1. Disorders of the Endocrine Glands
Nrsg 407

2. Function Various glands in body Secretes hormones
Transported throughout body

3. Negative feedback One hormone controls secretion of another
Last hormone in the pathway controls secretion of first hormone

4. Pituitary gland Master gland Controls several organs and hormones
Works together with hypothalamus

5. Pituitary Gland Anterior or Adenohypophysis contains glandular tissue
Posterior or Neurohypophysis contains nervous tissue

6. Anterior Pituitary - Hormones

7. Posterior Pituitary

8. Posterior pituitary - SIADH
Lack of ADH [aka Syndrome of inappropriate ADH] or diabetes insipidus
Vasopressin (pitressin)
Act on renal tubules to promote reabsorption of water
Vasopressor effect (raise BP)
SIADH – Syndrome of inappropriate ADH - The syndrome of inappropriate antidiuretic hormone (ADH) secretion (SIADH) is defined by the hyponatremia and hypo-osmolality resulting from inappropriate, continued secretion or action of the hormone despite normal or increased plasma volume, which results in impaired water excretion.

9. Thyroid 2 types of cells Parafollicular cells – calcitonin
Follicular cells – composed of iodine atoms
Thyroxine (T4)
Triiodothyronine (T3)

10. Thyroid cont’d Thyroxine hormone (T4) Regulates body metabolism
Thermal regulation
Regulation of physical/mental development
Thyroxine hormone (T4)

11. Triiodothyronine (T3) Same as T4 Converted once thyroxine enters cells
1 iodine atom eliminated by enzymes
Binds to intracellular receptors in nucleus

12. Thyrocalcitonin (Calcitonin)
Lowers plasma Ca and PO4
Increases Ca deposits in bone
Not as important due to parathyroid

13. Negative feedback mechanism
Low serum thyroxine  incr TSH  incr thyroxine  maintain normal BMR

14. Hypothyroidism Poorly functioning thyroid (primary disease) OR
Low secretion of TSH by pituitary gland (secondary cause)
Most common: chronic autoimmune thyroiditis – Hashimoto’s disease

15. Myxedema Fatigue General weakness Muscle cramps Dry skin Bradycardia
Cold intolerance

16. Hyperthyroid Most Common: Graves’ disease (primary)
Oversecretion of thyroid
Increased body metabolism
Tachycardia
Anxiety
Heat intolerance

17. Adrenal Cortex Glucocorticoids (Sugar) Sex hormones (Sex) Cortisol
Androgens

18. Adrenal Cortex
Mineralcorticoids (Salt)
Aldosterone

19. Mechanism of Control Negative feedback mechanism
Glucocorticoids and androgens: Anterior pituitary  release of ACTH  stimulates adrenal  glucocorticoid and androgen

20. Mechanism of Control Mineralcorticoids: RAAS
Hormone: Aldosterone produced
Promote sodium reabsorption and potassium excretion

21. Hypofunction Primary Secondary
Destruction by systemic infectious disease
Cancer
Autoimmune process
Secondary
Decrease ACTH or hypothalamus disease

22. Hypofunction Hypoglycemia Fatigue Hypotension
Increased skin pigmentation
Anorexia
Vomiting
diarrhea

23. Hypofunction
Chronic primary adrenocortical insufficiency (Addison’s disease)
Deficiency of all 3 hormones
Rare – usually caused by autoimmune destruction

24. Acute Adrenocortical Insufficiency
Caused when glucocorticoids abruptly withdrawn
Provide negative feedback to pituitary to stop secreting ACTH
No ACTH  adrenal stops secreting endogenous glucocorticoids
Adrenal cortex shrinks (adrenal atrophy)

25. Symptoms of Adrenal crisis
Nausea
Vomiting
Lethargy
Confusion
Coma / Shock

26. Cushing’s Syndrome Primary Secondary Iatrogenic
Cortisol-secreting tumors
Secondary
Pituitary or hypothalamus tumor
ACTH secreting tumor
Iatrogenic
Overdosage of glucocorticoid

27. Signs/Symptoms Hyperglycemia Protein tissue wasting Bruising
Osteoporosis
Peptic ulcers
Delayed wound healing

28. Signs/Symptoms Abnormal fat distribution Acne
Truncal obesity
Striae
“Buffalo hump”
Moon face
Acne
Mood/ personality changes

29. Signs/Symptoms Hypokalemia Na and water retention
Decrease inflammatory response