1. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Chapter 14 Endocrine System Diseases and Disorders

2. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Anatomy and Physiology Endocrine system consists of many glands, including: –Hypothalamus –Pituitary –Pineal –Thymus –Thyroid

3. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Anatomy and Physiology Endocrine system consists of many glands, including: –Parathyroids –Adrenals –Pancreatic islets –Ovaries and testes

4. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Anatomy and Physiology Each gland unique and delivers secretion into bloodstream Negative feedback system controls amount of hormones secreted

5. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Animation Click Here to Play Endocrine System Animation

6. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Diagnostic Tests Thyroid and testes –Endocrine glands that can be physically examined Blood and urine testing for hormones CT scan and MRI for tumors or alteration in organ size

7. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Pituitary Gland Diseases Hyperpituitarism –Increase in activity of pituitary gland –Oversecretion affects growth hormone leading to excessive growth of bones and tissues –If occurs before puberty, gigantism occurs –If occurs during adulthood, acromegaly occurs Affects small bones of hands, feet, and face by enlarging them

8. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Pituitary Gland Diseases Hypopituitarism –Abnormal decrease in activity of pituitary gland –Effects: Dwarfism Abnormality of secondary sex characteristics Amenorrhea and infertility in adult females

9. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Pituitary Gland Diseases Hypopituitarism –Effects: Adult males may have decreased testosterone levels and libido Decrease in adrenocorticotropic hormone (ACTH) and thyroid- stimulating hormone (TSH) may lead to metabolic disorder –Diagnosis of pituitary function by blood test

10. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Pituitary Gland Diseases Hypopituitarism –Treatment: Hormone replacement Monitoring Adjustment

11. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Pituitary Gland Diseases Diabetes insipidus –Caused by decrease in release of vasopressin or antidiuretic hormone –Excessive polyuria Urinating 2 to 15 gallons of urine in 24 hours

12. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Pituitary Gland Diseases Diabetes insipidus –Symptoms: Polydipsia Hypotension Dizziness Constipation

13. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Pituitary Gland Diseases Diabetes insipidus –Diagnosis by urinalysis and water restriction test –Urine Colorless Low specific gravity –Treatment: Administration of vasopressin

14. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Thyroid Gland Diseases Hyperthyroidism –Thyroid gland secretes excessive thyroxine –Caused by tumor of thyroid gland –Symptoms: Tachycardia Nervousness Hyperactivity Excessive excitability

15. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Thyroid Gland Diseases Hyperthyroidism –Symptoms: Tremendous appetite with weight loss Diarrhea High heat production Moist skin Extreme thirst

16. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Thyroid Gland Diseases Hyperthyroidism –Treatment to reduce thyroxine often effective –Surgery may be necessary

17. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Thyroid Gland Diseases Hyperthyroidism –Autoimmune condition Graves’ disease Symptoms: –Exophthalmos Treatment: –Medication –Radiation –Surgery

18. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Exophthalmos Photo courtesy Mark L. Kuss

19. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Thyroid Gland Diseases Simple goiter –Enlargement of thyroid generally due to inadequate iodine –Asymptomatic until thyroid presses on trachea and esophagus leading to dyspnea and dysphagia –Treatment: Potassium iodide followed by iodine in diet Surgery to decrease dysphagia and dyspnea

20. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Goiter Photo courtesy Mark L. Kuss

21. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Thyroid Gland Diseases Hypothyroidism –Decrease in thyroxine –Symptoms: Fatigue Sensitivity to cold temperatures Thin nails Brittle hair Excessive weight gain

22. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Thyroid Gland Diseases Hypothyroidism –Diagnosis by blood hormone level –Treatment: Hormone replacement

23. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Parathyroid Gland Diseases Hyperparathyroidism –Overproduction of parathormones by one or more of the four parathyroid glands –Causes hypercalcemia leading to kidney stones, bone weakness, and hyperactivity of heart

24. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Parathyroid Gland Diseases Hyperparathyroidism –Diagnosis by blood tests –Treatment directed at cause –Prognosis good with proper treatment

25. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Parathyroid Gland Diseases Hypoparathyroidism –Decrease in parathormone leading to low blood calcium Causing irritability of muscles –Tetany –Causes uncontrolled contraction of muscles in face and hands

26. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Parathyroid Gland Diseases Hypoparathyroidism –Diagnosis by checking for Chvostek’s and Trousseau’s signs –Treatment: Vitamin D Calcium

27. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Adrenal Gland Diseases Adrenal glands –Also known as suprarenals –Have two distinct parts: Inner –Medulla releases epinephrine and norepinephrine »Fight or flight hormones Outer –Cortex controlled by ACTH

28. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Adrenal Gland Diseases Adrenal glands secrete mineralocorticoids, glucocorticoids, and sex hormones Cortisone –Glucocorticoid used to treat inflammatory disease –Should be used short-term only

29. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Adrenal Gland Diseases Cortisone side effects: –Hypertension –Ulcers –Moon face –Drowsiness –May mask symptoms of infection

30. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Adrenal Gland Diseases Hyperadrenalism –Oversecretion of adrenal cortex hormones Conn’s syndrome –Overproduction of mineralocorticoid aldosterone

31. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Adrenal Gland Diseases Cushing’s syndrome –Overproduction of glucocorticoid cortisol Androgenital syndrome –Overproduction of sex hormones

32. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Adrenal Gland Diseases Hypoadrenalism or Addison’s disease –Low secretion of hormones by adrenal cortex

33. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Pancreatic Islets of Langerhans Diseases Pancreas –Both exocrine and endocrine gland Islets of Langerhans secrete insulin and glucagon Insulin lowers blood sugar Glucagon increases blood sugar

34. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Pancreatic Islets of Langerhans Diseases Sugar or glucose –Primary source of energy for all tissue cells Diabetes mellitus –Affects carbohydrate and sugar utilization due to lack of insulin

35. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Pancreatic Islets of Langerhans Diseases Diabetes mellitus –Symptoms: Polydipsia Polyuria Polyphagia –Types: Type 1 Type 2

36. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Pancreatic Islets of Langerhans Diseases Diabetes mellitus –Type 1 Also known as insulin-dependent diabetes mellitus Most serious Affects children and young adults before age 25 Requires daily injections of insulin Thought to be autoimmune disorder

37. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Pancreatic Islets of Langerhans Diseases Diabetes mellitus –Type 1 Individuals do not usually secrete insulin –Making control difficult Follow strict diet Monitor blood levels Administer daily insulin Exercise and stress can alter insulin needs

38. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Pancreatic Islets of Langerhans Diseases Diabetes mellitus –Type 2 More common in adults Gradual onset occurring most often in obese females over age 40 Thought to be caused by wearing out of pancreatic islets of Langerhans Usually controlled with diet, exercise, and oral medication to stimulate insulin secretion

39. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Pancreatic Islets of Langerhans Diseases Diabetes mellitus –Complications: Diabetic shock –Occurs rapidly –Result of taking too much insulin and not eating enough food

40. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Pancreatic Islets of Langerhans Diseases Diabetes mellitus –Complications: Diabetic shock –Symptoms: »Diaphoresis »Light-headedness »Trembling –Treatment: »Emergent with intravenous (IV) glucose to raise blood sugar

41. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Pancreatic Islets of Langerhans Diseases Diabetes mellitus –Complications: Diabetic coma –Not enough insulin or too many carbohydrates in diet –Progresses slowly with individual becoming lethargic and slipping into coma

42. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Pancreatic Islets of Langerhans Diseases Diabetes mellitus –Complications: Diabetic coma –Symptoms: »Slow, deep breathing pattern »Fruity or sweet-smelling breath »Polyuria »Polydipsia »Dehydration »Ketoacidosis

43. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Pancreatic Islets of Langerhans Diseases Diabetes mellitus –Complications: Atherosclerosis Diabetic retinopathy Kidney damage –Diagnosis by history and blood glucose testing –No cure

44. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Pancreatic Islets of Langerhans Diseases Gestational diabetes –Can occur during pregnancy –Usually discovered with routine urine testing during prenatal visits –Treatment: Diet Exercise Medications

45. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Pancreatic Islets of Langerhans Diseases Gestational diabetes –Injectable insulin controls sugar levels –Usually disappears after delivery –Women often affected later in life by adult-onset diabetes

46. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Pancreatic Islets of Langerhans Diseases Hypoglycemia –Abnormally low blood sugar Less than 60 –Symptoms: Light-headedness Diaphoresis Trembling

47. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Pancreatic Islets of Langerhans Diseases Hypoglycemia –Diagnosis by glucose test –Treatment dependent on cause

48. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Reproductive Gland Diseases Hypergonadism –Increased hormone production before puberty –Diagnosis by blood test for elevated hormones –Treatment: Removal or radiation of tumors to suppress hormones

49. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Reproductive Gland Diseases Hypogonadism –Decreased sex hormone production by puberty –Treated with hormones

50. Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Effects of Aging Decreased secretions from glands Lessened glucose tolerance Diabetes mellitus common