The Endocrine System

Controls many body functions

exerts control by releasing special chemical substances into the blood called hormones Hormones affect other endocrine glands or body systems

Derives its name from the fact that various glands release hormones directly into the blood, which in turn transports the hormones to target tissues via ducts.

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Exocrine glands transport their hormones to target tissues via ducts. Endocrine Emergencies:
from common: Diabetes to the unusual: Thyrotoxicosis

The Endocrine System

Consists of several glands located in various parts of the body.
Pituitary gland: a small gland located on a stalk hanging from the base of the brain - AKA The Master Gland Primary function is to control other glands. Produces many hormones. Secretion is controlled by the hypothalamus in the base of the brain.

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The Pituitary Gland is divided into 2 areas, which differ structurally and functionally each area has separate types of hormone production.
The two segments are: Posterior Pituitary: produces oxytocin and antidiuretic hormone (ADH) Anterior Pituitary: produces thyroidstimulating hormone (TSH) growth hormone (GH) adrenocorticotropin (ACTH) follicle-stimulating hormone (FSH)

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And even more
luteinizing hormone (LH) prolactin Posterior Pituitary Oxytocin (the natural form of pitocin) stimulates gravid uterus causes let down of milk from the breast. ADH (vasopressin) causes the kidney to retain water.

Lets go over these one at a time...

The Endocrine System

Anterior Pituitary Primarily regulates other endocrine glands rarely a factor in endocrinological emergencies TSH stimulates the thyroid gland to release its hormones, thus metabolic rate Anterior Pituitary Growth hormone (GH) glucose usage consumption of fats as an energy source ACTH stimulates the adrenal cortex to release its hormones FSH & LH stimulates maturation & release of eggs from ovary.

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The Thyroid Gland
lies in the anterior neck just below the larynyx. Two lobes, located on either side of the trachea, connected by a narrow band of tissue called the isthmus. Sacs inside the gland contain colloid Within the colloid are the thyroid hormones: thyroxine (T4) triiodothyronine (T3) When stimulated (by TSH or by cold), these are released into the circulatory system and the metabolic rate. C cells within the thyroid produce the hormone calcitonin.

The Endocrine System

Calcitonin, when released, lowers the amount of calcium in the blood. Inadequate levels of thyroid hormones = hypothyroidism, or Myxedema.
Myxedema symptoms: Facial bloating weakness cold intolerance lethargy altered mental status oily skin and hair TX: replacement of thyroid hormone.

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Increased thyroid hormone release causes hyperthyroidism, commonly called Graves disease. Signs and symptoms: insomnia, fatigue tachycardia hypertension heat intolerance weight loss Long term hyperthyroidism: Exopthalmos bulging of the eyeballs (picture Barbara Bush) In severe cases - a medical emergency called thyrotoxicosis can result.

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Parathyroid Glands
small, pea-shaped glands, located in the neck near the thyroid usually 4 - number can vary regulate the level of calcium in the body produce parathyroid hormone - level of calcium in blood Hypocalcemia can result if parathyroids are removed or destroyed.

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Pancreas
a key gland located in the folds of the duodenum has both endocrine and exocrine functions secretes several key digestive enzymes

Islets of Langerhans
specialized tissues in which the endocrine functions of the pancreas occurs include 3 types of cells:
alpha ( ) beta () delta ()

each secretes an important hormone.

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Alpha () cells release glucagon, essential for controlling blood glucose levels. When blood glucose levels fall, cells the amount of glucagon in the blood . The surge of glucagon stimulates the liver to release glucose stores (from glycogen and additional storage sites). Also, glucagon stimulates the liver to manufacture glucose gluconeogenesis.

The Endocrine System

Beta Cells () release insulin (antagonistic to glucagon). Insulin the rate at which various body cells take up glucose. Thus, insulin lowers the blood glucose level. Insulin is rapidly broken down by the liver and must be secreted constantly. Delta Cells () produce somatostatin, which inhibits both glucagon and insulin.

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Adrenal Glands
2 small glands that sit atop both kidneys. Each has 2 divisions, each with different functions.

the Adrenal Medulla secretes the catecholamine hormones norepinephrine and epinephrine (closely related to the sympathetic component of the autonomic nervous system).

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One at a time The Adrenal Cortex secretes 3 classes of hormones, all steroid hormones:
gluticocorticoids mineralocorticoids androgenic hormones gluticocorticoids: accounts for 95% of adrenal cortex hormone production the level of glucose in the blood Released in response to stress, injury, or serious infection - like the hormones from the adrenal medulla.

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Mineralocorticoids:
work to regulate the concentration of potassium and sodium in the body.

Signs & Symptoms of Cushings Disease:

in blood sugar levels unusual body fat distribution rapid mood swings

Prolonged in adrenal cortex hormone results in Cushings Disease.

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And - if there is an in mineralocorticoids as well
A serious electolyte imbalance will occur due to the potassium excretion by the kidney, which results in hypokalemia.

Sodium can also be retained by the kidney, resulting in hyponatremia.

Causes:
dysrhythmias coma death

usually results from a tumor - TX? Removal of tumor.

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Gonads and Ovaries:
the endocrine glands associated with human reproduction. Female ovaries produce eggs Male gonads produce sperm

Ovaries:
located in the abdominal cavity adjacent to the uterus. Under the control of LH and FSH from the anterior pituitary they manufacture
estrogen protesterone

both have endocrine functions.

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Estrogen and Progesterone have several functions, including sexual development and preparation of the uterus for implantation of the egg. Testes:
located in the scrotum produce sperm for reproduction manufacture testosterone promotes male growth and masculinization

Controlled by anterior pituitary hormones FSH and LH.

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Endocrine Emergencies: Diabetes Mellitus
one of the most common diseases in North America. insulin secretion by the Beta () cells of the islets of Langerhans in the pancreas.

Complications of Diabetes:
contributes to heart disease stroke kidney disease blindness

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Pathophysiology of Diabetes: Glucose Metabolism
Glucose (dextrose) is a simple sugar required by the body to produce energy. Sugars, or carbohydrates, are 1 of 3 major food sources used by the body.

The other 2 major food sources are

proteins fats

Most sugars in the human diet are complex and must be broken down into simple sugars: glucose, galactose and fructose - before use.

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Breakdown of sugars is carried out by enzymes in the gastro intestinal system.
As simple sugars, these are absorbed from the GE system into the body. More than 95% enter the body as glucose.

To be converted into energy, glucose must first be transmitted through the cell membrane. BUT - the glucose molecule is large and doesnt readily diffuse through the cell membrane.

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Glucose must pass into the cell by binding to a special carrier protein on the cells surface.
Facilitated diffusion doesnt use energy. The carrier protein binds with the glucose and carries it into the cell.

The rate at which glucose can enter the cell is dependent upon insulin levels.
Insulin serves as the messenger - travels via blood to target tissues. Combines with specific insulin receptors on the surface of the cell membrane.