Endocrine System Spring 2012 FINAL 1

Endocrine Glands Pituitary gland Pineal gland Adrenal glands Thyroid gland Parathyroid gland Thymus gland Pancreas Gonads Hypothalamus 21

Pituitary Gland Anterior – FSH – LH – TSH – ACTH – PRL – MSH – Endorphins – GH Posterior – ADH – Oxytocin 32

Pineal Gland Melatonin 4 3

Adrenal Glands Adrenal Cortex – Mineralocorticoids – Glucocorticoids – Androgens Adrenal Medulla – Epinephrine – Norepinephrine 54

Thyroid Gland TH – Thyroxine – Triiodothyronine Calcitonin 65

Parathyroid Gland PTH 76

Thymus Lymphocytes Thymosin 87

Pancreas Glucagon – Alpha cells Insulin – Beta Cells 98

109

Gonads Females – Estrogen – Progesterone Males – Testosterone 1110

Hypothalamus TRH GnRH GHRH CRH Somatostatin Dopamine 1211

Osteoporosis Classified by age groups – Most common is postmenopausal Decrease in bone density (subtractive) Treatment increase calcium and vitamin D in comination with hormone therapy 1312

Osteoporosis 1413

Osteomalacia 1.Lack of calcium in the tissues & a failure of the bone tissue to calcify 2.Caused by malabsorption of fats 3.If it occurs after growth plate closure it is called Rickets 1514

Osteomalacia 16 Demonstrates as osteopenia on x-ray. Appears similar to osteoporosis Except for the presence of bands Of radiolucency within the bone 15

Paget’s Disease 17 X-ray of affected bones show cortical thickening with a coarse Thickened trabecular pattern Often called “cotton wool” Appearance Mixed areas of radiolucency & radiopaque areas 16

Paget’s Disease 1.Metabolic disorder of unknown cause 2.Has two stages: 1.Osteolytic 2.Osteo blastic 3.Fairly common in elderly 4.Affects men twice as frequently as women 1817

Pituitary Gland Disorders 1918

Acromegaly 20 X-ray demonstrates an enlarged sella Turcica and changes in the skull Obliterates diploe found between inner & outer tables of the cortical bone 19

Acromegaly 1.Endocrine disorder caused by a disturbance of the pituitary gland 1.Primarily affects skeletal system 2.Have a prominent forehead & jaw, widened teeth, abnormally large hands, coarsening of facial features 2120

Hypopituitarism 1.Decreased levels of pituitary hormones 2.Most common cause is pituitary infarction 1.Caused by ischemic pituitary necrosis, postpartum hemorrhage, shock, sickle cell disease, meningitis, shock, syphilis, and head trauma 3.CT, MRI and angiography can be used for radiographic evaluation 2221

Hypopituitarism 1.Short stature with protruding abdomen 2.Sparse hair 3.Coarse facial features 4.Wide-set eyes 5.Broad nose 6.Protruding tongue 2322

Diabetes Insipidus Deficiency in vasopressin Insufficient ADH Usually secondary to intereference with ADH production Can be hereditary – Nephrogenic D.I. Symptomes – Polyuria – Increased thirst – Low urine osmolality Treatment – Hormone therapy 2423

Adrenal Gland Disorders 2524

Cushing’s Syndrome

Cushing’s Syndrome 1.Have a “moon” face with excess fat deposits in neck and trunk 2.Skin is thin and does not heal well 3.CT and MRI demonstrates pituitary adenomas 2726

Addison’s Syndrome 2827

Addison’s Syndrome 2928

Pancreatic Disorders 3029

Pancreas Anatomy 3130

Diabetes Mellitus 1.Syndrome characterized by chronic hyperglycemia is combination with glucose intolerance 2.Alteration is metabolism of carbs, fats and proteins 3231

Type 1 1.Produce little to no insulin 2.Symptoms 1.Increase urination 2.Excessive thirst 3.Increase in appetite 3.Treatment 3332

Type 2 1.Inadequate secretion of insulin 2.More common in women than men 3.Treatment is similar to DM

Thyroid and Parathryroid Gland Disorders 35

Thyroid Anatomy 36

Hyperthyroidism 3736

Hyperthyroidism 1.Autoimmune disorder 2.Thyroid gland secretes excess amounts of TSH 3.Enlarged thyroid and protruding eyes 4.Hyper and nervous 5.Treatment includes: medical management, surgical resection Administration of radioactive iodine 38

Hypothyroidism 1.TH deficiency 2.Commonly seen in PT’s with Hashimoto’s syndrome 3.May be caused by iodine insufficiency 4.Symptoms: 1. decreased energy levels 2. hot & cold intolerance 3. personality changes 4.weight gain 5.Treatment is hormone replacement therapy 39

Thyroid Cancers 40

Parathyroid Glands 41

Hyperparathyroidism 42 X-ray demonstrates osteopenia, especially in the diaphyses of the phalanges and clavicles Pathologic fractures may exist as a consequence of the softened bony matrix

Hyperparathyroidism 43 Disrupts the calcium Phosphate ration and Results in increased Levels of PTH.

Nephrocalcinosis 44 Tiny deposits of calcium dispersed through renal parenchyma Can be seen on an IVU and plain radiographs

Radiography 1.Useful in diagnosing some disorders 1.Metabolic diseases of the skeletal system 1.Cushing's’ 2.Decrease in CA in osteomalacia & osteoporosis 3.Disorders of pituitary gland 1.Changes in sella turcica 4.Acromegaly 45

Bone Mineral Densitometry 1.Determines mineral and calcium content in bone 2.Can assist in the diagnosis of 1.Osteoporosis 2.Osteomalacia 46

MRI 1.Useful in evaluating pituitary disorders 1.Pituitary adenomas 1.Presence of progress 2.With Gadolinium 2.Microadenomas 47

CT 1.Useful in diagnosis and follow-up of pituitary disorders 2.Pineal gland 3.Neoplastic diseases of thyroid, adrenal glands & parathyroid glands 1.Enlargement of adrenal glands 4.Biopsies frequently performed under CT 48

Nuclear Medicine 1.Diagnosing thyroid function 2.Detecting nonpalpable nodules 3.Evaluate remaining thyroid tissue 1.After surgical resection or ablation 4.Localize medullary tumors of adrenal glands 5.Using radioisotopes to treat this tumor of the medullary portion of the adrenal glands 49