Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.1 CHAPTER 18...

Copyright © 2012, 2007, 2003, 1997, 1991 by Mosby, Inc., an affiliate of Elsevier Inc. 1

CHAPTER 18 CHAPTER 18

ENDOCRINE SYSTEMENDOCRINE SYSTEM


Chapter 18 Learning ObjectivesChapter 18 Learning Objectives

Define 10 terms relating to the endocrine Define 10 terms relating to the endocrine system.system.

Describe the function of the endocrine Describe the function of the endocrine system.system.

Identify at least nine endocrine system Identify at least nine endocrine system structures.structures.


Chapter 18 Learning ObjectivesChapter 18 Learning Objectives

Identify at least one hormone produced by Identify at least one hormone produced by each of the 10 endocrine glands.each of the 10 endocrine glands.

Describe at least three methods used to Describe at least three methods used to assess the function of the endocrine system.assess the function of the endocrine system.

Describe at least five disorders of the Describe at least five disorders of the endocrine system.endocrine system.


Structure and Function Structure and Function of the Endrocrine Systemof the Endrocrine System

Primary function of the endocrine system is to Primary function of the endocrine system is to produce hormones that monitor and produce hormones that monitor and coordinate body activities.coordinate body activities.

Endocrine glands secrete hormones directly Endocrine glands secrete hormones directly into the bloodstream.into the bloodstream.

Two classes of hormonesTwo classes of hormones Nonsteroid Nonsteroid

• First messengersFirst messengers SteroidSteroid


The Endocrine SystemThe Endocrine System

FIGURE 18-1 The endocrine system. (From Patton KT, Thibodeau GA: Anatomy & physiology, ed 7, St. Louis, 2010, Mosby.)


HormonesHormones

Three categories of hormonesThree categories of hormones Tropic hormones Tropic hormones

• Target other endocrine structures to increase Target other endocrine structures to increase growth and secretionsgrowth and secretions

Sex hormones Sex hormones • Influence reproductive changesInfluence reproductive changes

Anabolic hormonesAnabolic hormones• Stimulate the process of building tissuesStimulate the process of building tissues


HormonesHormones

Hormones direct many body processes, Hormones direct many body processes, includingincluding GrowthGrowth MetabolismMetabolism ReproductionReproduction

Hormones regulate the body’s reaction to Hormones regulate the body’s reaction to stress and homeostasis.stress and homeostasis.


Glands and Their HormonesGlands and Their Hormones HypothalamusHypothalamus

Located above the pituitary gland Located above the pituitary gland Translates nervous system impulses into Translates nervous system impulses into

endocrine system messagesendocrine system messages Regulates secretions of the pituitary Regulates secretions of the pituitary

adenohypophysisadenohypophysis Pituitary glandPituitary gland

Located at the base of the brainLocated at the base of the brain Divided into two parts – anterior and posteriorDivided into two parts – anterior and posterior Sometimes called the Sometimes called the master glandmaster gland

• Produces the hormones that regulate the secretion Produces the hormones that regulate the secretion of other glandsof other glands


Glands and Their HormonesGlands and Their Hormones Pineal bodyPineal body

Pea-shaped organ located in the brainPea-shaped organ located in the brain Produces the hormone melatoninProduces the hormone melatonin

• Regulates the release of substances in the Regulates the release of substances in the hypothalamus of the brain that influence secretion of sex hypothalamus of the brain that influence secretion of sex hormoneshormones

• Influences menstrual cycle and onset of pubertyInfluences menstrual cycle and onset of puberty

• Thought to be involved in the regulation of the biologic Thought to be involved in the regulation of the biologic clockclock


Glands and Their HormonesGlands and Their Hormones

ThyroidThyroid Butterfly-shaped gland located in the neckButterfly-shaped gland located in the neck Produces hormones that regulate body Produces hormones that regulate body

metabolism:metabolism: thyroxine and triiodothyronine thyroxine and triiodothyronine• Iodine is required for production of both.Iodine is required for production of both.

Produces calcitonin, which decreases the amount Produces calcitonin, which decreases the amount of calcium in the bloodof calcium in the blood



ParathyroidParathyroid Four tiny glands attached in the back of thyroid Four tiny glands attached in the back of thyroid

glandgland Secretes parathyroid hormone, which affects the Secretes parathyroid hormone, which affects the

amount of calcium in the bloodamount of calcium in the blood• Increases the blood’s calcium levelIncreases the blood’s calcium level• Increases the rate of phosphorus excretion by the Increases the rate of phosphorus excretion by the

kidneyskidneys



ThymusThymus Butterfly-shaped gland located above the heartButterfly-shaped gland located above the heart Produces thymosinProduces thymosin

• Stimulates the lymphoid organs to produce T Stimulates the lymphoid organs to produce T lymphocytes and antibodies in newborns or young lymphocytes and antibodies in newborns or young childrenchildren



PancreasPancreas Located behind the stomachLocated behind the stomach Produces the hormones insulin and glucagonProduces the hormones insulin and glucagon

• Insulin regulates transportation of sugar, fatty acids, Insulin regulates transportation of sugar, fatty acids, and amino acids into the cells.and amino acids into the cells.

• Glucagon increases the blood sugar level.Glucagon increases the blood sugar level. The pancreas is the only gland that has both The pancreas is the only gland that has both

endocrine and exocrine functions.endocrine and exocrine functions.



AdrenalsAdrenals Located above the kidneysLocated above the kidneys Divided into two layersDivided into two layers

• Adrenal cortexAdrenal cortex Produces about 30 hormonesProduces about 30 hormones

• Adrenal medullaAdrenal medulla Produces epinephrine (adrenalin) and norepinephrineProduces epinephrine (adrenalin) and norepinephrine

– Epinephrine increases heart rate, blood pressure and blood Epinephrine increases heart rate, blood pressure and blood sugar. Decreases blood flow to internal organs.sugar. Decreases blood flow to internal organs.



Gonads Gonads Primary sex glandsPrimary sex glands

• Female: ovaries produce estrogen and Female: ovaries produce estrogen and progesteroneprogesterone

Hormones stimulate breast development, hair Hormones stimulate breast development, hair placement, and menstruation.placement, and menstruation.

Estrogen initiates ovulation.Estrogen initiates ovulation. Progesterone assists in pregnancy.Progesterone assists in pregnancy.

• Male: testes produce hormone testosteroneMale: testes produce hormone testosterone Hormone stimulates secondary characteristics of the Hormone stimulates secondary characteristics of the

male.male.



Prostaglandins Prostaglandins Fatty hormones produced by tissuesFatty hormones produced by tissues Can decrease blood pressure, cause fever, Can decrease blood pressure, cause fever,

increase hydrochloric acid secretion in the increase hydrochloric acid secretion in the stomach, increase uterine contraction during stomach, increase uterine contraction during pregnancy, and influence intestinal peristalsispregnancy, and influence intestinal peristalsis


Hormonal Changes of PubertyHormonal Changes of Puberty

Adrenal gland secretes the hormones that Adrenal gland secretes the hormones that begin the development of secondary sexual begin the development of secondary sexual characteristics.characteristics. In a man, the voice deepens, and facial hair In a man, the voice deepens, and facial hair

begins to grow. begins to grow. In a woman, the breasts enlarge, and fatty tissue In a woman, the breasts enlarge, and fatty tissue

is deposited around the hips. is deposited around the hips. In men and women, height and weight increase. In men and women, height and weight increase.


Hormonal Changes of PregnancyHormonal Changes of Pregnancy

The placenta, or interfacing organ between the fetal and The placenta, or interfacing organ between the fetal and maternal circulation, produces a hormone called maternal circulation, produces a hormone called human human chorionic gonadotropinchorionic gonadotropin (hCG). (hCG).

Increased estrogen and progesterone from the ovaries are Increased estrogen and progesterone from the ovaries are maintained until the placenta begins to produce these maintained until the placenta begins to produce these hormones.hormones.

Progesterone increases the mobility of the pelvic and lower Progesterone increases the mobility of the pelvic and lower back bones to allow the birthing process. back bones to allow the birthing process.

The pituitary and thyroid increase in size, resulting in a The pituitary and thyroid increase in size, resulting in a higher metabolic rate. higher metabolic rate.


Hormonal Changes of MenopauseHormonal Changes of Menopause

Menopause occurs after a decrease in Menopause occurs after a decrease in secretion of the gonadotropins follicle-secretion of the gonadotropins follicle-stimulating hormone (FSH) and luteinizing stimulating hormone (FSH) and luteinizing hormone (LH).hormone (LH).

Ovarian secretion of the hormone estrogen is Ovarian secretion of the hormone estrogen is decreased.decreased.

Hot flashes, periods of feeling extreme heat, Hot flashes, periods of feeling extreme heat, are the only universal symptom of are the only universal symptom of menopause. menopause.


Assessment TechniquesAssessment Techniques

Basal metabolic rate (BMR) Basal metabolic rate (BMR) Amount of energy needed to maintain functions of Amount of energy needed to maintain functions of

resting bodyresting body Protein-bound iodine (PBI) Protein-bound iodine (PBI)

Blood test to measure the amounts of proteins Blood test to measure the amounts of proteins attached to thyroxineattached to thyroxine

ImmunoassayImmunoassay Blood specimen is mixed with a specific chemical Blood specimen is mixed with a specific chemical

agent.agent. Number of complexes formed indicates the Number of complexes formed indicates the

presence of certain hormones.presence of certain hormones.


Assessment TechniquesAssessment Techniques

Radioiodine uptake (RAIU) studiesRadioiodine uptake (RAIU) studies Involves drinking radioactive iodine and measuring Involves drinking radioactive iodine and measuring

the iodine absorbed by the thyroid using a Geiger the iodine absorbed by the thyroid using a Geiger countercounter

Glucose tolerance testing (GTT) Glucose tolerance testing (GTT) Assesses function of pancreas using urine and Assesses function of pancreas using urine and

blood specimensblood specimens Measures the efficiency of the insulin production of Measures the efficiency of the insulin production of

the pancreasthe pancreas


Disorders of the Endocrine SystemDisorders of the Endocrine System

Acromegaly Acromegaly Enlargement of the bones of the hands, feet, and Enlargement of the bones of the hands, feet, and

jawsjaws Addison's disease Addison's disease

Caused by hyposecretion of the hormones Caused by hyposecretion of the hormones produced by the adrenal cortexproduced by the adrenal cortex

CretinismCretinism Condition resulting from a congenital deficiency of Condition resulting from a congenital deficiency of

thyroid secretion or hypothyroidismthyroid secretion or hypothyroidism


Disorders of the Endocrine SystemDisorders of the Endocrine System

Cushing’s syndrome Cushing’s syndrome Disorder that causes hyperactivity of the adrenalsDisorder that causes hyperactivity of the adrenals Triggered by the oversecretion of the pituitary Triggered by the oversecretion of the pituitary

hormone ACTHhormone ACTH Diabetes insipidusDiabetes insipidus

Acquired or inherited decrease in the antidiuretic Acquired or inherited decrease in the antidiuretic hormone secreted by the pituitaryhormone secreted by the pituitary

Diabetes mellitusDiabetes mellitus Disorder of carbohydrate, fat, and protein Disorder of carbohydrate, fat, and protein

metabolism resulting from insufficient insulin metabolism resulting from insufficient insulin production by the pancreasproduction by the pancreas


Signs and Symptoms of Signs and Symptoms of Diabetes MellitusDiabetes Mellitus


Disorders of the Disorders of the Endocrine SystemEndocrine System

Dwarfism Dwarfism Results from hyposecretion of growth hormone by Results from hyposecretion of growth hormone by

the pituitary glandthe pituitary gland May be caused by a tumor, infection, genetic May be caused by a tumor, infection, genetic

factors, or traumafactors, or trauma GigantismGigantism

Excessive growth of the long bones caused by Excessive growth of the long bones caused by hypersecretion of somatotropic hormonehypersecretion of somatotropic hormone

Graves’ disease Graves’ disease Caused by hyperthyroidism or thyrotoxicosisCaused by hyperthyroidism or thyrotoxicosis


Disorders of the Disorders of the Endocrine SystemEndocrine System

Hyperparathyroidism Hyperparathyroidism Causes hypercalcemia, an increased calcium Causes hypercalcemia, an increased calcium

blood levelblood level Hypoglycemia Hypoglycemia

Results from increased insulin production by the Results from increased insulin production by the pancreaspancreas

HypoparathyroidismHypoparathyroidism Decreased secretion of parathyroid hormone, Decreased secretion of parathyroid hormone,

which causes tetanywhich causes tetany


DisordersDisorders of the of the Endocrine SystemEndocrine System

HypothyroidismHypothyroidism Also called Also called Hashimoto's diseaseHashimoto's disease, results from an , results from an

insufficient production of thyroxineinsufficient production of thyroxine Syndrome of inappropriate antidiuretic Syndrome of inappropriate antidiuretic

hormone (SIAH) hormone (SIAH) Involves water intoxication and the dilution of Involves water intoxication and the dilution of

intracellular and extracellular body tissues, usually intracellular and extracellular body tissues, usually resulting from lung cancerresulting from lung cancer

VirilismVirilism Results from increased secretion in the adrenal Results from increased secretion in the adrenal

glandsglands


Issues and InnovationsIssues and Innovations

DiabetesDiabetes About 8% of the population have diabetesAbout 8% of the population have diabetes

• Rates are highest in China, India, and the United States.Rates are highest in China, India, and the United States.

ExuberaExubera• New form of insulin taken with an inhalerNew form of insulin taken with an inhaler

• Can be used by type 1 and 2 diabeticsCan be used by type 1 and 2 diabetics

Transplantation of a donor pancreasTransplantation of a donor pancreas• Used with various rates of successUsed with various rates of success

Infusion of cord stem cell into children with type 1 Infusion of cord stem cell into children with type 1 diabetesdiabetes• Safe and may slow down progression of type 1 diabetesSafe and may slow down progression of type 1 diabetes


Issues and InnovationsIssues and Innovations

Steroid abuseSteroid abuse Continues to be a problem, especially by athletesContinues to be a problem, especially by athletes Causes problems for men, such as stunted Causes problems for men, such as stunted

growth, liver tumors, and decreased sperm growth, liver tumors, and decreased sperm productionproduction

Causes problems for women, such as loss of Causes problems for women, such as loss of menstrual cycle and baldnessmenstrual cycle and baldness

Use of anabolic steroids may result in a prison Use of anabolic steroids may result in a prison sentence of up to 6 years.sentence of up to 6 years.


SummarySummary

The function of the endocrine system is to The function of the endocrine system is to produce hormones that monitor and produce hormones that monitor and coordinate body activities.coordinate body activities.

Endocrine system structuresEndocrine system structures PinealPineal HypothalamusHypothalamus ThyroidThyroid PituitaryPituitary Thymus glandsThymus glands OthersOthers


SummarySummary

The hormone produced by the thyroid gland The hormone produced by the thyroid gland (thyroxine) regulates body metabolism.(thyroxine) regulates body metabolism.

Methods used to assess the endocrine Methods used to assess the endocrine systemsystem Basal metabolic rateBasal metabolic rate Protein-bound iodine blood testsProtein-bound iodine blood tests Radioactive uptakeRadioactive uptake


SummarySummary

Disorders of the endocrine systemDisorders of the endocrine system AcromegalyAcromegaly CretinismCretinism Cushing’s syndromeCushing’s syndrome Diabetes insipidusDiabetes insipidus Diabetes mellitusDiabetes mellitus

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