adrenal glands

- EACH GLADN

• adrenal medulla- middle
• adrenal cortex- outer portion

pancreas

upper left abdomen

alpha cells

secretes glucagon

beta cells

secretes insulin

islets of langerhans

where alpha and beta cells are found

pineal gland

in the midbrain

thymus gland

front of thoracic cavity

body processes the endorine system is involved in

regulation of metabolism, growth rate, physical development, sexual function, reproduction, fluid balance

what hormones are produced by thyroid

t3, t4 calcitonin

hormones produced by parathyroid

parathyroid hormone (PTH)

hormones produced by anterior pituitary

prolactin, ACTH, GH, TSH, FSH, LH

hormones produced by posterior

ADH, oxytocin

hormones produced by adrenal medulla

epinephrine and norepinephrine (catecholamines)

hormones produced by adrenal cortex (mineral & glucocoticoids)

cortisol, aldosterone, sex hormones- androgens/estrogens

which gland is considered the master gland ?

pituitary gland

mnemonic for anterior pituitary

PRO

ALTHELETES

GOT

TO GROW

posterior pituitary

does NOT produce hormones/ stores and releases

ADH/OxCYTOCIN

effects of the thyroid hormones

• the thyroid gland is plapable
• thyroid gland secretes t3, t4 and calcitonin
• iodine and protein is needed
• controls metabolic rate

thyroid ;

hypothyroidism = decreased thyroid function

• TSH will be increased
• T3, T4 may be decreased
• s/s- cold, tired, sluggish, weight gain

thyroid;

hyperthyroidism = increased thyroid function

• TSH will be decreased
• T3, T4 may be increased
• s/s- warm increased temp/ weight loss

functions of the parathyroid gland

• PTH is produced and secreted in the parathyroid gland
• LOW calcium level stimulate the release of pth which will increase plasma CA levels

functions of the adrenal gland

adrenal medulla

secrete epinephrine and norepinephrine

functions of adrenal gland

epinephrine

prepares the body to meet stress or emergency situations and prevents hypoglycemia

functions of adrenal gland

norepinephrine

functions as a pressor to maintain blood pressure

fnctions of the adrenal gland

adrenal cortex

secretes corticosteroids- mineralcorticoids (aldosterone) & glucocoticoids (cortisol)

mineralocorticoids

primary is aldosterone, regulates the balance of water and electrolytes in the body (NA,K,CI)

-a person without mineralcorticoids would die in 7 days

glucocorticoids

• essential for utilization of carbohydrates, proteins and fats
• primary is cortisol which acts to increase the glucose levels in the blood
• cortisol also helps as a counteract the inflammatory response

cortisol testing

blood samples collected during the day and night, 24 hour urine or oral cotton swab testing

functions of the pancreas

pancreas is the ONLY gland in the body that is both endocrine and exocrine

• endocrine secretes into the bloodstream
• exocrine secretes thru a duct to the target tissue

endocrine function

• insulin: beta cells are responsible for producing and secreting insulin
• glucagon: alpha cells are responsible for releasing glucagon stimulates the liver to change glycogen to glucose

effects of aging on the endocrine syste,

• pituitary gland comes smaller
• metabolism declines/ slowing of metabolism
• aldosterone, renin, calcitonin, GH decrease
• older women have a decrease in estrogen and prolactin and men have a decrease in testosterone

endocrine disorders

either an imbalances in the production of the hormone or an alteration in the body's ability to use the hormone

stimulation test

substance injected to stimulate a gland

suppression test

opposite of stimulating test

diabetes mellitus

• A1c tests for over 6 weeks
• A1c normal: less than 5.7%
• pre diabetes: 5.7-6.4%
• diabetes: 6.4% or higher

hyperfunction of the anterior pituitary

acromegaly; over secretion of GH

• increase in bone size / enlargement of facial features, hands and feet
• s/s: changes in ring size, shoe size, enlargement of nose n jaw, brow, hands/thickened tongue/ osteoporosis
• treatment: hypophysectomy REQUIRES LIFE LONG REPLACEMENT OF THYROID HORMONES

Giantism

over secretion of GH in children/ diagnosis is the same as acromegaly

prolactin/ gonadotropin hyperfunctions (FSH/LH)

fertility issues

hyperfunction of the anterior pituitary

• caused by autoimmune disorders, injections, destruction of the pituitary gland
• s/s: depends on cause of the pituitary failure and the hormones involved.
• diagnosis: h&p, lab test hormones, mri
• sheehan syndrome ; rare/ pp hemorrhage

decreased in growth hormone

leads to short stature

- bone breakdown and increase risk of osteoporosis / metabolic problems

decreased in FSH/ LH

• sexual dysfunction
• fertility problems

dwarfism

hyposecretion of GH during fetal development or childhood

• s/s: head and extremities disproportionate to torso

posterior disorders

DI= decrease ADH = think die

• s/s: diuresis, polydipsia, deficient fluid volume, hypotension, weight loss, weight loss, poor skin turgor- can lead to shock if untreated
• excessive drinking cause they are DEHYDRATED

7 D's for DI

• diluted urine 1.0005
• dry inside so HI natremia and osmolity
• drinking alot
• dehydrated
• decreased BP
• desmopressin
• vasopressin

SIDAH

• excessive increased ADH
• fluid retention
• caused by tumor
• s/s: weight gain, edema, hyponatremia can be less than 120MEQ
• decreased urine output, high bp, seizures, loss of conciousness, muscle cramps

thyroid disorders

• hyperthyroidism
• graves
• thyroid storm
• hypothyroidism
• myexedema coma
• thyroiditis
• thyroid cancer

goiter

• enlarged thyroid gland, can be caused by iodine deficiency
• common causes is an increase in TSH from lack of thyroid hormone production
• s/s; enlargment in front of neck difficulty swallowing/ bretahing

hyperthyroidism

overactive thyroid/ primary hyperthyroidism: occurs within the thyroid gland= graves disease

secondary hyperthyroidism

the result of an abnormally in another gland; pituitary gland

• smoking is a r/f (graves disease)
• infection
• medicatiosn containing iodine such as amiodaroone
• s/s: weight loss, anxiety, tachycardia, insomnia , infertility, increased thirst and urination

thyroidectomy

subtotal/ total

• pre op; iver access, vs, ekg
• post op; high fowlers, keep head in neutral position to relieve rension
• do not hyperextend neck
• monitor for bleeding /swelling/ check breathing
• trachea kit should be available at bedside/ ett at bedside
• watch for voice changes

thyroid storm

severe hyperthyroid state

• can result in death in 2hrs
• can occur in hyperthyroidism/ stressor or illness/ after thyroid surgery
• s/s; tachycardia & pnea, hypertension/ temp 106 or higher

graves disease

autoimmune idsorder / causes hyperthyroidism

• s/s: enlarged thyroid gland, bulged eyes, mood swings, palpitations, heat insensitivity

hypothyroidism

s/s- weight gain, joint pain, slow hr, cold intolerance, non pitting edema, bag under eyes

-myxedema coma= severe hypothyroidism

thyroiditis

inflammation of thyroid gland 3 types

• acute: caused by an infection / tx antibotics
• subacute: viral infection (respiratory)/ tx symptoms
• chronic: autoimmune= hashimoto's (life long replacement synthroid)

hypoparathyroidism

low levels of PTH

• s/s- tingling, chvostek sign/ trouuseasu sign/ seizures/ broncho spasms

tetany

sign of low serum calcium levels/ muscle twitching/ cramps and spasms due to irritability of the neuro tissue/ seizures/ bronchospasms can occur= emergancy most likely to cause death of a pt with acute hypoparathyroidism

chvostek sign

occurs with hypocalcemia

- twitching of facial muscles when tapped infront of ear

trousseaus sign

occurs with hypocalcemia/ inflate bp cuff 20 mm for - mins

-a postive sign will present as a carpal spasm

addisons disease

results in deficit of all 3 hormones ( cortisol, aldosterone, testosterone)

-decreased function of adrenal cortex

2 types;

• primary insufficency; affecting adrenal cortex itself/ autoimmune/ inflamamtion/ infection: nonsecreting tumor
• secondary insufficeny; pituitary glands fail to excrete ATCH / after abrupt withdraw from steroid therapy
• s/s- vague, hypoglycemia, hyponatemia, hypotension, and anorexia

DKA type 1

caused by incomplete metabolism of fats from absent or insufficent supply of insulin

DKA (type 1 dm)

s/s

ketonuria , kussmauls resp, fruity breath, polyuria, polydipsia and N&V

type 2 diabetes : NON insulin dependent

insulin resistance

• factors assoicated with type 2: obesity, family history, GD, metabolic syndrome / inactivity
• s/s- weight gain, 2P's, poor healing, tingling numbeness in feet/ itching
• complications- HHNS

gestational diabetes

pregnancy diabetes / usually will develop type 2 in future

metabolic syndrome

hypertension, hyperglycemia, excess abdominal fat, elevated cholesterol and triglycerides

diabtes s/s

elevated blood sugars

• 3 P's= polydipsia, polyuria, polyphagia
• weight loss=type 1
• weight gain= type 2

hypoglycemia

decreased bs

• <70
• diagnosis; blood glucose levels
• causes: too much insulin or too much exercise/ skipped meal / bypass surgery/ alcohol abuse

15/15/15 rule for hypoglycemia

if awake administer 15g fast acting simple carbs/ wait 15 minutes then re check / administer another 15g of carbs/ 7g of protein

innate immunity

present at birth & does not have to be learned through exposure to an invader

adaptive acquired

exposed to foreign substances & the immune system responds

passive acquired

antibodies are transferred from one host to another

b cell immunity

antibodies (immunoglobins)

t cell immunity

lymphocytes

antigen

a substance recognized as foreign that triggers as immune response

antibody

immunoglobin / protein produced by B lymphocytes that binds a specific antigen

homeostatsis

bodys ability to maintain internal balance; the immune system helps maintain homeostasis by eliminating pathogens

fucntions of the immune system

• protects body from pathogens
• remove microorganisms through phagocytosis
• produces antibodies and immune memory
• provides humoral (bcell) cellular (tcell) immunity
• returns tissue to fluid
• drains excess tissue fluid & return it to circulation

kinins

inflmmatory medicators causing vasodilation and pain

IgG

Crosses placenta ; fetal immunity

-MOST abundent : crosses placenta

IgM

first antibody produced in infection

IgA

found inmucous membranes & breast milk

IgE

allergic reactions / parasitic defense

IgD

b cell receptor

a person with aids has hiv but a person with hiv does not have aids

(true / false)

true

CD4

500-1000

hodgkins

presense of reed-sternberg cells

non hodgkins

t cells / b cells