level. Biology is definitely more specific. I would say I'm not quite sure. I remember the levels were a little time. Sorry, I think what my said there was very, very accurate in terms of you get a lot of variants universities in terms of the question and then university. Like between different universities, they are different questions of different ways. But someone last a good question about the anti opportunity. Okay, so so the function, the posterior pituitary gland is to secrete the oxytocin and vasopressin eso. It's so we said that the hypothalamus sanity sent messages ravin through home owns it. Send messages to the posterior pituitary gland through know of signalling. I'm not sure that's not the once they've done that, and then that that stimulates the prostate gland to secrete your oxytocin, which is the hormone that was mentioned earlier. So the one that's important for labor on breastfeeding, maternal bonding and someone on vasopressin, or 88 was anti diuretic. Hormone helps retain water, UH, which ultimately increases your BP and stops Even. It's like it's basically reverses dehydration. So hopefully that helps with that question. It's good to see that people engaged that really happy. I'm really impressed with this guy's. I've sent the feedback link in the chat a couple times. Please. Do you feel out? Gives us something it's so useful for us to know, sort of what you guys are after, what you guys like, and it means we could see shapes, sessions in the future. Talk to you guys we could do is you could then, like, I guess, do just like, different, like you could do right Okay, We have you had your lecture on the endocrine system. Maybe next time we can do what you got for clinical cases anyway. But we could do but one of the session is the system to the session could be like here all the clinic cases go, Yeah, it's really useful for us to be able to, like shape what we do on the outside of. It's actually most people who who teach on the Siris, medical students or early years Progressional is in the field. They do, and actually for applications later on for proving you know how competent some of us are at teaching or improved is teaching. The feedback is brilliant for us. It's really useful, so pleased to fill that out a zit want certificates or anything like that for attendance that you get it from filling out the feedback for me. Please do fill out if you have time. We really, really appreciate it. There's two more here that I've just seen about. I don't have to increase testosterone testicles don't know, but yeah, I think the US that one is. If you got problems with the lack of testosterone, go see your GP and let them try to figure that one out for you Generally. Yeah, the last one here, which is a power of hyperthyroidism and a high hypo and hyper fire. It is, um, curable. Depends on what the cause is, isn't it? Like with my post? Usually you give a Roxy Levothyroxine for life. And that's why those pain medications, they're often and then get three prescriptions because low thyroid hormone levels can cause a lot of other probably down the line. If, for example, increasing your risk of diabetes. And so some of them, like some Hypo thyroid patients, is because they haven't got enough idea in the diet Any way that you? Yeah, it just just straightforward malnourishment causing hypothyroidism and then true system. They're actively cure that. That's probably more like be a problem in countries where there is no more kids. And that's why it's happening. But it can happen in even, I guess, in the hospital setting that's in scurvy in London. Yeah, that's true. So yeah, I got that. Yes. Now and then hyper like sometimes that they can just do is what's called. Uh uh huh. Yeah. We can take off the off the neck to me and cut off your thyroid. But then you get the opposite. Where somebody they they take a bit too much often. Therefore you get hypo Thyroidism. So then they're put on the referral thing. So again it does depend on the condition that's causing the high peril hypothyroidism and not watching the NHS. But for sometimes for hyperthyroidism. You could be given small amounts of radioactive idea to just basically a little bit off the kill off a little bit your thyroid and make it a little bit more the tame Um, yeah, so that then they know that they can be curable. Yeah, no picnic, necessarily lifelong. But there are obviously lifelong versions off those diseases. Um, makes think. Yeah, if that's the last question will give you guys never like 60 old seconds to just ask anymore questions you've got. If anyone comes up with ones afterwards, please feel free to email them to me. We can send them on my area. We can just come up with answers on there. Otherwise, we'll see you guys, I believe on the 10th is our next sessions or not next week. But two weeks' time, which will be clinical case discussions. We're trying to work out what cases? We're gonna go for the moment, but well, you'll see that evening. Other than that, please do feel that feedback if you're happy to and was have a lovely evening and a good two weeks. Think you'll feel a tending or we got no one it? How can chemicals affect into crime? Well, it depends on the chemical, doesn't it? But But what would be the question again? How do how can chemicals affect endocrine systems? Which is what? Chemicals like ideas. Um, so if you take a little Claritin, you can end up with a chemical. Say, you know what chemical you take? Yeah, really? Like, if you think about that urine, if, you know, even if you're considering, like like in just smoking out the whole food, everything affects hormones and chemicals in your body. So and yeah, I don't really know what that tells. That question depends on the chemical. Everything can affect things different ways. Yeah. Thank you guys for attending. Wonderful. Thank you. And thank you for your for your wonderful think. I'll call it there because of us. We end up being here all night, but thank you. Everybody on, uh, see you in two weeks' time.