Introduction to the Endocrine System

Prep red by:

Yvette M. B t r, RN, MAN, DM
Reference: Focus on Nursing Pharmacology by Amy M. Karch (Chapter 34)
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 Learning Objectives
Upon completion of this ch pter, future nurses will be ble to:

1. Label a diagram showing the glands of the traditional endocrine system, and list the hormones
produced by each.
2. Describe two theories of hormone action.
3. Discuss the role of the hypothalamus as the master gland of the endocrine system, including
in luences on the actions of the hypothalamus.
4. Outline a negative feedback system within the endocrine system, and explain the ways that this
system controls hormone levels in the body.
5. 5. Describe the hypothalamic–pituitary axis (HPA) and what would happen if a hormone level
was altered within the HPA.
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Structure and Function of the Glands
Endocrine System
Provides communication w/in the Endocrine glands are
body collections of specialized cells
Helps regulate growth & that produce hormones
development, reproduction, Hormones cause an e ect at
energy use, & electrolyte balance.
hormone receptor sites.
Maintain homeostasis w/in the
Do not have ducts, so they
body to ensure maximum function
secrete their hormones directly
& adequate response to various
internal & external stressors into the bloodstream.
together w/ nervous system.
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 Hormones The Hypothalamus
“Master gland” of the neuroendocrine system,
Produced in small amounts Helps regulate central & autonomic nervous
Secreted directly into the systems & the endocrine system to maintain
bloodstream homeostasis.
Produces stimulating & inhibiting factors that
Travel through the blood to
travel to anterior pituitary thru a capillary system
speci c receptor sites throughout to stimulate release of pituitary hormones or block
the body the production of certain pituitary hormones
Act to increase or decrease the when levels of target hormones get too high.
normal metabolic cellular Connected to posterior pituitary by a nerve
processes when they react with network that delivers hypothalamic hormones
their speci c receptor sites ADH & oxytocin to be stored in the posterior
pituitary until hypothalamus stimulates their
Are immediately broken down release.
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The Pituitary Gland The Posterior Pituitary
Located in the skull in the bony sella Stores 2 hormones produced by
turcica under a layer of dura mater. hypothalamus: ADH (vasopressin) &
Oxytocin
Divided into three lobes: an anterior
lobe, a posterior lobe, & an Hormones are deposited in the posterior lobe
via the nerve axons where they are produced.
intermediate lobe.

The Intermediate Lobe of Pituitary

The Anterior Pituitary
Produces six major hormones: GH, Produces endorphins & enkephalins,
adrenocorticotropic hormone (ACTH), which are released in response to severe
follicle-stimulating hormone (FSH), pain or stress & occupy speci c
luteinizing hormone (LH), PRL, and endorphin receptor sites in the brainstem
thyroid-stimulating hormone (TSH, also to block the perception of pain.
called thyrotropin).
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Endocrine Glands & their Locations & Secretions
 Endocrine Glands with Associated Hormones & Clinical Effects
Adenohypophysis or Neurohypophysis or
Anterior Pituitary Gland Posterior Pituitary Gland
HORMONE PRIMARY EFFECT HORMONE PRIMARY EFFECT
Produced Produced
Growth Promotes growth of bone & soft
Antidiuretic Acts on kidney tubules to
Hormone(GH) tissues
Hormone reabsorb water
Thyroid – Stimulates thyroid hormone (ADH)
stimulating secretion
Hormone (THS) Oxytocin Stimulates uterine contractions;
Adrenocorticotro Stimulates adrenal cortex to causes milk ejection reflex
pic Hormone secrete glucocorticoids & THYROID GLAND
(ACTH) androgens
Gonadotrophins ; Stimulates gonads to mature & Thyroid Regulate & stimulate basal
FSH; LH produce sex hormones & germ Hormones metabolic rate; Control rate of
cells body cell growth (how the body
uses energy
Prolactin Stimulates milk production
Thyrocalcitonin Influences ossification &
Melanocyte – Promotes pigmentation of skin development of bone;
stimulating Decreases serum calcium levels
Hormone
 Endocrine Glands with Associated Hormones & Clinical Effects
Parathyroid Gland Islets of Langerhans of Pancreas
HORMONE PRIMARY EFFECT HORMONE PRIMARY EFFECT
Produced Produced
Parathyroid Regulates calcium metabolism Insulin Promotes utilization of glucose by cells;
Hormone (PTH) (increases serum Ca+ levels) decreases blood glucose levels
ADRENAL CORTEX
Glucagon Increases blood glucose levels
Aldosterone Regulates sodium retention & Somatostatin Inhibits secretion of insulin & glucagon
potassium excretion
Sex hormones Influence development of bones, OVARIES
reproductive organs, &
secondary sex characteristics Estrogen Stimulates ripening of the ova; produces
secondary sex characteristics; promotes
Glucocorticoids Promote metabolism; mobilize epiphyseal closure of bones
body defenses during stress;
suppress inflammatory reaction Progesterone Prepares uterus for fertilization
ADRENAL MEDULLA TESTES
Catecholamines Produce a sympathetic response Testosterone Stimulates spermatogenesis; produces
Increase BP & blood glucose male secondary sex characteristics;
levels promotes epiphyseal closure of bones
 Disorders of Pituitary Function
Hypopituitarism Precocious Puberty
Growth hormone de ciency Manifestations of sexual development
De cient secretion of GH before age 9 yrs in boys & 8 yrs in girls
(somatotropin) Diabetes Insipidus
Pituitary Hyperfunction A result of hyposecretion of antidiuretic
Growth hormone excess hormone (ADH), or vasopresin, w/c
Excess GH before closure of produces a state of uncontrolled diuresis
epiphyseal shafts results in Syndrome of Inappropriate Antidiuretic
proportional overgrowth of long Hormone Secretion
bones until individual reaches a
height of 8 ft or more.
Hypersecretion of the posterior pituitary
ADH (vasopressin)
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 Disorders of the Thyroid
Hypothyroidism Goiter
A condition in which the Caused by abnormal functioning
thyroid is underactive & is of thyroid gland (Hypothyroidism
producing an insu cient or Hyperthyroidism).
amount of thyroid hormones. Lymphocytic Thyroiditis
Hyperthyroidism (Grave’s Dse) In ammation & enlargement of
Oversecretion of thyroid the thyroid gland resulting in
hormones by the thyroid gland. symptoms of hyperthyroidism.
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 Disorders of Adrenal Function
Acute Adrenocortical Cushing Syndrome - cont’d
Insu ciency Overproduction of cortisol results in
increased glucose production
Insu cient function of the entire
cortical adrenal gland. Cortisol is catabolic, so protein wasting
occurs.
Cushing Syndrome
Loss of protein matrix in bones causes
Caused by overproduction of the osteoporosis (loss of calcium in bones).
adrenal hormone cortisol; this
Cortisol also suppresses the immune
usually results from increased system,
ACTH production due to a
Cortisol causes vasoconstriction, so
pituitary tumor.
extreme hypertension may occur
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 Disorders of Adrenal Function
Congenital Adrenal Hyperplasia Hyperaldosteronism
Inability of adrenal glands to
Excessive secretion of
synthesize cortisol from its precursors
aldosterone
Because adrenal gland is unable to
produce cortisol, the level of ACTH Symptoms are caused by
increases, stimulating the adrenal increased sodium levels, water
glands to improve function retention, & potassium loss
Although the adrenals enlarge
Pheochromocytoma
(hyperplasia), they still cannot
produce cortisol; instead, they An adrenal tumor characterized
overproduce androgen. by secretion of catecholamines
 Disorders of the Pancreas
Pancreas
A unique organ, has both endocrine(ductless) & exocrine (with duct) types of tissue
Islets of Langerhans form the endocrine portion; these cells are scattered in-between the
exocrine cells like small islets
Islet cells represent only about 1% of the total weight of the pancreas
Alpha islet cells secrete glucagon
Beta islet cells secrete insulin
 TYPES OF DIABETES MELLITUS (DM)

Type 1 Formerly known as insulin-dependent DM; characterized by destruction of beta

cells in pancreas that leads to insulin deficiency.
a. Immune-mediated - from autoimmune destruction of beta cells.
b. Idiopathic - no known cause.
Type 2 Formerly known as non-insulin dependent DM; arises because of insulin
resistance combined w/ relative deficiency in insulin production.

Gestational Abnormal glucose metabolism that arises during pregnancy.

Diabetes Possible signal of an increased risk for type 2 diabetes later in life.

Impaired Glucose A state b/n “normal” & “diabetes” in w/c the body is no longer using &/or
Homeostasis secreting insulin properly.
a. Impaired Fasting Glucose (IFG) - fasting plasma glucose of at least 110 but
under 126mg/dL.
b. Impaired Glucose Tolerance (IGT) - oral glucose tolerance test of at least 140
but under 200mg/dL in 2-hr sample.
Other Specific Caused by known etiologies or as result of or complication of other diseases or
Types conditions.
 Types 1 & 2 Diabetes Mellitus (DM)

Type 1 DM (Born with)

A disorder that involves an absolute or
relative de ciency of insulin in contrast to
type 2 where Formerly referred to as juvenile
diabetes or insulin-dependent diabetes,
occurs almost exclusively in childhood
Must take insulin to replace what their
pancreas cannot produce
Type 2 DM (Develop)
Insulin production is only reduced
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Oral Antihyperglycemics
(Biguanide)
Promotes

Inhibits
Mechanism: Potentiate GLP-1

Adverse E ect: Pancreatitis

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Urine
Oligosaccharides

Feces
Mechanism: Works alongside
insulin

Adverse E ect: Hypoglycemia

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