Chapter 20, sp 10


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Chapter 20, sp 10

  1. 1. Human Anatomy, Second Edition McKinley & O'Loughlin Chapter 20 Lecture Outline: Endocrine System
  2. 2. Endocrine System <ul><li>Endocrine system and the nervous system often work together to bring about homeostasis. </li></ul><ul><li>Both use specific communication methods and affect specific target organs. </li></ul><ul><li>Their methods and effects differ. </li></ul>20-
  3. 3. Differences <ul><li>Communication Method </li></ul><ul><ul><li>NS: Nerve impulses and neurotransmitters </li></ul></ul><ul><ul><li>ES: Hormones </li></ul></ul><ul><li>Target of Stimulation </li></ul><ul><ul><li>NS: Other neurons, muscles cells, and gland cells </li></ul></ul><ul><ul><li>ES: Any cells with receptors for hormone </li></ul></ul><ul><li>Effect of Stimulation </li></ul><ul><ul><li>NS: Stimulates or inhibits muscle contraction +/- gland secretion </li></ul></ul><ul><ul><li>ES: Changes in metabolic activities </li></ul></ul><ul><li>Response time </li></ul><ul><ul><li>NS: Quick action: msec or minutes (sometimes minutes) </li></ul></ul><ul><ul><li>ES : Slower response: sec to hours to days </li></ul></ul>20-
  4. 4. Differences <ul><li>Range of Effect </li></ul><ul><ul><li>NS: Localized </li></ul></ul><ul><ul><li>ES: Widespread </li></ul></ul><ul><li>Duration of Response </li></ul><ul><ul><li>NS: Short term effects generally </li></ul></ul><ul><ul><li>ES: Long-term effects generally </li></ul></ul><ul><li>Recovery Time </li></ul><ul><ul><li>NS: rapid </li></ul></ul><ul><ul><li>ES : Slow </li></ul></ul>20-
  5. 5. Similarities <ul><li>Release chemicals that bind to receptors </li></ul><ul><li>Many of the same chemical messengers </li></ul><ul><li>Regulated mainly by negative feedback </li></ul><ul><li>Common goal: coordinate and regulate </li></ul><ul><li>Interlocking systems: neuroendocrine system </li></ul>20-
  6. 6.
  7. 7. Endocrine Glands & Hormones <ul><li>Exocrine glands </li></ul><ul><ul><li>secretions released into ducts opening onto an epithelial surface </li></ul></ul><ul><li>Endocrine glands </li></ul><ul><ul><li>ductless organs that secrete their molecules directly into the bloodstream </li></ul></ul><ul><li>All endocrine cells are located within highly vascularized areas to ensure that their products enter the bloodstream immediately. </li></ul>20-
  8. 8. Overview of Hormones <ul><li>Molecules that have an effect on specific organs. </li></ul><ul><li>Only cells with specific receptors respond to that hormone. </li></ul><ul><ul><li>Receptors are large proteins or glycoproteins </li></ul></ul><ul><ul><li>About 2000-100,000 receptors/target cell </li></ul></ul><ul><ul><li>Combination of hormone and receptor activates a chain of events in the target cell leading to physiological effects </li></ul></ul><ul><ul><li>Increasing the hormone levels leads to a decrease in the number of receptors </li></ul></ul><ul><ul><li>Amount of hormone released regulated by need </li></ul></ul>20-
  9. 9. Overview of Hormones <ul><li>Cell with receptors are called target cells , and the organs that contain them are called target organs . </li></ul><ul><ul><li>The response to a hormone depends on both the hormone and the target cell </li></ul></ul><ul><ul><li>Various target cells respond differently to the same hormone </li></ul></ul><ul><li>Organs, tissues, or cells lacking the specific receptor do not respond to its stimulating effects. </li></ul>20-
  10. 10. Blocking Hormone Receptors <ul><li>RU-486 blocks the receptor for progesterone and, thereby, blocks the effects of progesterone in maintaining the uterine lining and abortion of the embryo </li></ul>20-
  11. 11. Classification of Hormones <ul><li>Peptide hormones (water soluble) </li></ul><ul><ul><li>formed from chains of amino acids </li></ul></ul><ul><ul><li>most of our body’s hormones are peptide hormones </li></ul></ul><ul><ul><li>longer chains are called protein hormones </li></ul></ul><ul><ul><li>Examples: all hormones of the hypothalamus and the anterior pituitary </li></ul></ul><ul><li>Biogenic amines (water soluble) </li></ul><ul><ul><li>small molecules produced by altering the structure of a specific amino acid </li></ul></ul><ul><ul><li>Examples: thyroid hormone, catecholamines </li></ul></ul><ul><li>Steroid hormones (lipid soluble) </li></ul><ul><ul><li>derived from cholesterol </li></ul></ul><ul><ul><li>Examples: hormones of the reproductive organs and adrenal cortex </li></ul></ul>20-
  12. 12. Classification of Hormones <ul><li>Circulating hormones </li></ul><ul><ul><li>Act on distant target cells </li></ul></ul><ul><ul><li>Inactivated by liver in time </li></ul></ul><ul><ul><li>Most common </li></ul></ul><ul><li>Local hormones </li></ul><ul><ul><li>Act on nearby target cells or same cell </li></ul></ul><ul><ul><li>Inactivated quickly </li></ul></ul>20-
  13. 13. Negative Feedback Loop <ul><li>A stimulus starts a process, and eventually either the hormone that is secreted or a product of its effects causes the process to slow down or turn off. </li></ul><ul><li>Many hormonal systems work by negative feedback mechanisms. </li></ul>20-
  14. 14.
  15. 15. Positive Feedback Loop <ul><li>Accelerates the original process, either to ensure that the pathway continues to run or to speed up its activities. </li></ul><ul><li>Only a few positive feedback loops occur in the human endocrine system. </li></ul><ul><ul><li>one example is the process of milk release from the mammary glands </li></ul></ul>20-
  16. 16.
  17. 17. Control of Hormone Secretions <ul><li>Most hormones released in short bursts </li></ul><ul><li>When endocrine gland stimulated, then more frequent bursts </li></ul><ul><li>Three regulatory mechanisms </li></ul><ul><ul><li>Humoral (ex., blood levels of a nutrient) </li></ul></ul><ul><ul><li>Neural </li></ul></ul><ul><ul><li>Hormonal </li></ul></ul>20-
  18. 18. Hypothalamic Control of the Endocrine System <ul><li>The hypothalamus is the master control center of the endocrine system and oversees most endocrine activity. </li></ul><ul><ul><li>the hypothalamus secretes regulatory hormones that regulate the secretion of most of the anterior pituitary hormones </li></ul></ul><ul><li>The hypothalamus has indirect control over these endocrine organs. </li></ul><ul><li>It is the major integrating link between the nervous and endocrine systems </li></ul><ul><li>The hypothalamus and pituitary gland have important roles in all aspects of growth, development, metabolism, and homeostasis </li></ul>20-
  19. 19. Hypothalamic Control of the Endocrine System <ul><li>Hypothalamus produces two hormones that are transported to and stored in the posterior pituitary. </li></ul><ul><ul><li>oxytocin </li></ul></ul><ul><ul><li>antidiuretic hormone (ADH) or vasopressin </li></ul></ul><ul><li>Hypothalamus directly oversees the stimulation and hormone secretion of the adrenal medulla. </li></ul><ul><ul><li>An endocrine structure that secretes its hormones in response to stimulation by the sympathetic nervous system. </li></ul></ul><ul><li>Some endocrine cells are not under direct control of hypothalamus. </li></ul>20-
  20. 20.
  21. 21. Pituitary Gland (Hypophysis) <ul><li>Called the “master gland” but it is controlled in two ways by the hypothalamus </li></ul><ul><li>Partitioned both structurally and functionally into an anterior pituitary and a posterior pituitary. </li></ul><ul><ul><li>Anterior pituitary (adenohypophysis) is glandular tissue that produces hormones </li></ul></ul><ul><ul><li>Posterior pituitary (neurohypophysis) is neural tissue </li></ul></ul>20-
  22. 22.
  23. 23. Control of Anterior Pituitary Gland Secretions <ul><li>Anterior pituitary gland is controlled by regulatory hormones secreted by the hypothalamus. </li></ul><ul><ul><li>Releasing hormones </li></ul></ul><ul><ul><li>Inhibiting hormones </li></ul></ul><ul><li>Hormones reach the anterior pituitary via hypothalamo- hypophyseal portal system . </li></ul><ul><ul><li>a “shunt” that takes venous blood carrying regulatory hormones from the hypothalamus directly to the anterior pituitary before the blood returns to the heart </li></ul></ul>20-
  24. 24.
  25. 25. Tropic Hormones <ul><li>Most hormones from the anterior pituitary are tropic hormones or tropins and activate other endocrine glands </li></ul>20-
  26. 26.
  27. 27. Anterior Pituitary Hormones <ul><li>TSH - thyroid stimulating hormone </li></ul><ul><li>PRL - prolactin develops the breast and milk production in pregnant women </li></ul><ul><li>ACTH - adrenocorticotropic hormone </li></ul><ul><li>Gonadotropins: FSH and LH - regulate hormone synthesis by gonads and production and maturation of gametes </li></ul><ul><li>MSH - melanocyte stimulating hormone has little effect on humans and production ceases prior to adulthood except in specific diseases </li></ul><ul><li>GH - growth hormone (somatotropin) stimulates growth of the entire body by increasing protein production and growth of the epiphyseal plates </li></ul>20-
  28. 28. Disorders of Growth Hormone Secretion <ul><li>Pituitary dwarfism </li></ul><ul><ul><li>Lack of GH in a child </li></ul></ul><ul><ul><li>Very short and often have periodic low blood sugar </li></ul></ul><ul><ul><li>Injections of GH helps </li></ul></ul><ul><li>Pituitary gigantism </li></ul><ul><ul><li>Excess GH in a child </li></ul></ul><ul><ul><li>Very tall and leads to increased levels of blood sugar (untreated can lead to diabetes and heart failure) and large internal organs </li></ul></ul><ul><li>Acromegaly </li></ul><ul><ul><li>Excess GH in an adult </li></ul></ul><ul><ul><li>Bones of hands, feet and face increase in size </li></ul></ul><ul><ul><li>Diabetes and large internal organs </li></ul></ul><ul><ul><li>Cause: lack of feedback or pituitary tumor </li></ul></ul>20-
  29. 29. Hypophysectomy <ul><li>Historically, used to treat advanced breast and prostate cancer to remove the hormone stimulation for their growth. Medications used now. </li></ul><ul><li>Currently, used to treat pituitary tumors. Radiation may also be used. </li></ul>20-
  30. 30. Posterior Pituitary Hormones <ul><li>Made by the hypothalamus, stored in the posterior pituitary </li></ul><ul><li>Oxytocin (OT) </li></ul><ul><ul><li>stimulates contraction of smooth muscle of the uterus and ejection of milk in females </li></ul></ul><ul><ul><li>leads to prostate gland secretion in males </li></ul></ul><ul><ul><li>regulated by positive feedback! </li></ul></ul><ul><ul><li>makes us want to cuddle, groom, and pair bond </li></ul></ul><ul><li>Antidiuretic hormone (ADH) or vasopressin </li></ul><ul><ul><li>stimulates water reabsorption by the kidneys and arteriole constriction </li></ul></ul><ul><ul><li>secretion inhibited by alcohol </li></ul></ul><ul><ul><li>Lack: diabetes insipidus (normal urine output of 1-2 liters/day increases to about 20 liters/day) </li></ul></ul>20-
  31. 31. Thyroid Gland <ul><li>Inferior to the thyroid cartilage of the larynx and anterior to the trachea. </li></ul><ul><li>“ Butterfly” shape due to its left and right lobes connected by a narrow isthmus. </li></ul><ul><li>The thyroid gland is highly vascularized, giving it an intense reddish coloration. </li></ul><ul><li>Regulation of thyroid hormone secretion depends upon a complex thyroid gland–pituitary gland negative feedback process. </li></ul>20-
  32. 32. Thyroid Gland Hormones <ul><li>Follicular cells produce thyroxine (T4) and triiodothyronine (T3) </li></ul><ul><ul><li>Regulate the rate of metabolism </li></ul></ul><ul><ul><li>Most cells are targets </li></ul></ul><ul><ul><li>Needed for normal growth and development (including the brain) </li></ul></ul><ul><ul><li>Iodide is oxidized to iodine and then combines with tyrosine to produce these hormones - occurs within a large glycoprotein molecule, thyroglobulin, which is secreted into follicle </li></ul></ul><ul><ul><li>Scalloping of edges of thyroglobulin indicates active secretion </li></ul></ul>20-
  33. 33. Thyroid Gland Hormones <ul><li>Parafollicular cells (Clear or C cells) produce calcitonin which reduces blood calcium levels in children and deposits calcium in the bones. Opposes actions of parathyroid hormone. </li></ul>20-
  34. 34.
  35. 35.
  36. 36.
  37. 37. Disorders of Thyroid Gland Secretion <ul><li>Hyperthyroidism </li></ul><ul><ul><li>Increased metabolic rate, weight loss, hyperactivity and heat intolerance </li></ul></ul><ul><ul><li>Causes: ingestion of T4, excessive stimulation by the pituitary, loss of feedback control by the thyroid (Graves disease) </li></ul></ul><ul><ul><li>Graves disease </li></ul></ul><ul><ul><ul><li>Autoimmune </li></ul></ul></ul><ul><ul><ul><li>Exophthalmos </li></ul></ul></ul><ul><ul><ul><li>Goiter </li></ul></ul></ul><ul><ul><li>Treatment: removal or radioactive iodine </li></ul></ul>20-
  38. 38. Disorders of Thyroid Gland Secretion <ul><li>Hypothyroidism </li></ul><ul><ul><li>Lack of thyroid hormone </li></ul></ul><ul><ul><li>Low metabolic rate, lethargy, feel cold, weight gain some times, photophobia </li></ul></ul><ul><ul><li>Causes: decreased iodine intake, loss of pituitary stimulation, post-therapeutic hypothyroidism, autoimmune </li></ul></ul><ul><ul><li>Treatment: oral replacement </li></ul></ul><ul><ul><li>Cretinism - severe form </li></ul></ul><ul><ul><li>Myxedema - adult form </li></ul></ul><ul><li>Goiter </li></ul><ul><ul><li>Enlargement of the thyroid </li></ul></ul><ul><ul><li>Endemic from lack of iodine </li></ul></ul><ul><ul><li>Surgical removal to decrease size may be required </li></ul></ul>20-
  39. 39. Parathyroid Glands <ul><li>Small, brownish-red glands on the posterior surface of the thyroid gland. </li></ul><ul><li>Usually four small nodules, but some may have as few as two or as many as six. </li></ul><ul><li>The chief cells are the source of parathyroid hormone (PTH). </li></ul><ul><ul><li>stimulates osteoclasts to resorb bone and release calcium ions from bone matrix into the bloodstream </li></ul></ul><ul><ul><li>stimulates calcitriol hormone synthesis in the kidney </li></ul></ul><ul><ul><li>promotes calcium absorption in the small intestine </li></ul></ul><ul><ul><li>prevents the loss of calcium ions during the formation of urine </li></ul></ul><ul><li>The function of oxyphil cells is not known. </li></ul>20-
  40. 40.
  41. 41.
  42. 42.
  43. 43. Disorders of Parathyroid Gland Secretion <ul><li>Hyperparathyroidism is most common </li></ul><ul><ul><li>Bones depleted of calcium (fractures) </li></ul></ul><ul><ul><li>Extra urinary calcium leads to kidney stones </li></ul></ul><ul><ul><li>High blood calcium leads to decreased GI motility and constipation </li></ul></ul><ul><ul><li>High blood calcium leads to psychological changes </li></ul></ul><ul><li>Hypoparathyroidism is rare </li></ul><ul><ul><li>Most of the symptoms are neuromuscular and in severe cases, convulsions may occur </li></ul></ul><ul><ul><li>Due to accidental removal or damage during thyroid surgery usually or, less common, autoimmune disorder </li></ul></ul><ul><ul><li>Therapy is dietary vitamin D/calcium supplementation </li></ul></ul>20-
  44. 44. Adrenal Glands (suprarenal) <ul><li>Paired, pyramid-shaped endocrine glands anchored on the superior surface of each kidney. </li></ul><ul><li>Retroperitoneal and embedded in fat and fascia to minimize their movement. </li></ul><ul><li>Outer adrenal cortex and an inner adrenal medulla secrete different types of hormones </li></ul>20-
  45. 45. Adrenal Cortex <ul><li>Yellow color due to stored lipids in its cell. </li></ul><ul><li>Synthesize more than 25 different steroid hormones, the corticosteroids. </li></ul><ul><ul><li>corticosteroid synthesis is stimulated by the ACTH produced by the anterior pituitary </li></ul></ul><ul><ul><li>corticosteroids are vital to our survival; trauma to or removal of the adrenal glands requires corticosteroid supplementation </li></ul></ul><ul><li>Divided into the zona glomerulosa, the zona fasciculata, and the zona reticularis. </li></ul><ul><li>Different functional categories of steroid hormones are synthesized and secreted in the separate zones. </li></ul><ul><li>Regulates salt, sugar, and sex! </li></ul>20-
  46. 46.
  47. 47.
  48. 48.
  49. 49. <ul><li>Mnemonic device for adrenal cortical hormones: </li></ul><ul><ul><ul><li>Salt </li></ul></ul></ul><ul><ul><ul><li>Sugar </li></ul></ul></ul><ul><ul><ul><li>Sex </li></ul></ul></ul>
  50. 50. Zona glomerulosa (salt) <ul><li>Mineralocorticoids (ex., aldosterone) </li></ul><ul><li>Increase Na + (and water) reabsorption and K + loss from kidneys </li></ul><ul><li>Control salt/water balance (and, therefore, blood pressure) </li></ul><ul><li>Lack: Addison disease </li></ul><ul><li>Excess: hypertension, edema, loss of K + </li></ul>20-
  51. 51. Zona fasciculata (sugar) <ul><li>Glucocorticoids (ex., cortisone) </li></ul><ul><li>Acts on most cells </li></ul><ul><li>Help regulate blood nutrient levels (energy sources) </li></ul><ul><li>Increase blood sugar by increasing liver glucose and glycogen formation </li></ul><ul><li>Anti-inflammatory </li></ul><ul><li>Helps resist long-term stress </li></ul><ul><li>Lack: Addison disease </li></ul><ul><li>Excess: Cushing syndrome </li></ul>20-
  52. 52. Zona reticularis (sex) <ul><li>Gonadocorticoids or sex hormones </li></ul><ul><li>Most androgens from testes in adult males </li></ul>20-
  53. 53. Disorders in Adrenal Cortex Hormone Secretion <ul><li>Cushing syndrome </li></ul><ul><ul><li>Excessive glucocorticoids (usually from taking corticosteroids but may be from too much production) </li></ul></ul><ul><ul><li>Immunosuppressant, but have side effects: osteoporosis, muscle weakness, redistribution of body fat and salt retention </li></ul></ul><ul><ul><li>Symptoms: body obesity (“moon face” and “buffalo hump”), hypertension, excess hair growth, kidney stones, and menstrual irregularities </li></ul></ul>20-
  54. 54. Disorders in Adrenal Cortex Hormone Secretion <ul><li>Addison disease </li></ul><ul><ul><li>Chronic shortage of glucocorticoids and sometimes mineralocorticoids </li></ul></ul><ul><ul><li>Symptoms: weight loss, general weakening, hypotension (can be deadly), and darkening (“bronzing”) of the skin </li></ul></ul><ul><ul><li>Treat with oral corticosteroids </li></ul></ul><ul><ul><li>President Kennedy had it </li></ul></ul>20-
  55. 55. Disorders in Adrenal Cortex Hormone Secretion <ul><li>Adrenogenital syndrome (androgen insensitivity syndrome or congenital adrenal hyperplasia) </li></ul><ul><ul><li>Starts in embryo and fetus </li></ul></ul><ul><ul><li>Inability to synthesize corticosteroids so body releases massive amounts of ACTH </li></ul></ul><ul><ul><ul><li>Results in hyperplasia of the adrenal cortex and causes release of intermediary hormones that have a testosterone-like effect, virilization in newborn girls and enlarged penis and premature puberty in males. Most have salt-losing problem. </li></ul></ul></ul><ul><ul><ul><li>Treat with oral corticosteroids to inhibit release of ACTH </li></ul></ul></ul>20-
  56. 56. Adrenal Medulla <ul><li>Red-brown color due to its extensive vascularization. </li></ul><ul><li>Primarily clusters of large, spherical cells called chromaffin cells. </li></ul><ul><li>When innervated by the sympathetic division of the ANS, one population of cells secretes the hormone epinephrine and the other population secretes the hormone norepinephrine. </li></ul><ul><li>Hormones work with the sympathetic nervous system to prepare the body for an emergency or fight-or-flight situation. </li></ul>20-
  57. 57. Disorder in Adrenal Medulla Hormone Secretion <ul><li>Pheochromocytoma </li></ul><ul><ul><li>Benign tumor of chromaffin cells </li></ul></ul><ul><ul><li>Episodic secretion of large amounts of epinephrine and norepinephrine </li></ul></ul><ul><ul><li>Marked swings in blood pressure </li></ul></ul><ul><ul><li>Prolonged fight or flight symptoms </li></ul></ul><ul><ul><li>Metabolic problems: hyperglycemia and glycosuria </li></ul></ul><ul><ul><li>Untreated: fatal brain hemorrhage or heart failure </li></ul></ul><ul><ul><li>Treatment: surgery to remove tumor </li></ul></ul>20-
  58. 58. Pancreas <ul><li>Elongated, spongy, nodular organ between the duodenum of the small intestine and the spleen and posterior to the stomach. </li></ul><ul><li>Both exocrine and endocrine activities. </li></ul><ul><li>Mostly composed of cells called pancreatic acini that produce an alkaline pancreatic juice that aids in digestion </li></ul><ul><li>Scattered among the acini are small clusters of endocrine cells called pancreatic islets (islets of Langerhans) composed of four types of cells </li></ul>20-
  59. 59. Pancreas <ul><li>Alpha cells secrete glucagon when blood glucose levels drop. </li></ul><ul><li>Beta cells secrete insulin when blood glucose levels are elevated. </li></ul><ul><li>Delta cells are stimulated by high levels of nutrients in the bloodstream. </li></ul><ul><ul><li>synthesize somatostatin, also described as growth hormone-inhibiting hormone, or GHIH, which slows the release of insulin and glucagon and slows the rate of nutrient entry into the bloodstream </li></ul></ul><ul><li>F cells are stimulated by protein digestion. </li></ul><ul><ul><li>secrete pancreatic polypeptide to suppress and regulate somatostatin secretion from delta cells </li></ul></ul><ul><li>Pancreatic hormones provide for orderly uptake and processing of nutrients. </li></ul>20-
  60. 60.
  61. 61.
  62. 62. Diabetes Mellitus (“sweet urine”) <ul><li>General </li></ul><ul><ul><li>Inadequate uptake of glucose from blood </li></ul></ul><ul><ul><li>Glucose spills over into the urine </li></ul></ul><ul><ul><li>“ Starving in the midst of plenty” </li></ul></ul><ul><ul><li>Chronically high blood glucose damages blood vessels especially smaller arterioles </li></ul></ul><ul><ul><ul><li>Retinal blindness </li></ul></ul></ul><ul><ul><ul><li>Kidney failure </li></ul></ul></ul><ul><ul><ul><li>Leg amputations </li></ul></ul></ul><ul><ul><li>Increases incidence of heart disease and stroke </li></ul></ul>20-
  63. 63. Diabetes Mellitus (“sweet urine”) <ul><li>Type 1 diabetes </li></ul><ul><ul><li>Insulin-dependent DM </li></ul></ul><ul><ul><li>Usually in children and young individuals - not related to obesity </li></ul></ul><ul><ul><li>Autoimmune - trigger event may be viral </li></ul></ul><ul><ul><li>Beta cells are destroyed </li></ul></ul><ul><ul><li>New monitoring instruments and automated delivery of insulin have helped treatment and lifestyle </li></ul></ul>20-
  64. 64. Diabetes Mellitus (“sweet urine”) <ul><li>Type 2 diabetes </li></ul><ul><ul><li>Insulin-independent DM </li></ul></ul><ul><ul><li>Decreased insulin release or decreased insulin effectiveness at peripheral tissues </li></ul></ul><ul><ul><li>Formerly, adult-onset DM but it is being seen in the young increasingly </li></ul></ul><ul><ul><li>Obesity plays a major role in its development </li></ul></ul><ul><ul><li>Treatment: For most, diet, exercise, and medications that enhance insulin release or increase its sensitivity at the tissue level. More severe cases, insulin injections. </li></ul></ul>20-
  65. 65. Diabetes Mellitus (“sweet urine”) <ul><li>Gestational diabetes </li></ul><ul><ul><li>Occurs in some pregnant women esp. towards end of pregnancy </li></ul></ul><ul><ul><li>Untreated: risk to fetus and increases complications of delivery </li></ul></ul><ul><ul><li>Risk: overweight, African American, Native American, or Hispanic, or those with a family history </li></ul></ul><ul><ul><li>Usually resolves after birth, but 20-50% chance of type 2 DM within 10 years </li></ul></ul>20-
  66. 66. <ul><li>Pancreas transplants have many risks </li></ul><ul><li>Islet cell transplants less invasive but still many complications </li></ul>New Treatments for Severe DM 20-
  67. 67. <ul><li>May result from too much insulin </li></ul><ul><li>Quickly leads to insulin shock </li></ul><ul><li>If not sure if diabetic coma or insulin shock, treat for insulin shock </li></ul>Hypoglycemia Danger 20-
  68. 68. Metabolic Syndrome <ul><li>According to the American Heart Association, almost 25% of Americans have metabolic syndrome. </li></ul>20-
  69. 69. Metabolic Syndrome <ul><li>Metabolic syndrome increases the risk of: </li></ul><ul><ul><li>Coronary artery disease </li></ul></ul><ul><ul><li>Stroke </li></ul></ul><ul><ul><li>Diabetes </li></ul></ul>20-
  70. 70. Metabolic Syndrome <ul><li>Risk factors (must have 3) </li></ul><ul><ul><li>Obesity (waist greater than 35 in. for women and 40 in. for men) </li></ul></ul><ul><ul><li>High blood pressure (greater than 130/85 mm Hg) </li></ul></ul><ul><ul><li>High blood glucose (110 mg/dL or greater) </li></ul></ul><ul><ul><li>Abnormal cholesterol profile (dyslipidemia) </li></ul></ul><ul><ul><ul><li>Triglycerides (greater than 150 mg/dL) </li></ul></ul></ul><ul><ul><ul><li>HDL (less than 50 mg/dL for women and less than 40 mg/dL for men) </li></ul></ul></ul>20-
  71. 71. Metabolic Syndrome <ul><li>Treatment requires long-term management of the risk factors </li></ul><ul><ul><li>Lose weight </li></ul></ul><ul><ul><li>Exercise </li></ul></ul><ul><ul><li>Eat a heart healthy diet </li></ul></ul>20-
  72. 72. Pineal Gland (body) <ul><li>A small, cone-shaped structure attached to the posterior region of the epithalamus. </li></ul><ul><li>Secretes melatonin. </li></ul><ul><ul><li>helps regulate a circadian rhythm (24-hour body clock) </li></ul></ul><ul><ul><li>also appears to affect the synthesis of the hypothalamic regulatory hormone responsible for FSH and LH synthesis </li></ul></ul><ul><ul><li>role in sexual maturation is not well understood </li></ul></ul>20-
  73. 73. Thymus <ul><li>Bilobed - within the mediastinum superior to the heart and posterior to the sternum. </li></ul><ul><li>Size varies </li></ul><ul><ul><li>always relatively large in infants and children </li></ul></ul><ul><ul><li>as with the pineal gland, the thymus decreases in size and activity with age, especially after puberty </li></ul></ul><ul><li>Functions principally in association with the lymphatic system to regulate and maintain body immunity. </li></ul><ul><li>Produces complementary hormones thymopoietin and thymosins. </li></ul><ul><ul><li>act by stimulating and promoting the differentiation, growth, and maturation of T-lymphocytes (thymus-derived lymphocytes) </li></ul></ul>20-
  74. 74. Endocrine Functions of the Kidneys, Heart, GI Tract, and Gonads <ul><li>Organs of the urinary, cardiovascular, digestive, and reproductive systems contain their own endocrine cells, which secrete their own hormones. </li></ul><ul><ul><li>help regulate electrolyte levels in the blood </li></ul></ul><ul><ul><li>red blood cell production, blood volume, and blood pressure </li></ul></ul><ul><ul><li>digestive system activities </li></ul></ul><ul><ul><li>sexual maturation and activity </li></ul></ul>20-
  75. 75. Aging and the Endocrine System <ul><li>Secretory activity of endocrine glands decreases, especially secretion of growth hormone and sex hormones. </li></ul><ul><li>Reduction in GH levels leads to loss of weight and body mass. </li></ul><ul><li>Testosterone or estrogen levels decline </li></ul>20-