MEDICAL-SURGICAL NURSING

ENDOCRINE SYSTEM

ENDOCRINE SYSTEM bloodstream, rather than into a duct.

HORMONES
 Hormones circulate through the bloodstream to
specific sites called target tissues, or effectors.
chemical signals produced by specialized cells
secreted into the blood stream
 The hormones’ transport, interaction with its target,
and removal from the body is dependent to their
chemical structure. There are two major types of
hormones: lipidsoluble and water-soluble.
 necessary for normal growth, development,
reproduction, and homeostasis
ENDOCRINE SYSTEM
 The endocrine system is one of the two important
control systems of the body
 The endocrine system is composed of endocrine
glands and specialized endocrine cells located
throughout the body
 Group of ductless glands that secrete hormones
 Includes:
o Hypothalamus
o Pituitary gland
o Thyroid and Parathyroid Gland
o Adrenal Gland
 The hormones’ transport, interaction with its target,
o Ovaries and Testes
and removal from the body is dependent to their
o Pancreas
chemical structure. There are two major types of
FUNCTIONS OF THE ENDOCRINE SYSTEM hormones: lipidsoluble and water-soluble.
1. Regulation of metabolism. The endocrine system
controls the rate of nutrient utilization and energy
production.
2. Control of food intake and digestion. The endocrine
system regulates the level of satiation (fullness) and the
breakdown of food into individual nutrients.
3. Modulation of tissue development. The endocrine
system influences the development of tissues, such as
those of the nervous system.
4. Regulation of ion levels. The endocrine system helps
monitor blood pH, as well as Na+, K+, and Ca2+
concentrations in the blood.
5. Control of water balance. The endocrine system
regulates water balance by controlling the solute
concentration of the blood.
6. Changes in heart rate and blood pressure. The
endocrine system helps regulate the heart rate and blood
pressure and prepare the body for physical activity.
7. Control of blood glucose and other nutrients. The
endocrine system regulates the levels of glucose and
other nutrients in the blood.
8. Control of reproductive functions. The endocrine
system controls the development and functions of the
reproductive systems in males and females.
9. Stimulation of uterine contractions and milk
release. The endocrine system regulates uterine
contractions during delivery and stimulates milk release
from the breasts in lactating females.
10. Modulation of immune system function. The
endocrine system helps control the production of
immune cells.
ENDOCRINE GLANDS
 Endocrine glands secrete very small amounts of
chemical messengers called hormones into the

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ACTION  destined for secretion outside the cell

OTHER  hydrophilic in nature
PROPERTI
ES
EXAMPLES
Glycoprotei  carbohydrate-protein complex
n o Follicle stimulating hormone
(FSH)
o Human chorionic
gonadotropin (hCG)
o Thyroid-stimulating
hormone (TSH)
HORMONE ROLES o Erythropoietin
1 Stress response Polypeptides  made entirely of protein
HORMONES SUCH AS: o Adrenocorticotropic hormone
1 Cortisol  Known as fight (ACTH)
2 Epinephrine or flight hormones o Insulin
2 Homeostasis o Glucagon
HORMONES SUCH AS: o Somatostatin
1 Insulin  For glucose o ADH
2 Glucagon homeostasis o Angiotensin
3 Cortisol o Parathyroid Hormone (PTH)
4 Antidiuretic  Involved in o Calcitonin
Hormone (ADH) regulating blood o Growth Hormone
volume
o Cholecystokinin
3 Sexual maturation and reproductive process
o Gastrin
HORMONES SUCH AS
o Oxytocin
1 Testosterone
o Prolactin
2 Estrogen
4 Growth and development of the body
STEROID HORMONES
HORMONES SUCH AS
SYNTHESI  synthesized in the smooth ER
1 Growth Hormone
S  derived from cholesterol as their
2 Tropic  such as atropine, precursor substance
hormones corticotropin
STORAGE  no storage form
5 Energy production and stabilize metabolic rate RECEPTOR  nucleus of the target cell
6 Promote or inhibit other hormones SITE
HORMONES SUCH AS ACTION  onset of action is slower than the
1 Growth Hormone Releasing Hormone peptide hormones and lasts longer
(GHRH) OTHER  hydrophobic in nature
2 Dopamine PROPERTI
ES
COMPOSITION AND STRUCTURE EXAMPLES
Include  Mineralocorticoids
TYPES OF HORMONES o aldosterone
(1 Peptide/Protein Hormones  Glucocorticoids
) o cortisol
(2 Steroid Hormones  Androgens
) o testosterone
(3 Amino Acid Derived Hormones  Estrogens
)

PEPTIDE/PROTEIN HORMONES AMINO ACID DERIVED HORMONES/ AMINES

SYNTHESI  synthesized in the rough ER, in the SYNTHESI  function similar to steroid or peptides
S ribosomes as a prehormone or a S  synthesized in the cytoplasm
preprohormone (which means they are  derived mainly from amino acid such
not yet activated) as:
STORAGE  stored in vesicles of the cells of o Tyrosine
respective endocrine gland o Tryptophan
RECEPTOR  in the cell membrane of the target EXAMPLES
SITE cell
Include  Epinephrine

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 Norepinephrine EXAMPLE
o Peptide-like AA derived  increase in prolactin
 Triiodothyronine (T3) stimulates the secretion of
 Thyroxine (T4) oxytocin
o Steroid-like AA derived INHIBITORY  The presence of 1 hormone
REACTION inhibits the secretion of another
hormone
EXAMPLE
 increase in prolactin inhibits
FSH/GnRH (Gonadotropin
releasing hormone)

PATTERNS OF HORMONE COMMUNICATION

PATTERNS OF HORMONE COMMUNICATION

AUTOCRIN hormone secreted by a cell and acts on
E that cell
EXAMPLE
 Insulin when secreted by the beta
NOTE cells of the pancreas, it will also act on
 Hormones in the endocrine cell can only act on their the receptor of the beta cells itself
target cell via the receptors either in the cytoplasm or on
the nucleus

HORMONAL INTERACTION

TYPES OF HORMONAL INTERACTION

SYNERGISTIC  2 or more hormones are additive
or complementary in effect
EXAMPLE PARACRIN  hormones secreted by a cell and acts
 FSH and Luteinizing E on nearby cells
hormone (LH) complementary EXAMPLE
effect on the development of the Estrogen secreted by ovaries
ovaries  Testosterone secreted by the Leydig
cells
ANTAGONISTI  1 hormone offsets another
C hormone
EXAMPLE
 Insulin and Glucagon
 increase in concentration of
insulin attenuates secretion of
glucagon and vice versa like a ENDOCRIN  hormone secreted by glandular cell
“see saw” E into blood and acts on distant cells

PERMISSIVE  1 hormone enhance the EXAMPLE

responsiveness of a target to another  Tropic hormones and
hormone Gonadotropins (FSH and LH)
EXAMPLE secreted by the distant pituitary gland
 T3/T4 enhances the target and may act as far as the ovary
cells of epinephrine NEURO-  hormone secreted by nerve cell
ENDOCRIN (neuron) into blood and acts on distant
POTENTIATIO  1 hormone increases the action of E target cells
N REACTION another hormone EXAMPLE
EXAMPLE  Hypothalamic hormones
 Testosterone enhances the (releasing hormones)
activity of the FSH
THYROID GLAND
STIMULATOR  The presence of 1 hormone
Y REACTION stimulates the secretion of another
hormone’’

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 A shield-shaped organs located inferior to the larynx.  Divided into two portions: adrenal cortex (outer) and
 Typically, it has two lobes, located laterally to the
trachea.
 In 50% of the cases, it has a third lobe called
pyramidal lobe that extends superiorly to the isthmus.
adrenal medulla (inner).

WHAT HORMONES AND WHAT FOR?

Adrenal 1. Zona glomerulosa = mineralocorticoids
cortex 2. Zona fasciculata = glucocorticoids
3. Zona reticulata = androgens
1. Mineralocorticoids, mainly aldosterone,
regulates the homeostasis of two mineral ions:
sodium and potassium. It also promotes excretion
WHAT HORMONES AND WHAT FOR? of hydrogen via urination; thereby, preventing
Follicular cells T3 and T4 (thyroid hormone) acidosis. Its secretion is govern by the RAA
Parafollicular cells calcitonin pathway.
T3 (Triiodothyronine) Potent thyroxine
T4 (Tetraiodothyronine) Actual thyroxine
Calcitonin increase calcium absorption
by stimulating osteoblasts in
the bones.

PARATHYROID GLAND
 Four, small, round structures that are partially
embedded in the posterior surface of the lateral lobes of the
thyroid gland. 2. Glucocorticoids, mainly cortisol
 Chief/principal cells in the parathyroid gland produce (hydrocortisone), regulates metabolism and
the parathyroid hormone (PTH) or parathormone. resistance to stress. Functions include: protein
 Parathormone is responsible for regulating the serum and lipid breakdown, glucose formation
levels of calcium, magnesium, and phosphate. (gluconeogenesis), stress resistance, anti-
 It increases the calcium resorption by stimulating inflammatory response, and
osteoclast activity. immunosuppression.
 PTH also increases the excretion of phosphate by the 3. Androgens, mainly
kidneys while decreasing the elimination of calcium and dehydroepiandrosterone (DHEA), stimulates
magnesium in the urine. axillary and pubic hairs formation, female
 ↑Ca and ↑Mg while ↓HPO4 in the blood. libido, and is responsible for post-menopausal
Moreover, parathyroid hormone stimulates the kindey to estrogen production. All female estrogen
produce calcitriol (active vitamin D) that increases the comes from androgen. ACTH governs the
absorption of calcium by the intestines. regulation of androgens.
Adrenal  modified sympathetic ganglion of the SNS.
medulla  Instead of producing neurotransmitters, the
chromaffin cells of the adrenal medulla secrete
hormones: Epinephrine and Norepinephrine.
 Autonomic Nervous System (ANS) has a
direct control over the secretion of epinephrine
and norepinephrine that enhance the effect of
SNS.
 During stressful situation or exercise, the
hypothalamus stimulates the sympathetic
preganglionic neurons to stimulate chromaffin
cells to produce epinephrine and norepinephrine.

ADRENAL GLAND PANCREAS

 Two, flattened pyramidal glands located superior to  Both endocrine and exocrine gland
each kidneys.

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 Located in the first curve of the duodenum and is Female: ovaries produce estrogen and progesterone
consist of head, tail, and body Male: testes synthesize testosterone
Endocrine tissues are called endocrine islets which  Estrogen and progesterone is responsible for
include: A cells, B cells, D cells, and F cells. development and function of the female reproductive
organs and other female sexual characteristics
 Cyclical release of estrogen and progesterone regulates
the menstrual cycle.
 These two hormones promote development of
mammary glands and deposition of adipose tissue in
breast, hips, and thighs during puberty.

PINEAL GLAND
 A small, pinecone-shaped structure located superior and
posterior to the thalamus of the brain.
 It produces the hormone melatonin.
WHAT HORMONES AND WHAT FOR?  Melatonin is thought to have two functions:
A (alpha) produce glucagon to increase glucose level in 1. Sleep-wake cycle
cells the blood and to stimulate insulin production. 2. Inhibits the functions of the reproductive system
B (beta) produce insulin to increase glucose uptake of
cells cells; thereby, lowering blood glucose level. It THYMUS
also inhibits glucagon production.  A bilobed gland, roughly triangular in shape, located
D (delta) produce somatostatin that inhibits glucagon in the superior mediastinum, behind the sternum between
cells and insulin secretion. It also slows down the lungs.
nutrients absorption in the intestines.  It produces the hormones: thymosin, thymi humoral
F cells produce pancreatic polypeptide which inhibits factor (THF), thymic factor (TF), and thymopoietin. All of
somatostatin secretion. which promotes the maturation of T cells

COMMON ENDOCRINE DISORDER AND

NURSING MANAGEMENT

GONADS
 Gonads are organs that produce gametes and secretes
sex hormones.

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