1. Medical Assisting Chapter 32
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Medical Assisting Chapter 32
Second Edition
Ramutkowski • Booth • Pugh • Thompson • Whicker
Chapter 32
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2. The Endocrine System Objectives
32-1 Describe the general functions of the endocrine system.
32-2 Compare the endocrine and exocrine glands.
32-3 Define hormone.
32-4 Describe the locations of the pituitary gland, thyroid gland, parathyroid glands,adrenal glands, pancreas, thymus, and gonads.
32-5 List the hormones released by the pituitary gland and give the functions of each.
32-6 List the hormones released by the thyroid gland and parathyroid glands, and give the functions of each.

3. The Endocrine System Objectives (cont.)
List the hormones released by the adrenal glands and give the functions of each.
List the hormones released by the pancreas and give the functions of each.
List the hormones released by the thymus and gonads, and give the function of each.
32-10 Describe the signs, symptoms, causes, and treatments of various endocrine disorders.

4. The Endocrine System
The endocrine system includes the organs of the body that secrete hormones directly into body fluids such as blood.
hormones
bloodstream to
glands
secrete
into
target tissues

5. Hormones
Hormones are chemicals secreted by a cell that affects the functions of other cells.
Many hormones are derived from steroids that can easily cross the cell membrane .
Examples of steroid hormones:
Estrogen
Progesterone
Testosterone
Cortisol
hormones

6. Hormones (cont.) Nonsteroid Hormones Prostaglandins
Made of amino acids or proteins
Cannot cross the cell membrane with ease
Binds to receptors on the surface of the cells
G-protein is usually activated by the hormone-receptor complex.
Prostaglandins
Local hormones
Derived from lipid molecules
Typically do not travel into the blood stream
Target tissues are located close by
Produced by organs such as the:
 Kidneys  Uterus
 Heart  Brain
 Stomach

7. Pituitary Gland
This gland is located at the base of the brain and is controlled by the hypothalamus.
A bony structure called the sella turcica protects the pituitary gland.
The optic chiasm is located just above the pituitary gland.
The pituitary gland is divided into two lobes:
Anterior Lobe
Posterior Lobe

8. Pituitary Gland Anterior Lobe Growth Hormone Prolactin
Stimulates milk production
Stimulates increase in size of muscles and bones.
Anterior
Lobe
Thyroid-stimulating
Luteinizing
Stimulates the thyroid gland to release its hormones.
Stimulates ovulation in females and estrogen production. Stimulates production of testosterone in males
Follicle-stimulating
Adrenocorticotrophic
In females stimulates estrogen production and maturation of the ova. In males, it stimulates sperm production.
Stimulates the adrenal cortex to release its hormones

9. Pituitary Gland (cont.)
Antidiuretic Hormone
Oxytocin
Stimulates the kidneys to conserve water
In females causes contraction of the uterus and ejection of breast milk.
Posterior
Lobe

10. Apply Your Knowledge
The medical assistant in a local medical office is about to administer an injection of cortisol. The patient asks “Once you inject that steriod in my arm, why won’t it affect my arm and other body parts?” Which of the following would best answer this patient’s question?
Hormones do not affect any cells.
Cortisol is not a hormone so there is no need for concern.
Hormones have specific target cells that they bind with.

11. Apply Your Knowledge - Answer
The medical assistant in a local medical office is about to administer an injection of cortisol. The patient asks “Once you inject that steriod in my arm, why won’t it affect my arm and other body parts?” Which of the following would best answer this patient’s question?
Hormones do not affect any cells.
Cortisol is not a hormone so there is no need for concern.
Hormones have specific target cells that they bind with.

12. Thyroid Gland and Parathyroid Glands
Located below the larynx
Is covered by a capsule
Is divided into follicles that store some of the hormones
Major Hormones
Thyroid Hormones
T T4
Calcitonin
Stimulate protein synthesis and increase cellular energy production
Lowers blood calcium levels by activating osteoblasts

13. Thyroid Gland and Parathyroid Glands (cont.)
Most people have four parathyroid glands
These glands are located on the posterior surface of the
thyroid gland.
They secrete the parathyroid hormone (PTH)
Parathyroid hormone acts to raise the blood calcium levels by activating osteoclasts.

14. Adrenal Glands Located on top of each kidney
Divided into the adrenal medulla and adrenal cortex
Adrenal Medulla
Adrenal Cortex
central portion
secretes epinephrine and
norepinephrine
secretions prepare the body
for the stress response
outermost portion
aldosterone and cortisol
are the main two hormones
secreted

15. Pancreas Insulin Glucagon Located behind the stomach
Considered as both an endocrine and exocrine gland
Contains structures known as islets of Langerhans which secretes insulin and glucagon
Insulin
Glucagon
Blood glucose concentrations
Blood glucose concentrations
Protein synthesis
Protein synthesis

16. Apply Your Knowledge
A surgical patient is considered to have experienced physical external stress. All of the following are symptoms associated with stress except:
Increased blood pressure
Decreased blood glucose
Increased heart rate

17. Apply Your Knowledge - Answer
A surgical patient is considered to have experienced physical external stress. All of the following are symptoms associated with stress except:
Increased blood pressure
Decreased blood glucose
Increased heart rate

18. Other Hormone Producing Organs
The Pineal Body
The Thymus Gland
Located between the cerebral
hemispheres
Secretes melatonin
Located between the lungs
Secretes thymosin
Other Sites
The Gonads
Stomach produces gastrin
Small intestines release secretin
and cholecystokinin
Heart secretes atrial natriuretic
peptide
Kidneys secrete erythropoietin
Ovaries and testes
Ovaries release estrogen
and progesterone
Testes produce testosterone

19. The Body's Physiologic Response To Stress
The Stress Response
A stressor is any stimulus that produces stress.
Types of Stressors
Physical Factors  Psychological Factors  Positive Factors
The Body's Physiologic Response To Stress
The body’s response consist of a group of reactions called the general stress syndrome which is caused by the release of hormones.
Heart rate  Breathing rate
 Blood pressure Glucose levels

20. Common Diseases and Disorders of the Endocrine System
Causes
Increased productions of the growth hormone or a tumor.
Signs and Symptoms
Enlargement of skull, and hands and feet bones
Thickening of the skin
Headache, fatigue, pain, weight gain, heart disease
Treatment
Medications to decrease growth hormone production
Radiation therapy
Surgery
Acromegaly

21. Common Diseases and Disorders of the Endocrine System (cont.)
Addison's Disease
Causes
Specific causes unknown but may be due to cancer, or an autoimmune dysfunction
Signs and Symptoms
Weakness, fatigue, dizziness, weight loss, muscle pain, vomiting, diarrhea and dehydration
Treatment
Corticosteriods
Medications or hormones to balance sodium and potassium levels

22. Common Diseases and Disorders of the Endocrine System (cont.)
Cushing's Disease
Causes
Excessive production of ACTH (adrenal gland tumor)
Long-term use of steriods
Signs and Symptoms
Round or full face, hump of fat between the shoulders, fatigue, thin arms and legs with large abdomen, high blood pressure, high blood glucose levels
Treatment
Lifestyle changes
Radiation and surgery for tumor removal

23. Common Diseases and Disorders of the Endocrine System (cont.)
Diabetes Mellitus
Causes
Decreased or absent production of insulin by the pancreas
Obesity, high blood pressure, pregnancy, high cholesterol levels
Signs and Symptoms
High blood glucose levels, excessive thirst, frequent urination, increased appetite, blurred vision, slow wound healing, weight loss, foot problems, impotence in men
Treatment
Insulin (injection and oral tablets)
Lifestyle changes
Complications
Kidney disease, blindness, atherosclerosis, amputations

24. Common Diseases and Disorders of the Endocrine System (cont.)
Dwarfism
Causes
Underproduction of the growth hormone
Trauma to pituitary gland or pituitary tumor
Signs and Symptoms
Short height, abnormal facial features, cleft lip or palate, delayed puberty, headache, frequent urination, thirst
Treatment
Administer supplemental growth hormone

25. Common Diseases and Disorders of the Endocrine System (cont.)
Gigantism
Causes
Overproduction of the growth hormone or a pituitary tumor
Signs and Symptoms
Very tall height, delayed sexual maturity, thick facial bones, thick skin, weakness, vision problems
Treatment
Medications to decrease growth hormone levels
Radiation therapy or surgery for tumor

26. Common Diseases and Disorders of the Endocrine System (cont.)
Grave's Disease
Causes
Over production of thyroid hormones
Also considered an autoimmune disorder
Signs and Symptoms
Exophthalmos, goiter, insomnia, weight loss, muscle weakness, increased appetite, vision problems, increased heart rate
Treatment
Medications
Radiation and surgery to the thyroid gland

27. Common Diseases and Disorders of the Endocrine System (cont.)
Myxedema
Causes
Removal of the thyroid gland, neck radiation treatments and obesity
Signs and Symptoms
Weakness, fatigue, weight gain, depression, dry skin, general body aches, pale or yellow skin, slow heart rate, enlarged heart, coma
Treatment
Supplemental thyroid hormones
Close monitoring of thyroid hormone levels

28. Apply Your Knowledge Cushing’s disease Addison’s disease
A patient enters the medical office with complaints of fatigue and body aches. You notice that the patient’s arms are thin and the abdomen appears enlarged. The physician states to you “ This looks like a case of hypercortisolism.” You realize this refers to which of the following diseases?
Cushing’s disease
Addison’s disease
Diabetes mellitus

29. Apply Your Knowledge - Answer
A patient enters the medical office with complaints of fatigue and body aches. You notice that the patient’s arms are thin and the abdomen appears enlarged. The physician states to you “ This looks like a case of hypercortisolism.” You realize this refers to which of the following diseases?
Cushing’s disease
Addison’s disease
Diabetes mellitus

30. END OF CHAPTER
End of Chapter