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Chapter Fifteen Endocrine System Mosby items and derived items © 2010, 2006, 2003, by Mosby, Inc., an affiliate of Elsevier Inc. 1 Quote “If I’d known I was gonna live this long, I’d have taken better care of myself.” – Eubie Blake at age 100 Mosby items and derived items © 2010, 2006, 2003, by Mosby, Inc., an affiliate of Elsevier Inc. 2 Function and Specialty/Specialist Function Hormones/chemical messengers Specialty Endocrinology Specialist Endocrinologist Mosby items and derived items © 2010, 2006, 2003, by Mosby, Inc., an affiliate of Elsevier Inc. 3 Anatomy and Physiology Endocrine (crin/o) glands Target cells and receptor sites Endocrine glands Mosby items and derived items © 2010, 2006, 2003, by Mosby, Inc., an affiliate of Elsevier Inc. 4 Pituitary Gland/Hypophysis Location “Master gland” Anterior lobe/ adenohypophysis (aden/o, hypophys/o) Posterior lobe/ neurohypophysis (neur/o, hypophys/o) Pituitary hormones Mosby items and derived items © 2010, 2006, 2003, by Mosby, Inc., an affiliate of Elsevier Inc. 5 Thyroid Gland (thyroid/o) Location Regulation of metabolism Tetraiodothyronine (thyroxine) Triiodothyronine Control of calcium deposited in bones Calcitonin Thyroid gland From Thibodeau and Patton: Anatomy and physiology, ed 6, Mosby Mosby items and derived items © 2010, 2006, 2003, by Mosby, Inc., an affiliate of Elsevier Inc. 6 Parathyroid Glands (parathyroid/o) Location Regulate calcium (calc/o) in the bloodstream Parathyroid glands From Thibodeau and Patton: Anatomy and physiology, ed 6, Mosby Mosby items and derived items © 2010, 2006, 2003, by Mosby, Inc., an affiliate of Elsevier Inc. 7 Clicker Question Hypophys/o is a combining form for the: A. adrenal cortex B. adrenal medulla C. pineal gland D. pituitary gland Mosby items and derived items © 2010, 2006, 2003, by Mosby, Inc., an affiliate of Elsevier Inc. 8 Adrenal Glands/Suprarenals (adren/o) Location Adrenal cortex Secretes steroids Adrenal medulla Sympathomimetic hormones Mosby items and derived items © 2010, 2006, 2003, by Mosby, Inc., an affiliate of Elsevier Inc. 9 Pancreas (pancreat/o) Location Exocrine function Release digestive enzymes Endocrine function Regulate glucose in the blood Mosby items and derived items © 2010, 2006, 2003, by Mosby, Inc., an affiliate of Elsevier Inc. 10 Thymus Gland (thym/o) • • Location Stimulation of cells for immune response Thymus gland From Drake: Gray’s anatomy for students, Churchill-Livingstone Mosby items and derived items © 2010, 2006, 2003, by Mosby, Inc., an affiliate of Elsevier Inc. 11 Ovaries and Testes Locations Reproductive functions Mosby items and derived items © 2010, 2006, 2003, by Mosby, Inc., an affiliate of Elsevier Inc. 12 Pineal Gland Location Secretion of melatonin Mosby items and derived items © 2010, 2006, 2003, by Mosby, Inc., an affiliate of Elsevier Inc. 13 Clicker Question The gland that regulates metabolism and normal growth and development of the body is the: A. adrenal cortex B. pituitary C. thymus D. thyroid Mosby items and derived items © 2010, 2006, 2003, by Mosby, Inc., an affiliate of Elsevier Inc. 14 Terms Related to Signs and Symptoms of Endocrine Disorders Anorexia Exophthalmia Goiter Goiter Anorexia Exophalmia From Thibodeau: Anatomy and physiology, ed 6, Mosby Mosby items and derived items © 2010, 2006, 2003, by Mosby, Inc., an affiliate of Elsevier Inc. 15 Terms Related to Signs and Symptoms of Endocrine Disorders (cont’d) Hirsutism Paresthesia Tetany Hirsutism Mosby’s medical dictionary, ed 7, Mosby Tetany Mosby items and derived items © 2010, 2006, 2003, by Mosby, Inc., an affiliate of Elsevier Inc. 16 Terms Related to Signs and Symptoms of Endocrine Disorders (cont’d) Glucosuria Ketoacidosis Ketonuria Polydipsia Polyphagia Polyuria Mosby items and derived items © 2010, 2006, 2003, by Mosby, Inc., an affiliate of Elsevier Inc. 17 Terms Related to Signs and Symptoms of Endocrine Disorders (cont’d) Hypocalcemia – Hypercalcemia Hypoglycemia – Hyperglycemia Hypokalemia – Hyperkalemia Hyponatremia – Hypernatremia Mosby items and derived items © 2010, 2006, 2003, by Mosby, Inc., an affiliate of Elsevier Inc. 18 Clicker Question A condition of excessive potassium in the blood is: A. hypercalcemia B. hyperkalemia C. hypocalcemia D. hypokalemia Mosby items and derived items © 2010, 2006, 2003, by Mosby, Inc., an affiliate of Elsevier Inc. 19 Terms Related to Pituitary Gland Disorders Acromegaly Gigantism Growth hormone deficiency (GHD) GHD Acromegaly From Zitelli: Atlas of pediatric physical diagnosis, ed 5, Mosby From Ignatiavicious: Medical-surgical nursing, ed 5, Saunders Mosby items and derived items © 2010, 2006, 2003, by Mosby, Inc., an affiliate of Elsevier Inc. 20 Terms Related to Pituitary Gland Disorders (cont’d) Diabetes insipidus Syndrome of inappropriate antidiuretic hormone (SIADH) Panhypopituitarism Mosby items and derived items © 2010, 2006, 2003, by Mosby, Inc., an affiliate of Elsevier Inc. 21 Clicker Question Which of the following terms is an enlargement of the extremities due to hypersecretion of somatotropin? A. gigantism B. SIADH C. acromegaly D. GHD Mosby items and derived items © 2010, 2006, 2003, by Mosby, Inc., an affiliate of Elsevier Inc. 22 Terms Related to Thyroid Disorders Hyperthyroidism Thyrotoxicosis Graves disease Hypothyroidism Cretinism (childhood) Myxedema (adults) Mosby items and derived items © 2010, 2006, 2003, by Mosby, Inc., an affiliate of Elsevier Inc. 23 Terms Related to Parathyroid Disorders Hyperparathyroidism Hypoparathyroidism Mosby items and derived items © 2010, 2006, 2003, by Mosby, Inc., an affiliate of Elsevier Inc. 24 Terms Related to Adrenal Gland Disorders Addison disease Cushing disease Cushing disease Before treatment After treatment From Damjanov: Anderson’s pathology, ed 10, Msoby Mosby items and derived items © 2010, 2006, 2003, by Mosby, Inc., an affiliate of Elsevier Inc. 25 Terms Related to Pancreas Disorders Diabetes mellitus Gestational diabetes Hyperinsulinism Prediabetes Type I diabetes Type 2 diabetes Mosby items and derived items © 2010, 2006, 2003, by Mosby, Inc., an affiliate of Elsevier Inc. 26 Terms Related to Benign Neoplasms Pheochromocytoma Prolactinoma (pituitary tumor) Thymoma Prolactinoma Thymoma Mosby items and derived items © 2010, 2006, 2003, by Mosby, Inc., an affiliate of Elsevier Inc. 27 Terms Related to Malignant Neoplasms Islet cell carcinoma (pancreatic Cancer) Malignant thymoma (rare cancer of thymus gland) Thyroid carcinoma (5yr survival rate) Whipple Procedure Mosby items and derived items © 2010, 2006, 2003, by Mosby, Inc., an affiliate of Elsevier Inc. 28 Clicker Question A prolactinoma is a tumor of which gland? A. pituitary B. pancreas C. thyroid D. thymus Mosby items and derived items © 2010, 2006, 2003, by Mosby, Inc., an affiliate of Elsevier Inc. 29 Age Matters Pediatrics Growth hormone deficiency Gigantism Type 1 diabetes Geriatrics Type 2 diabetes Mosby items and derived items © 2010, 2006, 2003, by Mosby, Inc., an affiliate of Elsevier Inc. 30 Terms Related to Laboratory Tests A1c Fasting plasma glucose (FPG) Glucometer Oral glucose tolerance test (OGTT) Urine glucose Urine ketones Mosby items and derived items © 2010, 2006, 2003, by Mosby, Inc., an affiliate of Elsevier Inc. 31 Terms Related to Laboratory Tests (cont’d) Hormone tests Radioimmunoassay studies (RIA) Thyroid function tests (TFTs) Total calcium Urinalysis Mosby items and derived items © 2010, 2006, 2003, by Mosby, Inc., an affiliate of Elsevier Inc. 32 Terms Related to Imaging Computed tomography (CT) scan Magnetic resonance imaging (MRI) Radioactive iodine (RAI) uptake scan Radiography Sonography Sonography of abdomen From Hagen: Diagnostic ultrasonography, ed 5, Mosby Mosby items and derived items © 2010, 2006, 2003, by Mosby, Inc., an affiliate of Elsevier Inc. 33 Terms Related to Excisions Adrenalectomy Hypophysectomy Pancreatectomy Parathyroidectomy Thyroidectomy Hypophysectomy Mosby items and derived items © 2010, 2006, 2003, by Mosby, Inc., an affiliate of Elsevier Inc. 34 Clicker Question An A1c test is used to monitor treatment of which disorder? A. Addison disease B. Cushing disease C. diabetes mellitus D. diabetes insipidus Mosby items and derived items © 2010, 2006, 2003, by Mosby, Inc., an affiliate of Elsevier Inc. 35 Pharmacology Antidiabetics Antithyroid agents Corticosteroids Growth hormones Posterior pituitary hormones Thyroid hormones Mosby items and derived items © 2010, 2006, 2003, by Mosby, Inc., an affiliate of Elsevier Inc. 36 Pharmacology (cont’d) Antidiabetics Insulin pump Insulin injection sites Mosby items and derived items © 2010, 2006, 2003, by Mosby, Inc., an affiliate of Elsevier Inc. 37 Insulin Pumps and Glucose Monitoring Mosby items and derived items © 2010, 2006, 2003, by Mosby, Inc., an affiliate of Elsevier Inc. 38 Insulin Pump v. Insulin Injections: Ø The first and most obvious advantage with using an insulin pump is there is no need for painful individual injections. The pump is conveniently worn around your waist and a small cannula, attached to an infusion set, is inserted under the skin allowing for easier diabetes management. Instead of multiple injections per day, the cannula is changed every 3 days. Insulin pumps are more accurate than traditional injections and give you the freedom to live the way you want by having a continual delivery of insulin. Whether you are facing a tough week at work or running a marathon, the insulin pump allows you more freedom without having to calculate insulin to make up for a high carbohydrate meal or excessive exercise, and the pump also prevents severely low blood sugar. The pump can also be adjusted so you have even better control over your health and can monitor the correct dosages based on your blood sugar allowing better control and fewer swings in blood glucose levels. This greatly reduces the risk of dangerously low blood sugar. Mosby items and derived items © 2010, 2006, 2003, by Mosby, Inc., an affiliate of Elsevier Inc. 39 Did You Know? Some pharmacologic therapy can cure one disease while causing another. For example, long-term cortisone use, such as that for patients with Crohn disease or ulcerative colitis, can result in Addison disease. Mosby items and derived items © 2010, 2006, 2003, by Mosby, Inc., an affiliate of Elsevier Inc. 40 Clicker Question Vasopressin and desmopressin are used to treat: A. diabetes insipidus B. diabetes mellitus C. Addison disease D. hyperthyroidism Mosby items and derived items © 2010, 2006, 2003, by Mosby, Inc., an affiliate of Elsevier Inc. 41 Sort these terms into their correct categories Terms 1. neurohypophysis 2. hirsutism 3. hyponatremia 4. A1c 5. hypophysectomy Categories __ A+P __ Pathology __ Diagnostic Procedures __ Therapeutic Interventions Mosby items and derived items © 2010, 2006, 2003, by Mosby, Inc., an affiliate of Elsevier Inc. 42 Parting Thought “Wheresoever you go, go with all your heart.” –Confucius Mosby items and derived items © 2010, 2006, 2003, by Mosby, Inc., an affiliate of Elsevier Inc. 43