Endocrine System

Spring 2012 FINAL

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Endocrine Glands

• Pituitary gland• Pineal gland• Adrenal glands• Thyroid gland• Parathyroid gland• Thymus gland• Pancreas• Gonads• Hypothalamus

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Pituitary Gland• Anterior

– FSH– LH– TSH– ACTH– PRL– MSH– Endorphins– GH

• Posterior– ADH– Oxytocin

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Pineal Gland

Melatonin

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Adrenal Glands

• Adrenal Cortex– Mineralocorticoids– Glucocorticoids– Androgens

• Adrenal Medulla– Epinephrine– Norepinephrine

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Thyroid Gland

• TH– Thyroxine– Triiodothyronine

• Calcitonin

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Parathyroid Gland

• PTH

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Thymus

• Lymphocytes

• Thymosin

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Pancreas

• Glucagon– Alpha cells

• Insulin– Beta Cells

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Gonads

• Females– Estrogen– Progesterone

• Males– Testosterone

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Hypothalamus

• TRH• GnRH• GHRH• CRH• Somatostatin• Dopamine

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Osteoporosis

• Classified by age groups– Most common is

postmenopausal• Decrease in bone

density (subtractive)• Treatment increase

calcium and vitamin D in comination with hormone therapy

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Osteoporosis

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Osteomalacia1. Lack of calcium in the tissues & a failure of the bone tissue to calcify

2. Caused by malabsorption of fats

3. If it occurs after growth plate closure it is called Rickets

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Osteomalacia

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Demonstrates as osteopenia onx-ray.

Appears similar to osteoporosis

Except for the presence of bands Of radiolucency within the bone

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Paget’s Disease

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X-ray of affected bones showcortical thickening with a coarseThickened trabecular pattern

Often called “cotton wool” Appearance

Mixed areas of radiolucency &radiopaque areas

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Paget’s Disease1. Metabolic disorder of unknown cause

2. Has two stages:1. Osteolytic2. Osteo blastic

3. Fairly common in elderly

4. Affects men twice as frequently as women

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Pituitary Gland Disorders

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Acromegaly

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X-ray demonstrates an enlarged sellaTurcica and changes in the skull

Obliterates diploe found between inner& outer tables of the cortical bone

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Acromegaly1. Endocrine disorder caused

by a disturbance of the pituitary gland1. Primarily affects skeletal

system

2. Have a prominent forehead & jaw, widened teeth, abnormally large hands, coarsening of facial features

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Hypopituitarism1. Decreased levels of pituitary hormones

2. Most common cause is pituitary infarction1. Caused by ischemic

pituitary necrosis, postpartum hemorrhage, shock, sickle cell disease, meningitis, shock, syphilis, and head trauma

3. CT, MRI and angiography can be used for radiographic evaluation

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Hypopituitarism1. Short stature with protruding

abdomen

2. Sparse hair

3. Coarse facial features

4. Wide-set eyes

5. Broad nose

6. Protruding tongue

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Diabetes Insipidus

• Deficiency in vasopressin

• Insufficient ADH• Usually secondary to

intereference with ADH production

• Can be hereditary– Nephrogenic D.I.

• Symptomes– Polyuria– Increased thirst– Low urine osmolality

• Treatment– Hormone therapy

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Adrenal Gland Disorders

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Cushing’s Syndrome

26http://www.youtube.com/watch?v=vxSAhLyKVqw

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Cushing’s Syndrome1. Have a “moon” face

with excess fat deposits in neck and trunk

2. Skin is thin and does not heal well

3. CT and MRI demonstrates pituitary adenomas

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Addison’s Syndrome

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Addison’s Syndrome

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Pancreatic Disorders

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Pancreas Anatomy

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Diabetes Mellitus

1. Syndrome characterized by chronic hyperglycemia is combination with glucose intolerance

2. Alteration is metabolism of carbs, fats and proteins

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Type 11. Produce little to no insulin

2. Symptoms

1. Increase urination2. Excessive thirst3. Increase in appetite

3. Treatment

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Type 21. Inadequate secretion

of insulin

2. More common in women than men

3. Treatment is similar to DM 1

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Thyroid and Parathryroid Gland Disorders

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Thyroid Anatomy

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Hyperthyroidism

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Hyperthyroidism1. Autoimmune disorder

2. Thyroid gland secretes excess amounts of TSH

3. Enlarged thyroid and protruding eyes

4. Hyper and nervous

5. Treatment includes: medical management, surgical resectionAdministration of radioactive iodine

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Hypothyroidism1. TH deficiency

2. Commonly seen in PT’s with Hashimoto’s syndrome

3. May be caused by iodine insufficiency

4. Symptoms:1. decreased energy levels2. hot & cold intolerance3. personality changes4. weight gain

5. Treatment is hormone replacement therapy

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Thyroid Cancers

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Parathyroid Glands

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Hyperparathyroidism

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X-ray demonstrates osteopenia, especially in the diaphyses of the phalanges and clavicles

Pathologic fractures may exist as a consequence of the softenedbony matrix

Hyperparathyroidism

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Disrupts the calciumPhosphate ration andResults in increased Levels of PTH.

Nephrocalcinosis

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Tiny deposits of calcium dispersed through renalparenchyma

Can be seen on an IVU andplain radiographs

Radiography1. Useful in diagnosing some disorders

1. Metabolic diseases of the skeletal system1. Cushing's’

2. Decrease in CA in osteomalacia & osteoporosis

3. Disorders of pituitary gland1. Changes in sella turcica

4. Acromegaly45

Bone Mineral Densitometry

1. Determines mineral and calcium content in bone

2. Can assist in the diagnosis of 1. Osteoporosis2. Osteomalacia

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MRI

1. Useful in evaluating pituitary disorders

1. Pituitary adenomas1. Presence of progress2. With Gadolinium

2. Microadenomas

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CT1. Useful in diagnosis and follow-up of pituitary

disorders

2. Pineal gland

3. Neoplastic diseases of thyroid , adrenal glands & parathyroid glands1. Enlargement of adrenal glands

4. Biopsies frequently performed under CT 48

Nuclear Medicine1. Diagnosing thyroid function

2. Detecting nonpalpable nodules

3. Evaluate remaining thyroid tissue 1. After surgical resection or ablation

4. Localize medullary tumors of adrenal glands

5. Using radioisotopes to treat this tumor of the medullary portion of the adrenal glands

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