the endocrine system. endocrine system endocrine vs. exocrine organs are not physically connected...
TRANSCRIPT
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The Endocrine System
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Endocrine System
Endocrine vs. Exocrine
Organs are not physically connected
Alters activities of target organs/cells
Purpose: Growth/Development
Reproduction
Regulation
Stress Reactions
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Hormones are Activated By
Hormonal
Humoral
Neural
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Gland/Hormone Functions
Some glands produce >1 hormone
Some hormones produced by >1 gland
Some organs have >1 function
Some hormones have >1 function
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Functions of Endocrine Glands
Endocrine Functions only
Production
Secretion
Contained within other organs which have other functions
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Categories of Glands
Central: PituitaryHypothalamus
Peripheral: Thyroid PinealAdrenals GonadsParathyroids PancreasThymus Others
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Hypothalamus
Found on floor of diencephalon
Neural and endocrine functions
Biofeedback mechanism for:
Osmotic pressures
Temperature regulations
Metabolic functions
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Pituitary
Extends from Hypothalamus-behind sphenoid bone
“Master Gland” of body
Anterior- Portal network
Posterior- Neural-contains axons of
Hypothalamus neurons
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Anterior Pituitary
GH- Growth Hormone
Prolactin
TSH- Thyroid Stimulating Hormone
ACTH- Adrenocorticotropic
FSH- Follicle Stimulating Hormone
LH- Luteinizing Hormone
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Posterior Pituitary
ADH- Anti-Diuretic Hormone
Oxytocin
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Pituitary Disorders
Acromegaly- Hypersecretion of GH
Dwarfism- Hyposecretion of GH
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Thyroid
Inferior to larynx
2 Lobes
T3- Triiodothyronine
T4- Thyroxine
Calcitonin
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Thyroid Disorders
Hypothyroidism- Hyposecretion
Hyperthyroidism- HypersecretionGraves Disease
Goiters- iron deficiencies
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Parathyroids
4 small glands posterior surface of thyroid
Parathyroid hormone
Responsible for osteoclast of bone
Decreases blood phosphate levels
(By way of kidneys)
Enhances activation of Vitamin D
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Parathyroid Disorders
Hyperparathyroidism
“Moan and groan, stones and bones”
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Pineal Gland
Forms part of diencephalon
Melatonin
Inhibits hypothalamus release of gonadotropins
Melatonin-decreases in light/increase in dark (circadian rhythm)
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Thymus Gland
Posterior to sternum, around great vessels
Thymosin
Both lymphatic and endocrine
Lymphatic- produces T-lymphocytes
Endocrine- ‘programs’ T-cells
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The Adrenals
Located on superior end of each kidney
Medulla- inner gland
Cortex- outer gland
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Adrenal Medulla
Sympathetic preganglionic fibers synapse on cells in medulla
Release of epinephrine/norepinephrine into general circulation
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Adrenal Cortex
Produce over 30 steroid hormones
Three main cortical hormones
Mineralocorticoids
Glucocorticoids
Sex hormones
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Mineralocorticoids
Regulate levels of electrolytes and water in extracellular fluid
95% are aldosteroneSodium reabsorption Potassium excretion
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Glucocorticoids
Influence carbohydrate metabolism
Important in body’s response to stress
95% cortisol (hydrocortisone)
stimulates gluconeogenesis
secretion is regulated by ACTH
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Sex Hormones
Androgens (testosterone)
Estrogens
Both are secreted in greater numbers by gonads
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Adrenal Disorders
Cushing’s disease-
cortisol over-production secondary to
increased ACTH
Addison’s Disease-
cortisol/aldosterone deficiencies
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Gonads
Testes- males
Testosterone
Ovaries- females
Estrogens
Progesterone
Both produce hormones/gametes
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Pancreas
Retroperitoneal-posterior to stomach
Exocrine & Endocrine
Endocrine- islets of Langerhans
Alpha
Beta
Delta
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Alpha cells
20% of islets
Hormone glucagon
Stimulates breakdown of glycogen in liver- raises glucose levels in blood
(glycogenolysis & glyconeogenesis)
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Beta Cells
75% of islets
Hormone- insulin
Decreases glucose levels
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Glucose Metabolism
Organic components of food:
Carbohydrates (instant-energy)
Glucose
Fats
Fatty acids/glycerols
Proteins
Amino acids
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Carbohydrate Metabolism
Insulin is released by humoral, hormonal, neural means
Increased glucose
Parasympathetic stimulation
Gastrointestinal hormones
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Carbohydrate Metabolism
60% of carbohydrates are stored as
glycogen in liver
If muscles are not exercised after eating-stored as muscle glycogen
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Glycolysis
Glucose is broken down into pyruvate
and lactate- releasing 2ATPs
(Anaerobic metabolism)
Krebs Cycle
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Fat Metabolism
A third of any glucose passing through liver is converted to fatty acids
Fatty acids are converted to triglycerides and stored in adipose tissue
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Fat Metabolism
Without insulin, fat is broken back down into triglycerides/cholesterol CAD
Fatty acids are also broken down into ketone bodies
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Protein Metabolism
In absence of insulin- protein storage stops and breakdown begins (muscle)
Amino acid breakdown for energy leads to increased urea in urine organ dysfunction
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Pancreas Disorders
Diabetes-
Type 1- Juvenile onsetType 2- Mature onset Gestational diabetes
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Type 1 Diabetes
Insulin dependant
S/S:polyuria
polydipsia
polyphagia
blurred vision
weight loss
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Type 2 Diabetes
Generally non-insulin dependant
Has ability to make small amounts of
insulin
Can develop into insulin dependant
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Gestational Diabetes
Develops during pregnancy
Deficiencies in insulin leads to inability to metabolize carbohydrates
Generally disappears after delivery
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Insulin Agents
Early- porcine, bovine
Recent- genetic engineered human insulin
Protein
Rapid, intermediate and long-term
Combination of long-term, rapid each day
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Insulin Types
Regular- Fast acting
0.5-1 hour onset
6-8 hour duration
NPH- Intermediate
1-1.5 hour onset
24 hour duration
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Insulin Types
Ultralente- Long acting4-6 hour onset36 hour duration
Oral agents:Diabinese (chlorpropamide)Orinase (tolbutamide)Micronase (glyburide)Glucotrol
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Diabetic Emergencies
Hypoglycemia
Hyperglycemia
Diabetic Ketoacidosis (DKA)
Hyperosmolar Hyperglycemic Nonketotic Coma (HHNK)
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Hypoglycemia
Rapid on-set
< 60 mg/dl
Causes: too much insulin
decreased intake salicylates
excessive activity beta blockers
emotional stress hypothermia
chronic alcoholism sepsis
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S/S of Hypoglycemia
Altered LOCs- irritability, nervousness,
confusion, combative
Cool, clammy
Weak, rapid pulse
Snoring, salivation
Normal BP
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Diabetic Ketoacidosis
Fat metabolism leads to ketoacids
Acidosis leads to K+ in circulation &
hyperkaluria K+ deficiency
Osmotic diuresis dehydration,
electrolyte imbalances
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S/S of DKA
Warm, dry skin
Dry mucous membranes
Tachycardia, thready pulse
Postural hypotension
Weight loss
‘Polys’
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S/S of DKA
Abdominal pain
Anorexia, nausea/vomiting
Acetone breath
Kussmauls
Decreased LOC
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Hyperosmolar Hyperglycemic Nonketotic
ComaGenerally Type II diabetic
Osmotic diuresis secondary to sugars
Not acidotic as in DKA
Factors: Geriatric
Preexisting diseases
Increased insulin requirements
Medication use- thiazide, diuretics
Parenteral/enteral feedings
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S/S of HHNK
Weakness
Thirst
Polyuria
Weight Loss
Extreme dehydration
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Treatment of Diabetic Emergencies
Hypoglycemia- ABCs
IV- NS
Monitor ECG
Oral, IV Dextrose
Poss. Glucagon IM
Poss. Thiamine
Monitor glucose!
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Treatment of Diabetic Emergencies
Hyperglycemia (DKA, HHNK)-
ABCs
O2
IV- NS
Monitor ECG for abnormalities