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

Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.

Chapter 14

Endocrine System Diseases and Disorders

Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.

Anatomy and Physiology

• Endocrine system consists of many glands, including:– Hypothalamus

– Pituitary

– Pineal

– Thymus

– Thyroid



• Endocrine system consists of many glands, including:– Parathyroids

– Adrenals

– Pancreatic islets

– Ovaries and testes



• Each gland unique and delivers secretion into bloodstream

• Negative feedback system controls amount of hormones secreted


Animation

Click Here to Play Endocrine System Animation


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


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



• Hypopituitarism– Abnormal decrease in activity of pituitary gland

– Effects:• Dwarfism

• Abnormality of secondary sex characteristics

• Amenorrhea and infertility in adult females



• 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



• Hypopituitarism– Treatment:

• Hormone replacement

• Monitoring

• Adjustment



• Diabetes insipidus– Caused by decrease in release of vasopressin or antidiuretic

hormone

– Excessive polyuria• Urinating 2 to 15 gallons of urine in 24 hours



• Diabetes insipidus– Symptoms:

• Polydipsia

• Hypotension

• Dizziness

• Constipation



• Diabetes insipidus– Diagnosis by urinalysis and water restriction test

– Urine• Colorless

• Low specific gravity

– Treatment:• Administration of vasopressin


Thyroid Gland Diseases

• Hyperthyroidism– Thyroid gland secretes excessive thyroxine

– Caused by tumor of thyroid gland

– Symptoms:• Tachycardia

• Nervousness

• Hyperactivity

• Excessive excitability



• Hyperthyroidism– Symptoms:

• Tremendous appetite with weight loss

• Diarrhea

• High heat production

• Moist skin

• Extreme thirst



• Hyperthyroidism– Treatment to reduce thyroxine often effective

– Surgery may be necessary



• Hyperthyroidism– Autoimmune condition

• Graves’ disease

• Symptoms:– Exophthalmos

• Treatment:– Medication

– Radiation

– Surgery


Exophthalmos

Photo courtesy Mark L. Kuss



• 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


Goiter

Photo courtesy Mark L. Kuss



• Hypothyroidism– Decrease in thyroxine

– Symptoms:• Fatigue

• Sensitivity to cold temperatures

• Thin nails

• Brittle hair

• Excessive weight gain



• Hypothyroidism– Diagnosis by blood hormone level

– Treatment:• Hormone replacement


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



• Hyperparathyroidism– Diagnosis by blood tests

– Treatment directed at cause

– Prognosis good with proper treatment



• Hypoparathyroidism– Decrease in parathormone leading to low blood calcium

• Causing irritability of muscles– Tetany

– Causes uncontrolled contraction of muscles in face and hands



• Hypoparathyroidism– Diagnosis by checking for Chvostek’s and Trousseau’s

signs

– Treatment:• Vitamin D

• Calcium


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



• Adrenal glands secrete mineralocorticoids, glucocorticoids, and sex hormones

• Cortisone– Glucocorticoid used to treat inflammatory disease

– Should be used short-term only



• Cortisone side effects:– Hypertension

– Ulcers

– Moon face

– Drowsiness

– May mask symptoms of infection



• Hyperadrenalism– Oversecretion of adrenal cortex hormones

• Conn’s syndrome– Overproduction of mineralocorticoid aldosterone



• Cushing’s syndrome– Overproduction of glucocorticoid cortisol

• Androgenital syndrome– Overproduction of sex hormones



• Hypoadrenalism or Addison’s disease– Low secretion of hormones by adrenal cortex


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



• Sugar or glucose– Primary source of energy for all tissue cells

• Diabetes mellitus– Affects carbohydrate and sugar utilization due to lack of

insulin



• Diabetes mellitus– Symptoms:

• Polydipsia

• Polyuria

• Polyphagia

– Types:• Type 1

• Type 2



• 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




• 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




• 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



• Diabetes mellitus– Complications:

• Diabetic shock– Occurs rapidly

– Result of taking too much insulin and not eating enough food




• Diabetic shock– Symptoms:

» Diaphoresis

» Light-headedness

» Trembling

– Treatment:» Emergent with intravenous (IV) glucose to raise blood sugar




• Diabetic coma– Not enough insulin or too many carbohydrates in diet

– Progresses slowly with individual becoming lethargic and slipping into coma




• Diabetic coma– Symptoms:

» Slow, deep breathing pattern

» Fruity or sweet-smelling breath

» Polyuria

» Polydipsia

» Dehydration

» Ketoacidosis




• Atherosclerosis

• Diabetic retinopathy

• Kidney damage

– Diagnosis by history and blood glucose testing

– No cure



• Gestational diabetes– Can occur during pregnancy

– Usually discovered with routine urine testing during prenatal visits

– Treatment:• Diet

• Exercise

• Medications



• Gestational diabetes– Injectable insulin controls sugar levels

– Usually disappears after delivery

– Women often affected later in life by adult-onset diabetes



• Hypoglycemia– Abnormally low blood sugar

• Less than 60

– Symptoms:• Light-headedness

• Diaphoresis

• Trembling



• Hypoglycemia– Diagnosis by glucose test

– Treatment dependent on cause


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


Reproductive Gland Diseases

• Hypogonadism– Decreased sex hormone production by puberty

– Treated with hormones


Effects of Aging

• Decreased secretions from glands

• Lessened glucose tolerance

• Diabetes mellitus common

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

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