Endocrine Pathophysiology

Endocrine
Pathophysiology
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
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
• Hypothalamus
 Part of the brain that links the endocrine
system to the nervous system
 Controls the pituitary gland
• 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
• Adrenal Glands
 One pair of ductless glands
located above the kidneys
 Adrenal Cortex produces
steroidal hormones
 Adrenal Medulla produces
epinephrine and
norepinephrine
• Pancreas
 Located partially behind the stomach and the
abdomen
 Functions as both an endocrine and exocrine
gland
 Produces digestive enzymes
 Produces insulin and glucagon
• Pineal Gland
 Small mass of tissue
near the brain
 Secretes melatonin
• Thymus Gland
 Gland located near
the heart
 Aid’s in the body’s
defense against
infection by making
antibodies
• 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
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
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
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
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
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
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
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
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
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
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)
Classification of Hormones
• Posterior Pituitary Gland
 Anti-diuretic Hormone (ADH)
 Oxytocin
Hormone Regulation
• Nervous System Signals
• Chemical Changes in the Blood
• Hormones regulate other hormones
Gigantism
• Acromegaly
• Thicker skull and jaw

• Occurs after joint plates fuse
Hyperthyroidism
• Common Cause: Graves

Disease
• Common Symptoms:
exopthalamos, goiter,
heat intolerance, and
anxiety
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
Thyroid Storm
• T3 and T4 are dumped into the system
• Causes tachycardia, fever, and agitation
• Life-threatening
condition associated
with untreated or undertreated
hyperthyroidism
Thyroid Cancer
• Very treatable
• Most
are benign – only 5%
are malignant and most do
not metastasize
• Palpationwill be painless,
unilateral, and in one spot
Parathyroid Cancer
• Cannot be easily distinguished from thyroid
cancer
• Weakness, feeling tired, lump in the neck
Addison’s Disease
• HYPOADRENAL
autoimmune disease
• Skinchanges color to a
slight grey
Cushing’s Syndrome
• HYPERADRENAL
• Too much glucocorticoids in the system

• Cancause muscle wasting, bone
demineralization, and ligament laxity
Diabetes
• Fasting plasma glucose >126 mg/dL
• Insulin makes glucose transporters closer to
the cell
• Three types:
 Type 1
 Type 2
 Gestational
Type 1 Diabetes
• Autoimmune; typically presents in under
age 20
• Insulin produces B-cell destruction
• Risk Factors: sibling or parents have type 1
Type 2 Diabetes
• Obesity; insulin resistance; pancreas intact
• Receptor does not bind to insulin as well as
it used to
• Hyperglycemia develops slowly
• RiskFactors: genetic predisposition;
overweight, over 45 y/o, sedentary lifestyle,
women who have had a baby over 9 lbs,
and low HDL levels
Gestational Diabetes
• Associated with type 2 diabetes
• Glucose intolerance with pregnancy
• increased
risk of diabetes later on if it
continues >6 weeks after pregnancy
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
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
Obesity: BMI Classification
• Underweight <18.5
• Normal Weight 18.5 to 24.9
• Overweight 25 to 29.9
• Obese >30
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
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

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Endocrine

• Thicker skull and jaw

• Common Cause: Graves

• Too much glucocorticoids in the system

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