Endocrine System Spring 2012 FINAL 1 Endocrine Glands

Endocrine System Spring 2012 FINAL 1

Endocrine Glands • • • 1 Pituitary gland Pineal gland Adrenal glands Thyroid gland Parathyroid gland Thymus gland Pancreas Gonads Hypothalamus 2

• Anterior Pituitary Gland – FSH – LH – TSH – ACTH – PRL – MSH – Endorphins – GH • Posterior – ADH – Oxytocin 2 3

Pineal Gland Melatonin 3 4

Adrenal Glands • Adrenal Cortex – Mineralocorticoids – Glucocorticoids – Androgens • Adrenal Medulla – Epinephrine – Norepinephrine 4 5

Thyroid Gland • TH – Thyroxine – Triiodothyronine • Calcitonin 5 6

Parathyroid Gland • PTH 6 7

Thymus • Lymphocytes • Thymosin 7 8

Pancreas • Glucagon – Alpha cells • Insulin – Beta Cells 8 9

9 10

Gonads • Females – Estrogen – Progesterone • Males – Testosterone 10 11

Hypothalamus • • • 11 TRH Gn. RH GHRH CRH Somatostatin Dopamine 12

Osteoporosis • Classified by age groups – Most common is postmenopausal 12 • Decrease in bone density (subtractive) • Treatment increase calcium and vitamin D in comination with hormone therapy 13

Osteoporosis 13 14

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 14 15

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

Paget’s Disease 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 17

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 17 18

Pituitary Gland Disorders 18 19

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

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 20 21

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 21 22

1. Short stature with protruding abdomen Hypopituitarism 2. Sparse hair 3. Coarse facial features 4. Wide-set eyes 5. Broad nose 6. Protruding tongue 22 23

Diabetes Insipidus • Deficiency in vasopressin • Insufficient ADH • Usually secondary to intereference with ADH production • Can be hereditary • Symptomes – Polyuria – Increased thirst – Low urine osmolality • Treatment – Hormone therapy – Nephrogenic D. I. 23 24

Adrenal Gland Disorders 24 25

Cushing’s Syndrome http: //www. youtube. com/watch? v=vx. SAh. Ly. KVqw 25 26

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 26 27

Addison’s Syndrome 27 28

Addison’s Syndrome 28 29

Pancreatic Disorders 29 30

Pancreas Anatomy 30 31

Diabetes Mellitus 1. Syndrome characterized by chronic hyperglycemia is combination with glucose intolerance 2. Alteration is metabolism of carbs, fats and proteins 31 32

Type 1 1. Produce little to no insulin 2. Symptoms 1. Increase urination 2. Excessive thirst 3. Increase in appetite 3. Treatment 32 33

1. Inadequate secretion of insulin Type 2 2. More common in women than men 3. Treatment is similar to DM 1 33 34

Thyroid and Parathryroid Gland Disorders 35 35

Thyroid Anatomy 36 36

Hyperthyroidism 36 37

1. Autoimmune disorder Hyperthyroidism 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

1. TH deficiency 2. Commonly seen in PT’s with Hashimoto’s syndrome Hypothyroidism 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 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 42

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

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

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