5 NURSING CARE OF PATIENTS WITH ENDOCRINE DISORDERS escalante-saac

Exocrine GlandsDucts carry secretion to epithelial surface or mucosa of digestive tract external secretions

Exocrine GlandsExtracellular effect (food digestion)

Endocrine glandsDuctless that contains capillary network to allow easy uptake of hormones into bloodstream internal secretions

Endocrine glandsIntracellular effects such as altering target cell metabolism

Endocrine glandsInterconnected network of glands and nervous system.

Secretions of hormonesKey feature of endocrine glands

HormoneBiochemical that exert effect on target tissue

Target tissueLocated some distance from endocrine glands with no direct physical connection between endocrine and target cells.

Pituitary, Adrenal, ThyroidIslets of pancreas, Parathyroid, GonadsEndocrine glands must use circulatory system to transport secreted hormone to target tissue such as:

Neuroendocrine circulationWorks with nervous system to regulate overall physiologic function called_Also regulate environmental changes

HYPOTHALAMUS (anatomy)endocrine glandsRegulate function of _

Flattened funnelIt is_ shaped

Third ventricle Forms floor and walls of the_ of brain

HypothalamusRegulate primitive function of body from water balance to sex drive

Pituitary glandCarried by_

HYPOPHYSIS (pituitary gland)infundibulumSuspended from hypothalamus by stalk- _

Kidney beanSize and shape of a_

Adenohypophysis(anterior)Neurohypophysis(posterior)Composed of 2 structures with independent origins and separate functions

Anterior pituitaryComposed of of pituitary

AP cellsHypothalamic hormones that regulate_

Posterior PituitaryComposed of of pituitary

Nerve tissueCompose of_, not a true neuron gland

Posterior PituitaryHypothalamic secrete hormone that are stored in_ until released to blood

Hypothalamic hormones There are 8 hormones, 6 of these regulate the Anterior P. glands, and the other 2 hormones release into capillaries in the Posterior P.

*Gonadotropin Releasing Hormone,*Thyrotropin Releasing Hormone, *Corticotrophin Releasing Hormone, *Prolactin Inhibiting Hormone, *Growth ReleasingHormone,*Somatostatin6 hormones releasing and inhibiting

*Follicle Stimulating Hormone,*Luteinizing Hormone,*Thyroid Stimulating Hormone(Thyrotropin),*Adrenocorticotropic Hormone, *Prolactin,*Growth HormoneAnterior lobe hormones

Oxytocin and Antidiuretic 2 other hypothalamic hormones

ANTERIOR PITUITARY HORMONES1. FSH (follicle stimulating hormone)2. LH (luteinizing hormone)

3.TSH (thyroid stimulating hormone)4. ACTH (adrenocorticotropic hormone)5. PRL (prolactin)

6. GH (growth hormone)There are 2 gonadotropin hormone that target gonads:*stimulates secretion of ovarian sex hormones and development of ovarian follicles and sperm production.*stimulates ovulation, stimulates corpus luteum to secret progesterone, stimulates testes to secret testosterone.*stimulates secretion of thyroid hormone.

*stimulates adrenal cortex to secrete glucocorticoids.

*stimulates mammary glands to synthesize milk, enhance secretion of testosterone by testes*stimulates mitosis and cellular differentiation

POSTERIOR PITUITARY HORMONES

1. ADH (antidiuretic hormone)2. OT (oxytocin)Produced by hypothalamus, released when hypothalamic neurons are stimulated.*increases water retention, prevents dehydration*released during sexual arousal, promotes feeling of sexual satisfaction and emotional bonding between partners, stimulates labor and contraction during childbirth, stimulates flow of milk during lactation, causes uterine contraction.

CONTROL OF PITUITARY SECRETION*not*hypothalamus*rate of secretions are_*regulated by_ other brain center and feedback from target organs

Hypothalamic and cerebral controlAnterior lobe control releasing hormone and inhibiting hormone from hypothalamus.Ex. In cold weather, pituitary stimulated by hypothalamus to release TSH to generate body heat

Posterior lobe controlNeuroendocrine reflex hormone release in response to N.S signalEx. suckling infant-stimulates nerve endings-hypothalamus-posterior lobe-oxytocin-milk ejection

GROWTH HORMONEbones, muscle, cartilage and fatWidespread effect of body tissue- _

*liver*insulin like growth factor(IGF-I or IGF-II)*increase protein synthesis*lipid metabolism*Carbohydrate metabolism*electrolyte balance*bone growth thickening and remodeling*secretion release during first_ of sleep*Gradually decrease with age*proteinInduces the _ to produce growth stimulants like_

*provides energy*makes glucose available for glycogen synthesis and storage

*2 hrs.

*lack of_ synthesis contributes to aging of tissue and wrinkling of the skin

PINEAL GLANDcorpus callosumAttached to roof of 3rd ventricle beneath the posterior end of _

Involution(shrinkage)After age 7, undergoes_

Circadian rhythmMay synchronize physiologic function with 24-hour_of daylight and darkness

Melatonin, serotoninSynthesize _ from_ during the night

PubertyRegulate timing of_ in humans

THYMUSPlays a role in three system- Endocrine, Lymphatic and Immune

Bilobed, superior_glands in the mediastinum_ to the heart

Immune defenseImportant in_

HormoneSecretes_ that affect immune activity

thymusGland that relate to myasthenia gravis

THYROID GLAND*butterfly*left and right*T3 (triiodothyronine),T4 (thyroxine)*calcitonin*osteoblast>_shaped glands>There are two lobe the_>Secretes_ and_. >Para follicular C or clear cells secretes_ with rising blood calcium.>stimulates_ activity and bone formation

PARATHYROID GLAND4, posteriorAre _ glands that are embedded to the _surface of thyroid gland

PTH or parathyroid HormoneRelease_

HypercalcemiaCalcitonin is released when there is_. And the effect is to decrease calcium in blood

Hypocalcemia PTH id released when there is_. And the effect is to increase calcium in blood

*increase blood calcium levels*promotes synthesis of calcitriol*increase absorption of calcium*decrease urinary excretion*increase bone reabsorptionPT gland uses:

ADRENAL GLANDSAbove(suprarenal) or topAdrenal cortex and medullaLocated_ the kidneyThese are formed_

Medulla Inner core, 10-20% of gland

MedullaHas dual nature, endocrine glands and sympathetic ganglion of the SNS

Catecholamine, dopamineWhen stimulates, releases_ (epinephrine, norepinephrine) and trace of_ into the bloodstream

Hypertension, increase digestionCatecholamine causes_

ADRENAL CORTEXCorticosteroids and corticoidsSurrounds medulla and produces more than 25 steroid hormones called_

1. mineralocorticosteroids(aldosterone)2. glucocorticoids (cortisol)3. sex steroids (androgen)Secretes 3 classes of steroid hormones, the_*sodium retention and water balance

*sugar level*sexual development

ALDOSTERONE*electrolyte balance*stimulates sodium retention and potassium secretion

CORTISOL*regulates metabolism of glucose and other fuels*stimulates release of fuels in blood*helps adapt stress and tissue repair*anti-inflammatory effect can become immunosuppression in long term use

CATEGORIES OF CORTICOSTEROIDS1. sex steroids (androgen)2. estradiol*sets libido, prenatal development*small quantity but important after menopause

PANCREASExocrine digestive gland and endocrine cell duster(pancreatic islets)

PANCRATIC HORMONE1-298%, digestive enzymes_ million pancreatic islets Langerhans produces hormoneOther _ of pancreas cells produces_

1. INSULIN>BETA>glucose and amino acid>nutrients>glycogen, fat and protein>suppresses>DM*secreted by_ cells*secreted during and after meals when _blood levels are RISING*stimulates cell to absorb_*promotes synthesis of_*_use of already used stored fluids*insufficiency of inactivity causes_

2. GLUCAGON>ALPHA>blood glucose>glucose>increase>fat catabolism*secreted by_ cells*released between meals when_ concentration is FALLING*in liver, stimulates release of_ into circulation*_blood glucose level in adipose*stimulates_

3. SOMATOSTATIN>DELTA>glucagon and insulin>nutrient digestion and absorption*stored by_ cells*particularly suppresses secretion of_*inhibits_ which prolongs absorption of nutrients

4. GASTRIN>GAMMA>acid secretion*secreted by_ cells*stimulates stomach_ motility and emptying

GONADSOvaries and testes are both endocrine and exocrine

Whole cells eggs and spermExocrine product

Gonadal hormone mostly steroidsEndocrine products

Estradiol and progesteroneOvarian hormone

Testosterone,weaker androgen, estrogen and inhibinTesticular hormone

PROSTAGLANDINS>PLASMA>fertility,blood clotting and body tempWork locallyReleased by _ cells