Endocrine system
Endocrine:
- Produces hormones
- Releases hormones directly into the bloodstream
- Hormones travel to reach target cells or organs
- Examples:
- Pituitary gland (growth hormone)
- Thyroid gland (thyroid hormones)
- Pancreas (insulin, glucagon)
Exocrine:
- Produces enzymes, sweat, saliva, etc.
- Releases substances through ducts to specific location.
(skin, digestive tract, etc.)
- Examples:
- Sweat glands (sweat)
- Salivary glands (saliva)
- Pancreas (digestive enzymes)
The pancreas is a bit special because it has both endocrine (islets of Langerhans producing insulin/glucagon) and exocrine
(acinar cells producing digestive enzymes) functions
Introduction
• The endocrine system consists of glands that exerts their actions at distant parts of the body via the production of biologically active
hormones secreted in to the blood stream
• Unlike the neurological response, which produces immediate response,
• The endocrine system has typically slower and longer lasting effects on the body
General characteristic of hormones
1. they have specific rates and patterns of secretion (diurnal, pulsatile, cyclic patterns, pattern that depends on the level of circulating
substrates)
2. they operate within feedback systems, either positive(rare) or negative, to maintain an optimal internal environment
3. they affect only cells with appropriate receptors specific cell
function(s) is initiated
4. they are excreted by the kidney, deactivated by the liver or by
other mechanisms
Main endocrine glands are:
1)pituitary
2)thyroid
3)parathyroids
4)pancreas
5)adrenals
6)gonads
Pituitary
Diseases of the posterior pituitary gland
Syndrome of inappropriate ADH secretion (SIADH) -It is characterised by high levels of ADH in the absence of normal
physiologic stimuli for its release
1. Elevated levels of ADH is caused by ectopically produced ADH (cancer of the lung, leukemia, response to surgery, inflammation of lung tissue,
psychiatric disease, drugs-barbiturates, general anaesthesia, diuretics...)
water retention total body H2O aldosteron production
solute loss (Na+) hyponatremia hypoosmolality
ADH is released continually
dilutional hyponatremia suppression of renin production
aldosterone production Na+ reabsorbtion in kidney
even if hyponatremia develops slowly, serum sodium levels below 110
to 115 mmol/l are likely to cause severe and sometimes irreversible neurologic damage
rapid decrease of serum Na+ from 140 to 130 mmol/l thirst, anorexia,
dyspnea on exertion, fatigue occur
2. Diabetes insipidus (DI) - is related to an insufficiency of ADH leading to polyuria and polydipsia
Three forms of DI do exist:
a) neurogenic or central form - amount of ADH production
b) nephrogenic form - inadequate response to ADH
c) psychogenic form - extremely large volumes of fluid intake inhibition of ADH production
Pathophysiology:
DI - partial to total inability to concentrate urine due to chronic polyuria washout of renal medullary concentration gradient
- increase in plasma osmolality thirst polydipsia (looking for cold drinks)
urine output, urine specific gravity (1.00-1.005)
Dehydratation (if not adequate fluid intake)
Diseases of the anterior pituitary gland
Hypopituitarism is caused e.g. by infarction of the gland, removal, or destruction of the gland
Hyperpituitarism - adenoma
Hypopituitarism - insufficient secretion of one (selective form), more than one or all (panhypopituitarism) hormones of adenohypophysisysis
Causes: idiopathic, organic damage of adenohypophysis or hypothalamus e.g. pituitary infarction= Sheehan syndrome, pituitary apoplexy,
shock, DM, head trauma, infections, vascular malformations, tumors
Consequences - they depend on the affected hormones
- if all hormones are defficient panhypopituitarism, the patients suffer from:
- cortisol deficiency - because of lack of ACTH
- thyroid hormones deficiency - because of lack of TSH
- ADH defficincy - diabetes insipidus
- defficiency of FSH and LH - gonadal failure and loss of secondary sex characteristics
- growth hormone somatomedin (they affect children growth)
- absence of prolactin postpartum women are unable to lactate
- ACTH deficiency (within 2 weeks) symptoms of cortisol insufficiency developed (nausea, vomiting, anorexia, fatigue, weakness)
hypoglycemia (it is caused by increased sensitivity of tissues to insulin, decreased glycogene reserves, decreased gluconeogenesis)
- in women, loss of body hair and decreased libido due to decreased adrenal androgen production
- limited maximum aldosteron secretion
- TSH deficiency (within 4-8 weeks) symptoms of TSH deficiency are developed: cold intolerance, dryness of skin, decreased metabolic
rate, mild myxedema, lethargy.
- FSH and LH deficiences in female of reproductive age: amenorrhea, atrophic changes of vagina, uterus and breasts
in postpubertal men: atrophy of the testicles, decreased beard growth.
Hyperpituitarism - excessive production of adenohypophyseal hormones.
Causes: - adenoma of adenohypophysis
- hypothalamic form of hyperpituitarism