Endocrine System
u Throughout the body
u Functions
1. Differentiation of the reproductive & CNS in developing fetus
2. Stimulation of growth & development
3. Coordination of male and female reproductive systems
4. Maintenance of optimal internal environment throughout life
5. Initiation of corrective and adaptive responses when emergent
demands occur
u Definitions
u Autocrine- within cells
u Paracrine- between local cells
u Endocrine- between remote located cells
Mechanisms of Hormonal Regulation
Hormones have specific rates and rhythms
Hormones operate within similar feedback systems
Hormones affect only target cells with specific receptors for the
hormone and then act to initial specific cell functions or activities
Steroid hormones are either secreted directly by the kidneys or
metabolized by the liver
Peptide hormones are catabolized by circulating enzymes and
eliminated in feces or urine
Hormone Regulation:
Regulation 1. Chemical Factors
of
2. Endocrine Factors
3. Neural Control
Hormonal Feed Back Systems
Release 1. Positive
2. Negative
Hypothalamic-Pituitary System
Hypothalamic-pituitary axis forms the structural & functional basis for
central integration of the neurologic & endocrine systems
Hypothalamus- base of brain
Pituitary- depression of the sphenoid bone at the base of the skull
• 2 lobes- anterior and posterior
Pituitary
Anterior Posterior
u Tropic Hormones- affect the u Polypeptide Hormones
physiologic function of the specific
u Antidiuretic hormone (ADH) &
target organ
oxytocin
u Melanocyte-stimulating hormone
(MSH), Follicle-stimulating hormone
(FSH), Lutenizing hormone (LH),
Adrenocortiotropic hormone (ACTH),
Thyroid-stimulating hormone (TSH),
Growth hormone (GH)
Pineal Gland
Thyroid Gland
2 Lobes Isthmus Consists of follicles
Essential for growth and neurological function
Growth, maturation, and function in the fetus and infant and metabolic,
of cells and tissues throughout the neurologic, cardiovascular, and respiratory
body function across the lifespan. Also metabolism
and function of blood cells, and muscle, skin,
nails, and hair
Parathyroid
u 2 pairs of small parathyroid glands
behind upper and lower poles of the
thyroid
u Produces PTH- regulates serum
calcium
u Changes in serum calcium
concentration increases or decreases
PTH secretion
u If calcium low -> PTH increases
u PTH acts directly on the bone to
release calcium
u PTH acts on kidneys to increase
calcium reabsorption
Endocrine Pancreas
u Endocrine- produces hormones
Exocrine- produces digestive enzymes
u Islets of Langerhans- produce 4 types of
hormone cells:
A. Alpha- glucagon
B. Beta- insulin and amylin
C. Delta- gastrin and somatostatin
D. F or PP- pancreatic polypeptide
Endocrine Pancreas Hormones-
Beta
Insulin Amylin
u Secretion is regulated by chemical, hormonal,
u Secreted in response to nutrient stimuli
and neural control
u Primary stimulus for secretion is increase in blood u Regulates blood glucose concentration by
glucose
u Insulin decreases with decrease in blood delaying gastric emptying and suppressing
glucose(hypoglycemia), high levels of insulin glucagon secretion after meals
(negative feedback to beta cells), and
sympathetic stimulation of the beta cells
u Has a satiety effect- reduces food intake
u Insulin sensitivity is affected by age, weight,
abdominal fat, and physical activity u Helps prevent hyperglycemia
u Promotes glucose uptake primarily in liver,
muscle, and adipose tissue
Endocrine Pancreatic Hormones- Delta
Gastrin Somatostatin
u Stimulates the secretion of gastric acid u Produced in response to food intake
(hydrochloric acid (HCl)) and essential in carbohydrate, fat,
and protein metabolism
u Also responsible for enhancing gastric
mucosal growth and gastric motility u Regulates alpha and beta cell
function by inhibiting secretion of
insulin, glucagon, and pancreatic
polypeptide
Endocrine Pancreas Hormones-
Alpha and F (PP)
Alpha- GLUCAGON F- Pancreatic Polypeptide
u Antagonist to effects of insulin u Released in response to hypoglycemia and
protein-rich meals
u Released when stimulated by low blood
sugar levels u Inhibits gallbladder contraction and exocrine
secretion
u Also produced in the lining of the
gastrointestinal tract u Elevated frequently in people with pancreatic
tumors or DM
u Acts primarily in liver and increases the
blood glucose by stimulating glucogenesis
in the muscle and lipolysis in adipose tissue
Adrenal Glands
u Paired pyramid shaped organs close to the upper pole of each kidney
u Outer Adrenal Cortex
u Aldosterone, glucocorticoids, cortisol, cortisone, corticosterone, adrenal androgens, and estrogens
u Glucocorticoids- steroid hormones, metabolic, neurologic, anti-inflammatory, and growth suppressing effects
u Cortisol- protects body from stress-> stimulates production of ACTH
u Aldosterone- regulated by RAA, enhances cardiac muscle contraction, maintains ECV
u Inner Adrenal Medulla
u Secretes and stores catecholamines- adrenaline and norepinephrine
u Physiologic stress to the body triggers exocytosis and releases into bloodstream
u Fight or Flight response
u Catecholamines promote hyperglycemia
u Elevated or depressed hormone levels
Mechanisms may result from 2 primary mechanism
of Hormonal 1. Inappropriate amounts of hormone
delivered to the target cell
Alterations
2. Inappropriate responses by the target cell
Diseases of the posterior pituitary cause
either increased or decreased secretion
of ADH (antidiuretic hormone)
Diseases of
Excess amounts of this hormone results in
the Posterior water retention
Pituitary
Deficiencies in amount or response to
ADH result in water loss
Syndrome of Inappropriate
Antidiuretic Hormone Secretion
(SIADH)
u High levels of ADH in the absence of normal physiologic stimuli
u Causes: tumors- cancer lungs, stomach, pancreas, bladder, Pulmonary disorders- pneumonia, TB, asthma, CF, CNS-
encephalitis, meningitis, trauma, also: surgery and certain medications
u Free water retention- induces a water channel protein into the tubular luminal membrane which increases the water
absorption by kidneys
u Urine is inappropriately concentrated
u Sx: hyponatremia, thirst, impaired taste, anorexia, dyspnea on exertion, fatigue, GI sx, weight gain, CNS sx start NA levels
<115
u Dx: serum hypoosmolality, hyponatremia, urine hyperosmolarity, and absence of conditions that alter volume status
u Tx: correct underlying problem, fluid restriction with careful lab monitoring, vasopressin
Insufficient ADH activity leading to loss of too much free water into the
urine
•Neurogenic or Central- organic lesion of the hypothalamus, pituitary stalk, or posterior
pituitary, brain tumors, injury, aneurysms, thrombosis, infections
•Nephrogenic- inadequate response by renal tubules to ADH, pyelonephritis, amyloidosis,
polycystic kidney disease, medications- lithium, colchicine, loop diuretics, anesthesia
Partial to total inability to concentrate urine leading increased plasma
osmolality
Diabetes Sx: polyuria, nocturia, continuous thirst, polydipsia, up to 8-12L of urine a
Insipidus
day, hypernatremia, and hyperosmolality (other electrolytes not
affected)
Dx: low urine osmolality, water deprivation testing
Tx: fluid replacement, ADH replacement, reversal of underlying
disorders, discontinuation of medications, and correction of electrolyte
issues
Diseases of the Anterior Pituitary
Hypopituitary
u Absence of 1 or more anterior hormones or complete failure
u Panhypopituitarism- all hormones are deficient
Sx of CORTISOL deficiency- nausea, vomiting, anorexia, fatigue, weakness, hypoglycemia
Sx of TSH deficiency: cold intolerance, skin dryness, lethargy, and decreased metabolism
Sx of FSH & LH deficiency women- amenorrhea, atrophy of vagina, uterus and breasts; in
men- testicle atrophy and diminished growth of facial hair
Sx of GH deficiency in children- dwarfism
Dx: MRI
Tx: treat underlying condition
uGigantism
Thyrotoxicosis/Hyperthyroidism
u Thyrotoxicosis- any cause of increased TH
u Hyperthyroidism- TH excreted in excess from thyroid
u Primary- GRAVES
u Autoimmune
u Key sx: exophthalmos and pretibial myxedema
u Central (secondary)- adenoma
u Dx: Low tsh, high t3, t4, free t4, US
u Tx: antithyroid drugs, radioactive iodine, surgical removal
Hypothyroidism
Deficient production of TH
Sx: next slide
Dx: High TSH, low- t3, t4, and free
t4
Tx: replacement, or eliminate
cause
Types of Diabetes Mellitus
u Type 1
u Type 2
u Type ½
u Gestational
