WEEK 4: Anatomy And Physiology of The Endocrine System

**After Exam #1: Start reading the content of this handout in

preparation for lecture and discussion and participation at the
next class. **Students can read the assigned textbook as his or
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textbook, so all students must be prepared for discussion and
participation from this content.
Read the handout and highlight what you believe is most
important to know. All have significance, but all can’t have the
same weight of significance.
Endocrine Glands And Hormones
A gland is a specialized organ devised from a group of epithelial cells that form tissues
that work together to produce and secrete hormones, enzymes, and other components
that help regulate the body. There are two different types of glands, and each one
regulates a reciprocal system. The exocrine glands secrete fluid products called enzymes.
The enzymes are transported through a series of ducts and/or channels. The primary
purpose of the exocrine ducts and channels is to move substances into the body or
outside the body. The exocrine gland is responsible for the digestive system (gastric
enzymes and saliva) as well as the sweat glands. The exocrine gland secretions are
protective and functional.
Endocrine glands are ductless and release hormones directly into the bloodstream. The
hormones control regulatory function such as cellular metabolism, human growth, fluid
and electrolyte balance, and finally the production of energy. Endocrine and exocrine
glands control homeostasis (constant balance) by communicating with other organs and
tissues while regulating their assigned bodily functions. Hormones are chemical
messengers that travel through the bloodstream to their target organs and work closely
with the nervous system. Metabolic changes occur in response to the actions of
hormones.
The slightest change in hormonal levels can disrupt the metabolic balance of the entire
body. Hormones can increase or decrease a normal body process by affecting a target
organ, and the actions are known to be interrelated. Interrelatedness refers to a
fluctuation in a single hormone, which can significantly affect the actions of other
hormones. The endocrine glands (Fig. 11.1) have a generalized effect on the patient’s
metabolism, growth, development, reproduction, and many other bodily activities such
as temperature, fluid balance, and emotional responses as seen in the fight-or-flight
response.
The amount of hormone released is controlled by negative feedback inhibition. The
negative feedback inhibition process occurs when a gland releases a primary hormone,
which stimulates target cells to release a secondary hormone; the gland slows the
release of the primary hormone as it senses the rise of the secondary hormone.
Information is exchanged constantly via the bloodstream between target organs and
endocrine glands.
KEY TERMS **KNOW WELL.
adrenocorticotropic hormone (ă-DREN-o-KOR-ti-kō-TRŌ-pik HŌR-mōn, p. 846)
endocrine (EN-do-krin, p. 847)
exocrine (Ek-so-krin, p. 847)
glucocorticoids (glū-kō-KOR-ti-koydz, p. 846)
glucose tolerance test (GLŪ-cōs TŎL-ĕr-ĕns tĕst, p. 849)
hemoglobin A1c (A1c) (HĒ-mō-glō-bin, p. 849)
hormones (HOR-mōnz, p. 843)
hypersecretion (hī-per-SE-KRĒ-shun, p. 849)
hyposecretion (hī-pō-SE-KRĒ-shun, p. 849)
insulin (IN-sū-lin, p. 847)
mineralocorticoids (min-er-ăl-ō-KOR-ti-koydz, p. 846)
target cells (TÄR-gĕt sĕlz, p. 847)
target tissues (TÄR-gĕt TĬ-shū, p. 847)
thyrocalcitonin (thī-rō-KĂL-si-TŌ-nin, p. 844)
thyroid panel (THĪ-royd PĂN-ĕl, p. 849)
thyroxine (THĪ-rok-sin, p. 844)
triiodothyronine (trī-ī-ō-dō-THĪ-rō-nen, p. 844)
http://evolve.elsevier.com/Stromberg/medsurg
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Anatomy and Physiology of the Endocrine System
Organs and Structures of the Endocrine System (Fig. 35.1)
• The pituitary gland connects to the hypothalamus via the hypophyseal stalk. The
pituitary gland has two parts: the anterior pituitary (adenohypophysis) and the posterior
pituitary (neurohypophysis).
• The thyroid gland has two lobes and lies below the larynx over the thyroid cartilage, in
front of and on either side of the trachea.
• The parathyroid glands are four to six small glands that are located on the posterior
surface of the thyroid gland.
• The adrenal glands are located on the anterior upper surface of each kidney; each is
composed of the cortex and medulla.
• The pancreas sits in the upper left aspect of the abdominal cavity. Beta cells, which
secrete the hormone insulin, and alpha cells, which secrete the hormone glucagon, are
both found in the islets of Langerhans.
• The ovaries are located in the pelvic cavity in females.
• The testes hang suspended in the scrotum in males.
• The pineal gland is in the midbrain, in the cranial vault.
• The thymus gland lies at the base of the neck, in the front of the thoracic cavity.
• The heart is midchest and functions as an endocrine gland when it secretes the
hormones atrial natriuretic peptide (ANP) and B-type (or brain) natriuretic peptide
(BNP).
Functions of the Endocrine System
• When the muscle is stretched, the heart secretes hormones with a diuretic effect.
• The endocrine system alters chemical reactions and controls the rate at which
chemical activities take place within cells.
• The hormones secreted change the permeability of cell membranes and select the
substances that can be transported across cell membranes.
• The endocrine hormones activate a particular mechanism in a cell, such as the system
that controls cellular growth and reproduction. The hormones produced by the
endocrine system, the target organs on which they act, and the principal actions of each
hormone are presented in Table 35.1.
Effects of the Pituitary Hormones
• The effects of pituitary hormones when secreted are illustrated in Fig. 35.2.
• Any type of dysfunction of the pituitary gland will affect one or more of the hormones,
as well as their target organs (Fig. 35.3).
• The posterior pituitary gland does not produce hormones; it stores and then releases
oxytocin and antidiuretic hormone (ADH), which are produced in the hypothalamus.
• The anterior pituitary produces hormones that are secreted into the bloodstream as a
result of “releasing hormones” from the hypothalamus.
Effects of the Thyroid Hormones
• The thyroid gland secretes the hormones thyroxine (T4), triiodothyronine (T3), and
thyrocalcitonin. The 3 and the 4 indicate how many iodine atoms are attached.
• T3 is the more potent form of thyroid hormone. T4 is converted to T3 by removing an
iodine atom from the T4 molecule.
• Intake of protein and iodine is needed to synthesize both thyroid hormones.
• Thyroid hormones activate the cellular production of heat; stimulate protein and lipid
synthesis, mobilization, and degradation (breakdown); and stimulate the manufacture of
coenzymes from vitamins.
• Thyroid hormones regulate many aspects of carbohydrate metabolism and affect
tissue response to epinephrine and norepinephrine.
Functions of the Parathyroid Glands
• Parathormone, or parathyroid hormone, is produced and secreted by the parathyroid
glands.
• A low calcium level will stimulate release of parathormone, which increases the
plasma level of calcium. A high calcium level will inhibit the release of parathormone.
• Parathormone acts on the renal tubules to increase the excretion of phosphorus in the
urine and to stimulate the reabsorption of calcium. It also stimulates the production of
the active form of vitamin D, which enhances calcium absorption in the small intestine.
Parathormone also acts on bone, causing the release of calcium from the bone into the
bloodstream.
• Calcitonin (released by the thyroid gland) is the balance to parathormone that causes
calcium to go into the bones and allows for renal excretion to reduce calcium levels in
the blood.
Safety Alert: Parathyroid Deficiency
A deficiency of parathyroid hormone produces muscle cramps, twitching of the muscles,
and in some cases severe convulsions because of hypocalcemia.
Functions of the Adrenal Gland Hormones
• The adrenal medulla (middle portion) secretes two hormones, epinephrine and
norepinephrine (called catecholamines), in response to stimulation from the
sympathetic nervous system.
• Epinephrine prepares the body to meet stress or emergency situations and prevents
hypoglycemia (Fig. 35.4). Norepinephrine functions as a pressor (causing blood vessel
constriction) to maintain blood pressure.
• The hormones secreted by the adrenal cortex are called adrenal corticosteroids. (The
word steroid is sometimes used to designate an adrenal corticosteroid or a synthetic
compound with similar properties.)
• The two major types of hormones secreted by the adrenal cortex are the
mineralocorticoids (aldosterone) and the glucocorticoids (cortisol) (Fig. 35.5).
• The adrenal glands also secrete small amounts of androgenic hormones, which have
effects similar to those of the male and female sex hormones.
• The mineralocorticoids affect the electrolytes, particularly sodium, potassium, and
chloride. The primary mineralocorticoid is aldosterone, which promotes conservation of
water by acting on the kidney to retain sodium in exchange for potassium. Water stays
with sodium, and potassium is excreted in the urine.
• Without the mineralocorticoids, a person would die within 3 to 7 days because these
hormones directly control fluid balance, blood volume, cardiac output, exchange of
nutrients, and wastes in each cell; mineralocorticoids affect all chemical processes and
glandular functions within the body.
• The glucocorticoids are essential to the metabolic systems for proper use of
carbohydrates, proteins, and fats.
• The primary glucocorticoid is cortisol, or hydrocortisone. Cortisol acts to increase
glucose levels in the blood. Cortisol also helps counteract the inflammatory response.
• Both aldosterone and cortisol are controlled by adrenocorticotropic hormone (ACTH)–
releasing hormone from the hypothalamus and ACTH secreted by the anterior pituitary
(see Fig. 35.3).
Hormonal Function of the Pancreas
• The pancreas is both an endocrine (secretes into the bloodstream) and an exocrine
(secretes through a duct to the target tissues) gland. Its endocrine function is to produce
the hormones insulin and glucagon.
• The beta cells are responsible for producing and secreting insulin. Insulin is needed for
the cells of the body to be able to use glucose as fuel. The alpha cells release glucagon,
which stimulates the liver to change glycogen to glucose (Fig. 35.6).
Effects of Aging on the Endocrine System
• The pituitary gland becomes smaller.
• The thyroid becomes more lumpy or nodular; beginning around age 20 years,
metabolism gradually declines.
• Hormones that usually decrease with older age include aldosterone, renin, calcitonin,
and growth hormone; specific hormones decrease in older women (estrogen and
prolactin) and older men (testosterone).
• Hormones that may increase with older age include follicle-stimulating hormone (FSH),
luteinizing hormone (LH), norepinephrine, and ADH.
• Hormones that remain unchanged or are only slightly decreased with older age include
thyroid hormones (T3 and T4), cortisol, insulin, epinephrine, parathyroid hormone, and
25-hydroxyvitamin D.
• Blood glucose levels rise with older age, with fasting levels climbing about 1 mg/dL for
each decade after the age of 50 years and postprandial levels increasing 6 to 13 mg/dL.
• Although insulin levels remain unchanged with age, decreased glucose tolerance may
occur because of changes in the cell receptor sites; older adults experience
hypoglycemia more quickly than younger people and may progress to dangerously low
levels of blood glucose before signs and symptoms are obvious. This decreased glucose
tolerance because of cell receptor change can place older adults at risk for
hyperglycemia and the onset of type 2 diabetes.
• Although thyroid hormone levels may decrease with aging, the body makes up for it by
decreasing the rate at which thyroid hormone is broken down; therefore resting levels of
thyroid hormone are usually normal in older adults. However, thyroid disorders are
twice as common in older adults. Hypothyroidism is the most common thyroid disorder,
especially in older women.
• The amount of hormones secreted by older adults changes, decreasing the individual’s
ability to adapt to stress and respond to environmental changes.
• Because of decreasing liver and kidney function in older adults, hormone replacement
therapy must be done very cautiously to prevent hormone overdosage.
The Endocrine System
The endocrine system regulates metabolism, growth and development, sexual function,
and reproductive processes. A primary function of the endocrine system is to synthesize
and release hormones directly into the bloodstream. The cells and tissues that are
affected by a specific hormone are called its target cells or target tissues.
Some of the endocrine hormones, such as the thyroid hormones, affect practically every
cell in the body. Others, such as the sex hormones, exert their special effects on only one
organ system. Moreover, hormones from one endocrine gland can affect another
endocrine gland. The pituitary gland, for example, secretes several different kinds of
hormones that affect other endocrine glands. For this reason, the pituitary gland is often
referred to as the “master gland” of the body.
The endocrine system and the nervous system are the two major control systems of the
body, and their regulatory functions are interrelated. However, the endocrine system
typically controls body processes that occur slowly, such as cell growth, whereas the
nervous system controls body processes that occur more rapidly, such as breathing and
body movement.
The secretion of a particular hormone normally depends on the need. If an endocrine
gland receives a message that its hormone is in short supply, it will synthesize and
release more of that hormone. If, on the other hand, the hormonal need of a target
tissue is being satisfied, production or secretion of the hormone will be inhibited—a
concept known as negative feedback.
Some glands, such as the adrenal medulla and posterior pituitary, receive their
information about hormone levels in the body directly and respond only to stimulation
of nerve endings within the glands themselves. However, the posterior pituitary gland
indirectly receives notice to either release or inhibit hormones: stimulation comes by
way of the hypothalamus and the anterior lobe of the pituitary (the adenohypophysis).
The hypothalamus contains special nerve endings that produce releasing and inhibiting
hormones; these hormones are then absorbed into capillaries of a portal system, which
transports the hormones to the adenohypophysis (the anterior lobe of the pituitary).
Thus the hypothalamus controls the secretion of hormones from the pituitary. The
pituitary, in turn, controls the release or inhibition of hormones from other glands. Many
of the hormones of the anterior pituitary are “tropic” hormones; that is, they tend to
cause a change in the endocrine gland that is the target of the specific pituitary
hormone. An example is adrenocorticotropic hormone (ACTH), which acts on the
adrenal cortex. (If you break down this term, you can easily see that the components
adrenal–cortex–tropic tell you exactly where or what type of hormone this is and where
it comes from.) The major endocrine glands are shown in Fig. 35.1; see Table 35.1 for the
various tropic hormones and target tissues.
SEE Table 35.2: Diagnostic Tests and Procedures of the Endocrine
System:
SEE Table 35.3: Diagnostic Tests for Detecting and Monitoring
Diabetes Mellitus