The Language Of Medicine th 9 edition DaviEllen

Chapter 18 Endocrine System Copyright © 2011, 2008, 2005 by Saunders, an imprint of

Chapter Goals Identify the endocrine glands and their hormones. Gain an understanding of the

Chapter Goals (cont’d) Identify abnormal conditions resulting from excessive and deficient secretions of the

Chapter 18 Lesson 18. 1 Copyright © 2011, 2008, 2005 by Saunders, an imprint

Introduction Endocrine System Glands release hormones. Hormones regulate the many and varied functions of

Introduction Endocrine System (cont’d) ENDOCRINE glands— Secrete their hormones directly into the bloodstream EXOCRINE

Endocrine Glands thyroid gland parathyroid glands (four glands) adrenal glands (one pair) pancreas (islets

The Endocrine System Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier

The Endocrine System (cont’d) Copyright © 2011, 2008, 2005 by Saunders, an imprint of

Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights

Thyroid Gland Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc.

Thyroid Gland (cont’d) Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier

Thyroid Function There are two hormones: thyroxine or tetraiodothyronine (T 4) Ø triiodothyronine (T

Thyroid Gland: Hormones and Actions Copyright © 2011, 2008, 2005 by Saunders, an imprint

Parathyroid Gland Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc.

Parathyroid Gland (cont’d) Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier

Parathyroid Glands Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc.

Parathyroid Function Parathyroid hormone (PTH): causes calcium to mobilize from bones into the bloodstream

Adrenal Glands Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc.

Adrenal Glands (cont’d) Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier

Adrenal Glands: Location and Structure Each gland has two parts Ø an outer portion,

Function: Adrenal Cortex Secretes Glucocorticoids: influence metabolism of sugars, fats, and proteins (cortisol) and

Function Adrenal Medulla Secretes Two types of catecholamine hormones Ø Epinephrine (adrenaline): increases heart

The Adrenal Cortex and Adrenal Medulla Copyright © 2011, 2008, 2005 by Saunders, an

Pancreas Located near and partially behind stomach Exocrine and endocrine organ Copyright © 2011,

Pancreas (cont’d) Located near and partially behind stomach Exocrine and endocrine organ Copyright ©

Pancreas Function Endocrine function islets of Langerhans produce: Insulin: promotes movement of glucose into

Pancreas Function (cont’d) Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier

Chapter 18 Lesson 18. 2 Copyright © 2011, 2008, 2005 by Saunders, an imprint

Pituitary Gland Pea-sized gland in depression of skull (sella turcica) also called the hypophysis

Pituitary Gland (cont’d) Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier

Relationship of the Hypothalamus to the Pituitary Gland Copyright © 2011, 2008, 2005 by

Pituitary Function Anterior Pituitary Growth hormone (GH) or somatotropin (STH) Ø Thyroid-stimulating hormone (TSH;

Pituitary Function (cont’d) Posterior pituitary: stores and releases hormones synthesized in the hypothalamus Antidiuretic

Pituitary Gland: Hormones and Actions Copyright © 2011, 2008, 2005 by Saunders, an imprint

Ovaries and Testes: Hormones and Actions Copyright © 2011, 2008, 2005 by Saunders, an

Male Testes Female Ovaries Hormone: testosterone Maintains germ cell formation and secondary sexual characteristics

QUICK QUIZ: 1. The outer section of each adrenal gland is the …. adrenal

QUICK QUIZ: (cont’d) 2. Secreted by the anterior lobe of the pituitary gland; stimulates

Combining Forms, Suffixes, Prefixes, and Terminology GLANDS Combining Form. Meaning aden/o gland adren/o adrenal

Combining Forms, Suffixes, Prefixes, and Terminology (cont’d) GLANDS Combining Form Meaning pituitar/o thyroid/o pituitary

Combining Forms, Suffixes, Prefixes, and Terminology (cont’d) RELATED FORMS Combining Form andr/o calc/o, calici/o

Combining Forms, Suffixes, Prefixes, and Terminology (cont’d) GLANDS Combining Form Meaning home/o hormon/o kal/I

Combining Forms, Suffixes, Prefixes, and Terminology (cont’d) GLANDS Combining Form Meaning phys/o somat/o ster/o

Combining Forms, Suffixes, Prefixes, and Terminology (cont’d) SUFFIXES Suffix Meaning -agon -emia -in, -ine

Combining Forms, Suffixes, Prefixes, and Terminology (cont’d) PREFIXES Prefix Meaning euhyperhypooxypantetratri good, normal excessive,

QUICK QUIZ: 3. Which term means surgical excision of the adrenal gland (specifically)? adenectomy

QUICK QUIZ: (cont’d) 4. Which term means a blood condition of too little potassium?

Chapter 18 Lesson 18. 3 Copyright © 2011, 2008, 2005 by Saunders, an imprint

Pathology—Thyroid Gland Goiter: Enlargement of the thyroid Hypersecretion Hyperthyroidism Ø Graves’ disease • Exophthalmos

Pathology—Parathyroid Hypersecretion Hyperparathyroidism Loss of bone density Ø Kidney stones Ø Hypercalcemia Ø Hyposecretion

Pathology—Adrenal Cortex Hypersecretion adrenal virilism amenorrhea, hirsutism, acne, voice deepening Cushing syndrome Obesity, moonface,

Pathology—Adrenal Medulla Hypersecretion Pheochromocytoma Benign tumor of adrenal medulla Excess epinephrine and norepinephrine Hypertension,

Pathology—Pancreas Hypersecretion Hyperinsulinism Hypoglycemia, convulsions, fainting Hyposecretion Diabetes mellitus Lack of insulin secretion or

Comparison of Type 1 and Type 2 Diabetes Copyright © 2011, 2008, 2005 by

Pathology Pituitary Gland: (Anterior Lobe) Hypersecretion acromegaly gigantism Hyposecretion dwarfism panhypopituitarism Copyright © 2011,

Pathology Pituitary Gland: (Posterior Lobe) Hypersecretion Syndrome of inappropriate ADH (SIADH) Excess ADH Excess

Review Abnormal Conditions of Endocrine Glands Copyright © 2011, 2008, 2005 by Saunders, an

Chapter 18 Lesson 18. 4 Copyright © 2011, 2008, 2005 by Saunders, an imprint

Laboratory Tests Fasting plasma glucose (FPG) Ø Serum and urine tests Ø Measures circulating

Clinical Procedures exophthalmometry computed tomography (CT) scan magnetic resonance imaging (MRI) of the head

Review Sheet COMBINING FORMS Combining Form Meaning aden/o ______ adren/o ______ adrenal/o andr/o ______

Review Sheet (cont’d) COMBINING FORMS Combining Form Meaning aden/o gland adren/o adrenal glands adrenal/o

Review Sheet (cont’d) COMBINING FORMS Combining Form Meaning crin/o ______ dips/o ______ estr/o ______

Review Sheet (cont’d) COMBINING FORMS Combining Form crin/o dips/o estr/o gluc/o, glyc/o gonad/o home/o

Review Sheet (cont’d) COMBINING FORMS Combining Form hormon/o kal/i insulin/o lact/o myx/o natr/o Meaning

Review Sheet (cont’d) COMBINING FORMS Combining Form pancreat/o parathyroid/o phys/o pituitar/o somat/o ster/o Meaning

Review Sheet (cont’d) COMBINING FORMS Combining Form thyr/o thyroid/o toc/o toxic/o ur/o Meaning ____________

Review Sheet (cont’d) COMBINING FORMS Combining Form thyr/o thyroid/o toc/o toxic/o ur/o Meaning thyroid

Review Sheet (cont’d) SUFFIXES Suffix Meaning -agon -emia -in, -ine -tropin -uria ____________ ______

Review Sheet (cont’d) SUFFIXES Suffix Meaning -agon -emia -in, -ine -tropin -uria assemble, gather

Review Sheet (cont’d) PREFIXES Prefix Meaning euhyperhypooxypantetratri- ____________ ____________ Copyright © 2011, 2008, 2005

Review Sheet (cont’d) PREFIXES Prefix Meaning euhyperhypooxypantetratri- good, normal excessive, above deficient, below rapid,

QUICK QUIZ: 5. What is the pathologic condition in which enlargement of the extremities

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Chapter Goals Identify the endocrine glands and their hormones. Gain an understanding of the functions of these hormones in the body. Analyze medical terms related to the endocrine glands and their hormones. Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. 3

Chapter Goals (cont’d) Identify abnormal conditions resulting from excessive and deficient secretions of the endocrine glands. Describe laboratory tests and clinical procedures related to endocrinology, and recognize relevant abbreviations. Apply your new knowledge to understanding medical terms in their proper contexts, such as medical reports and records. Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. 4

Introduction Endocrine System Glands release hormones. Hormones regulate the many and varied functions of an organism. Hormones bind to receptors. Receptors are recognition sites in the various target tissues on which hormones act. Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. 6

Introduction Endocrine System (cont’d) ENDOCRINE glands— Secrete their hormones directly into the bloodstream EXOCRINE glands— Send chemical substances (tears, sweat, milk, saliva) via ducts to the outside of the body Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. 7

Endocrine Glands thyroid gland parathyroid glands (four glands) adrenal glands (one pair) pancreas (islets of Langerhans) pituitary gland ovaries (one pair) testes (one pair) pineal gland thymus gland Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. 8

Thyroid Function There are two hormones: thyroxine or tetraiodothyronine (T 4) Ø triiodothyronine (T 3). Ø Thyroid hormones aid cells in their uptake of oxygen and regulate metabolic rate. Calcitonin: stimulates calcium to leave the blood and enter the bone. Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. 14

Adrenal Glands: Location and Structure Each gland has two parts Ø an outer portion, the adrenal cortex • Secretes corticosteriods or steriods, chemicals derived from cholesterol Ø an inner portion, adrenal medulla • Secretes catecholamines chemicals derived from amino acids Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. 22

Function: Adrenal Cortex Secretes Glucocorticoids: influence metabolism of sugars, fats, and proteins (cortisol) and are antiinflammatory (cortisone). Influences—SUGAR Mineralocorticoids: regulate electrolytes Ø Aldosterone: reabsorption of sodium/excretion of potassium. Influences—SALT Gonadocorticoids: androgens and estrogens. Influences—SEX Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. 23

Function Adrenal Medulla Secretes Two types of catecholamine hormones Ø Epinephrine (adrenaline): increases heart rate and blood pressure, dilates bronchial tubes, releases glucose from storage. Ø Norepinephrine (noradrenaline): constricts vessels to raise blood pressure. Ø Both are sympathomimetic agents. Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. 24

Pancreas Function Endocrine function islets of Langerhans produce: Insulin: promotes movement of glucose into cells and promotes storage as glycogen Ø Glucagon: promotes movement of glucose into the blood by breaking down glycogen stored in liver cells Ø Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. 28

Pituitary Gland Pea-sized gland in depression of skull (sella turcica) also called the hypophysis Anterior lobe (adenohypophysis) Ø Posterior lobe (neurohypophysis) Ø Hypothalamus controls secretions of the pituitary via releasing factors (hormones) Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. 31

Pituitary Function Anterior Pituitary Growth hormone (GH) or somatotropin (STH) Ø Thyroid-stimulating hormone (TSH; thyrotropin) Ø Adrenocorticotropic hormone (ACTH) Ø Gonadotropic hormones (FSH, LH) Ø Prolactin (PRL) Ø Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. 35

Pituitary Function (cont’d) Posterior pituitary: stores and releases hormones synthesized in the hypothalamus Antidiuretic hormone (ADH; vasopressin) Ø Oxytocin (OT) Ø Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. 36

Male Testes Female Ovaries Hormone: testosterone Maintains germ cell formation and secondary sexual characteristics Hormones: estrogen and progesterone Maintains menstrual cycle, release of ovum, secondary sexual characteristics, preparation of uterus for pregnancy Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. 39

QUICK QUIZ: 1. The outer section of each adrenal gland is the …. adrenal medulla B. adrenal cortex C. adrenaline D. adrenocorticotropic hormone A. Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. 40

QUICK QUIZ: (cont’d) 2. Secreted by the anterior lobe of the pituitary gland; stimulates ovulation in females and testosterone secretion in males…. A. luteinizing hormone (LH) B. estrodoil C. oxytocin D. prolactin Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. 41

Combining Forms, Suffixes, Prefixes, and Terminology GLANDS Combining Form. Meaning aden/o gland adren/o adrenal glands adrenal/oadrenal glands gonad/o sex glands (ovaries, testes) pancreat/o pancreas parathyroid/o parathyroid gland Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. 42

Combining Forms, Suffixes, Prefixes, and Terminology (cont’d) GLANDS Combining Form Meaning pituitar/o thyroid/o pituitary gland; hypophysis thyroid gland Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. 43

Combining Forms, Suffixes, Prefixes, and Terminology (cont’d) RELATED FORMS Combining Form andr/o calc/o, calici/o cortic/o crin/o dips/o estr/o gluc/o, glyc/o Meaning male calcium cortex, outer region secrete thirst female sugar Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. 44

Combining Forms, Suffixes, Prefixes, and Terminology (cont’d) GLANDS Combining Form Meaning home/o hormon/o kal/I lact/o myx/o natr/o sameness hormone potassium (an electrolyte) milk mucus sodium (an electrolyte) Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. 45

Combining Forms, Suffixes, Prefixes, and Terminology (cont’d) GLANDS Combining Form Meaning phys/o somat/o ster/o toc/o toxic/o ur/o growing body solid structure childbirth position urine Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. 46

Combining Forms, Suffixes, Prefixes, and Terminology (cont’d) SUFFIXES Suffix Meaning -agon -emia -in, -ine -tropin -uria assemble, gather together blood condition a substance stimulating the function of urine condition Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. 47

Combining Forms, Suffixes, Prefixes, and Terminology (cont’d) PREFIXES Prefix Meaning euhyperhypooxypantetratri good, normal excessive, above deficient, below rapid, sharp, acid all four three Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. 48

QUICK QUIZ: 3. Which term means surgical excision of the adrenal gland (specifically)? adenectomy B. adrenopathy C. adrenalectomy D. pancreatectomy A. Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. 49

QUICK QUIZ: (cont’d) 4. Which term means a blood condition of too little potassium? hyperkalemia B. hypocalcemia C. hypercalciuria D. hypokalemia A. Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. 50

Pathology—Thyroid Gland Goiter: Enlargement of the thyroid Hypersecretion Hyperthyroidism Ø Graves’ disease • Exophthalmos and proptosis Hyposecretion Hypothyroidism Ø Myxedema Ø Cretinism Neoplasms Thyroid carcinoma Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. 52

Pathology—Parathyroid Hypersecretion Hyperparathyroidism Loss of bone density Ø Kidney stones Ø Hypercalcemia Ø Hyposecretion Hypoparathyroidism Muscle and nerve weakness Ø Tetany Ø Hypocalcemia Ø Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. 53

Pathology—Adrenal Cortex Hypersecretion adrenal virilism amenorrhea, hirsutism, acne, voice deepening Cushing syndrome Obesity, moonface, thoracic fat deposition Hyposecretion Addison disease Deficient mineral-and gluco-corticoids, hyponatremia, fatigue, weakness, weight loss, low blood pressure Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. 54

Pathology—Adrenal Medulla Hypersecretion Pheochromocytoma Benign tumor of adrenal medulla Excess epinephrine and norepinephrine Hypertension, palpitations, severe headaches, sweating, flushing of the face, and muscle spasms Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. 55

Pathology—Pancreas Hypersecretion Hyperinsulinism Hypoglycemia, convulsions, fainting Hyposecretion Diabetes mellitus Lack of insulin secretion or resistance of insulin in promoting sugar, starch, and fat metabolism in cells Type 1 : childhood onset, typically Type 2 : adult onset, typically Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. 56

Pathology Pituitary Gland: (Anterior Lobe) Hypersecretion acromegaly gigantism Hyposecretion dwarfism panhypopituitarism Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. 58

Pathology Pituitary Gland: (Posterior Lobe) Hypersecretion Syndrome of inappropriate ADH (SIADH) Excess ADH Excess water retention Hyposecretion Diabetes insipidus Deficient ADH Polyuria and polydipsia Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. 59

Laboratory Tests Fasting plasma glucose (FPG) Ø Serum and urine tests Ø Measures circulating glucose in a patient who has fasted at least 8 hours Measures hormones, electrolytes, glucose, etc. , in blood and urine as indicators of endocrine function Thyroid function tests Ø Measures T 3, T 4, and TSH in the bloodstream Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. 62

Clinical Procedures exophthalmometry computed tomography (CT) scan magnetic resonance imaging (MRI) of the head radioactive iodine uptake (RAIU) thyroid scan ultrasound examination Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. 63

Review Sheet COMBINING FORMS Combining Form Meaning aden/o ______ adren/o ______ adrenal/o andr/o ______ calc/o, calici/o ______ cortic/o ____________ Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. 64

Review Sheet (cont’d) COMBINING FORMS Combining Form Meaning aden/o gland adren/o adrenal glands adrenal/o andr/o male calc/o, calici/o calcium cortic/o cortex, outer region adrenal glands Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. 65

Review Sheet (cont’d) COMBINING FORMS Combining Form Meaning crin/o ______ dips/o ______ estr/o ______ gluc/o, glyc/o ______ gonad/o ______ home/o ______ Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. 66

Review Sheet (cont’d) COMBINING FORMS Combining Form crin/o dips/o estr/o gluc/o, glyc/o gonad/o home/o Meaning secrete third female sugar sex glands (ovaries, testes) sameness Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. 67

Review Sheet (cont’d) COMBINING FORMS Combining Form hormon/o kal/i insulin/o lact/o myx/o natr/o Meaning ____________ ____________ Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. 68

Review Sheet (cont’d) COMBINING FORMS Combining Form hormon/o kal/i insulin/o lact/o myx/o natr/o Meaning hormone potassium (an electrolyte) insulin milk mucus sodium (an electrolyte) Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. 69

Review Sheet (cont’d) COMBINING FORMS Combining Form pancreat/o parathyroid/o phys/o pituitar/o somat/o ster/o Meaning ____________ or ____________ Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. 70

Review Sheet (cont’d) COMBINING FORMS Combining Form pancreat/o parathyroid/o phys/o pituitar/o somat/o ster/o Meaning pancreas parathyroid gland growing pituitary gland; or hypophysis body solid structure Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. 71

Review Sheet (cont’d) COMBINING FORMS Combining Form thyr/o thyroid/o toc/o toxic/o ur/o Meaning ____________ ______ Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. 72

Review Sheet (cont’d) COMBINING FORMS Combining Form thyr/o thyroid/o toc/o toxic/o ur/o Meaning thyroid gland childbirth position urine Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. 73

Review Sheet (cont’d) SUFFIXES Suffix Meaning -agon -emia -in, -ine -tropin -uria assemble, gather together blood condition a substance stimulating the function of urine condition Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. 75

Review Sheet (cont’d) PREFIXES Prefix Meaning euhyperhypooxypantetratri- good, normal excessive, above deficient, below rapid, sharp, acid all four three Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. 77

QUICK QUIZ: 5. What is the pathologic condition in which enlargement of the extremities is caused by hypersecretion of the anterior pituitary after puberty? A. Addison disease B. acromegaly C. Cushing syndrome D. Graves disease Copyright © 2011, 2008, 2005 by Saunders, an imprint of Elsevier Inc. All rights reserved. 78