Chapter 14
Endocrine System Diseases and
Disorders
Copyright
Copyright
© 2010
© 2010
Delmar,
Delmar,
Cengage
Cengage
Learning.
Learning.
ALLALL
RIGHTS
RIGHTS
RESERVED.
RESERVED.
Anatomy and Physiology
• Endocrine system consists of many glands,
including:
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Hypothalamus
Pituitary
Pineal
Thymus
Thyroid
Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Anatomy and Physiology
• Endocrine system consists of many glands,
including:
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Parathyroids
Adrenals
Pancreatic islets
Ovaries and testes
Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Anatomy and Physiology
• Each gland unique and delivers secretion into
bloodstream
• Negative feedback system controls amount of
hormones secreted
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Animation
Click Here to Play Endocrine System Animation
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Diagnostic Tests
• Thyroid and testes
– Endocrine glands that can be physically examined
• Blood and urine testing for hormones
• CT scan and MRI for tumors or alteration in
organ size
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Pituitary Gland Diseases
• Hyperpituitarism
– Increase in activity of pituitary gland
– Oversecretion affects growth hormone leading to excessive
growth of bones and tissues
– If occurs before puberty, gigantism occurs
– If occurs during adulthood, acromegaly occurs
• Affects small bones of hands, feet, and face by enlarging them
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Pituitary Gland Diseases
• Hypopituitarism
– Abnormal decrease in activity of pituitary gland
– Effects:
• Dwarfism
• Abnormality of secondary sex characteristics
• Amenorrhea and infertility in adult females
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Pituitary Gland Diseases
• Hypopituitarism
– Effects:
• Adult males may have decreased testosterone levels and libido
• Decrease in adrenocorticotropic hormone (ACTH) and thyroidstimulating hormone (TSH) may lead to metabolic disorder
– Diagnosis of pituitary function by blood test
Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Pituitary Gland Diseases
• Hypopituitarism
– Treatment:
• Hormone replacement
• Monitoring
• Adjustment
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Pituitary Gland Diseases
• Diabetes insipidus
– Caused by decrease in release of vasopressin or antidiuretic
hormone
– Excessive polyuria
• Urinating 2 to 15 gallons of urine in 24 hours
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Pituitary Gland Diseases
• Diabetes insipidus
– Symptoms:
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Polydipsia
Hypotension
Dizziness
Constipation
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Pituitary Gland Diseases
• Diabetes insipidus
– Diagnosis by urinalysis and water restriction test
– Urine
• Colorless
• Low specific gravity
– Treatment:
• Administration of vasopressin
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Thyroid Gland Diseases
• Hyperthyroidism
– Thyroid gland secretes excessive thyroxine
– Caused by tumor of thyroid gland
– Symptoms:
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Tachycardia
Nervousness
Hyperactivity
Excessive excitability
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Thyroid Gland Diseases
• Hyperthyroidism
– Symptoms:
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Tremendous appetite with weight loss
Diarrhea
High heat production
Moist skin
Extreme thirst
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Thyroid Gland Diseases
• Hyperthyroidism
– Treatment to reduce thyroxine often effective
– Surgery may be necessary
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Thyroid Gland Diseases
• Hyperthyroidism
– Autoimmune condition
• Graves’ disease
• Symptoms:
– Exophthalmos
• Treatment:
– Medication
– Radiation
– Surgery
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Exophthalmos
Photo courtesy Mark L. Kuss
Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Thyroid Gland Diseases
• Simple goiter
– Enlargement of thyroid generally due to inadequate iodine
– Asymptomatic until thyroid presses on trachea and
esophagus leading to dyspnea and dysphagia
– Treatment:
• Potassium iodide followed by iodine in diet
• Surgery to decrease dysphagia and dyspnea
Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Goiter
Photo courtesy Mark L. Kuss
Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Thyroid Gland Diseases
• Hypothyroidism
– Decrease in thyroxine
– Symptoms:
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Fatigue
Sensitivity to cold temperatures
Thin nails
Brittle hair
Excessive weight gain
Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Thyroid Gland Diseases
• Hypothyroidism
– Diagnosis by blood hormone level
– Treatment:
• Hormone replacement
Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Parathyroid Gland Diseases
• Hyperparathyroidism
– Overproduction of parathormones by one or more of the
four parathyroid glands
– Causes hypercalcemia leading to kidney stones, bone
weakness, and hyperactivity of heart
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Parathyroid Gland Diseases
• Hyperparathyroidism
– Diagnosis by blood tests
– Treatment directed at cause
– Prognosis good with proper treatment
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Parathyroid Gland Diseases
• Hypoparathyroidism
– Decrease in parathormone leading to low blood calcium
• Causing irritability of muscles
– Tetany
– Causes uncontrolled contraction of muscles in face and
hands
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Parathyroid Gland Diseases
• Hypoparathyroidism
– Diagnosis by checking for Chvostek’s and Trousseau’s
signs
– Treatment:
• Vitamin D
• Calcium
Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Adrenal Gland Diseases
• Adrenal glands
– Also known as suprarenals
– Have two distinct parts:
• Inner
– Medulla releases epinephrine and norepinephrine
» Fight or flight hormones
• Outer
– Cortex controlled by ACTH
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Adrenal Gland Diseases
• Adrenal glands secrete mineralocorticoids,
glucocorticoids, and sex hormones
• Cortisone
– Glucocorticoid used to treat inflammatory disease
– Should be used short-term only
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Adrenal Gland Diseases
• Cortisone side effects:
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Hypertension
Ulcers
Moon face
Drowsiness
May mask symptoms of infection
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Adrenal Gland Diseases
• Hyperadrenalism
– Oversecretion of adrenal cortex hormones
• Conn’s syndrome
– Overproduction of mineralocorticoid aldosterone
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Adrenal Gland Diseases
• Cushing’s syndrome
– Overproduction of glucocorticoid cortisol
• Androgenital syndrome
– Overproduction of sex hormones
Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Adrenal Gland Diseases
• Hypoadrenalism or Addison’s disease
– Low secretion of hormones by adrenal cortex
Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Pancreatic Islets of Langerhans
Diseases
• Pancreas
– Both exocrine and endocrine gland
• Islets of Langerhans secrete insulin and
glucagon
• Insulin lowers blood sugar
• Glucagon increases blood sugar
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Pancreatic Islets of Langerhans
Diseases
• Sugar or glucose
– Primary source of energy for all tissue cells
• Diabetes mellitus
– Affects carbohydrate and sugar utilization due to lack of
insulin
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Pancreatic Islets of Langerhans
Diseases
• Diabetes mellitus
– Symptoms:
• Polydipsia
• Polyuria
• Polyphagia
– Types:
• Type 1
• Type 2
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Pancreatic Islets of Langerhans
Diseases
• Diabetes mellitus
– Type 1
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Also known as insulin-dependent diabetes mellitus
Most serious
Affects children and young adults before age 25
Requires daily injections of insulin
Thought to be autoimmune disorder
Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Pancreatic Islets of Langerhans
Diseases
• Diabetes mellitus
– Type 1
• Individuals do not usually secrete insulin
– Making control difficult
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Follow strict diet
Monitor blood levels
Administer daily insulin
Exercise and stress can alter insulin needs
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Pancreatic Islets of Langerhans
Diseases
• Diabetes mellitus
– Type 2
• More common in adults
• Gradual onset occurring most often in obese females over age 40
• Thought to be caused by wearing out of pancreatic islets of
Langerhans
• Usually controlled with diet, exercise, and oral medication to
stimulate insulin secretion
Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Pancreatic Islets of Langerhans
Diseases
• Diabetes mellitus
– Complications:
• Diabetic shock
– Occurs rapidly
– Result of taking too much insulin and not eating enough food
Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Pancreatic Islets of Langerhans
Diseases
• Diabetes mellitus
– Complications:
• Diabetic shock
– Symptoms:
» Diaphoresis
» Light-headedness
» Trembling
– Treatment:
» Emergent with intravenous (IV) glucose to raise blood sugar
Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Pancreatic Islets of Langerhans
Diseases
• Diabetes mellitus
– Complications:
• Diabetic coma
– Not enough insulin or too many carbohydrates in diet
– Progresses slowly with individual becoming lethargic and slipping
into coma
Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Pancreatic Islets of Langerhans
Diseases
• Diabetes mellitus
– Complications:
• Diabetic coma
– Symptoms:
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Slow, deep breathing pattern
Fruity or sweet-smelling breath
Polyuria
Polydipsia
Dehydration
Ketoacidosis
Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Pancreatic Islets of Langerhans
Diseases
• Diabetes mellitus
– Complications:
• Atherosclerosis
• Diabetic retinopathy
• Kidney damage
– Diagnosis by history and blood glucose testing
– No cure
Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Pancreatic Islets of Langerhans
Diseases
• Gestational diabetes
– Can occur during pregnancy
– Usually discovered with routine urine testing during
prenatal visits
– Treatment:
• Diet
• Exercise
• Medications
Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Pancreatic Islets of Langerhans
Diseases
• Gestational diabetes
– Injectable insulin controls sugar levels
– Usually disappears after delivery
– Women often affected later in life by adult-onset diabetes
Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Pancreatic Islets of Langerhans
Diseases
• Hypoglycemia
– Abnormally low blood sugar
• Less than 60
– Symptoms:
• Light-headedness
• Diaphoresis
• Trembling
Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Pancreatic Islets of Langerhans
Diseases
• Hypoglycemia
– Diagnosis by glucose test
– Treatment dependent on cause
Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Reproductive Gland Diseases
• Hypergonadism
– Increased hormone production before puberty
– Diagnosis by blood test for elevated hormones
– Treatment:
• Removal or radiation of tumors to suppress hormones
Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.
Reproductive Gland Diseases
• Hypogonadism
– Decreased sex hormone production by puberty
– Treated with hormones
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Effects of Aging
• Decreased secretions from glands
• Lessened glucose tolerance
• Diabetes mellitus common
Copyright © 2010 Delmar, Cengage Learning. ALL RIGHTS RESERVED.