Human Diseases A Systemic Approach Copyright ©2010 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. CHAPTER Human Diseases: A Systemic Approach, Seventh Edition Mark Zelman, Elaine Tompary, Jill Raymond, Paul Holdaway, and Mary Lou Mulvihill Diseases of the Endocrine System 12Copyright ©2010 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Human Diseases: A Systemic Approach, Seventh Edition Mark Zelman, Elaine Tompary, Jill Raymond, Paul Holdaway, and Mary Lou Mulvihill The Endocrine System • Responsible for the production, storage, and secretion of hormones • Major organs of the Endocrine System – Hypothalamus – Pituitary gland – Thyroid gland – Parathyroid glands – Pancreas – Adrenal glands – Testes and ovariesCopyright ©2010 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Human Diseases: A Systemic Approach, Seventh Edition Mark Zelman, Elaine Tompary, Jill Raymond, Paul Holdaway, and Mary Lou Mulvihill Pituitary Gland • Pea-sized organ located at base of brain • Produces 6 major hormones that are collectively known as “_______ hormones” – They control the function of other endocrine glands TropicCopyright ©2010 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Human Diseases: A Systemic Approach, Seventh Edition Mark Zelman, Elaine Tompary, Jill Raymond, Paul Holdaway, and Mary Lou Mulvihill Thyroid Gland • In the neck region; 2 lobes, 1 located on either side of the trachea • Plays important role in regulating _____________ and _____________ balance RegulatingCalciumCopyright ©2010 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Human Diseases: A Systemic Approach, Seventh Edition Mark Zelman, Elaine Tompary, Jill Raymond, Paul Holdaway, and Mary Lou Mulvihill Diseases of the Thyroid Gland: Hypothyroidism • A result of below-normal production of T4, the principal thyroid hormone; a hormone ___________ • Risk Factors: being female, over age ____, having an autoimmune disorder, having relatives with thyroid problems, use of radioactive iodine, pregnancy, certain medications • Sign & Symptoms vary widely: – Unexplained weight gain, dry skin, hair loss, swollen face, hands, legs, ankles, or feet; increased sensitivity to cold, muscles aches, raspy voice, fatigue, slower thinking, problems remembering things, slower speech, depression Deficiency50Copyright ©2010 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Human Diseases: A Systemic Approach, Seventh Edition Mark Zelman, Elaine Tompary, Jill Raymond, Paul Holdaway, and Mary Lou Mulvihill Hypothyroidism (cont’d) • Treatment: – Thyroid hormone replacement therapy – Typically for rest of patient’s life Hypothyroidism is NOT preventable!Copyright ©2010 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Human Diseases: A Systemic Approach, Seventh Edition Mark Zelman, Elaine Tompary, Jill Raymond, Paul Holdaway, and Mary Lou Mulvihill Diseases of the Thyroid Gland (cont’d): Hyperthyroidism • A condition of excessive thyroid hormone • Most common form: __________________ • More common in ______ than _______ • Onset between 20 and 40 years of age • Often associated with autoimmune diseases • Family history, stress, and smoking are other risk factors Grave's diseaseWomenMenCopyright ©2010 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Human Diseases: A Systemic Approach, Seventh Edition Mark Zelman, Elaine Tompary, Jill Raymond, Paul Holdaway, and Mary Lou Mulvihill Hyperthyroidism (cont’d) • Symptoms include enlargement of thyroid, nervousness, irritability, heat intolerance, increased sweating, insomnia, fatigue, weight loss • Can be life-threatening • Treatment: – Depend on severity, etiology, and presence of complications – Medications, radioactive iodine, and surgery are possibilitiesThe Pancreas Two glands in one – Exocrine gland – Endocrine gland Endocrine glands discharge secretions directly into blood stream. Exocrine glands discharge secretions through a duct onto a mucosal surface.Pancreas (cont’d) • Exocrine function: exocrine tissue of the pancreas – Concerned solely with digestion – Secretes alkaline pancreatic juice rich in digestive enzymes into the duodenum through the pancreatic duct to aid digestionPancreas (cont’d) • Endocrine function: endocrine tissue of the pancreas – Consists of multiple small clusters of cells scattered throughout the gland as pancreatic islets or Islets of Langerhans – Discharge secretions directly into the bloodstream – Each islet is composed of different types of cells • Alpha cells: secrete ___________; raise blood glucose • Beta cells: secrete ____________; lower blood glucose • Delta cells: secrete ____________; inhibit secretion of glucagon and insulin GlucagonInsulinSomatostatinChronic Pancreatitis • Repeated episodes of mild inflammation of pancreas • Each bout destroys some pancreatic tissue • Inflammation subsides and damaged pancreatic tissue is replaced by scar tissue, leading to progressive destruction of pancreatic tissue • Manifestations – Difficulty digesting and absorbing nutrients – Not enough surviving pancreatic tissue to produce adequate enzymes – Destruction of pancreatic islets may lead to diabetes • Diagnosis: Blood levels of lipase & amylaseAcute Pancreatitis • Pathogenesis – Escape of pancreatic juice from the ducts into the pancreatic tissue – Pancreatic digestive enzymes cause destruction and severe hemorrhage – Resulting build-up of pancreatic juice increases pressure within the duct system, causing ducts to ruptureAcute Pancreatitis (cont’d) • Predisposing factors – Gallbladder disease/gallbladder stones (45%) • Common bile duct and common pancreatic duct enter the duodenum via the ampulla of Vater • Impacted stone in ampulla obstructs pancreatic duct – Excessive alcohol consumption (35%) • Potent stimulus for pancreatic secretions • Induces edema, spasm of pancreatic sphincter, in ampulla of Vater • Result in high intraductal pressure, duct necrosis, and escape of pancreatic juice – Other (20%) (meds, hereditary, trauma, chronic pancreatitis)Acute Pancreatitis (cont’d) • Clinical manifestations – Severe