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Erma Wahyu M., S.Kep., Ns., M.SiProgram Studi S1 Keperawatan

Fakultas Ilmu Kesehatan Universitas Muhammadiyah Malang2012

The Endocrine Glands & their Hormones

PEMBAGIAN HORMON a. Luas Efek 1. Local Hormone 2. General Hormone b. Susunan Kimia 1. Steroid (= Cholesterol) Cortex Adrenal : Cortisol dan Aldosteron Ovarium : Estrogen dan Progesteron Testis : Testosteron 2. Derivat Asam Amino Tyrosin Tiroid : Thyroxine dan Triiodothyronine Medula Adrenal : Epinephrine dan Nor- Epinephrine 3. Peptida/Protein

C. Mekanisme Kerja Kelarutan 1. Hidrofilik (larut air) : Sebagian besar hormon 2. Hidrofobik (tidak larut air) : Hormon Steroid dan Hormon Tiroid FUNGSI HORMON : Mengontrol Tingkat Aktivitas dari Jaringan Target dengan Jalan : 1. Mengubah Rekasi Kimia dalam Sel 2. Mengubah Permiabilitas Membran Sel terhadap bahan spesifik HOMEOSTASIS


Pineal Gland

-Main hormone secretedMELATONIN

-Role Melatonin

--Mammals : Regulate reproductive activity in response to environmental light cyclese.g. Some mammals mate in summer (lot of light), while others mate in winter (low light).


Thyroid Gland

-Produces 3 main hormones

-Triiodothyronine (T3)-Thyroxine (T4)

Regulate body metabolism and areimportant in bone growth and maturationof the brain-Congenital lack of thyroid hormones:

Cretinism.-Calcitonin

Acts by reducing calcium levels


Parathyroid Gland

-Parathyroid Hormone

Raises Blood Calcium

(antagonize Calcitonin)

This hormone acts on bone, kidneyand the gut


Thymus Gland

-Thymosin : Stimulates the production of Lymphocytes

-Thymostatin : Inhibits the production of Lymphocytes

Thymus : Important for the neonatalproduction of antibodies

Thymus : Gland being at the centerof endocrine, neural, and immunesystems


Heart-Granular cells in the heart musclesecrete Atrial Natriuretic Factor (ANF)

..ANF : Regulates blood pressure,blood volume, and excretionof water, sodium andpotassium

..ANF : Also a neuropeptide in the brain


Gastrointestinal Hormones

-The mucosa of the GI tract secretes a dozen PEPTIDE hormones3 most important:1. Secretin : Secreted in the small intestine

Stimulates the secretion ofpancreatic bicarbonate and hasother functions on digestion

2. Gastrin: Secreted in the walls of stomachStimulate hydrochloric acid secretionstimulate pancreatic enzyme secretion

3. Cholecystokinin : Secreted in the small intestineStimulate gall bladder contractionStimulate pancreatic enzyme secretion


PancreasEndocrine cells in the pancreas secrete2 major types of hormones

1. Insulin : Secreted in response to increase in blood glucose levels ;So insulin LOWERS glucose levels byINCREASING glucose UPTAKE in cellswhere it is stored as glycogen.2. Glucagon : Increases blood glucoselevels by stimulating the conversionof glycogen to glucose in the liver.

KELNJAR PANCREAS

Terdiri atas :

1. ACCINI : sekresi enzim pencernaan

2. PULAU LANGERHANS* SEL ALFA : sekresi glukagon* SEL BETA : sekresi insulin* SEL DELTA : sekresi somatostatin* SEL F

Transport Glukosa :

Tanpa insulin ¼ dari normal Dengan insulin 5 kali dari normal Insulin efektif di OTOT SKELET dan JARINGAN ADIPOSA Insulin tidak mempercepat transport glukosa di :

1. Sel otak2. Sel darah merah3. Mukosa usus Simple Diffusion4. Epitel tubuli ginjal

Pentingnya Pengaturan Konsentrasi Glukosa1. Energi diperoleh dari glukosa, lemak dan protein2. Glukosa merupakan satu satunya nutrien untuk :

* Otak* Retina konsentrsi glukosa tdk boleh rendah* Germinal epithelium

3. Bila konsentrasi glukosa tinggi :* Tekanan osmotik ekstraseluler Air keluar sel DEHIDRASI* Glukosa pada tubuli ginjal 1. Glukosa terbuang di urin 2. Osmotic diuretic cairan banyak yghilang

Konsentrasi Glukosa Darah Normal : Puasa : 80-90 mg% 1 jam post prandial : 120-140 mg% 2 jam post prandial : 120 mg%

EFEK METABOLIK INSULIN

1. Metabolisme Karbohidrat* Transport glukosa * Glikogen * Metabolisme glukosa

Dibakar Glukosa Glukosa

Glikogen

Insulin

2. Metabolisme Lemak

Glukosa

Insulin

Glukosa * Sintesis* Lipoprotein

Glikolisis

Alfa Glycerophosphat Asam Lemak

Triglyceride

Glycerol Asam Lemak

SINTESIS TRIGLYCERIDE DALAM JARINGAN ADIPOSA

Glukosa Glukosa-6-phosphate

Pyruvic acid Lipoprotein

-glicerol Acetyl CoA Liporotein phosphate lipase

Fatty acids Fatty Acids

Triglyceride Glycerol

JARINGAN ADIPOSAPLASMA PLASMA

Insulin SEL LEMAK

Asam Lemak

disintesis oksidasi oleh hepar

Cholesterol Acetyl Co A Triglyceride

Phospholipid Energi Aceto-acetic acid

Atheroscerosis -(OH)-butyric acid Aceton

KETOBODIES

3. Metabolisme Protein

Insulin cukup

Tansport aktif asam amino ke dalam sel

Sintesis protein

Pertumbuhan (mempunyai efek potensiasi dengan GH)

N balans (+)

Insulin Tidak Cukup

Transport Asam amino ke dalam sel

Sintesis Protein Asam amino plasma

Hepar Degradasi aa

Energi Ekskresi Urea Glukoneogenesis

Pemecahan protein tdk diimbangi dengan sintesis protein baru

Pembuangan protein

Kedua hal tersebut dapat menyebabkan :1. Atropi oto2. Rasa lelah3. Fingsi organ tubuh

terganggu

Pembuangan protein BERAT BADAN Lipolisis

Insulin & Diabetes

Insulin & DiabetesDiabetes : Hyperglycemia, ie.

Elevated Blood Sugar2 Types : The distinction is based upon

whether the blood sugar problem iscaused by insulin deficiency (Type 1)or insulin resistance (Type 2)

Type 1- Insulin Deficiency : There is notenough insulin produced by the pancreasso the patient must inject insulin on a dailybasis

Type 2 - Insulin Resistance : There is plenty ofinsulin but the cells of the body are resistantto its action so, increase in blood sugarThis form is controlled by a strict diet


Adrenal Glands

2 parts : Medulla & Cortex

Adrenal Cortex : 3 categories of steroidhormones

1. Mineralocorticoids2. Glucocorticoids3. Sex Steroids

Adrenal Medulla1. Adrenaline2. Noradrenaline


Adrenal Cortex

If there is a sodium deprivation,Aldosterone is secreted and actsto increase reabsorption ofsodium ions (NA+) in the kidneyssalivary glands, and sweat glands.

Stress Hormone, converts storedproteins to carbohydrate during stress.Antiinflammatory andImmunosuppressive functions.

Androgen

Estrogen

Influence sexual differentiationand bodily changes during puberty


Adrenal Medulla

Adrenaline : Released followingstress due to environmental extremes; Increases heartrate and blood glucose levelsso, increases the amount of workthe muscles can do (FLIGHT)

Noradrenaline : As Adrenaline, act as a NTin the brainPeriphery; increase blood pressureand constrict blood vessels(noradrenaline, stress, and heart disease…)


Gonads ; TestesThe male gonads : produces Androgens

Primary androgen = TESTOSTERONEOther androgen : Dihydrotestosterone

Androstenedione

Testosterone : Important for masculinizationControl of sperm productionDevelopment of male sexualcharacteristicsActivation of sexual and aggressive behaviors


Gonads ; Ovaries

2 major classes of hormonesESTROGENSPROGESTINS

Primary ESTROGEN : Estradiolothers : Estriol

EstroneSynthetic estrogens : Birth control pillsEstrogens : -Development of sexual

characteristics at puberty -Influence metabolic rate -Influence sexual and maternal behavior


Gonads ; Ovaries

PROGESTIN : Progesterone

-Stimulates breast and uterine enlargement at puberty & during menstrual cycle-Maintains pregnancy (inhibits menstrualcycle during pregnancy)

Other hormone released at the end ofpregnancy : RelaxinActs to prepare the birth canal.

Estrogen and Progesterone act in synergy.


Placenta-Hormones secreted by the fertilized egg(Used in pregnancy tests)

Human Chorionic Gonadotropin (HCG)Act by keeping progesterone high at thebeginning of a pregnancy

Human Placental Lactogen (HPL)Stimulates the mammary glands to beginto secrete milk

The Pituitary Gland & its Hormone

Also calledthe HYPOPHYSIS

SEKRESI HORMON a. Hipofisis Posterior 1. Antidiuretic Hormone (ADH) 2. Oxcytocin b. Hipofisis Anterior 1. Growth Hormone (GH) 2. Adrenocorticotropic Hormone (ACTH, Adrenocorticotropin) 3. Tyroid Stimulating Hormone (TSH, Thyrotropin) 4. Prolactin (LTH = Luteotropic Hormone) 5. Follicle Stimulating Hormone (FSH) 6. Luteinizing Hormone (LH) Gonadotropic Hormone


-Attached to the HYPOTHALAMUS

-Secretion of the pituitary hormones is regulated by hypothalamus

-HYPOTHALAMIC-PITUITARY connection


ANATOMY

-3 parts

--> Anterior Lobe-pars distalis

--> Intermediate Lobe-pars intermedia

--> Posterior Lobe-pars nervosa (“neural” cells)direct extensionof the hypothalamus

AD

ENO

hypophysisN

EUR

Ohypophysis


Attaches the hypothalamus to thepituitary. Also calledthe Infundibulum

Neurohypophysis

-Neuroscretory Cells -Paraventricular nucleus (PVN) -Supraoptic nucleus (SON)

-Hormones secreted

-OXYTOCIN-VASOPRESSIN

PVN SON

AXONS



Neurohypophysis

PVN SON

AXONS

OXYTOCIN & VASOPRESSIN-Are really HYPOTHALAMIC hormones

-OXYTOCIN :

2 main functions

--> promotes uterine contractions --> stimulates milk ejection from mammary glands during lactation

-VASOPRESIN :

--> Antidiuretic hormone --> Raises blood pressure --> promotes water reabsorption by kidneys --> centrally : may promote memory

- Binding proteins for both oxytocin & vasopressin

--> Neurophysins



Neurohypophysis

PVN SON

AXONS



Adenohypophysis

AXONS

ADENOHYPOPHYSIS (ANTERIOR)

Mechanism for release of hormones

True endocrine gland because release hormone in the bloodstream(hypophysal portal system)


Median eminence

1. Neurosecretory cells of the hypothalamus release their hormones at the median eminence

2. Hormones circulate in bloodstream

3. Carried to the adenohypophysis

4. Stimulates secretion of other hormones from the adenophysis

5. These hormones are then released in the bloodstream to reach their target cells.



Adenohypophysis

AXONS

Adenohypophysis : 6 hormones

1. Growth Hormone (GH) (also called ‘somatotropin’) …’tropic’=stimulating effect

GH = promotes growth in almost all body cells

A lot of attention for degenerativedisease…..

-Alzheimer-Parkinson-Anti-Aging

etc.



Adenohypophysis

AXONS


2. Adrenocorticotropic HormoneACTH

Role : Stimulates synthesis andrelease of glucocorticoidhormones

‘Hypothalamic-pituitary-adrenalaxis’

1970’s : Role of memory….little problems…..



Adenohypophysis

AXONS


3. Thyroid Stimulating HormoneTSH

Role : Stimulates the synthesis andrelease of thyroxine (T4)and triiodochyronine (T3)from the thyroid.



Adenohypophysis

AXONS

Adenohypophysis : 6 hormones3 last hormones= ….gonadotropic hormones

4. Follicle stimulating hormone (FSH)

Role : In both sexes, promotes thedevelopment of reproductivecells (gametes) and promotes secretion ofgonadal hormones

Males : stimulates sperm productionFemales : stimulates growth of

primary follicle of ovary



Adenohypophysis

AXONS


5. Luteinizing hormone (LH)

Role :

Female : Stimulates ovulation and formation of progesterone- secreting cells

Males : Stimulates cells that secrete androgens (e.g. testosterone)



Adenohypophysis

AXONS


6. Prolactin (PRL)

Role : Initiates milk synthesis inmammary glands

Other functions related to growth & parental behavior

Interaction with serotonin also(important in depression)



Pars Intermedia

AXONS

Pars Intermedia :

Not present in adult humans butpresent in fetal humans and mammals

Synthesize the hormone calledMelanocyte stimulating hormoneswhich acts in amphibian to changeskin color….

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