endocrine system

Medical TerminologyMedical TerminologyA Word-Building Approach

Medical Terminology: A Word-Building Approach, Seventh EditionJane Rice

CHAPTER

Seventh Edition

Endocrine System

Learning OutcomesLearning Outcomes

• Describe the vital function of the endocrine system.

• State the description and primary functions of the organs/structures of the endocrine system.

• Identify the various hormones secreted by the endocrine glands and their hormonal function.

Learning OutcomesLearning Outcomes

• Analyze, build, spell, and pronounce medical words.

• Comprehend the drugs highlighted in this chapter.

• Describe diagnostic and laboratory tests related to the endocrine system.

• Identify and define selected abbreviations.

Multimedia DirectoryMultimedia Directory

Endocrine System Animation

Chemical Messengers Animation

Diabetes Video

Adolescent Diabetes Video

Hypoglycemia Animation

Hyperglycemia Animation

Insulin Video

Glucose Evaluation Video

Anatomy and Physiology Anatomy and Physiology OverviewOverview

• The endocrine system is made up of ductless glands and the hormones they secrete.

• Endocrine glands are the body’s main hormone producers; some other organs produce and release hormones:– Brain

– Heart

– Lungs

– Liver

• Endocrine glands are the body’s main hormone producers; some other organs produce and release hormones:– Skin

– Thymus

– Gastrointestinal mucosa

– Placenta during pregnancy

• Primary glands of the endocrine system:– Pituitary– Pineal– Thyroid– Parathyroid– Islets of Langerhans– Adrenals– Ovaries in the female– Testes in the male

Figure 13.1Primary glands of the endocrine system.

• Vital function of endocrine system: Production and regulation of chemical substances called hormones.

• Hormones– Chemical transmitters released in small

amounts and transported via bloodstream to a target organ or other cells.

– Transfer information and instructions from one set of cells to another.

– Regulate growth, development, mood, tissue function, homeostasis, metabolism, sexual function in male and female.

Insert table 13-1

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• Hyposecretion or hypersecretion of specific hormones that are caused by or are associated with pathological conditions.

• Controlling the production of or replacing specific hormones can treat many hormonal disorders and/or conditions.

• Hypothalamus – A collection of specialized cells located in the

lower central part of the brain.– Is the primary link between the endocrine and

nervous system.– Nerve cells control pituitary gland by

producing chemicals that either stimulate or suppress hormone secretions from the pituitary.

• Hypothalamus– Exerts direct nervous control over the anterior

pituitary and the adrenal medulla.– Controls the secretion of hormones

epinephrine and norepinephrine.

Table 13.2Summary of the Endocrine Glands, Hormones, and Hormonal Functions

Table 13.2 (continued)Summary of the Endocrine Glands, Hormones, and Hormonal Functions

Insert table 13-2

Life Span ConsiderationsLife Span Considerations

• Most of the structures and glands of the endocrine system develop during the first 3 months of pregnancy.

• Endocrine system of newborn is supplemented by hormones that cross placental barrier.

• Both male and female newborns may have swelling of the breasts and genitalia from maternal hormones.

Pituitary Gland (Hypophysis)Pituitary Gland (Hypophysis)

• A small gray gland located at the base of the brain.

• Lies or rests in a shallow depression of the sphenoid bone known as the sella turcica.

• Attached by infundibulum stalk to hypothalamus.

• Divided into anterior lobe and posterior lobe.

• Also called the master gland of the body because of its regulatory effects on the other endocrine glands.

• Anterior Lobe– Also called the adenohypophysis.– Secretes several hormones essential for

growth and development of bones, muscles, other organs, sex glands, the thyroid gland, and the adrenal cortex.

Figure 13.2Pituitary hormones and their target cells, tissues, and/or organs.

• Posterior Lobe– Also called the neurohypophysis.– Stores and secretes two important hormones,

ADH and oxytocin, that are synthesized in the hypothalamus.

Pineal GlandPineal Gland

• Small, pine cone-shaped gland located near the posterior end of corpus callosum.

• Secretes hormones melatonin and serotonin.– Melatonin can be released at night to help

regulate release of gonadotropin.– Serotonin is a neurotransmitter,

vasoconstrictor, and smooth muscle stimulant and acts to inhibit gastric secretion.

Thyroid GlandThyroid Gland

• Large, bilobed gland located in neck.• Plays a vital role in metabolism and

regulates body's metabolic processes.

Figure 13.3Thyroid gland.

• Hyposecretion of T3 and T4 results in:

– cretinism during infancy– myxedema during adulthood– Hashimoto’s disease

• Hypersecretion of T3 and T4 results in:

– hyperthyroidism, also called thyrotoxicosis– Graves’ disease– exophthalmic goiter– toxic goiter– Basedow’s disease

• Simple or endemic goiter is an enlargement of the thyroid gland caused by a deficiency of iodine in the diet.

Parathyroid GlandsParathyroid Glands

• Small, yellowish-brown bodies occurring as two pairs located on the dorsal surface and lower aspect of the thyroid gland.

• Secrete parathyroid (PTH), or parathormone hormone.

Figure 13.4Parathyroid glands.

Parathyroid GlandsParathyroid Glands

• Hyposecretion of PTH can result in hypoparathyroidism, which can result in tetany (intermittent cramp or tonic muscular contractions).

• Hypersecretion of PTH can result in hyperparathyroidism, which may result in osteoporosis, kidney stones, and hypercalcemia.

Figure 13.5Tetany of the hand in hypoparathyroidism.

Pancreas (Islets of Langerhans)Pancreas (Islets of Langerhans)

• The islets of Langerhans are small clusters of cells located within the pancreas.

• The islets of Langerhans are composed of three major types of cells:– Alpha cells secrete glucagon, elevating blood

sugar.– Beta cells secrete insulin, maintaining normal

blood sugar.– Delta cells secrete somatostatin, which

suppresses release of glucagon and insulin.

Figure 13.6Pancreas — an endocrine and exocrine gland.

Figure 13.7Islets of Langerhans.

• Hyposecretion or inadequate use of insulin may result in diabetes mellitus (DM).

• Hypersecretion of insulin may result in hyperinsulinism.

• Diabetes mellitus is the most common endocrine system disorder of childhood.

• Symptoms include:– Polyuria– Polydipsia– Polyphagia

• Management of DM during childhood is very difficult because diet, exercise, and medication have to be adjusted and regulated according to growth and development stages.

• With aging, the number of tissue receptors decreases, thus diminishing the body’s response to hormones.

• Older adults who develop Type 2 diabetes mellitus produce sufficient insulin, but because cell receptors are modified and/or reduced, glucose does not enter the cells.

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Adrenal Glands (Suprarenals)Adrenal Glands (Suprarenals)

• Two small, triangular-shaped glands on top of each kidney.

• Each gland consists of:– an outer portion or cortex– an inner portion or medulla

Figure 13.8Adrenal glands.

• Adrenal Cortex– The cortex is essential to life due to its

secretion of a group of hormones: Glucocorticoids Mineralocorticoids Androgens

• Glucocorticoids– Cortisol (hydrocortisone): Principal steroid

hormone secreted by the cortex.– Hyposecretion of cortisol can result in

Addison’s disease.– Hypersecretion can result in Cushing’s

disease.

• Glucocorticoids– Corticosterone: Steroid hormone secreted by

the adrenal cortex.– Essential for:

normal use of carbohydrates. absorption of glucose. formation of glycogen in the liver and tissues.

– Also influences potassium and sodium metabolism.

• Mineralocorticoids– Aldosterone is the principal mineralocorticoid

secreted by the adrenal cortex.– Aldosterone is essential in regulating

electrolyte and water balance by promoting sodium and chloride reabsorption and potassium excretion.

• Mineralocorticoids– Hyposecretion can result in a reduced plasma

volume.– Hypersecretion can result in a condition

known as primary aldosteronism.

• Androgens– Hormones that promote the development of

male characteristics.– The two main androgen hormones essential

for the development of the male secondary sex characteristics are: testosterone androsterone

• Adrenal Medulla– Synthesizes, secretes, and stores

catecholamines, specifically the following: Dopamine: Dilates systemic arteries, elevates

systolic blood pressure, increases cardiac output, and increases urinary output.

Epinephrine (adrenaline): Acts as a vasoconstrictor, vasopressor, cardiac stimulant, antispasmodic, and sympathomimetic.

Norepinephrine (noradrenaline): Acts as a vasoconstrictor, vasopressor, and neurotransmitter.

OvariesOvaries

• Ovaries produce estrogens (estradiol, estrone, estriol) and progesterone.

• Estrogen is the female sex hormone secreted by the graafian follicles of the ovaries.

• Progesterone is a steroid hormone secreted by the corpus luteum.

TestesTestes

• Produce the male sex hormone testosterone, which is important for:– Sexual development– Sexual behavior– Libido– Supporting spermatogenesis– Erectile function

PlacentaPlacenta

• During pregnancy, the placenta, containing separate vascular systems of the mother and fetus, serves as an endocrine gland.

• It produces chorionic gonadotropin hormone, estrogen, and progesterone.

Gastrointestinal MucosaGastrointestinal Mucosa

• The mucosa secrete the following hormones:– Gastrin: Stimulates gastric acid secretion.– Secretin: Stimulates pancreatic juice, bile, and

intestinal secretion.– Pancreozymin-cholecystokinin: Stimluates the

pancreas.– Enterogastrone: Regulates gastric secretions.

ThymusThymus

• A bilobed body located in the mediastinal cavity in front of and above the heart.

• Composed of lymphoid tissue and is a part of the lymphatic system.

• This ductless, glandlike body secretes:– Thymosin– Thymopoietin

Figure 13.9Thymus gland. (A) Appearance and position; (B) with anatomic structures.

• Acidosis

• Acromegaly

• Addison’s disease

• Adenectomy

• Adenoma

-megaly

Audio PronunciationsAudio Pronunciations

= extremity

= enlargement

• Adenosis

• Adrenal

• Adrenalectomy

• Adrenopathy

• Androgen

andr/o

= formation, produce

• Catecholamines

• Cortisone

• Cretinism

• Cushing’s disease

• Diabetes

• Dopamine

• Dwarfism

Figure 13.10(A) A 6-year-old child with congenital hypothyroidism, cretinism, exhibiting marked mental and physical retardation. (B) The same patient after 3

years of thyroxine therapy, which resulted in a spurt of growth and regression of pathological manifestations. Mental retardation is delayed.

Figure 13.11Cushing’s syndrome patient showing round, red face; stocky neck; and marked obesity of the trunk with protruding abdomen. Note bruises on

trunk and legs and stretch marks and fat pads above the collar bone and on the back of the neck, which produces the buffalo hump.

• With the increase in obesity in children, as many as 1 out of 20 children who have diabetes has Type 2 diabetes.

• May be possible to prevent onset of Type 2 diabetes in both children and adults by:– eating a healthy diet– exercising for 30 minutes at least 5 days a

week– maintaining proper body weight

• Warning signs and symptoms of Type 1 and Type 2 diabetes mellitus:– polyuria– polydipsia– polyphagia– unusual weight loss– fatigue– irritability– blurred vision

• Additional symptoms in Type 2 diabetes mellitus can include:– tingling or numbness in feet– frequent vaginal or skin infections

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• Endocrine

• Endocrinologist

• Endocrinology

• Epinephrine

• Estrogen

• Euthyroid

crin/o

= within

= to secrete

= study of

• Exocrine

• Exophthalmic

• Galactorrhea

• Gigantism

• Glandular

• Glucocorticoid

Figure 13.12Patient with exophthalmos.

• Hirsutism

• Hormone

• Hydrocortisone

• Hypergonadism

• Hyperinsulinism

• Hyperkalemia

Figure 13.13Hirsutism. (Courtesy Jason L. Smith, MD)

Audio Pronunciations Audio Pronunciations

• Hyperthyroidism

• Hypogonadism

• Hypoparathyroidism

• Hypophysis

• Hypothyroidism

• Congenital hypothyroidism (CHT):– affects infants from birth– results from partial or complete loss of thyroid

function– occurs when thyroid gland fails to develop or

function properly

• In 80% to 85% of cases, the thyroid gland is:– absent – abnormally located, or– severely reduced in size

• If CHT is untreated, it can lead to mental retardation and abnormal growth.

• In the United Stats and many other countries, all newborns are tested for CHT.

• If treatment begins in the first month after birth, infants usually develop normally.

Figure 13.14Endemic Goiter.

• Insulin

• Insulinogenic

• Iodine

• Lethargic

• Myxedema

• Norepinephrine

• Oxytocin

-edema

= mucus

= swelling

Figure 13.15(A) A 62-year-old patient with myxedema exhibiting marked edema of the face and a somnolent look. The hair is stiff

and without luster. (B) The same patient after 3 months of treatment with thyroxine.

• Pancreatic

• Parathyroid glands

• Pineal

• Pituitarism

• Pituitary

• Progeria

• Progesterone

• Simmonds’ disease

• Somatotropin

• Steroids

• Testosterone

• Thymectomy

• Thymitis

• Thyroid

• Thyroidectomy

• Thyroiditis

• Thyrotoxicosis

• Thyroxine

• Vasopressin

• Virilism

Figure 13.16Palpating the thyroid gland from behind the patient is a most effective way of assessing the gland for abnormality.

Drug HighlightsDrug Highlights

• Thyroid Hormones• Antithyroid Hormones• Insulin

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Drug HighlightsDrug Highlights

• Oral Hypoglycemic Agents• Hyperglycemic Agents

Diagnostic and Lab TestsDiagnostic and Lab Tests

• Catecholamines– Test performed on urine to determine the

amount of epinephrine and norepinephrine present.

• Corticotropin, Corticotropin-releasing factor (CRF)– Test performed on blood plasma to determine

the amount of corticotrophin present.

• Fasting Blood Sugar (FBS)– Test performed on blood to determine the

level of sugar in the bloodstream.– Also referred to as fasting blood glucose

(FBG).

• Glucose Tolerance Test (GTT)– Blood sugar test performed at specified

intervals after the patient has been given a significant amount of glucose.

• Hb A1C Test– Blood test used to:

diagnose diabetes identify people at risk of developing diabetes monitor how well blood sugar levels are being

controlled by the diabetic patient

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• 17-hydroxycorticosteroids (17-OHCS)– Test performed on urine to identify

adrenocorticosteroid hormones and to determine adrenal cortical function.

• 17-ketosteroids (17-KS)– Test performed on urine to determine the

amount of 17-KS present, the end product of androgens that is secreted from the adrenal glands and testes.

• Protein-bound iodine (PBI)– Test performed on serum to indicate the

amount of iodine that is attached to serum protein.

• Radioactive Iodine Uptake (RAIU)– Test to measure the ability of the thyroid

gland to concentrate ingested iodine.

• Radioimmunoassay (RIA)– Standard assay method used to measure

minute quantities of specific antibodies and/or antigens.

• Thyroid Scan– Test to detect tumors of the thyroid gland.

Patient is given radioactive iodine131, which localizes in the thyroid gland, which is then visualized with a scanner device.

• Thyroxine (T4)

– Test performed on blood serum to determine the amount of thyroxine present.

• Triiodothyronine uptake (T3U)

– Test performed on blood serum to determine the amount of triiodothyronine present.

• Ultrasonography– Use of high-frequency sound waves as a

screening test or as a diagnostic tool to visualize the structure being studied.

• Total calcium– Test performed on blood serum to determine

the amount of calcium present.

Abbreviations

Combining Form Match Up QuizCombining Form Match Up Quiz

1. aden/o a. milk

2. galact/o b. seed

3. gluc/o c. hairy

4. gonad/o d. gland

5. hirsut/o e. sweet

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