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1) Where is the Parathyroid located?
2) What is the function of the Parathyroid?
3) What are the two cells of the Parathyroid?
4) What is the main cell that releases PTH
5) What organs does PTH effect?

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Quiz:
1) What are the 3 causes of hyperparathyroidism?
2) What does hyperparathyroidism do in the body?
3) Whats the pneumonic for the symptoms of hyperparathyroidism?
4) What can we give to help promote the excretion of Ca2+?
5) What does EMS do for patients with these conditions?

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1. What dysrhythmias would you expect with hypoparathyroidism?
2. What types of foods are high in calcium?
3. Do you have any other treatment methods to add?
4. What are the normal values of calcium? (textbook)
5. What are the normal values of phosphate? (textbook)

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PTH causes reabsorption of calcium into blood.

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A low production of PTH (Parathyroid Hormone) secretion.

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Primary Hyperparathyroidism- Tumour on parathyroid causes increased secetion of PTH.

Secondary Hyperparathyroidism- Renal failure + lack of Vitamin D = low Ca+ blood levels. Parathyroid secretes more PTH into system, hyperplasia helps compensate for lack of Ca+.

Tertiary Hyperparathyroidism= secondary Hyperparathyroidism is controlled via treatment of renal failure and Vitamin D intake. But hyperplasia cells continue to overcompensate and secrete PTH.

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1. There is a cause for a decreased production of PTH.
2. PTH regulates the calcium (Ca+) and phosphate (P04) levels in the blood.
3. Low (Ca+) levels in the blood causes PTH secretion from the parathyroid glands.
4. When PTH is released, it effects the kidneys and bones:
- Kidneys: Absorbs (Ca+) and excretes (P04). Causes    activation of Vitamin D (works on the small intestines for reabsorption of (Ca+) from food.
- Bones: PTH causes osteoclasts (cells that break down bone tissues) and releases (Ca+) back into blood.

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Most common:

Surgeries - including removal of the thyroid, tumors, or cancers (Chance of causing damage to blood supply line).
Other causes:

Hypomagnesemia - Low magnesium causes low release of PTH.

Autoimmune disorders - Can cause antibodies of the body to attack the parathyroid glands.

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-PTH promotes the osteoclasts to break down bones, and teeth, increasing calcium levels in the blood.
-The kidneys begin to reabsorb Ca2+, which causes the buildup of calcium in the kidney.
-The GI tract begins to absorb Ca2+ from food.
-Severe cases of hypercalcemia can cause arrhythmias or types of heart blocks.

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An increase in blood calcium reabsorption:

Moans: abdominal pain, nausea, constipation
Groans: lethargy, weakness, confusion, and coma
Stones: polyuria, kidney stones, renal failure
Bones: bone aches and pains, fractures

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Due to <Ca+ and  >P04
1. Chevostek's Sign (twitching of facial muscles)
2. Trousseau's Sign "True so" (involuntary contraction of hand and wrist)
3. Muscle cramping/weakness
4. Cardiac dysrhythmias
5. Bronchospasm's
6. Seizures

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"While EMS providers generally are unable to determine electrolyte levels in the field, a careful analysis of the patient's presentation, coupled with a well-conducted history taking, can bring an electrolyte disorder to light." - Arthur Hsieh, MA, NRP.

1) Treat ABC's
2) With additional expert advice, orders could be given to administer calcium or magnesium via IV.
3) Educate the patients on the disease and how to properly diet with foods focusing on high (Ca+) and low (PO4).

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Treat the symptoms and take them to the hospital because I can't fix kidney stones and fractured bones.
-Recognize the conditions
-Treat symptoms, Normal Saline infusion may promote the renal secretion of calcium.
-Transport to a higher level of care

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Parathyroid Glands located on the Posterior Thyroid gland.

Superior Parathyroid Glands

Inferior Parathyroid Glands

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Increase calcium levels in the blood

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1) Chief Cells

The main function is to produce and secrete Parathyroid Hormone(PTH).

The calcium sensing receptors inside chief cells react to low calcium levels in the blood by releasing Parathyroid Hormone(PTH)

2) Oxyphil Cells

Do not have endocrine functions

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1) Low blood calcium levels

2) Chief cells release PTH

3) PTH effects on bones, kidneys, small intestines.
Bones:

PTH stimulates osteoclasts to breakdown bones and release calcium into the blood

Kidneys:

PTH stimulates tubule cells to recover calcium from the urine.

PTH activates vitamin D

Small Intestine:

Activated Vitamin D stimulates the small intestine cells to absorb more calcium from digesting foods.

4) Blood calcium levels increase

drops