Anatomy and Physiology
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Anatomy and Physiology Chapter 11 Endocrine System
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Introduction to the Endocrine System Works with the nervous system to maintain homeostasis Includes a network of specialized cells and glands that secrete hormones which travel in the blood stream and affect the functioning of target cells.
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Hormones Function to: Help regulate metabolic processes Help regulate rates of chemical reactions Aid in transport of substances across membranes Regulate water and electrolyte balances Play a vital role in reproduction, development, and growth.
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Other Secretions Paracrine secretions: local hormones. Affect only neighboring cells. Break down rapidly Autocrine secretions: affect only the secreting cell itself. (also called a local hormone) Exocrine glands: secrete outside the body through tubes or ducts that lead to the surface of the skin. Ex. sweat glands
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Larger Endocrine Glands (10 of them) Pituitary gland Thyroid gland Parathyroid gland Adrenal gland Pancreas Thymus Hypothalamus Pineal gland Ovary Testis
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Locations of major endocrine glands
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Comparison to the Nervous System
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Hormone Action Steroids and Steroid-like substances Non-steroid Hormones Prostaglandins
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Steroids and Steroid-like substances Synthesized from cholesterol Contain complex rings of carbon and hydrogen Insoluble in water; lipid-soluble ? easily diffuse into cells Combines with specific receptor protein after entering cell. Joins with target cell’s DNA and activates specific gene. Gene directs production of specific proteins which may be enzymes, transport proteins, or hormone receptors which exert the characteristic effects of that particular steroid hormone. Animation of Aldosterone Step through slides
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Steroid hormones. 1.) A steroid hormone crosses a cell membrane and 2.) combines with a protein receptor, usually in the nucleus.3.) The hormone-receptor complex activates synthesis of specific messenger RNA (mRNA) molecules. 4.) The mRNA molecules leave the nucleus and enter the cytoplasm 5.) where they guide synthesis of the encoded proteins.
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Nonsteroid Hormones Amines, peptides, proteins, glycoproteins Synthesized from amino acids Combine with receptors in target cell membranes to deliver its message. Cellular responses include: May alter function of enzymes or membrane transport mechanisms or activate a secondary messenger which can alter membrane permeabilities, Activate enzymes Promote synthesis of proteins Stimulate/inhibit specific metabolic pathways Move the cell Initiate secretion of hormones or other substances. Step through Slides
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One mechanism of non-steroid hormones. 1.) Body fluids carry nonsteroid hormone molecules to target cell. Where 2.) they combine with receptor molecules on the cell membrane. 3.) This activates molecules of adenylate cyclase, which 4.) catalyze conversion of ATP into cyclic adenosine monophosphate (cAMP) 5.) The cAMP promotes a series of reactions leading to the cellular changes associated with the hormone’s action.
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Hormones can stimulate changes in target cells even if present in extremely low concentrations. Very potent
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Prostaglandins Lipids synthesized from a fatty acid in cell membranes. Produced by liver, kidneys, heart, lungs, thymus gland, pancreas, brain, and reproductive organs. Usually act more locally than hormones, affecting only the organ where produced. Potent. Present in small quantities. Not stored. Synthesized just before released. Rapidly activated.
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Produce diverse effects: Relax smooth muscles in airways of lungs and in blood vessels Contract smooth muscles in uterus and intestines Stimulate hormone secretion from adrenal cortex. Inhibit secretion of hydrochloric acid in stomach Influence movement of sodium ions and water in kidneys Regulate blood pressure Effect male and female reproductive physiology
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Control of Hormonal Secretions Precisely regulated. Continually excreted in urine and broken down by the liver.
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Controlled in three ways – all of which employ negative feedback In response to releasing hormones secreted by the hypothalamus In response to nerve impulses In response to levels of a substance in the bloodstream
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Control of the endocrine system occurs in 3 ways: A.) the hypothalamus and anterior pituitary, B.) the nervous system directly, and C.) glands that respond directly to changes in the internal environment. Negative feedback inhibition is indicated by (-)
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Negative Feedback: A gland is sensitive to the concentration of a substance it regulates. When concentration reaches a certain high point, it inhibits the gland Inhibited gland releases less hormone, controlled substance level also decreases. Maintains relatively stable hormone concentrations. Animation of Positive and Negative Feedback
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As a result of negative feedback, hormone concentrations remain relatively stable, although they may fluctuate slightly above and below average concentrations.
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Pituitary Gland (hypophysis) Located at the base of the brain attached to the hypothalamus 1cm in diameter and consists of 2 lobes Most pituitary activities are controlled by the hypothalamus.
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The pituitary gland is attached to the hypothalamus and lies in the stella turcica of the sphenoid bone.
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The two parts of the pituitary gland secrete hormones by different mechanisms. Hypothalamic releasing hormones stimulate cells of the anterior lobe to secrete hormones. Nerve impulses originating in the hypothalamus cause nerve endings in the posterior lobe of the pituitary gland to release hormones.
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Anterior Pituitary Hormones (anterior lobe) Growth Hormone (GH) stimulates cells to increase in size and divide more frequently. Enhances movement of amino acids across membranes. Disorders include: Acromegaly hypopituitary dwarfism gigantism
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Dwarfism Insufficient secretion of growth hormone (GH) during childhood that limits growth Body parts usually correctly proportioned, normal mental development Usually accompanied by deficient secretion of other anterior pituitary hormones – additional symptoms Treatment with hormone therapy
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Deficiency of growth hormone early in life leads to pronounced inhibition of longitudinal growth, resulting in dwarfism. The interrelationship between the pituitary and the thyroid is demonstrated by the concomitant hypothyroidism secondary to deficiency of thyrotropic hormone. Therefore, growth is not only stunted but the development of secondary ossification centers is noticeably delayed, and the epiphysial and apophysial growth plates remain open late in adult life, although they do ultimately close in old age. The cranial sutures remain widely open into adult age. The sella turcica may show widening, if the tumor was intersellar, or an aperture may remain on the floor of the endocranial bones. The skeleton is gracile in dimensions, the cortices are thin, and the spongiosa porotic and sparse. Although growth plates may remain, the metaphysial surface is usually closed by a thin layer of bone, an indication of arrested growth.
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Gigantism Oversecretion of GH during childhood Height may exceed 8 ft Rare. Results of a pituitary gland tumor. May have over-secretion of other pituitary hormones. Often have several metabolic disturbances.
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Acromegaly Overproduction of growth hormone in adulthood Symptoms include enlarged heart, bones, thyroid, facial features, hands, feet, and head. Early symptoms include headache, joint pain, fatigue, and depression.
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Prolactin (PRL) stimulates and sustains a woman’s milk production following birth of an infant Thyroid-stimulating Hormone (TSH) controls thyroid gland secretions Thyrotropin-releasing hormone (TRH) from the hypothalamus stimulates the anterior pituitary gland to release thyroid-stimulating hormone (TSH), which stimulates the thyroid gland to release hormones. These thyroid hormones reduce the secretion of TSH and TRH. Step through Slides
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Adrenocorticotropic Hormone(ACTH) controls secretion of certain hormones from adrenal cortex Adrenal gland stimulating hormone (Cushing's Disease) (ACTH) widened face with acne and flushing fatty deposits over back of neck stretch marks, easy bruising, hair growth diabetes mellitus muscle loss and fatigue depression and psychosis
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Nelson's syndrome with excessive pigmentation of the skin due to ACTH stimulation of the melanocytes in the skin Cushing's disease: medical treatment for tumors which cause the over secretion of corticosteroids by the adrenal glands is unsatisfactory because of their side effects and response rates. Two classes of medication are used: those which interfere with the production of steroids in the adrenal glands and those which act within the brain. Removal of the adrenal glands is an option when pituitary surgery and medical measures fail to control Cushing's disease. This may lead to rapid growth of the pituitary tumor and massive blood levels of ACTH. ACTH stimulates melanin production in the skin, darkening the skin color. This is termed Nelson's syndrome
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Follicle-stimulating Hormone (FSH) a gonadotrophin (exerts action on the gonads or reproductive organs) responsible for the development of egg-containing follicles in ovaries and stimulates follicular cells to secrete estrogen. Luteinizing Hormone (LH) a gonadotrophin that promotes secretion of sex hormones and plays a role in releasing an egg cell in females.
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Posterior Pituitary Hormones (posterior lobe) Antidiuretic Hormone (ADH) causes kidneys to conserve water. In high concentration it increases blood pressure. An injury or tumor damaging any parts of the ADH- regulating mechanism causing too little ADH produces diabetes insipidus. Individual produces 25-30 liters of very dilute urine/day and solute concentrations in body fluids rise. Oxytocin (OT) contracts muscles in the uterine walls, contracts muscles associated with milk-secreting glands. Commercial preparations of oxytocin are sometimes used to stimulate uterine contractions, inducing labor. Also used following childbirth to contract uterine muscles to normal size and minimize risk of hemorrhage.
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Thyroid Gland Located in the neck and consists of two lobes Consists of many follicles that are fluid-filled and store hormones Thyroxine (T4) and Tri-iodothyronine (T3) increase the metabolic rate of cells, enhance protein synthesis, and stimulate lipid utilization.
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Thyroid gland. A.) Consists of 2 lobes connected anteriorly by an isthmus. B.) Follicular cells secrete thyroid hormones.
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Thyroid hormones Major factors in determining basal metabolic rate (BMR) Required for normal growth and development and essential to nervous system maturation. Up to 80% of the iodine in the body is in the thyroid gland. 25x higher concentration than bloodstream. Iodine salts absorbed from food in the intestine
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Calcitonin lowers blood calcium and phosphate ion concentration by inhibiting release of calcium and phosphate ions from bones and increasing excretion of these ions by kidneys. Thyroid disorders Hyperthyroidism: overactivity. Elevated metabolic rate, restlessness, overeating. Protruding eyes due to tissue swelling. Goiter – enlarged thyroid gland Hypothyroidism: underactivity.
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Simple Goiter This condition is characterized by an enlargement of the entire gland, or of one of its two lobes, caused by a deficiency of iodine in the diet. The disease is especially apt to appear in adolescence. Simple goiter occurs in inland areas of all continents. It was common in what was at one time referred to as the goiter belt of the U.S., which includes the Great Lakes region and inland mountain areas. The administration of iodine, or of the iodine-containing hormone thyroxine, effectively prevents the disease. Prevention requires taking small doses of iodine for long periods. Ingestion of iodine during pregnancy prevents development of the disease in the infant as well as in the mother. Public health measures, including the addition of iodine to water supplies and to table salt, have helped to reduce the incidence of simple goiter in certain areas. Iodine is most effective when administered to children who have the disease. Thyroidectomy, or surgical removal of the gland, may be necessary in cases in which the gland has become greatly enlarged. Toxic Goiter This disease, also called exophthalmic goiter, hyperthyroidism, thyrotoxicosis, or Graves' disease, for the Irish physician Robert James Graves, is caused by an excess of thyroxine secretion. The cause of the excessive secretion is obscure. In some cases it may result from excessive stimulation by the pituitary gland. The symptoms of toxic goiter may include a rapid heartbeat, tremor, increased sweating, increased appetite, weight loss, weakness, and fatigue. Some patients have eye problems, such as staring or protrusion. Thiouracil and iodine are sometimes used in the treatment of toxic goiter, as is irradiation of the gland by radioactive iodine.
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Parathyroid Glands On the posterior surface of the thyroid gland Usually 4 parathyroid glands – a superior and inferior on each of the thyroid’s lateral lobes. Structure: thin capsule of connective tissue covers each small, yellowish-brown parathyroid gland. Inside consists of many tightly packed secretory cells closely associated with capillary networks.
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The parathyroid glands are embedded in the posterior surface of the thyroid gland.
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Parathyroid Hormone (PTH) Increases blood calcium concentration and decreases blood phosphate ion concentration Affects bones, kidneys, and intestine Bones: inhibits osteoblast (build bone) and stimulates osteocytes and osteoclasts to resorb bone and release calcium and phosphate ions into the blood. Kidneys: conserve blood calcium and excrete more phosphate ions in urine Intestine: stimulates calcium absorption from food in the intestine, increasing blood calcium concentration.
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Parathyroid hormone (PTH) stimulates bone to release calcium (Ca+2) and the kidneys to conserve calcium. It indirectly stimulates the intestine to absorb calcium. The resulting increase in blood calcium concentration inhibits secretions of PTH
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Hyperparathyroidism Can be caused by a tumor Increases PTH secretion Bones are resorbed and soften, deform more easily. Fracture spontaneously Excess calcium and phosphate released into body fluids may be deposited in abnormal places. (kidney stones)
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Hypoparathyroidism Can be caused by injury or surgical removal Decreased PTH Reduced osteoclast activity. Bones are strong, but blood calcium concentration decreases. Abnormally excitable nervous system. Trigger spontaneous impulses. Tetanic contractions may cause respiratory failure and death.
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Adrenal Glands Sits atop each kidney and is embedded in the mass of adipose tissue that encloses the kidney Structure: Adrenal medulla: central portion. Irregularly shaped cells organized in groups around blood vessels. Connected with the sympathetic division of the autonomic nervous system. Modified post-ganglionic neurons Adrenal cortex: outer portion. Epithelial cells in layers. Well supplied with blood vessels.
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Adrenal glands. A.) An adrenal gland consists of an outer cortex and an inner medulla. B.) The cortex consists of the three layers or zones of cells.
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Hormones of the Adrenal Medulla Epinephrine (adrenalin) and Norepinephrine Effects resemble those of the sympathetic neurons stimulating their effectors but last up to 10x longer because the hormones are broken down more slowly than neurotransmitters. Increased heart rate, increased force of cardiac muscle contraction, increased breathing rate, elevated blood pressure, increased blood glucose, decreases digestive activity.
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Stimulated by nerve fibers originating in the hypothalamus in response to stress. “fight or flight” responses Tumors in the adrenal medulla increase hormonal secretion. Treatment involves surgical removal of tumor.
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Hormones of the Adrenal Cortex Produces more than 30 different steroids Some are vital – cannot survive without. Death within 1 week unless extensive electrolyte therapy is provided. Aldosterone: a mineralocorticoid that causes the kidneys to conserve sodium ions and water and to excrete potassium ions.
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Cortisol: a glucocorticoid that affects carbohydrate, protein, and fat metabolism. Helps keep blood glucose concentration within normal range between meals. Controlled by negative feedback. Set point of feedback mechanism changes in response to conditions such as stress, injury, disease
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Negative feedback regulates cortisol secretion, similar to the regulation of thyroid hormone secretion.
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Addison Disease Caused by hyposecretion of adrenal cortical hormones Characterized by decreased blood sodium, increase blood potassium, low blood glucose concentration (hypoglycemia) Dehydration, low blood pressure and increased skin pigmentation. Lethal within days without treatment due to severe disturbances in electrolyte balance
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Cushing Syndrome Associated with an adrenal tumor and hypersecretion of hormones. Alters carbohydrate and protein metabolism and electrolyte balance. Blood glucose concentration remains high depleting tissue protein. Too much sodium is retained increasing tissue fluids (puffy skin). Increased adrenal sex hormone may cause masculinizing effects in a female.
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Adrenal Sex Hormones (adrenal androgens) Mostly male, some converted to female hormones (estrogens) in the skin, liver, and adipose tissue. Supplement supply of sex hormones from the gonads Stimulate early development of reproductive organs.
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Pancreas Consists of two major types of secretory tissues that involve two functions: Exocrine gland: secrete digestive juice Endocrine gland: releases hormones
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Structure: elongated somewhat flattened organ posterior to the stomach and behind the parietal peritoneum Duct joins the pancreas to the duodenum (first section of the small intestine). Juices help digest carbohydrates, fats, nucleic acids, and proteins. Endocrine portion involves groups of cells called Islets of Langerhans that are closely associated with blood vessels and secrete glucogon and insulin
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The hormone-secreting cells of the pancreas are grouped in clusters, or islets, that are closely associated with blood vessels. Other pencreatic cells secrete digestive enzymes into ducts.
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Light micrograph of an islet of Langerhans within the pancreas.
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Glucogon: Stimulates the liver to break down glycogen and amino acids into glucose, raising blood sugar concentrations (more effective than epinephrine) Negative feedback regulation prevents hypoglycemia between meals or during exercise
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Effective blood glucose regulation is fundamentally important for health. Even mild disruptions of glucose homeostasis can have adverse consequences. After a carbohydrate meal, blood sugar increases for several hours, then returns to base line in response to homoeostatic mechanisms. The rise in blood glucose is due to the intestinal absorption of glucose, released from starch and sugars by amylase and disaccharidases. Fructose and galactose are more slowly metabolized to glucose by the liver. Insulin secreted by beta cells of the endocrine pancreas is released in response to elevated blood sugar. Insulin, a major anabolic hormone, stimulates skeletal muscle and adipose tissue to take up glucose from the circulation.
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The liver, brain and red blood cells do not require insulin for glucose uptake. The central nervous system requires glucose as its primary fuel. Though the brain accounts for only about 10% of body weight, it uses more than 30% of blood glucose. To maintain fasting blood glucose levels in the face of this steady drain of glucose, a variety of hormones are required, chiefly, glucagon from alpha cells of the endocrine pancreas and glucocorticoids from the adrenal glands. Glucagon acts rapidly on the liver to break down stored glycogen to glucose, while glucocorticoids more slowly stimulate protein breakdown; for example, in skeletal muscle to release free amino acids. Many amino acids can be converted to glucose by the liver (gluconeogenesis). Fat breakdown to free fatty acids is also stimulated by glucagon in order to provide an alternative fuel for most of the body, exclusive of the CNS. Other glands involved: the thyroid gland helps determine the metabolic rate, while the pituitary orchestrates most endocrine activity including the thyroid. The kidneys reabsorb most of the glucose in the filtrate. However, when blood glucose increases above a threshold, the kidneys spill glucose into the urine, a sign of abnormal glucose regulation.
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Insulin: has the opposite effect of glucogon Stimulates the liver to form glygocen from glucose and inhibits conversion of non-carbohydrates into glucose. Promotes facilitated diffusion of glucose across cell membranes that have insulin receptors Promotes transport of amino acids into cells, increases protein synthesis and stimulates adipose cells to synthesize and store fat. Negative feedback helps to prevent too high blood glucose concentrations. Nerve cells are particularly sensitive to changes in blood glucose concentrations
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Insulin and glucagon function together to help maintain a relatively stable blood glucose concentration. Negative feedback responding to blood glucose concentration controls the levels of both hormones.
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Diabetes mellitus Results from insulin deficiency Disturbs carbohydrate, protein, and fat metabolism Blood sugar levels rise (hyperglycemia) Kidneys excrete excess glucose in urine causing more water and electrolytes than usual to be excreted and the person becomes dehydrated. Glucose-starved cells increase their use of proteins as an energy source. Tissues waste away Ketone bodies accumulate in blood, lower pH, cause dehydration. May harm brain cells, disorientation, coma, death
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Type 1:Insulin-dependent diabetes mellitus or Juvenile-onset diabetes mellitus Appears before age 20 Autoimmune disease – immune system destroys beta cells of the pancreas. Treatment involves insulin injections or implantation of insulin pump Historically treatments used insulin extracted from pig pancreases, now human version obtained from bacteria modified with human insulin gene. People less allergic to new form.
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Type 2:Noninsulin-dependent diabetes mellitus or Maturity-onset diabetes mellitus 70-80% of people with diabetes. Develops gradually after age 40 Milder symptoms. Most are overweight Beta cells of pancreas function but body cells lose sensitivity to insulin Treatment involves controlling diet, exercising, maintaining desirable body weight, and medication Monitor blood glucose levels Complications involving coronary artery disease and retinal and nerve damage.
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Pineal Gland Small structure located deep between the cerebral hemispheres where it attaches to the upper portion of the thalamus Secretes melatonin in response to light conditions outside the body Nerve impulses from the retinas of the eyes send information to the pineal gland Acts on certain brain regions that function as a “biological clock” and helps regulate circadian rhythms Patterns of repeated activity associated with the environmental cycles of day and night. (p299)
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Thymus Gland Lies in the mediastinum, posterior to the sternum and between the lungs. Large in children, but shrinks with age Thymosins: affect production and differentiation of certain white blood cells (lymphocytes) and plays a role in immunity
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In the thymus gland lymphocytes become specialized. The thymus plays an important role in lymphocyte specialization and immunity.
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Reproductive Glands Ovaries: produce estrogens and progesterone Placenta: produces estrogens, progesterone, and gonadotropin
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Testes: produces testosterone (more in Ch 19-20)
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Digestive Glands Associated with the linings of the stomach and small intestines (more in Chapter 15)
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Other Hormone-Producing Organs Heart: atrial natriuretic peptid – stimulates urinary sodium excretion Kidneys: secrete red blood cell growth hormone called erythropoietin
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Stress and Health When the body senses danger, nerve impulses to the hypothalamus trigger physiological responses that preserve homeostasis Increased activity in the sympathetic division of the autonomic nervous system Increased secretion of adrenal and other hormones
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Types of Stress Physical factors: Exposure to extreme heat or cold Decreased oxygen concentration Infections Injuries Prolonged heavy exercise Loud sounds Physiological factors: Thoughts about real or imagined dangers Personal losses Unpleasant social interactions Anger Fear Grief Anxiety Depression Guilt
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General Stress Syndrome Physiological responses to stress are under hypothalamic control and work to maintain homeostasis The hypothalamus stimulates hormone action from the adrenal medulla, anterior pituitary, and the adrenal cortex.
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During stress, the hypothalamus helps prepare the body for “fight or flight” by triggering sympathetic impulses to various organs. It also stimulates epinephrine release, intensifying the sympathetic responses.
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Clinical Terms Related to the Endocrine System
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Adrenalectomy Surgical removal of the adrenal glands
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Adrenogenital Syndrome A group of symptoms associated with changes in sexual characteristics Results from increased secretion of adrenal androgens.
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Diabetes insipidus Condition due to insulin deficiency or the inability to respond to insulin. Disturbs carbohydrate, protein, and lipid metabolism. Part of the job of the kidneys is to continually filter water from the blood that passes through them and reestablish the balance of the body’s water by reabsorbing fluid from the blood. Efficient re-absorption requires an adequate level of a hormone known as antidiuretic hormone (ADH) which is produced by the posterior lobe of the pituitary gland in the brain. If this hormone is not produced in sufficient quantities or if the kidney fails to respond to it, diabetes insipidus can occur. Diabetes insipidus is a rare form and is only definitely diagnosed after extensive blood and urine tests.
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Exophthalmos Abnormal protrusion of the eyes.
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Goiter Bulge in the neck resulting from an enlarged thyroid gland.
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Hirsutism Excess hair growth, especially in women.
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Hypercalcemia Excess blood calcium Causes of hypercalcemia and hypocalcemia
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Hyperglycemia Excess blood glucose
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Hypocalcemia Deficiency of blood calcium
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Hypoglycemia Deficiency of blood glucose
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Hypophysectomy Surgical removal of the pituitary gland The pituitary gland is a small, oval-shaped endocrine gland about the size of a pea located in the center of the brain above the back of the nose. Its major role is to produce hormones that regulate growth and metabolism in the body. Removing this important gland is a drastic step that is usually taken in the case of cancers or tumors that resist other forms of treatment, especially craniopharyngioma tumors. Hypophysectomy may also be performed to treat Cushing's syndrome, a hormonal disorder caused by prolonged exposure of the body's tissues to high levels of the hormone cortisol, in most cases associated with benign tumors called pituitary adenomas. The goal of the surgery is to remove the tumor and try to partially preserve the gland.
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Parathyroidectomy Surgical removal of the parathyroid glands The parathryoid gland is accessed through an incision in the neck (A). Muscles and connecting tissues, or fascia, are cut open (B). The thyroid gland is exposed, and the superior (C) and inferior parathyroid glands are removed (D). The muscle layers are stitched (E), and the wound closed Parathyroidectomy is the removal of one or more parathyroid glands. A person usually has four parathyroid glands, although the exact number may vary from three to seven. The glands are located in the neck, in front of the Adam's apple, and are closely linked to the thyroid gland. The parathyroid glands regulate the balance of calcium in the body. Parathyroidectomy is usually performed to treat hyperparathyroidism (abnormal over-functioning of the parathyroid glands).
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Pheochromocytoma Type of tumor in the adrenal medulla usually associated with high blood pressure.
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Polyphagia Excessive eating
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Thymectomy Surgical removal of the thymus gland
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Thyroidectomy Surgical removal of the thyroid gland Thyroidectomy is a surgical procedure in which all or part of the thyroid gland is removed. The thyroid gland is located in the forward (anterior) part of the neck just under the skin and in front of the Adam's apple. The thyroid is one of the body's endocrine glands, which means that it secretes its products inside the body, into the blood or lymph. The thyroid produces several hormones that have two primary functions: they increase the synthesis of proteins in most of the body's tissues, and they raise the level of the body's oxygen consumption. All or part of the thyroid gland may be removed to correct a variety of abnormalities. If a person has a goiter, which is an enlargement of the thyroid gland that causes swelling in the front of the neck, the swollen gland may cause difficulties with swallowing or breathing. Hyperthyroidism (overactivity of the thyroid gland) produces hypermetabolism, a condition in which the body uses abnormal amounts of oxygen, nutrients, and other materials. A thyroidectomy may be performed if the hypermetabolism cannot be adequately controlled by medication, or if the condition occurs in a child or pregnant woman. Both cancerous and noncancerous tumors (frequently called nodules) may develop in the thyroid gland. These growths must be removed, in addition to some or all of the gland itself. To remove the thyroid gland, an incision is made at the front of the neck (A). Muscles and connecting tissue, or fascia, are divided (B). The veins and arteries above and below the thyroid are severed (C), and the gland is removed in two parts (D). The tissues and muscles are repaired before the skin incision is closed (E)
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Thyroiditis Inflammation of the thyroid gland. he inflamed thyroid gland can release an excess of thyroid hormones into the blood stream, resulting in a temporary hyperthyroid state. Once the thyroid gland is depleted of thyroid hormones, the patient commonly goes through a hypothyroid (low thyroid) phase. This phase can last 3-6 months until the thyroid gland fully recovers. Thyroiditis can be diagnosed by a thyroid scan (a picture taken of the thyroid gland after radioactive iodine is taken by mouth).
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Virilism Masculinization of a female.
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