–  Controls body through hormones

•    Nervous

–  Controls body through electrical impulses

•    Endocrine

–  Ductless

–  Secrete hormones directly into bloodstream

–  More widespread (systemic)

–  Fundamental structural unit of endocrine system

–  Contain ducts

–  Release hormones through ducts

–  Have a local effect

–  Majority are exocrine

Endocrine Gland

•    Why bloodstream?

–  Can travel great distances

–  Can act on multiple sites

•    Receptors Hormone

–  Some act on specific areas

•  Some act on the entire body

•    Negative Feedback

–  Hormone is produced

–  It works

–  Another hormone released to stop it

•    Positive Feedback

–  Low hormone level is produced

–  It doesn’t work

–  More hormone is released

•    Pineal

•    Hypothalamus

•    Pituitary Gland

•    Parathyroid

•    Thyroid

•    Thymus

•    Adrenal Glands

•    Pancreas

•    Gonads

Pineal Gland

•    Orientation to time

Hypothalamus and Pituitary Gland

•    Hypothalamus secretes hormones

•    Pituitary regulates the hormones

–  Oxytocin and Vasopressin

Hypothalamus

•    Link between Nervous and Endocrine System

–  Sends info from brain to gland

Pituitary Gland

•    “The Master Gland”

–  Controls how all other glands work

–  Size of a pea

•    Posterior Lobe

–  Responds to nerve impulses from hypothalamus

•    Anterior Lobe

–  Responds to hormones from hypothalamus

Posterior Pituitary Hormones

•    Oxytocin (Pitocin)

–  Uterine contractions

–  Milk production

•    Vasopressin (Antidiuretic hormone)

–  Kidneys retain water

–  Vasoconstriction

Anterior Pituitary Hormones

•    ACTH – targets adrenal cortexes

•    TSH – targets thyroid

•    FSH – targets gonads

•    LH – targets gonads

•    PRL – targets mammary glands in women

•    GH – targets ALL body cells

•    Gigantism and Acromegaly

–  Usually from a tumor

–  Increases growth hormone

•    Dwarfism (“Little People”)

–  Caused by tumor usually

–  Related Problems

•  Breathing difficulties

•  Paralysis

•    Diabetes Insipidus

  Pituitary Disorders

–  kidneys unable to conserve water

•  Polyuria (pees a lot) and excessive thirst

•  Loss of > 3 L/day

–  Caused by trauma, tumors, genetics

Parathyroid

•    4 pea-sized organs

•    Raises Calcium

–  PTH

•    Lowers Phosphate

•    Located on surface of Thyroid

Parathyroid Disorders

•    Tumor here takes calcium from bones and puts it into the bloodstream

•    Results in kidney stones

•    Damage to Parathyroid messes up the calcium

•    Can cause death

Thyroid

•    Body’s Thermostat

–  Controls how we burn fuels

•    Stimulates O2 metabolization

•    Regulates body development

•    Prevents rise of Calcium

–  calcitonin

Thyroid Disorders

•    Deficiencies result in:

–  Cretinism - physical and mental retardation within 6 months of birth

–  Myxedema - weight gain, moon face

•  Acute coma can occur after surgery or trauma

Decreased Thyroid

•    Hyposecretion during adulthood equals Hashimoto's Disease

–  (Slow the body down -- hypothermia, bradycardia, bradypnea, CHF, facial edema, weakness, sensitivity to narcotics and barbiturates)

•    Severe Hashimoto’s = Myxedema Coma

–  Medical Hypothermia

•    Treatment

–  Supportive – No active rewarm (blankets are fine), intubation, ABC’s, watch arrhythmias

How slow is slow?

•    Notice the thick, dry, doughy skin

•    Edema (slowed blood flow)

•    Slow, thick voice, Cold intolerance, Thin, brittle hair, Slow thought, Muscle weakness

•    AKA Adult Hypothyroidism

–  Women > 60 y/o

•    Myxedema Coma (rare)

–  50% mortality (with good care)

Other Thyroid Disorders

•    Too much thyroid hormone = Grave’s Disease

–  Swelling of tissues behind the eyes

–  Bulging of the eyeballs

–  Anti-immune disorder, triggered by antibodies

•    Iodine has a key role

–  Without it, will enlarger to a “Goiter”

•  huge mass in neck

•  Iodinized salt will help

Thyrotoxicosis

•    ANY condition resulting from thyroid hyperfunction

–  Grave’s Disease

–  Thyroid Storm

•  Life-threatening, but rare

Hyperthyroid Signs/symptoms

•    Iodine has a key role

–  Without it, will enlarger to a “Goiter”

•  huge mass in neck

•  Iodinized salt will help

•    Hyperthyroidism

–  Exophthalmus

–  Goiter

–  Warm flushed skin

–  Fever

–  Agitation/psychosis

–  Hyperactivity

–  Weight Loss

•    Hypothyroidism

–  Facial edema

–  JVD (?goiter)

–  Cool skin

–  Hypothermia

–  Coma

–  Weakness

–  Weight gain

•    Prehospital -- Based on Presenting Problem

–  Cretinism -- Treat issues with mental retardation

–  Hashimoto’s Disease (Myxedema Coma) -- Watch for bradycardias, hypothermia, hypotension

–  Graves Disease (Thyroid storm) -- Watch for tachycardias, hyperthermia

–  Goiter -- No Treatment (hypo or hyper thyroid)

Thymus

•    Located just behind sternum

•    Larger in children, then shrinks

–  Deals with aging

•    Secretes Thymosin

–  Promotes T lymphocytes

–  immunity

•    Release Epi & Norep

–  Response to stress

•    Maintains blood-sugar level

•    Maintains BP

Adrenal Gland Disorders

•    Addison’s Disease (too little)

–  H2O loss, low BP, N/V, REAL sick, hypoglycemia

–  Develop a brownish pigmentation

Hyperpigmentation (Addison’s Disease)

Hyposecretion of Adrenal

•    Prehospital Treatment

Adrenal Gland Disorders

•    Cushing’s Syndrome ( too much)

–  moon face, obesity, hair growth

–  changes in bony structure

•  “humpback”

Hypersecretion of Adrenal

•    Disorders -- Cushing's Disease

–  Prehospital Treatment

•  Watch numbers of IV sticks, Check Blood Sugar, and BP, Strict infection control, TLC

Prednisone

•    Trade: Deltasone, and many others

•    Action: Corticosteroid

•    Uses: Adrenocortical deficiency and MANY other uses

•    Dosage: 5-60 mg per day

•    Notes

–  If bid: take every other day

–  If once per day: take AM with breakfast

Adrenal Medulla

•    Epinephrine and Norepinephrine

–  Sympathetic nervous system effects during flight or fight response.

–  Disorders -- Hypersecretion (Pheochromocytoma)

•  Hypertension, nervousness, weight loss, tachycardia, arrhythmia

–  Prehospital -- Monitor, IV, BP, Antiarrhythmics may be needed

No GLUCAGON – run away hypertension

Pancreas

•    Pancreatic islets

–  Islets of Langerhans

•    Clusters of cells

Islet Cell Types

•    Alpha islets of Langerhans

–  secrete Glucagon

–  raises blood sugar

•    Beta islets of Langerhans

–  secrete insulin

–  path for glucose to enter cells

Ovaries

•    Increases Estrogen

•    Produces Progesterone

•    Female Reproduction

•    Puberty Hits

Testes

•    Produces Estrogen

•    Increases Testosterone

•    Male Reproduction

•    Puberty Hits