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14. Endocrinology. Endocrinology. The medical specialty that studies the anatomy and physiology of the endocrine system and uses diagnostic tests, medical and surgical procedures, and drugs to treat endocrine system diseases. Figure 14-1 Endocrine system. Anatomy and Physiology.

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14

Endocrinology


Endocrinology

The medical specialty that studies the anatomy and physiology of the endocrine system and uses diagnostic tests, medical and surgical procedures, and drugs to treat endocrine system diseases.


Figure 14-1 Endocrine system


Anatomy and Physiology

The endocrine system includes:

Hypothalamus

Pituitary gland

Pineal gland

Thyroid gland

Parathyroid glands


Anatomy and Physiology

The endocrine system includes:

Thymus

Pancreas

Adrenal glands

Ovaries

Testes


Anatomy and Physiology (cont’d)

All endocrine glands are alike in these ways:

They secrete substances known as hormones.

They secrete their hormones directly into the blood and not through ducts.

Their hormones regulate specific body functions.


Anatomy and Physiology (cont’d)

One of the functions of the endocrine system is to keep the body in homeostasis by regulating body fluids, electrolytes, glucose, cellular metabolism, growth, and the wake-sleep cycle.


Anatomy and Physiology (cont’d)

Some endocrine glands do “double duty” as part of another body system, such as the nervous system (hypothalamus and posterior pituitary gland), immune system (thymus), the digestive system (pancreas), or the genital and reproductive system (ovaries, testes).


Anatomy of the Endocrine System

Hypothalamus

Located in the brain just below the thalamus

Functions as part of both the nervous system and the endocrine system

Secretes substances that stimulate or inhibit the secretion of hormones from the anterior pituitary gland

Produces hormones ADH and oxytocin


Figure 14-2 Endocrine glands in the brain


Anatomy of the Endocrine System (cont’d)

Pituitary Gland

Located in the brain at the end of the stalk from the hypothalamus

Known as the master gland of the body

Contains two different glands that function independently of each other: the anterior pituitary gland and the posterior pituitary gland


Anatomy of the Endocrine System (cont’d)

The anterior pituitary gland secretes seven hormones:

Thyroid-stimulating hormone (TSH)

Follicle-stimulating hormone (FSH)

Luteinizing hormone (LH)

Prolactin

Adrenocorticotropic hormone (ACTH)

Growth hormone (GH)

Melanocyte-stimulating hormone (MSH)


Figure 14-3 Hormones of the anterior and posterior pituitary gland


Anatomy of the Endocrine System (cont’d)

The posterior pituitary gland secretes two hormones that are produced in the hypothalamus.

Antidiuretic hormone (ADH)

Oxytocin


Anatomy of the Endocrine System (cont’d)

Pineal Gland

Located between the two lobes of the thalamus

Secretes the hormone melatonin

Maintains the body’s internal clock and regulates the onset and duration of sleep


Anatomy of the Endocrine System (cont’d)

Thyroid Gland

An irregularly shaped gland that has two lobes connected by a thin bridge of tissue (the isthmus)

Located in the neck on either side of the trachea and across its anterior surface


Anatomy of the Endocrine System (cont’d)

The thyroid gland secretes three hormones:

T3 or triiodothyronine

T4 or thyroxine

Calcitonin

When the thyroid gland is functioning properly, this steady state is known as euthyroidism.


Figure 14-4 Thyroid gland and parathyroid glands


Anatomy of the Endocrine System (cont’d)

Parathyroid Glands

Four tiny glands

Located on the posterior surface of the thyroid gland, two on each lobe

Secrete parathyroid hormone, which regulates the amount of calcium in the blood


Anatomy of the Endocrine System (cont’d)

Thymus Gland

A pink gland with two lobes located in the thoracic cavity posterior to the sternum

Large during childhood and puberty but shrinks during adulthood

Functions as part of both the body’s immune response and the endocrine system

Secretes thymosin


Anatomy of the Endocrine System (cont’d)

Pancreas

A yellow, elongated, triangular gland located posterior to the stomach

Functions as part of both the digestive system and the endocrine system

Secretes the hormones glucagon, insulin, and somatostatin from a group of cells known as the islets of Langerhans


Figure 14-5 Pancreas


Anatomy of the Endocrine System (cont’d)

Adrenal Glands

Contains two different glands draped over the superior end of each kidney.

Each gland has an outer layer (cortex) and an inner layer (medulla).

Each layer functions independently of the other and secretes its own hormones.


Figure 14-6 Adrenal gland


Anatomy of the Endocrine System (cont’d)

Adrenal Cortex

Secretes three groups of hormones:

Mineralocorticoids―Aldosterone

Glucocorticoids―Cortisol

Androgens―Male sex hormones (in the blood, some of the androgens are changed to estrogens, female sex hormones)


Anatomy of the Endocrine System (cont’d)

Adrenal Medulla

Secretes the hormones epinephrine and norepinephrine into the blood when the gland is stimulated by a nerve impulse


Anatomy of the Endocrine System (cont’d)

Ovaries

Small, egg-shaped glands located in the pelvic cavity

Function as part of both the female reproductive system and the endocrine system


Anatomy of the Endocrine System (cont’d)

Ovaries

Follicles of the ovary secrete estradiol, the most abundant and most biologically active female hormone

The corpus luteum (ruptured ovarian follicle) secretes estradiol and progesterone.

Cells around the follicle secrete testosterone


Anatomy of the Endocrine System (cont’d)

Testes

Egg-shaped glands located outside the body in the scrotum

Function as part of both the male genitourinary system and the endocrine system

Seminiferous tubules produce spermatozoa

Secrete testosterone, the most abundant and biologically active of all the androgens


Anatomy of the Endocrine System (cont’d)

Physiology of Hormone Response and Feedback

The endocrine system uses hormones as chemical messengers.

Some neurotransmitters (epinephrine and norepinephrine) are also hormones because they are secreted by a gland and travel in the blood.

Hormones target specific glands or organs with receptors to which they can bind.


Anatomy of the Endocrine System (cont’d)

Synergism − When two hormones work in conjunction with one another to accomplish an enhanced effect.

Antagonism − When two hormones exert an opposite effect.

The endocrine system maintains body homeostasis through the use of hormones and a negative feedback mechanism.


Figure 14-7 Effects of hormones


Diseases and Conditions

Anterior Pituitary Gland: All Hormones

Hyperpituitarism

Hypopituitarism

Dwarfism


Diseases and Conditions (cont’d)

Anterior Pituitary Gland: Prolactin

Galactorrhea

Failure of lactation


Diseases and Conditions (cont’d)

Anterior Pituitary Gland: Growth Hormone

Gigantism

Acromegaly

Dwarfism


Figure 14-8 Gigantism

CORBIS-NY


Figure 14-9 Acromegaly

NMSB/Custom Medical Stock Photo, Inc.


Diseases and Conditions (cont’d)

Posterior Pituitary Gland: Antidiuretic Hormone (ADH)

Syndrome of inappropriate ADH (SIADH)

Diabetes insipidus (DI)


Diseases and Conditions (cont’d)

Posterior Pituitary Gland: Oxytocin

Uterine inertia

Postpartum hemorrhage


Diseases and Conditions (cont’d)

Pineal Gland: Melatonin

Seasonal affective disorder (SAD)


Diseases and Conditions (cont’d)

Thyroid Gland: T3 and T4 Thyroid Hormones

Hyperthyroidism

Thyrotoxicosis

Graves’ disease


Figure 14-10 Exophthalmos

Custom Medical Stock Photo, Inc.


Figure 14-11 Goiter

Marka/Custom Medical Stock Photo, Inc.


Figure 14-12 Physical examination of the thyroid gland

Pearson Education/PH College


Diseases and Conditions (cont’d)

Thyroid Gland: T3 and T4 Thyroid Hormones (cont’d)

Goiter or thyromegaly


Diseases and Conditions (cont’d)

Thyroid Gland: T3 and T4 Thyroid Hormones (cont’d)

Hyperthyroidism

Hypothyroidism


Diseases and Conditions (cont’d)

Thyroid Gland: T3 and T4 Thyroid Hormones (cont’d)

Hypothyroidism

Thyroid carcinoma

Thyroiditis


Diseases and Conditions (cont’d)

Parathyroid Glands: Parathyroid Hormone

Hyperparathyroidism

Hypoparathyroidism


Diseases and Conditions (cont’d)

Pancreas: Insulin

Hyperinsulinism

Insulin resistance syndrome


Diseases and Conditions (cont’d)

Pancreas: Insulin (cont’d)

Diabetes Mellitus (DM)

Ketoacidosis


Table 14-1 Diabetes Mellitus


Diseases and Conditions (cont’d)

Adrenal Cortex: Aldosterone

Hyperaldosteronism

Hypoaldosteronism


Diseases and Conditions (cont’d)

Adrenal Cortex: Cortisol

Cushing’s syndrome

Addison’s disease


Figure 14-13 Cushing’s syndrome

(a) Biophoto Associates / Science Source / Photo Researchers, Inc.


Diseases and Conditions (cont’d)

Adrenal Cortex: Androgens

Adrenogenital syndrome


Diseases and Conditions (cont’d)

Adrenal Medulla: Epinephrine and Norepinephrine

Pheochromocytoma


Diseases and Conditions (cont’d)

Ovaries: Estradiol and Progesterone

Precocious puberty

Infertility

Menopause


Diseases and Conditions (cont’d)

Testes: Testosterone

Precocious puberty

Gynecomastia

Infertility


Laboratory and Diagnostic Procedures

Blood Tests

Antithyroglobulin antibodies

Calcium

Cortisol level


Laboratory and Diagnostic Procedures (cont’d)

Blood Tests (cont’d)

Fasting blood sugar (FBS)

FSH assay and LH assay

Glucose self-testing


Figure 14-14 Blood glucose monitor

Pearson Education/PH College


Laboratory and Diagnostic Procedures (cont’d)

Blood Tests (cont’d)

Glucose tolerance test (GTT)

Growth hormone


Blood Tests (cont’d)

Hemoglobin A1c (HbA1c)

Testosterone

Thyroid function tests (TFTs)

Laboratory and Diagnostic Procedures (cont’d)


Urine Tests

ADH stimulation test

Estradiol

Urine dipstick

Vanillylmandelic acid (VMA)

Laboratory and Diagnostic Procedures (cont’d)


Radiology Tests

Radioactive iodine uptake (RAIU) and thyroid scan

Laboratory and Diagnostic Procedures (cont’d)


Figure 14-15 Thyroid scan

Custom Medical Stock Photo, Inc.


Medical and Surgical Procedures

Medical Procedures

ADA diet


Medical and Surgical Procedures (cont’d)

Surgical Procedures

Adrenalectomy

Fine-needle biopsy


Medical and Surgical Procedures (cont’d)

Surgical Procedures (cont’d)

Parathyroidectomy

Thymectomy

Thyroidectomy

Transsphenoidal hypophysectomy


Drug Categories

These categories of drugs are used to treat endocrine Diseases and Conditions:

Antidiabetic drugs

Antithyroid drugs

Corticosteroid drugs

Growth hormone drugs

Insulin

Thyroid supplement drugs


Figure 14-16 Insulin injection

Custom Medical Stock Photo, Inc.


Figure 14-17 Humulin R insulin

SIU BioMed/Custom Medical Stock Photo, Inc.


Abbreviations


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