chapter 38 exam 1 soukup endocrine

 Fluid balance  Metabolism, energy balance  Growth & development  Contraction of smooth and cardiac muscle  Reproduction  Circadian rhythms........................................Hormones are secreted in response to a stimulus and travel through the blood to target cells  Target cells have receptors for that specific hormone  Hormone binds on or within the target cell

Hormones flow through capillaries  Travel everywhere in body  “Lock & Key” system used when hormone needed  Hormone – Key  Target Cell (Receptor Site) – Lock  Receptor site is specific for one hormone

Body condition moves away from normal range  Specific hormone stimulated - starts chain of events to return body to normal  Once need is met and body condition normalized, secretion of the hormone will cease

Through capillaries in the bloodstream

Also used to regulate hormone synthesis and release  These systems reinforce (or increase) changes that occurred  Generally control infrequent conditions – ovulation, childbirth, blood clotting  Release of the hormone causes an action which stimulates more of its own release...........(example):...Hypothalamus orders posterior pituitary to secrete oxytocin  Oxytocin stimulates uterine contractions  Contractions stimulates more oxytocin and more contractions until a baby is born!

targets the thyroid gland by stimulating the thyroid to secrete thyroid hormones

ACTH(adrenocorticotropic hormone)

FSH(follicle-stimulating hormone)Stimulates secretion of estrogen and the development of ova in women and sperm development in men (control of reproductive function

ADH(antidiuertic hormone or vasopressin) that targets the kidneys

GH(growth hormone) promotes growth indirectly acting on liver, adipose tissue

LH(lutenizing hormone) for OVULATION

Prolactin

oxytocin

Produces regulatory hormones, which are either:  Releasing hormones  Inhibiting hormones  Function of regulatory hormones is to either stimulate or inhibit the release of hormones from the anterior pituitary gland

Regulated by hypothalamus  Contains tropic hormones  Hormones that send messages to other endocrine glands to release their hormones  Thyroid Stimulating Hormone (TSH)  Adrenocorticotropic Hormone (ACTH)  Follicle-Stimulating Hormone (FSH)  Luteinizing Hormone (LH)  Other two hormones in this gland act directly on final target tissues  Growth Hormone  Prolactin

Extension of the hypothalamus  Does not synthesize hormones  Hormones produced in the hypothalamus  The posterior pituitary gland stores and releases hormones  Antidiuretic Hormone (ADH)  Oxytocin

Inhibit breakdown of bones for calcium and phosphate(Lowers serum blood levels & retains calcium/phosphate in the bones – Stimulated when serum calcium levels are too high)

Anterior to the trachea, consists of two lobes  Produces three hormones:  Triiodothyronine (T3)  T3 is stronger  Thyroxine (T4)  Calcitonin

increase cellular respiration of glucose and fatty acids – Increases metabolic rate (energy & heat production) ■ Example: in cold temperatures, more thyroid hormones released to increase heat production – Thyroid Hormones are essential for life! ■ Essential for physical growth, mental development, & reproductive maturation – Stimulated by TSH from the anterior pituitary gland

Four glands that sit on the thyroid gland  Produce parathyroid hormone (PTH)  Parathyroid hormone raises serum calcium levels & lowers phosphate levels  Pulls calcium that is stored in bones  Encourages the small intestine to absorb more calcium  Encourages the kidneys to reabsorb more calcium  Antagonist to calcitonin  Target organs of PTH include  Bones  Small intestine  Kidneys

Adrenal medulla--Releases catecholamines  Epinephrine & Norepinephrine  When released from adrenal medulla, these catecholamines act as hormones, not neurotransmitters  Released during stress to manage the body’s stress response  Increase HR, BP, glucose levels

Key Hormone: Aldosterone  Target organ: Kidneys  Increases reabsorption of sodium and excretion of potassium

Cortisol-----Glucocorticoids  Key Hormone: Cortisol  Target tissue: Many  Provides energy sources to the body & ensures glucose is made available for the brain  Increased during body’s response to stress – the body requires more energy for stress induced changes  Has an anti-inflammatory effect

Key Hormones: Sex steroids (Androgens, estrogen)  Contribute to libido  Contribute to sexual and reproductive function

Delta Cells: Secretes somatostatin

Synthesized and secreted by beta cells  Released by the pancreas when serum glucose levels rise  Insulin is the key to unlock the cells, once unlocked glucose can travel inside the cells & be used for energy

Adrenal Cortex MNEMONIC: “MAKE GOOD SWEETS” Saying: “Salt, Sex & Sugar” • Mineralocorticoids • Glucocorticoids • Sex hormone

MNEMONIC: “MEN” •Medulla •Epinephrine •Norepinephrine

Glucagon  Synthesized and secreted by alpha cells  Released by the pancreas when serum glucose levels are low  Glucagon stimulates the liver to turn glycogen into glucose

Both an endocrine gland and an exocrine gland  Exocrine gland function includes release amylase & lipase for digestion assistance  As endocrine gland, the pancreas secretes insulin and glucagon for glucose homeostasis  Also secretes somatostatin- blocks the production of insulin and glucagon to help regulate blood sugar

Cells within the pancreas include:  Alpha Cells: Secretes Glucagon  Beta Cells: Secretes Insulin  Delta Cells: Secretes somatostatin  These cells live within a section of the pancreas called the “islet of Langerhans”

Abnormality in the endocrine gland itself-----------Causes:  Overproduction of the hormone  Underproduction of the hormone  Side effects of certain drugs.....................................................Secondary Disorder  Something wrong with a different gland/organ  affects endocrine gland

Health history  Neuromuscular  Weight change  Excessive thirst or urination  Heat or cold tolerance  Mood and memory  Family history

Vital signs  Height & Weight  Skin & hair changes  Tremor  Mood & Affect  Exophthalmos  Moon face  Fat pads/Buffalo Hump  Thyroid size

decrease growth hormone, decrease tsh and thyroid hormone, decrease insulin secretion, decrease msuclemass and increas in fat, decrease metabolic rate, decrease glucose tolerance but not diabetes, decrease in energy

The thyroid gland is the only gland of the endocrine system that can be palpated  Usually palpated by a NP or physician  Nurse may assist with positioning, giving patient sip of water  If a patient has a suspected thyroid issue, the provider must take extra precaution when palpating because it can release additional hormone & exacerbate symptoms

Primary disorder affects the gland itself, while secondary disorder affects a different gland or organ.

 Parathyroid hormone (PTH)  Calcium  Phosphorus

Growth hormone (GH)  Antidiuretic hormone (ADH)  Urine specific gravity  Adrenocorticotropic hormone (ACTH)

Cortisol  24-hour urine for vanillylmandelic acid (VMA)  Aldosterone

Fasting blood glucose  Oral glucose tolerance  Glycosylated hemoglobin

Help to determine endocrine gland function  A substance is injected into the body to stimulate a gland  Hormone that is secreted by that gland is measured in the blood to determine how well it responded to the initial stimulation

Determine presence of nodules or tumors  Radioactive material injected or radioactive iodine is taken orally.  Assess for shellfish allergy  Material taken up by thyroid  After specified time—the thyroid gland is scanned with a scintillation camera  Scan will show hot spots and possibly cold spots  Educate patients that small amount of radioactive material used—no risk to patient – no special radiation precautions are needed

Done to locate tumor or identify hypertrophy of gland

Thyroid or parathyroid glands—to determine if enlarged or to find masses

To obtain tissue to examine for possible cancerous cells........................................and a supression tests Opposite of stimulating tests  Substance injected  Expected to suppress hormone’s release