Sections View Full Chapter Figures Tables Videos Annotate Full Chapter Figures Tables Videos Supplementary Content ++ Chronic renal insufficiency1Hypocortisolism1 ++ 255.41 Glucocorticoid deficiencyPT diagnoses/treatment diagnoses that may be secondary adrenal gland disorders315.4 Developmental coordination disorder719.70 Difficulty in walking involving joint site, unspecified728.2 Muscular wasting and disuse atrophy, not elsewhere728.89 Other disorders of muscle, ligament, and fasciaclassified729.9 Other and unspecified disorders of soft tissue780.7 Malaise and fatigue781.2 Abnormality of gait782.3 Edema786.0 Dyspnea and respiratory abnormalities786.05 Shortness of breath ++ E27.1 Primary adrenocortical insufficiencyE27.2 Addisonian crisisE27.40 Unspecified adrenocortical insufficiency ++ 4C: Impaired muscle performance +++ Description ++ Insufficient production or release of glucocorticoids (cortisol),1 androgens, and mineralocorticoids from the adrenal glandsThese hormones play a role inConversion of food to energyInflammatory responseResponse to stressMaintaining sodium-potassium balance for blood pressureRegulation and production of androgens in males and females, involved in maintaining libidoMay be insidious onset or sudden onset, as in Addisonian crisis +++ Essentials of Diagnosis ++ May cause pathology in multiple organ systems or be caused by pathology in other organ systemsCardiovascular: heart, peripheral circulation, blood pressureIntegumentary systemConfirmation of suspected disease through blood testing +++ General Considerations ++ Clinic should have carbohydrates available if needed for drop in blood sugarOrange juice, sugar packets, or similarMay result in secondary problems such asAerobic capacity and muscle endurance impairmentSarcopeniaWeakness/impaired muscle performanceMusculoskeletal problemsNeuromuscular problemsWeight loss, indicating the need for PT intervention depending on severity +++ Demographics ++ Affects males and females equallyCan develop at any ageMaybe familial5 +++ Signs and Symptoms ++ It is not the purview of a PT to medically diagnose hypothyroid, but rather to recognize the possibility in the differential diagnosis process, especially when the findings are not consistent with conditions commonly treated such as musculoskeletal, neuromuscular, integumentary, and cardiopulmonaryPTs may, however, treat conditions caused by adrenal disorders or treat patients with Addison’s disease for other pathologies that are unrelatedHypotensionFatigueWeight loss,1 loss of appetiteDecreased activity toleranceFainting/loss of consciousnessHeadachesSweatingAnorexiaMuscle weakness1Darkening/hyperpigmentation of skinCraving for saltHypoglycemiaNauseaDiarrheaVomitingIrritabilityDepressionPainJoint painLow back painAbdominal painLeg painHyperkalemiaLoss of libidoOral lesionsMetabolic acidosisPersonality changesAmenorrheaSparseness of hair in axilla +++ Functional Implications ++ Severe symptoms such as immediacy of need to defecate and diarrhea, which may be disabling and result in the inability to leave homeDecreasing weight with inability to exercise or move wellSarcopenia, resulting in weakness, muscle mass loss, inability to ambulate or perform self-care, and aerobic capacity limitation secondary to inactivityDecreased exercise toleranceLimitations in ADLs or IADLs ++... Your Access profile is currently affiliated with [InstitutionA] and is in the process of switching affiliations to [InstitutionB]. Please select how you would like to proceed. Keep the current affiliation with [InstitutionA] and continue with the Access profile sign in process Switch affiliation to [InstitutionB] and continue with the Access profile sign in process Get Free Access Through Your Institution Learn how to see if your library subscribes to McGraw Hill Medical products. Subscribe: Institutional or Individual Sign In Error: Incorrect UserName or Password Username Error: Please enter User Name Password Error: Please enter Password Sign in Forgot Password? Forgot Username? Download the Access App: iOS | Android Sign in via OpenAthens Sign in via Shibboleth You already have access! Please proceed to your institution's subscription. Create a free profile for additional features.