Transcript Document

ESSENTIALS OF A&P
FOR EMERGENCY CARE
CHAPTER
12
The Endocrine System:
The Body’s Other Control
System
Essentials of A&P for Emergency Care
Bruce J. Colbert • Jeff Ankney • Karen T. Lee • Bryan E. Bledsoe
Copyright ©2011 by Pearson Education, Inc.
All rights reserved.
Multimedia Asset Directory
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Hyperglycemia Animation
Hypoglycemia Animation
Pathology of Diabetes Video
Insulin Video
Hypothalmic Pituitary Axis Animation
Monitoring Glucose Levels Video
Aging and the Endocrine System Video
Phlebotomy Video
Dieticians Video
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Introduction
• The nervous system and the endocrine
system are totally interconnected and
always monitor each other’s activities.
• The endocrine system also collects
information and sends orders but it is a
slower, more subtle control system. While
it acts slowly, the effects last longer than
those of the nervous system.
Essentials of A&P for Emergency Care
Bruce J. Colbert • Jeff Ankney • Karen T. Lee • Bryan E. Bledsoe
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Learning Objectives
• Discuss the functions of the various
endocrine glands.
• Explain mechanisms of control of hormone
levels.
• Describe the purpose and effects of
hormones within the body.
• Discuss the functions of the various
endocrine glands.
• Differentiate between hormonal and humoral
control.
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Pronunciation Guide
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adrenal cortex (ad REE nal KOR teks)
adrenal medulla (ad REE nal meh DULL lah)
endocrine (EHN doh krin)
epinephrine (EP ih NEFF rin)
homeostasis (HOH mee oh STAY sis)
hypothalamus (HIGH poh THAL ah mus)
norepinephrine (nor EP ih NEFF rin)
oxytocin (AHK see TOH sin)
parathyroid gland (PAIR ah THIGH royd)
Essentials of A&P for Emergency Care
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Pronunciation Guide
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pineal gland (PIN ee al)
pituitary (pih TOO ih TAIR ee)
prolactin (proh LAK tin)
testes (TESS teez)
thymus (THIGH mus)
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The Endocrine Organs
• The endocrine system is a series of
organs and glands in your body that
secrete chemical messengers into your
blood stream.
• Exocrine glands, like sweat glands,
secrete out of the body, but are not part of
the endocrine system that secrete into the
body.
• Many glands, like the hypothalamus and
pancreas, have multiple functions.
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Figure 12-1 The endocrine glands and their hormones.
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Table 12-1 Endocrine Organ Functions.
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Table 12-1 (continued) Endocrine Organ Functions.
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Hormones
• The chemical messengers released by
endocrine glands are called hormones.
• Hormones are released into the blood
stream and travel all over your body, some
affecting millions of cells simultaneously.
Their effects last for minutes or even hours
or possibly days.
• Many hormones are secreted all the time,
with the amount secreted changing as
needed.
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Table 12-2 Comparison of Neurotransmitters and Hormones.
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How Hormones Work
• Hormones work by binding to receptors on
target cells. They bind to not only sites
outside the cell, like neurotransmitters, but
also to sites inside the cell.
• If hormones bind to the outside of the cell,
they can have several different effects,
either changing cellular permeability or
sending the target cell a message that
changes enzyme activity inside the cell.
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Steroids
• One special class of hormones, called
steroids, is particularly powerful because
steroids can bind to sites inside cells.
• Steroids are lipid molecules which can
pass easily through the target cell
membrane, allowing them to interact
directly with the cell’s DNA to change cell
activity.
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Steroids
• They are carefully regulated because only
small amounts are needed to perform their
task.
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Control of Endocrine Activity
• The amount of hormone secreted changes
based on situational demands.
• Many endocrine organs secrete hormones
continuously.
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Homeostasis and Negative
Feedback
• Many of the chemical and physical
characteristics of your body have a
standard level, or set point, that is the
ideal level for that particular value. Blood
pressure, blood oxygen, heart rate, and
blood sugar are examples.
• Your control systems (endocrine and
nervous system) work to keep levels at or
near ideal.
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Homeostasis and Negative
Feedback
• There is a way for your body to measure
the variable, a place where the ideal level
is stored, and a way for your body to fix
levels that are not near ideal. For example,
the hypothalamus stores the ideal setpoint for temperature.
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Figure 12-2 Homeostasis is analogous to regulation of temperature via a thermostat.
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Homeostasis and Negative
Feedback
• If any of your body’s dozens of
characteristics become seriously
abnormal, your control systems work to
bring them back to set point via a process
called negative feedback.
• Negative feedback counteracts a change.
Thus, as blood pressure rises, your body
works to bring it down to normal, the set
point. If blood pressure falls, your body
works to raise it back up to normal.
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Homeostasis and Negative
Feedback
• Hormones work the same way. If hormone
levels rise, negative feedback will turn off
the endocrine organ that is secreting the
hormone.
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Figure 12-3 Homeostasis and negative feedback as related to control of body temperature.
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Positive Feedback
• Positive feedback increases the magnitude of a
change.
• The flow of sodium into a neuron during
depolarization is a real-life example we have
already visited. The more depolarized a neuron
becomes, the more sodium flows in, so it
becomes more depolarized, so more flows in,
etc. This kind of process is also known as a
vicious cycle. Positive feedback is not a way to
regulate the body, since positive feedback
increases a change away from set point.
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Clinical Application: Childbirth and
Positive Feedback
• Positive feedback is harmful if the vicious
cycle cannot be broken, but is sometimes
necessary for a process to run to
completion. A good example is the
continued contraction of the uterus during
childbirth. When a baby is ready to be
born, a signal tells the hypothalamus to
release oxytocin from the posterior
pituitary, increasing the intensity of
contractions.
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Clinical Application: Childbirth and
Positive Feedback
• As the uterus contracts, the pressure
inside the uterus increases the signal to
the hypothalamus and more oxytocin is
released, causing the uterus to contract
harder. This cycle of ever-increasing
uterine contractions, due to everincreasing release of oxytocin from the
hypothalamus, continues until the
pressure inside the uterus decreases
when the baby is born.
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Neural Control
• Some hormones are directly controlled by
the nervous system. For example, the
adrenal glands receive signals from the
sympathetic nervous system. When the
sympathetic nervous system is active, it
sends signals to the adrenal glands to
release epinephrine and norepinephrine
as hormones, prolonging the effects of
sympathetic activity.
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Figure 12-4 Sympathetic control of adrenal gland.
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Hormonal Control
• Other hormones are part of a hierarchy of
hormonal control, where one gland is
controlled by the release of hormones from
another gland up the chain, which is
controlled by another gland’s release of
hormones up the chain. Orders are sent from
one organ to another, like a relay race.
• Negative feedback controls the flow of orders
via hormones from one part of the chain to
the other.
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Figure 12-5 Hormonal control of adrenal gland.
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Humoral Control
• Some endocrine organs directly monitor
the body’s internal environment by
monitoring body fluids, such as blood, and
then respond accordingly.
• Humoral is the term that pertains to body
fluids or substances and therefore this is
called humoral control. For example, the
pancreas secretes insulin in response to
rising blood sugar levels.
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Figure 12-6 Humoral control of blood sugar levels.
Essentials of A&P for Emergency Care
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From the Streets:
Endocrine Emergencies
• Symptoms of endocrine emergencies can
usually be assigned to one of two
categories:
– Symptoms of underproduction
 Hyposecretion
– Symptoms of overproduction
 Hypersecretion
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Endocrine Glands:
The Hypothalamus
• The hypothalamus, located in the
diencephalon, is an important link between
the two control systems.
• The hypothalamus controls much of your
physiology, including hunger, thirst, fluid
balance, and body temperature to name a
small number of its functions.
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Endocrine Glands:
The Hypothalamus
• The hypothalamus also acts as a
“commander in chief” for the other glands
in the endocrine system since it controls
the pituitary gland, and thus, most other
glands in the endocrine system.
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The Pituitary
• The pituitary, also a part of the diencephalon,
has been commonly known as the “master
gland” because of its role in controlling other
endocrine glands.
• The pituitary gland really acts only under
orders from the hypothalamus.
• If the hypothalamus is the “commander in
chief,” the pituitary is a high-ranking general.
• The pituitary is split into two segments, the
posterior pituitary and the anterior pituitary.
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The Posterior Pituitary
• The posterior pituitary is an extension of
the hypothalamus. Hypothalamic neurons,
specialized to secrete hormones instead of
neurotransmitters, extend their axons
through a stalk in the posterior pituitary.
• These neurons secrete two hormones,
antidiuretic hormone (ADH) and oxytocin.
While they are secreted by the pituitary,
they are made by the hypothalamus.
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Antidiuretic Hormone
• The name suggests exactly what it does, it
decreases urination, which decreases fluid
loss, increasing body fluid volume.
• ADH is secreted when the hypothalamus
senses decreased blood volume or
increased blood osmolarity (more solids
suspended in blood).
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Antidiuretic Hormone
• ADH circulates through the blood stream
and targets the kidneys specifically,
causing them to absorb more water.
• ADH is very important in long-term control
of blood pressure, especially during
dehydration.
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Oxytocin
• Oxytocin is important in maintaining
uterine contractions during labor and is
involved in milk production in nursing
mothers.
• Oxytocin’s function in males is unknown.
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The Anterior Pituitary
• The anterior pituitary makes and secretes a
number of hormones under hormonal control of
the hypothalamus.
• The hypothalamus secretes a hormone that
controls hormone secretion by the anterior
pituitary, which usually controls the secretion of
hormones by another endocrine gland (growth
hormone is an exception).
• The hormone levels are controlled by negative
feedback to both the pituitary and the
hypothalamus.
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Clinical Application:
Stature Disorders
• Stature disorders are those that result in
well below normal (dwarfism) or well
above normal (gigantism or giantism)
height. Some are caused by abnormalities
in skeletal development or nutritional
deficiencies, but growth hormone (GH)
problems are often implicated.
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Clinical Application:
Stature Disorders
• If GH secretion is insufficient during
childhood, children don’t grow to normal
height. If GH deficiency is diagnosed
before closure of the growth zones of the
long bones it can be treated with GH
supplements, otherwise these children
grow to be undersized adults.
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Clinical Application:
Stature Disorders
• Oversecretion of GH during childhood
results in very, very tall people. Robert
Wadlow, one of the tallest men to ever
live, according to The Guinness Book of
World Records, was more than 8 feet tall.
People with gigantism have many health
problems, including a skeleton that can’t
support them. Surgery and medication are
the only treatments.
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Clinical Application:
Stature Disorders
• If the oversecretion of GH starts after the
bones have stopped growing the person
doesn’t get taller but the tissue of the
hands, feet, face, and many internal
organs will continue to grow out of control
causing pain and organ dysfunction. Most
oversecretion is due to noncancerous
pituitary tumors.
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Table 12-3 Selected Hypothalamic and Pituitary Hormones.
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Table 12-3 (continued) Selected Hypothalamic and Pituitary Hormones.
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From the Streets:
Vasopressin
• Antidiuretic hormone (ADH), also called
vasopressin, is one of two hormones
secreted by the posterior pituitary.
• ADH causes increased reabsorption of
water in the kidneys and vasoconstriction
of peripheral vessels.
• Both mechanisms increase blood
pressure.
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From the Streets:
Vasopressin
• Vasopressin may be used in certain types
of cardiac arrest as an alternative to
epinephrine.
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Figure 12-7 The hypothalamus, anterior and posterior pituitary glands, and their targets and
associated hormones.
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The Thyroid Gland
• The thyroid gland is located in the anterior
portion of the neck and is butterfly-shaped.
• The thyroid gland secretes the hormones
triiodothyronine (T3) and thyroxine (T4)
under orders from the pituitary. The third
hormone is calcitonin, involved in calcium
storage.
• T3 and T4 contain iodine and control cell
metabolism and growth.
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The Thyroid Gland
• Over- or under-production cause a variety
of clinical symptoms, because the level of
these hormones is essential in controlling
growth and metabolism of body tissues,
particularly in the nervous system.
• Table salt contains iodine to ensure
people get enough iodine in their diets to
make thyroid hormones.
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Parathyroid Glands
• The thyroid gland has two small pairs of
glands, called the parathyroid glands,
embedded in its posterior surface.
• They produce parathyroid hormone (PTH),
which regulates the levels of calcium in the
blood stream.
• If calcium levels get too low, the parathyroid
glands are stimulated to release PTH, which
stimulates bone dissolving cells and releases
calcium into the blood stream.
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Figure 12-8 The thyroid and parathyroid glands.
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Figure 12-8 (continued) The thyroid and parathyroid glands.
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Clinical Application:
Hyperthyroidism
• Jenny was a healthy 25-year-old school
teacher starting her first job when she began
having strange symptoms, including a rapid
heart rate, profuse sweating, and constant
hunger. Initially, she thought the symptoms
were caused by the stress of her new job and
moving from home, but then other, more
alarming, symptoms appeared.
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Clinical Application:
Hyperthyroidism
• Jenny became irritable and restless,
developed insomnia, and couldn’t
concentrate. Soon she couldn’t focus long
enough to read the newspaper or get through
a half hour sitcom. Her thoughts became so
scattered she thought she might be going
crazy so she made an appointment with her
doctor and found out she had Graves’
disease, a disorder that causes oversecretion
of the thyroid hormone.
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Figure 12-9 The hypothalamus controls the anterior pituitary, which in turn controls the
thyroid gland. Negative feedback loops prevent the oversecretion of hormones.
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Table 12-4 Common Signs and Symptoms of Thyroid Disease
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Figure 12-10 Graves’ disease results from an increase in the levels of circulating thyroid
hormones.
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Figure 12-11 Hypothyroidism results from a decrease in the levels of circulating thyroid
hormones.
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The Thymus Gland
• The thymus gland is located in the upper
thorax.
• It plays an important function in the
immune system.
• It produces a hormone, called thymosin,
which helps with the maturation of white
blood cells during childhood, to fight
infection.
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The Pineal Gland
• The tiny pineal gland is found within the
diencephalon of the brain.
• Its full function remains unknown.
• It has been shown to produce the
hormone melatonin which rises and falls
during the waking and sleeping hours. It is
believed that this hormone triggers our
sleep by peaking at night and causing
drowsiness.
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The Pancreas
• The pancreas is responsible controlling
blood sugar.
– Glucose levels are important because all cells
need glucose for cellular respiration.
– Blood glucose levels affect the fluid balance
of the cells.
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The Pancreas
• Blood sugar rises – the pancreas releases
insulin
– Helps glucose get into cells
– Causes excess glucose to be stored as
glycogen in the liver
• Blood sugar falls – the pancreas releases
glucagon
– Causes glucose to be released from the liver
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Figure 12-13 Intravenous glucose administration may be required for patients with confirmed
hypoglycemia.
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Clinical Application:
Diabetes Mellitus
• Diabetes mellitus (DM) is a condition
characterized by abnormally high blood glucose
levels. Type 1 diabetes is caused by destruction
of insulin-producing cells of the pancreas,
resulting in inadequate insulin production. These
patients require daily insulin injections.
• Type 2 diabetes is caused by insensitivity of the
body’s tissues to insulin and can be treated with
a carefully controlled diet and a weight loss
regimen.
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Clinical Application:
Diabetes Mellitus
• In either type of DM, elevated blood sugar
must be controlled because high glucose
levels cause the kidneys to work overtime
to secrete the excess sugar. Increased
urination (polyuria), dehydration leading to
increased thirst (polydipsia), and hunger
are the most common symptoms.
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Clinical Application:
Diabetes Mellitus
• Untreated diabetes leads to weight loss as
the body searches for other sources of
energy. As abnormal cell metabolism
breaks down muscle, acid is produced and
blood acidity worsens, leading to tissue
and organ damage. Lack of treatment will
lead to coma and death.
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The Adrenal Glands
• The adrenal glands are a pair of small
glands that sit on the kidneys, like baseball
hats.
• The adrenal glands are split into two
regions:
– The adrenal cortex is the outer layer.
– The adrenal medulla is the middle of the
gland.
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Adrenal Medulla
• The adrenal medulla releases two
hormones:
– Epinephrine (formally known as adrenalin)
– Norepinephrine (both a hormone and a
neurotransmitter)
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Adrenal Medulla
• These hormones increase the duration of
the effects of your sympathetic nervous
system. The effects of hormones last
longer than a neurotransmitter.
• Effects include increased heart rate, blood
pressure, and respiration, along with
profuse sweating and a dry mouth.
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Adrenal Cortex
• The adrenal cortex makes dozens of
steroid hormones, known collectively as
adrenocorticosteroids, which are released
under the direct stimulation of the anterior
pituitary.
• Many of these hormones are so important
that a decrease in production could be
fatal relatively quickly.
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Adrenal Cortex
• Each of these hormones has a specific
function, including regulation of fluids,
electrolytes, blood sugar, reproduction,
secondary sex characteristics, cell
metabolism, growth, and immune system
function.
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Clinical Application: Prednisone
• Prednisone is clinically important in the
treatment of inflammation, organ rejection,
and immune disorders. Prescription
steroids are a two-edged sword because
they have dangerous side effects including
bone loss, weight gain, hair growth, fat
deposits, and delayed wound healing.
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Clinical Application: Prednisone
• This drug cannot be discontinued
suddenly because the drug decreases
adrenal cortex production. The adrenal
cortex must be allowed to resume normal
functions gradually – gearing up to secrete
the proper amount of steroids.
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The Gonads
• The gonads include
– Testes
– Ovaries
• Their chief function is to produce and store
gametes
– Eggs
– Sperm
• They also produce a number of sex hormones
which control reproduction
– Testosterone in men
– Estrogen in women
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From the Streets:
Disorders of the Adrenal Gland
•
•
•
•
•
Hyperadrenalism (Cushing’s Syndrome)
Causes: Excessive adrenocortical activity.
Signs and symptoms
Assessment
Treatment
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Figure 12-14 Facial features of Cushing’s syndrome.
(Photo Researchers)
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From the Streets:
Disorders of the Adrenal Gland
•
•
•
•
•
Adrenal insufficiency (Addison’s Disease)
Causes: Deficient adrenocortical activity
Signs and symptoms
Assessment
Treatment
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Disorders of the Endocrine System:
Anabolic Steroid Abuse
• Anabolic steroids cause large increases in
muscle mass.
• Some athletes use them to increase
performance, or to get big muscles faster
than working out alone would produce.
• There are numerous side effects including
changes in sperm production, enlarged
breasts, and shrinking testicles in men.
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Anabolic Steroid Abuse
• Women experience a deepening voice,
decreased breast size, and excessive body hair
growth.
• Use of steroids can lead to cardiovascular
disease and lipidemia.
• Steroids may suppress immune response, and
because they are illegal, can expose users to
HIV and hepatitis B when sharing needles.
• Steroids have been linked to increased
aggressiveness.
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Hashimoto’s Disease
• Hashimoto’s disease is a form of hypothyroidism
caused by an autoimmune attack of the thyroid
gland.
• The cause is unknown. The body attacks the
thyroid gland, causing inflammation and damage
to the gland, leading to decreased production of
thyroid hormones (hypothyroidism).
• The thyroid may swell, causing painful
swallowing. It is most common in women 30 to
50-years-old and is treated with a daily synthetic
hormone treatment.
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Graves’ Disease
• Graves’ disease is an autoimmune disorder
affecting the thyroid, stimulating an increased
production of hormones, called hyperthyroidism.
• Symptoms include insomnia, bulging eyes, and
jitteriness.
• Treatment involves decreasing hormone
secretion by destroying the thyroid with
radioactive iodine, or surgery if this is not
effective. After treatment, patients will need
synthetic thyroid hormone because the thyroid
no longer functions properly, if at all.
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Pheochromocytoma
• A pheochromocytoma is a tumor of the
adrenal gland causing increased
epinephrine secretion.
• The symptoms are similar to an adrenalin
rush, including severe headaches, excess
sweating, racing heart, anxiety, abdominal
pain, heat intolerance, and weight loss.
• They are rarely cancerous but must be
removed or the effects of excessive
epinephrine production will be fatal.
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Addison’s Disease
• Addison’s disease is caused by insufficient
production of the adrenocorticosteroid
cortisol. The deficiency causes weight
loss, muscle weakness, fatigue, low blood
pressure, and excessive skin
pigmentation.
• Aldosterone may also be deficient.
• Many cases of Addison’s are autoimmune.
It is treated with hormone replacement.
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Cushing’s Syndrome
• Cushing’s syndrome is caused by
oversecretion of cortisol.
• Symptoms include upper body obesity,
round face, easy bruising, weakened
bones, fatigue, high blood pressure, and
high blood sugar.
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Cushing’s Syndrome
• Women may have excessive facial hair
and irregular periods while men have
decreased fertility and sex drive. It may be
a side effect of medical use of steroids,
like prednisone, or may be due to primary
tumors, lung tumors, adrenal tumors, or
one of several genetic disorders.
• Treatment depends on the underlying
cause. Hormone replacement may be
required.
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Figure 12-15 Examples of Endocrine Disorders. (A) A 6-year-old child with congenital
hypothyroidism. (B) A patient with Cushing’s syndrome.
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Figure 12-15 (continued) Examples of Endocrine Disorders. (C) A patient with
exophthalmos, a symptom of hyperthyroidism (Graves’ disease). (Source: Custom Medical
Stock Photo, Inc.)
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Figure 12-15 (continued) Examples of Endocrine Disorders. (D) A patient with a goiter.
(Source: Custom Medical Stock Photo, Inc.)
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Snapshots from the Journey
• The endocrine system works together with
the nervous system to regulate the
activities of all the body systems. The
endocrine system is linked to the nervous
system but works very differently. The
endocrine system secretes hormones that
act very slowly on distant targets. Their
effects are long lasting. Some organs, like
the pancreas and the thyroid gland,
function mainly to release hormones.
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Snapshots from the Journey
• However, many other organs, like the
heart and stomach, can also release
hormones. They aren’t considered
endocrine glands because hormone
release isn’t their primary role.
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Snapshots from the Journey
• Most hormones act on cells by binding to
external receptors, causing changes in
enzyme activity inside the target cell.
Steroids, however, can enter cells and
interact directly with DNA, which makes
steroids very powerful.
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Snapshots from the Journey
• Hormone levels are controlled largely by
negative feedback. When hormone levels
rise, signals are transmitted to the
endocrine organ releasing the hormone,
telling the organ to decrease the amount
of hormone released. Hormone levels will
then decrease. The optimal level of the
hormone is called the set point.
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Snapshots from the Journey
• If the signal brings a hormone back to set
point, the action is called negative
feedback. If the signal causes the
hormone to get further away from set
point, the action is positive feedback.
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Snapshots from the Journey
• Hormone levels can be regulated via three
mechanisms: changes in the body’s
internal environment (humoral), control by
hormones released by another endocrine
gland (hormonal), and direct control by the
nervous system (neural).
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Snapshots from the Journey
• The hypothalamus, a part of the
diencephalon, controls much of the
endocrine system by controlling the
pituitary gland.
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Snapshots from the Journey
• The pituitary gland has two parts: the
posterior pituitary, which is part of the
hypothalamus and actually secretes
hypothalamic hormones (ADH and
oxytocin), and the anterior pituitary, which
secretes several different hormones under
the influence of hormones from the
hypothalamus.
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Snapshots from the Journey
• The hormones secreted by the anterior
pituitary typically control other endocrine
glands (growth hormone is an exception).
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Snapshots from the Journey
• Several other endocrine glands have
important control functions. The thyroid
gland secretes the iodine-containing
hormones triiodothyronine (T3) and
thyroxine (T4), which control growth and
cellular metabolism. The pancreas
secretes two hormones: insulin, which
lowers blood sugar, and glucagon, which
raises blood sugar.
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Snapshots from the Journey
• Diabetes is caused by a decrease in
insulin secretion or decreased sensitivity
to insulin. Very high blood sugar is the
result.
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Snapshots from the Journey
• The adrenal glands are split into two parts.
The adrenal medulla is an extension of the
sympathetic nervous system, releasing
epinephrine and norepinephrine as
hormones during fight-or-flight response.
The adrenal cortex releases many
different adrenocorticosteroid hormones,
which control reproduction, inflammation,
tissue growth, and immunity.
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Case Study
A 40-year-old patient presents to the
emergency department with the following
symptoms:
– Recent weight loss
– Generalized weakness
– Excessive thirst and urination
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Case Study
• Portions of his lab values show a blood
glucose of 150 mg/dl and acidic urine and
blood. He has a family history of diabetes,
but this is the first time he’s presented with
these symptoms.
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Case Study Questions
• What type of diabetes does he have?
• What organs will be affected if he is not
properly diagnosed and treated?
• What treatment and lifestyle suggestions
would you give?
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From the Streets
You are called to the home of the 40 yearold patient who presented to the ED 1 month
ago. Family states that he did not follow up
for diabetic treatment. You find him lying in
bed slow to respond with rapid & deep
breathing, hypotension, tachycardia,
severely incontinent of urine, and pale, cool,
& clammy skin. His breath has a fruity odor.
His blood glucose is 600 mg/dl (normal
range 60—120 mg/dl).
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From the Streets Questions
• What is his most likely diagnosis?
• What is the term for his rapid and deep
respiratory pattern?
• Why is the patient hypotensive?
• What is his prognosis?
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From the Streets Questions
• What is his most likely diagnosis? Diabetic
Ketoacidosis (DKA)
• What is the term for his rapid and deep
respiratory pattern? Kussmaul respirations
• Why is the patient hypotensive? Polyuria
(glucosuria) has lead to dehydration
• What is his prognosis? This is life
threatening, he needs supportive
measures and emergency transport.
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End of Chapter
Review Questions
Match the Hormone with the Description
___ADH
___Insulin
___Glucagon
___Oxytocin
___Epinephrine
___Thyroxine
___Prolactin
___ACTH
___TSH
___Growth Hormone
a. Decreases blood sugar
b. Increases thyroid hormone
secretion
c. Regulates cell metabolism
d. Increases steroid release
e. Increases uterine contractions
f. Decreases urination
g. Prolongs sympathetic response
h. Stimulates tissue growth
i. Increases blood sugar
j. Increases milk production in
females
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Review Questions
1. ADH stands for:
a. Antidiuretic hormone
b. Androdoginin hormone
c. American Department of Health
d. All-diglyceride hormone
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Review Questions
2. The “master gland” is the:
a.
b.
c.
d.
Adrenal
Pituitary
Pineal
Pancreas
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Review Questions
3. The thymus gland’s main function is for:
a. Reproduction
b. Growth
c. Immunity
d. RBC levels
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Review Questions
4. The pineal gland is located in/on the:
a. Kidneys
b. Brain
c. Thorax
d. Abdomen
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Review Questions
5. Glucagon performs the opposite action
of:
a. Glucose
b. Insulin
c. ATP
d. WBC’s
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Review Questions
6. Some of the following disorders are
associated with weight gain. Which ones?
I.
II.
III.
IV.
–
–
–
–
Type II diabetes
Hyperthyroidism
Cushing’s syndrome
Addison’s disease
I, II
I, II, III
I, II, IV
I, III
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Review Questions
7. If an adult patient is treated for gigantism
by removal of their pituitary gland, which
hormone would have to be replaced with
drug therapy.
a.
b.
c.
d.
Cortisol
Melatonin
Thyroid-stimulating hormone
Insulin
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Review Questions
1. Glucagon _________ blood sugar.
2. Thyroxine __________ cell metabolism.
3. _________ increases uterine
contractions.
4. Sympathetic response is enhanced by
epinephrine secreted by the _______.
5. Increased secretion of aldosterone, a
corticosteroid, could be caused by a
tumor on the _________ or __________
glands.
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Review Questions
6. Damage to the ______ in the brain could
cause widespread endocrine
abnormalities.
7. This hormone is less important than in
adults than children _____________.
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Review Questions
1. Compare and contrast neurotransmitters
and hormones.
2. Explain negative feedback and its role in
controlling hormone levels.
3. Discuss why the use of anabolic steroids
should be outlawed for performance
enhancement.
4. What is the difference between neural
control and humoral control of endocrine
glands?
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