Endocrine System

I.
General principles of endocrine physiology: body homeostasis is controlled by 2 major

regulating systems: the nervous system and the endocrine or hormonal system. Organs
that secret hormones are called endocrine glads; collectively, these glands make up the
endocrine system. Endocrine glands secrete their hormone products directly nto the
surrounding ecf. This distinguishes them from exocrine glands, such as salivary or sweat
glands, whose products are discharged through ducts. Important endocrine glands
include the pituitary fland, thyroid gland, parathyroid glands, adrenal glands, pancrease,
ovaries and testes, and placenta.
a. Hormones
i. Endocrine function is mediated by hormones. Hormones are the signaling
molecules or chemical messengers that transport information from one set of
cells (endocrine cells) to another ( tartget cells).
ii. Hormones are released from endocrine glands into body fluids in minute
quantities but exert powerful control over most metabolic functions.
iii. Transmission of a hormonal signal thorugh the blood stream to a distant
target cell is called an endocrine function.
iv. If a hormone signal acts on a neighboring cell of a different type, the
interaction is termed a paracrine function. If the secreted hormone acts on
the producer cell itself or on neighboring identical cells, the interaction is
called an autocrine function.
b. Types of hormones can be clasdified into 3 major categories.
i. Peptide or protein hormones
1. Most hormones have a peptide or protein sturcutre.
2. These group of hormones include insulin, GH, vasopressin, angiotensin,
prolactin, erythropoietin, calcitonin, somatostatin, adrenocorticotropic
hormone, oxytocin, glucagon, and pth.
3. Peptide hormones are synthesized in endocrine cells as prehormones
and prohormones. They are processed by the cell and stored in
secretory granules witiin the endocrine gland. The proper stimulus to
secretion causes exocytosis of the peptide or protein hormone into the
ecg
4. Protein hormones such as insulin, eryuthropoietin and gh can now be
synthesized for therapeutic purposes by recomnbinant dna techniques.
ii. Amine or amino acid-derivative hormones
1. Serotonin, important for its central nervous system effects, is
synthesized from the naturally occurring amino acid tryptophan.
2. Thyroid hormones and catecholamine hormones are derived from the
amino acid tyrosine.
3. Thyroid hormones and catecholamine hormones are stored in the
thyroid gland and adrenal medulla, respectively, and are erelased by
the appropriate stimulation.
iii. Steroid hormones
1. All steroid hormones are lipid soluble derived from cholesterol or have
a chemical structure similar to that of cholesterol.
2. Common steroid hormones include hormone of the adrenal cortex
(cortisol aldosterone) and reproductive hormones (estrogen,
progesterone, testosterone).
3. Active metabolies of vitamin D are also steroid hormones.
4. In contrast to most other hormoenes, steroid hormones are not stored
in discrete secretory granules but are compartmentalized within the
endocrine cell and released into the ECF by simple diffusion through
the cell membrane.
II.
III.
IV.
V.
5. Circulating steroid and thyroid hormones are bound to transport

proteins, wheras circulating catecholamine hormones and most protein
hormones are not bund to carriers. Plasma protein binding protects
hormones from metabolism and renal clearance. Steroid and thyroid
hormones have a longer half life than that of peptide and
catecholamine hormones.
a. Example, the thyroid hormone thyroxine, which has a 99.95%
protein bound, has a plasma life of 6 days, whereas insulin,
which has essentially no plasma protein binding, has a half-life
about 7 minutes.
6. The major sites of hormone degradation and elimination are the liver
and the kidneys.
7. Some hormone degradation also occurs at the target-cell sites.
c. Hormone receptors. Binding t o a specific target-cell receptor is the primary event
that initiates a hormone response. The hormone receptor displaces high specificity
and affinity for the proper hormone ligand, and the location of the receptor directs
the hormone to the specific target organ
i. Hormone receptor activation
ii. Hormone receptor regulation
iii. Regulation of hormone secretion
Pituitary gland
a. Relationship between pituitary gland and hypothalamus
b. Anterior pituitary lobe FLATPG
i. Control of anterior pituitary hormone secretion
ii. Anterior pituitary disorders
1. Hyposecretion
2. Hypersecretion
iii. Growth hormome
1. Hyposecretion
2. Hypersecretion
3. Anesthetic implications of acromegaly
iv. ADH
1. Deficient antidiuretic hormone and anesthetic implications
2. Hypersecretion of ADH and anesthetic implications
Parathyroid gland
a. Calcium regulation
i. Vitamin D
ii. Parathyroid hormone
iii. Effect on the intestinal tract
iv. Effect on the kidney
v. Calcitonin
Parathyroid gland dysfunction
a. Hypoparathyroidism
b. Anesthesia implications for hypoparathyroidism
c. Hyperparathyroidism
d. Anesthesia implications for hyperparathyroidism
Pancrease
a. Islet of Langerhans
b. Energy balance
i. Obligate vs facultative tissue
c. Insulin
i. Storage and release
ii.
iii.
iv.
v.
vi.
vii.
viii.
Effects of insulin
Effects on carbohydrate metabolism
Effects on protein metabolism
Effects on fat metabolism
Effects on ion transport
Control of insulin secretion
glucagon

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I.

General principles of endocrine physiology: body homeostasis is controlled by 2 major

5. Circulating steroid and thyroid hormones are bound to transport

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