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Urinary System Endocrine System Male Reproductive System Female Reproductive System Urinary System Anatomical structures – Kidneys – Adrenal glands – Ureters – Bladder – Urethra – CVA • Costovertebral angle • Kidney – gross anatomy – Cortex – Medulla • Pyramids • Papilla – Hilum – Pelvis • Calyx • Ureter • Kidney – microanatomy – Nephron • Glomerulus • Bowman’s capsule • Proximal collecting tubule • Henle’s loop • Distal collecting tubule • Collecting duct Note: cortex has everything medulla has only: loop of Henle Collecting tubules Functions of the kidney 1. Removes nitrogenous wastes – – – – Urea Uric acid Creatinine Ammonia 2. Maintains homeostasis – Fluid balance – Electrolyte balance – Acid-base balance 3. Excretory organ – Via blood filtration & formation of urine 4. Regulation of blood pressure – Juxtaglomerular apparatus (JGA) • Urine formation 1. Filtration – 2. Reabsorption – – 3. Occurs in proximal convoluted tubule It takes things back into blood Secretion – – 4. Occurs in renal corpuscle Occurs in distal convoluted tubule Blood gives things up to the urine Concentration – Occurs in collecting tubules Terms reflective of urinary function • • • • • • • • • Polyuria Oligouria Anuria Hematuria Pyuria Nocturia Dysuria Urinary retention Urinary incontinence Pathology of the Urinary System • • • • • • Urethritis Cystitis Glomerulonephritis Pyelonephritis Renal calculus (stones) Urine outflow obstruction – Hydronephrosis – Hydroureter Endocrine System 2 kind of glands 1. Exocrine --- have ducts to lead secretions to where they going 2. Endocrine --- no ducts; secretions (hormones) into bloodstream “official” Endocrine Glands – – – – – – – – – – Pineal Hypothalamus Pituitary Thyroid Parathyroids Thymus Pancreas Adrenals Ovaries Testes • Concept: – Many organs produce hormones (chemical messengers) Endocrine glands in `mixed function' organs and in exclusive function glands. Pineal Gland • Located near roof of third ventricle just above the thalamus • as one ages this gland becomes fibrous & calcifies • called “third eye” • because its secretion of melatonin is dependent on amount of light one sees (less light; more melatonin) • Melatonin’s actions: » may inhibit anterior pituitary gonadotropins » regulates the body’s internal clock • Also secretes Serotonin • serotonin levels effect depression • serotonin is a neurotransmitter Hypothalmus • Two things it does relating to the endocrine system – it makes the posterior pituitary hormones » oxytocin (OT) » antidiuretic hormone (ADH) – it controls the anterior pituitary by means of hormones it makes » Releasing Hormones * exp = GnRH (gonadotropin releasing hormone) » Inhibiting Hormones • It also acts as a connector between the nervous & endocrine system – For example, emotions originate there & stimulate the endocrine system – emotions = hunger, sex, pain, pleasure, anger, fear Pituitary Gland • Also called hypophysis – 2 parts: Anterior Pituitary (adenohypophysis) Posterior Pituitary (neurohypophysis) • Anterior Pituitary Posterior Pituitary • TSH * ADH (vasopressin) • ACTH * OT • FSH • LH • GH • PRL KNOW THE NAMES & FUNCTIONS OF EACH HORMONE • Key Point: the Posterior Pituitary is an extension of the Hypothalmus – Its two hormones are made in the hypothalmus and secreted from the axon terminals in the posterior pituitary. Diseases of the pituitary • • • • TSH – hypersecretion = hyperthyroidism – hyposecretion = hypothyroisism ACTH – hyposecretion = Addisonian synd. – hypersecretion = Cushingoid synd FSH – hyposecretion • F = low estrogen, amenorrhea • M = poor sperm production – hypersecretion • F = menopause LH – hyposecretion • F = no ovulation • M = low testosterone • GH – hypersecretion • during growth = giantism • after growth = acromegaly – hyposecretion = dwarfism • PRL – hypersecretion = galactorrhea, infertility – hyposecretion = poor milk production • ADH – hyposecretion = diabetes insipidus Thyroid Gland • 3 hormones • Thyroxine (T4) = more abundant than T3, but less potent • Triiodothyronine (T3) = more potent than T4 • Calcitonin • Thyroid hormones (T4 & T3) – function is to increase the metabolic rate – hyperthyoidism • Grave’s disease = one type; inherited; get exopthalmos – hypothyroidism • cretinism = congenital type • myxedema = adult type • Hashimoto’s disease = autoimmune; chronic inflam. produces fibrosis • Calcitonin – lowers serum calcium by preventing the bones from giving it up – works in harmony with the parathyroid & parathormone Parathyroid Glands • • Normally 4 glands located on posterior surface of thyroid • may have up to 8 glands produces hormone: Parathormone (PTH) – it increases calcium in blood by breaking down bone to release calcium – it works in conjunction & opposite calcitonin – hypersecretion = hypercalcemia (get hyperparathyroidism) • symptoms = muscle weakness + SOUP • Secondary Hyperparathyroidism more common – Etiology = decrease serum calcium secondary to: » Renal disease » Cancer » Endocrine diseases (Grave’s & Addison’s) – hyposecretion = hypocalcemia ( get hypoparathyroidism) » symptoms = tetany + hyperexcitible nervous system » Commonest etiology = metastatic cancer to bone (gives increase in serum calcium) Thymus • Located behind the manubrium • prominent in the newborn; by age 21 it atrophies • produces hormone: Thymosin • it matures T- lymphocytes – after they have been acted upon by the thymus, they are sent for storage & future activation » this occurs in the lymph nodes & spleen Pancreas • Pancreas is both endocrine & exocrine gland – exocrine = digestive enzymes secreted via duct into duodenum – endocrine located in Islets of Langerhans • has 2 types of cells each producing its own hormone – alpha cells produce glucagon » it raises blood sugar by increasing liver glycogenolysis – beta cells produce insulin » it lowers blood sugar by escorting glucose into the cells – lack or improper response to insulin gives diabetes mellitus • Insulin Dependent Diabetes Mellitus(IDDM) = Type I – autoimmune; get decreased production of insulin • Non Insulin Dependent Diabetes Mellitus(NIDDM) = Type II – get cellular insensitivity to insulin Diabetes Mellitus • As cells deprived of sugar, they begin to metabolize fats & proteins • This process allows wastes(ketone bodies) to accumulate • Etiology = autoimmune process triggered by an infection early in life • Main systems affected: » Vascular » Renal » Eye • Symptoms = polyuria, polyphagia, & polydipsia • Fruity odor to breath • Complications – Diabetic coma ---- lethargy, dry (dehydrated) – Insulin shock ---- anxiety, sweating Adrenal, Cortex & Medulla Adrenal Cortex • Has 3 distinct layers or zones – from outside towards middle: • secretes mineralcorticoids (Aldosterone) • secretes glucocorticoids (Cortisol) • secretes gonadocorticoids (sex steroids) • Mineralcorticoids retain water + sodium & excrete potassium – purpose = to maintain blood volume & electrolyte balance • Glucocorticoids make glucose especially in times of prolonged stress – this glucose made by increased metabolic breakdown of protein & fat » Thus cortisol is catabolic, not anabolic – also is anti-inflammatory – also maintains blood pressure Adrenal Medulla • Produces 2 hormones » Epinephrine (Adrenalin) » Nor-epinephrine (Nor-Adrenalin) • These very important during stressful situations • They are under the control of the sympathetic nervous system – also known as the adrenergic nervous system – deals with Fear, Flight, or Fight » It produces excess epinephrine Diseases of the Adrenal Cortex – even though there are 3 different classes of hormones, most diseases affect primarily the glucocorticoids – Hypersecretion • Cushing’s Disease (MOODIAH) – Moon face; Obesity & edema from salt & water retention; Osteoporosis; Diabetes; Infections; Atherosclerosis; Hypertension – Hyposecretion • Addison’s Disease – get hypotension, fatigue, weakness, & weight loss – get dehydration & hyperkalemia* (from lack of aldosterone) – get bronze skin color & pigmentation * This can become life threatening The Gonads Testes • Secretes testosterone • Produces sperm Ovaries • Secretes estrogen • Secretes progesterone • Produces mature ova Male Reproductive System • Scrotum • Testes – Seminiferous tubules • • • • Epididymis Vas deferens Ejaculatory duct Penis • Urethra • Glans penis • Prepuce • • • • Seminal vesicles Prostate Bulbourethral glands Semen • Testis – Seminiferous tubules – Hormones produced • Pathology – BPH • Benign prostatic hypertrophy – Testicular cancer Female Reproductive System • • • • • • • • • Vulva Vagina Vestibule Labia majora Labia minora Clitoris Bartholin’s glands Perineum Breasts – Lactiferous ducts – Areola & nipple • Ovaries • Fallopian tubes • Uterus – Fundus, corpus, cervix • Menstrual cycle – – – – Menses Proliferative phase Ovulation Secretory phase • Breast – Ducts – Areola – Nipple • Pathology – Cancer • • • • Breast Uterus Cervix Ovarian – Endometriosis – PID – PMS STD’s • • • • • • • • • causative agent comments Chlamydia bacteria most common, “silent” STD Gonorrhea bacteria Penicillin resistant At birth, Crede procedure is done to the baby’s eyes Syphilis bacteria 3 stages, penicillin treats it Hepatitis B virus babies vaccinated at birth Hepatitis C virus Herpes virus HPV (papilloma) virus warts, causes cervical ca HIV virus use condoms, test frequency Vaginitis – Monilia – BV – Trichomonas fungus bacteria protozoa All these vaginal infections may or may not be STD’s!! Essentials of Human Anatomy Endocrine System 37 Endocrine System • Major control system – Works with the nervous system – Function: • to maintain homeostasis • Both use – specific communication methods – affect specific target organs • Their methods and effects differ. Endocrine Glands & Hormones • Exocrine glands: ducted – secretions released into ducts – open onto an epithelial surface • Endocrine glands: ductless – secrete product directly into the bloodstream • All endocrine cells are located within highly vascularized areas – ensure that their products enter the bloodstream immediately. Major Endocrine Glands Hypothalamic Control of the Endocrine System • Master control center of the endocrine system • Hypothalamus oversees most endocrine activity: – special cells in the hypothalamus secrete hormones that influence the secretory activity of the anterior pituitary gland • called regulatory hormones – releasing hormones (RH) – inhibiting hormones (IH) • Hypothalamus has indirect control over these endocrine organs. Hypothalamic Control of the Endocrine System • Hypothalamus produces two hormones that are transported to and stored in the posterior pituitary. – oxytocin – antidiuretic hormone (ADH) • Hypothalamus directly oversees the stimulation and hormone secretion of the adrenal medulla. – An endocrine structure that secretes its hormones in response to stimulation by the sympathetic nervous system. • Some endocrine cells are not under direct control of hypothalamus. Hypothalamic Hormones Pituitary Gland Size of a grape Hangs by a stalk from the hypothalamus Protected by the sphenoid bone Has two functional lobes Anterior pituitary – glandular tissue Posterior pituitary – nervous tissue السرج التركيSella Turcica Hormones of the Anterior Pituitary Six anterior pituitary hormones Two affect non-endocrine targets Four stimulate other endocrine glands (tropic hormones) Hormones of the Anterior Pituitary Control of Anterior Pituitary Gland Secretions • Anterior pituitary gland is controlled by regulatory hormones secreted by the hypothalamus. • Hormones reach the anterior pituitary via hypothalamo- hypophyseal portal system. – takes venous blood carrying regulatory hormones from the hypothalamus directly to the anterior pituitary Thyroid Gland • Located immediately inferior to the thyroid cartilage of the larynx and anterior to the trachea. • Distinctive “butterfly” shape due to its left and right lobes, which are connected at the anterior midline by a narrow isthmus. • Both lobes of the thyroid gland are highly vascularized, giving it an intense reddish coloration. • Regulation of thyroid hormone secretion depends upon a complex thyroid gland–pituitary gland negative feedback process. Thyroid Gland • Follicle cells: – Produce and secrete thyroid hormone – Precursor is stored in colloid • Thyroid hormone – Increases metabolic rate – Important in growth and development. • Parafollicular cells – Produce and secrete calcitonin • Calcitonin – Secreted in response to elevated calcium levels – Reduces blood calcium levels – Acts on osteoblasts. Disorders of the Thyroid Gland Graves Disease • Hyperthyroidism Cretinism • Infantile hypothyroidism Goiter • Small, brownish-red glands Parathyroid Glands – located on the posterior surface of the thyroid gland • Usually four small nodules – may have as few as two or as many as six. • Two different types of cells in the parathyroid gland: – chief cells – oxyphil cells • Chief cells are the source of parathyroid hormone (PTH). – stimulates osteoclasts to resorb bone and release calcium ions from bone matrix into the bloodstream – stimulates calcitriol hormone synthesis in the kidney – promotes calcium absorption in the small intestine – prevents the loss of calcium ions during the formation of urine • The function of oxyphil cells is not known. Adrenal Glands (suprarenal) • Paired, pyramid-shaped endocrine glands anchored on the superior surface of each kidney. • Retroperitoneal and embedded in fat and fascia to minimize their movement. • Outer adrenal cortex and an inner central core called the adrenal medulla. – secrete different types of hormones Adrenal Cortex • Distinctive yellow color due to stored lipids in its cell. • Synthesize more than 25 different steroid hormones, collectively called corticosteroids. – corticosteroid synthesis is stimulated by the ACTH produced by the anterior pituitary – corticosteroids are vital to our survival; trauma to or removal of the adrenal glands requires corticosteroid supplementation throughout life Adrenal Cortex • Partitioned into: • the zona glomerulosa • the zona fasciculata • the zona reticularis. • Different functional categories of steroid hormones are synthesized and secreted in the separate zones. • Regulates salt, sugar, and sex! Adrenal Medulla • Forms the inner core of each adrenal gland. • Pronounced red-brown color due to its extensive vascularization. • Primarily consists of clusters of large, spherical cells called chromaffin cells. • When innervated by the sympathetic division of the ANS, one population of cells secretes the hormone epinephrine (adrenaline). • The other population secretes the hormone norepinephrine (noradrenaline). • Hormones work with the sympathetic nervous system to prepare the body for an emergency or fight-or-flight situation. Pancreas • Elongated, spongy, nodular organ – between the duodenum and the spleen – posterior to the stomach. • Both exocrine and endocrine – considered a heterocrine (mixed) gland. • Mostly composed of cells called pancreatic acini. – produce an alkaline pancreatic juice that aids digestion • Scattered among the pancreatic acini are small clusters of endocrine cells called pancreatic islets (islets of Langerhans) composed of four types of cells: – two major types (called alpha cells and beta cells) – two minor types (called delta cells and F cells) – each type produces its own hormone Pancreas • • • Alpha cells secrete glucagon when blood glucose levels drop. Beta cells secrete insulin when blood glucose levels are elevated. Delta cells are stimulated by high levels of nutrients in the bloodstream. – synthesize somatostatin, also described as growth hormone-inhibiting hormone, or GHIH, which slows the release of insulin and glucagon and slows the rate of nutrient entry into the bloodstream • • F cells are stimulated by protein digestion. – secrete pancreatic polypeptide to suppress and regulate somatostatin secretion from delta cells Pancreatic hormones provide for orderly uptake and processing of nutrients. Pineal Gland • Pineal gland or pineal body, is a small, cone-shaped structure attached to the posterior region of the epithalamus. • Secretes melatonin. – helps regulate a circadian rhythm (24-hour body clock) – also appears to affect the synthesis of the hypothalamic regulatory hormone responsible for FSH and LH synthesis – role in sexual maturation is not well understood Thymus • A bilobed structure located within the mediastinum superior to the heart and immediately posterior to the sternum. • Size of the thymus varies between individuals. – it is always relatively large in infants and children – as with the pineal gland, the thymus diminishes in size and activity with age, especially after puberty • Functions principally in association with the lymphatic system to regulate and maintain body immunity. • Produces complementary hormones thymopoietin and thymosins. – hormones act by stimulating and promoting the differentiation, growth, and maturation of a category of lymphocytes called Tlymphocytes (thymus-derived lymphocytes) Other Endocrine Glands Reproductive • ovaries produce estrogens and progesterone • testes produce testosterone • placenta produces estrogens, progesterone, and gonadotropins THE END