ENDOCRINE SYSTEM

Endocrine System

Endocrine system regulates essential activities of the body

Metabolism

of nutrients Reproduction Growth and development Adapting to change in internal and external environments

Major Endocrine Organs

Hypothalamus Pituitary gland Thyroid gland Parathyroid glands Pancreas Adrenal glands Ovaries Testes

Local Tissue Hormones

Endocrine like cells in the Gastrointestinal mucosa hormones that aid in digestion Kidneys erythropoietin hormone that stimulates bone marrow to produce RBCs White blood cells cytokines inflammation Body tissues prostaglandins and leukotrienes

Endocrine System and Nervous System

Closely connected Work together to regulate body function Main connecting link is the hypothalamus responds to nervous system stimulation by producing hormones Hypothalamus will initiate the hormone response

Hormone Pharmacokinetics

Water soluble hormones, protein-derived hormones have a short duration of action and are inactivated by enzymes in liver and kidneys. Lipid soluble hormones and thyroid hormones have a longer duration because they are bound to plasma protein they are broken down in the liver and excreted in bile or urine.

Hormones types

Lipid Soluble Hormones

Steroid

and thyroid are constantly present in the

blood.

Water Soluble Hormones

not enter the target cells form weak bonds with receptor sites on the cell membrane. Sometimes called the second messenger Examples: glucagon, adrenalin and parathyroid hormones. Hormones are be released as needed.
Do

Hormone Disorders

Abnormal secretion and function of hormones can impair physical and mental health. Malfunction of endocrine organ
Hypersecretion

(too much) hyposecetion (too little)

What Can Influence Hormone Levels?

Stress Infection Fluid balance Minerals in blood Structural changes in glands

HYPOTHALAMIC AND PITUITARY

Hypothalamus

Interacts with the pituitary gland to control most metabolic functions of the body. Controls secretions of the pituitary gland.

Pituitary Gland

The pituitary gland is sometimes called the "master" gland of the endocrine system, because it controls the functions of the other endocrine glands. The pituitary gland is no larger than a pea, and is located at the base of the brain. The gland is attached to the hypothalamus (a part of the brain that affects the pituitary gland) by nerve fibers.

Hypothalamas and Pituitary

Pharmacologic applications of drugs that mimic or block the effects of hypothalamic and pituitary hormones are:
replacement

therapy antagonists for diseases diagnostic tools

Anterior Pituitary Gland

Anterior pituitary gland

Growth

hormone Adrenal cortex ACTH glucocorticoids TSH thyroid stimulating hormone FSH follicle stimulating hormone ovary estrogen and progesterone LH - luteinizing hormone stimulates ovulation Prolactin breast tissue milk production Testosterone testes

Anterior Pituitary Hormones

Each of anterior pituitary hormone is synthesized by a cell population.

Corticotropes Lactotropes Somatotropes Thyrotropes Gonadotropes

ACTH Prolactin GH Thyrotropin

FSH, LH

Anterior Pituitary Hormones

Growth Hormone (GH, Somatotropin): primary hormone responsible for regulating body growth, and is important in metabolism Thyroid-stimulating Hormone (TSH): stimulates secretion of thyroid hormone & growth of thyroid gland

Adrenocorticotropic Hormone (ACTH): stimulates cortisol secretion by the adrenal cortex & promotes growth of adrenal cortex

Anterior Pituitary Hormones

Follicle-stimulating Hormone (FSH):

Females: stimulates growth & development of ovarian follicles, promotes secretion of estrogen by ovaries. Males: required for sperm production

Luteinizing Hormone (LH):

Females: responsible for ovulation, formation of corpus luteum in the ovary, and regulation of ovarian secretion of female sex hormones.
Males: stimulates cell in the testes to secrete testosterone Females: stimulates breast development and milk production. Males: involved in testicular function

Prolactin:

Endocrine Control: Three Levels of Integration

Hypothalamic stimulationfrom CNS Pituitary stimulationfrom hypothalamic trophic Hs Endocrine gland stimulationfrom pituitary trophic Hs

Endocrine Control: Three Levels of Integration

Figure 7-13: Hormones of the hypothalamic-anterior pituitary pathway

Growth Hormone (Somatotropin)

primary hormone responsible for regulating body growth Increases plasma free fatty acids (FFA) - source of energy for muscle tissue Increases hepatic glucose output Decreases insulin sensitivity in muscle Is protein anabolic hormone

Exerts its growth-promoting through interactions

IGF-I synthesis is stimulated by GH

Indications of Growth hormone

Growth failure in pediatric patients

Growth hormone deficiency Chronic renal insufficiency pre-transplant Turner syndrome

Growth hormone deficiency in adults

Improved metabolic state, increased lean body mass, sense of well-being

Increased lean body mass, weight, and physical endurance Improved gastrointestinal function

Wasting in AIDS patients

Short bowel syndrome (TPN pts)

Posterior Pituitary

Comprised of the endings of axons from cell bodies in the hypothalamus (supraoptic and paraventricular) Axons pass from the hypothalamus to the posterior pituitary via the hypothalamohypophysial tract Hormones synthesized in the hypothalamus are transported down the axons to the endings in the posterior pituitary Hormones are stored in vesicles in the posterior pituitary until release into the circulation

Posterior Pituitary Gland

ADH antidiuretic hormone kidney regulates water balance Oxytocin uterus and breast labor and breast feeding

Oxytocin

Is synthesized as the precursor hormone: prepro-oxyphysin Acts primarily on the mammary gland and uterus

Increases contraction of smooth muscle of the vas deferene

Secretion is increased during labor May also act to facilitate sperm transport in uterus (non-pregnancy state)

Oxytocin

Clinical uses: After delivery of infant and placenta in obstetrics. In small dosages to stimulate or induce labor in a pregnant woman Oxytocin (Pitocin) given IV after delivery to help the uterus to contract.

Posterior Pituitary: Regulation of Osmolality

Plasma osmolality is monitored by osmoreceptors in the hypothalamus Increases in plasma osmolality stimulates secretion of vasopressin Small changes above the normal plasma osmotic pressure (285 mosm/kg) stimulate release of vasopressin

Vasopressin (ADH)
Is also known as antiduretic hormone (ADH) Participates in body water regulation (Water is lost from lungs, sweat, feces and urine on a daily basis)

Vasopressin (ADH) Secretion

Secretion is Stimulated by:

Large

decreases in blood volume

in blood pressure

Decreases Pain,

fear, trauma, and stress

Vasopressin Activity
Decreases water excretion by kidneys (V2 receptors) Constricts blood vessels (V1 receptors)arteriolar smooth muscle Increases adrenocorticortropin hormone (V1B receptors) secretion from the anterior pituitary

Dysfunction of Posterior Pituitary

Remember the pituitary gland directs function of the antidiuretic hormone in the kidneys which has to do with normal fluid balance.

Posterior Pituitary Dysfunction

Clinical Diagnosis: diabetes insipidus characterized by high output of dilute urine can be idiopathic (do not know the cause) can occur after head trauma, with tumor of hypothalamus or posterior pituitary Importance of intake and output and specific gravity

ADH and Water Balance

Synthesized in the brain (what part?), released from posterior pituitary. Stim by hypo-osmotic neurons in response to incr osmolarity of blood or decr blood vol., and by pain, some drugs, low bp. Action: increases permeability of the distal convoluted tubule and collecting ducts to water Result: - increased water reabsorption from urine - decreased urine volume - decreased osmolality of interstitial fluids - increased blood pressure

Regulation of ADH Secretion

Response to osmolality of interstitial fluid: - Osmoreceptors in the brain detect changes in osmolality of the interstitial fluid or blood. - Increased osmolality results in increased [solutes] ADH release - increased water reabsorption - decreased osmolality of fluids - Decreased osmolality results in decreased ADH release = NEGATIVE FEEDBACK! - decreased water reabsorption - increased osmolality of fluids

Regulation of AVP Secretion

Response to changes in blood pressure: - Blood pressure receptors in heart, aortic arch, and carotid artery - Increased blood pressure results in decreased ADH release - decreased water reabsorption - decreased blood volume, blood pressure - Decreased blood pressure results in increased ADH release - increased water reabsorption - increased blood volume, pressure

Feedback mechanisms in the control of blood osmotic pressurethe control of ADH.

Nursing Considerations

Observe for headache, nasal congestion, nausea Monitor blood pressure drug may cause increase in blood pressure Most serious side effect is water retention and hyponatremia