Endocrine Pathophysiology

Anatomy and Physiology of the Endocrine System, Thyroid Disorders and Diseases, Diabetes, Hyperglycemia, Hypoglycemia, Obesity

1. Endocrine Pathophysiology

2. Functions of the Endocrine System Collection of glands that produce hormones to: Regulate metabolism Regulate growth and development Regulate tissue function Regulate sexual function Regulate reproduction Regulate sleep Regulate mood

3. Anatomy of the Endocrine System Pituitary Gland Master gland of the endocrine system Produces critical hormones Anterior Lobe Releases hormones upon receiving releasing/inhibiting hormones from the hypothalamus Posterior Lobe Contains the ends of nerve cells from the hypothalamus Hypothalamus sends hormones directly to the posterior lobe via these nerves and then the pituitary gland releases them

4. Anatomy of the Endocrine System Hypothalamus Part of the brain that links the endocrine system to the nervous system Controls the pituitary gland

5. Anatomy of the Endocrine System Parathyroid Glands Four tiny glands located in the neck Control body’s calcium levels Produce parahormone Thyroid Gland found in the neck Regulates rate of metabolism Produces thyroxine

6. Anatomy of the Endocrine System Adrenal Glands One pair of ductless glands located above the kidneys Adrenal Cortex produces steroidal hormones Adrenal Medulla produces epinephrine and norepinephrine

7. Anatomy of the Endocrine System Pancreas Located partially behind the stomach and the abdomen Functions as both an endocrine and exocrine gland Produces digestive enzymes Produces insulin and glucagon

8. Anatomy of the Endocrine System Pineal Gland Small mass of tissue near the brain Secretes melatonin

9. Anatomy of the Endocrine System Thymus Gland Gland located near the heart Aid’s in the body’s defense against infection by making antibodies

10. Anatomy of the Endocrine System Ovaries in females Secrete estrogen and progesterone, hormones that are vital to normal reproductive development and fertility Testicles in males Secrete testosterone, a hormone that is vital to the normal development of male characteristics

11. Endocrine Hormones Hormones are the chemical messengers of the endocrine system that are released into the blood Protein Hormones Class of hormones that cannot pass through the cell membrane Less likely to be stored in the body Steroid Hormones Class of hormones that can pass through the cell membrane Can be stored in the body

12. Endocrine Hormones Prostaglandins Local hormones that do not enter the bloodstream Growth Hormone Secreted by anterior pituitary gland Stimulates bone growth Luteinizing Hormone Protein hormone secreted by anterior pituitary gland Stimulates ovulation in females and androgen production in males

13. Endocrine Hormones Prolactin Peptide hormone released by anterior pituitary Promotes lactation Follicle-Stimulating Hormone Secreted in increasing amounts during puberty by the anterior pituitary Stimulates development of reproductive cell follicles

14. Endocrine Hormones Adrenocorticotropic Hormone Peptide hormone released from anterior pituitary Stimulates production and secretion of steroid hormones by adrenal cortex Oxytocin Produced by the hypothalamus and released from posterior pituitary Induces contractions of uterine muscles during labor

15. Endocrine Hormones Antidiuretic Hormone Secreted by posterior pituitary Aids in water reabsorption by the kidney Calcitonin Produced by thyroid gland Decreases blood calcium levels by stimulating calcium deposit in the bones Antagonist of parathyroid hormone Parahormone Secreted by parathyroid glands Controls calcium and phosphate metabolism

16. Endocrine Hormones Cortisol Secreted from adrenal cortex Aids the body during stress Regulates glucose, carbohydrate, and fat levels Aldosterone Corticosteroid hormone secreted by adrenal cortex Regulates mineral balance in blood Controls fluid volume

17. Endocrine Hormones Insulin Hormone secreted by the beta cells of the pancreas Responsible for regulating the metabolism of glucose Glucagon Hormone secreted by the alpha cells of the pancreas Raises blood glucose levels

18. Endocrine Hormones Estrogen General term for female steroid sex hormones Secreted by the ovary Responsible for typical female sexual characteristics Progesterone Hormone produced by the ovaries Acts with estrogen to bring about the menstrual cycle

19. Endocrine Hormones Testosterone Male sex hormone produced by the testes Promotes maturation of the reproductive system accessory structures Promotes development of the male secondary sex characteristics Melatonin Hormone secreted by the pineal gland Used to regulate sleep patterns

20. Classification of Hormones Anterior Pituitary Gland Adrenocorticotrophic Hormone (ACTH) Thyroid-Stimulating Hormone (TSH) Luteinizing Hormone (LH) Follicle-Stimulating Hormone (FSH) Growth Hormone (GH) Melanocyte-stimulating hormone (MSH)

21. Classification of Hormones Posterior Pituitary Gland Anti-diuretic Hormone (ADH) Oxytocin

22. Hormone Regulation Nervous System Signals Chemical Changes in the Blood Hormones regulate other hormones

23. Gigantism Acromegaly Thicker skull and jaw Occurs after joint plates fuse

24. Hyperthyroidism Common Cause: Graves Disease Common Symptoms: exopthalamos , goiter, heat intolerance, and anxiety

25. Hypothyroidism Very familial; 4 times more likely in women Common Symptoms: weight gain, cold intolerance, and fatigue Myxedema Fluid buildup that does not pit Can look like fibromyalgia because of muscle aches and trigger point tenderness Sparse hair, brittle nails, Buffalo hump

26. Thyroid Storm T3 and T4 are dumped into the system Causes tachycardia, fever, and agitation Life-threatening condition associated with untreated or undertreated hyperthyroidism

27. Thyroid Cancer Very treatable Most are benign – only 5% are malignant and most do not metastasize Palpation will be painless, unilateral, and in one spot

28. Parathyroid Cancer Cannot be easily distinguished from thyroid cancer Weakness, feeling tired, lump in the neck

29. Addison’s Disease HYPOADRENAL autoimmune disease Skin changes color to a slight grey

30. Cushing’s Syndrome HYPERADRENAL Too much glucocorticoids in the system Can cause muscle wasting, bone demineralization, and ligament laxity

31. Diabetes Fasting plasma glucose >126 mg/ dL Insulin makes glucose transporters closer to the cell Three types: Type 1 Type 2 Gestational

32. Type 1 Diabetes Autoimmune; typically presents in under age 20 Insulin produces B-cell destruction Risk Factors: sibling or parents have type 1

33. Type 2 Diabetes Obesity; insulin resistance; pancreas intact Receptor does not bind to insulin as well as it used to Hyperglycemia develops slowly Risk Factors: genetic predisposition; overweight, over 45 y/o, sedentary lifestyle, women who have had a baby over 9 lbs , and low HDL levels

34. Gestational Diabetes Associated with type 2 diabetes Glucose intolerance with pregnancy increased risk of diabetes later on if it continues >6 weeks after pregnancy

35. Acute Hyperglycemia Early Signs Blood sugar >180 mg/ dL Blurred vision Ketones, dry skin, fatigue Thirsty, increased urination Late Signs Blood sugar > 240 mg/ dL Nausea/vomiting Deep/rapid breathing Large ketones in urine, fruity breath Some patients don’t sense changes because of neuropathy

36. Acute Hypoglycemia Causes : over treatment with insulin, missed meal, exercising when insulin is peaking, or stress Early Signs : tachycardia, hunger, headache, dizziness, sweating, shaking, pale skin, and tingling around the mouth Late Signs : slurred speech, confusion, sudden moodiness, clumsiness, jerky movements, seizures, and syncope Treatment : quick action is essential

37. Obesity: BMI Classification Underweight <18.5 Normal Weight 18.5 to 24.9 Overweight 25 to 29.9 Obese >30

38. Obesity: Fat Locations Subcutaneous Fat Necessary for thermal control Intra-abdominal Fat Abdominal obesity is the most important factor in determining pre-diabetic state 1 in 5 adults have metabolic syndrome Goal: avoid fat around organs, especially the liver

39. Obesity: Hormonal Regulation Fat Largest and most active endocrine organ Releases 50 hormones Adiponectin Signals to the brain that we are full As fat cells get bigger, less is released