The Endocrine System: Introduction

• Effective comm between different parts of the

body is absolutely essential for the
functioning of any multicellular organism.
• In vertebrates this communication is
maintained by nerve fibers and hormones.
• Endocrinology is concerned with the nature of
these hormones and with hormonal comm.
• Hormones are specialized chemical subs
produced by particular ductless glands of the
body.
• Hormones are discharged directly into the
blood by a process of endocrine secretion.
• Hormones are released in extremely small
quantities.
• Hormones exert specific regulatory effects on
their selected ‘target’ cells.
• Target cells possess particular recognition
features called the hormone receptors.
• Most hormones enter interstitial fluid and
then the bloodstream.
• The target cells are equipped with receptors
that bind hormones with high affinity and
specificity.
• Once bound, hormones initiate xristic
biologic responses by the target cells.
 Hormones travel via the bloodstream to
target cells:
The endocrine system
broadcasts its hormonal
messages to all cells by
secretion into blood and
ECF. Like a radio
broadcast, it requires a
receiver to get the
message
 A cell is a target bcoz is has a specific receptor
for the hormone:
 Most hormones circulate in blood, coming

into contact with essentially all cells.

 However, a given hormone usually affects only

a its target cells.

 A target cell responds to a hormone bcoz it

bears receptors for the hormone.

 Most hormones have multiple actions in their
target tissues: they have pleiotropic effects.
 Phenomenon occurs when a single hormone

regulates several functions in a target tissue.

 Example - in skeletal muscle, insulin:

 Stimulates glucose uptake, glycolysis,

glycogenesis, inhibit glycogenolysis, increase

amino acid uptake and protein synthesis
 Inhibits protein degradation
 Hormones are secreted in rhythmic patterns.
 A defined set of chemical subs in the blood or

environmental factors may either stimulate or

inhibit the secretion of any particular
hormone – (i.e., the specific secretagogues).
 In addition to these specific secretagogues,

many hormones are secreted in a defined,

rhythmic pattern.
• These rhythms can take several forms –
o They may be pulsatile
o They may be episodic spikes in secretion
lasting just a few minutes
o They may follow a daily, monthly, or
seasonal change in overall pattern
• Pulsatile secretion may occur in addition to
other longer secretory patterns.
• NB: For these reasons, a single randomly
drawn blood sample for determining a certain
hormone conc may be of little or no
diagnostic value.
• A dynamic test of endocrine function in which
a known agent specifically stimulates
hormone secretion often provides much more
meaningful information.
 The endocrine system (ES) plays a significant
role in growth, metabolism, and environ
adaptation.
 Along with the NS , the endocrine system

provides a comm system for the body.

 Via release of hormones, the ES carefully

regulates many physiologic functions.

 Disorders of the ES are manifested as either
hyperfunction and hypofunction.
 Hormone secretion is typically controlled thro’

a negative feedback system.

 Endocrine disorders are manifested as states

of hormone deficiency or hormone excess.

 The underlying pathophysiology may be
expressed as:
 Primary - secreting gland releases

inappropriate hormone bcoz of disease of

the gland itself.
 Secondary - secreting gland releases

abnormal amounts of hormone bcoz of

disease in a regulator gland (e.g., pituitary).
 Tertiary - secreting gland releases
inappropriate hormone bcoz of
hypothalamic dysfunction, resulting in
abnormal stimulation by the pituitary.
 General Effects of Hormone Action

 Regulate the overall metabolic rate and the

storage, conversion, and release of energy.
 Regulate fluid and electrolyte balance.

 Initiate coping responses to stressors.

 Regulate growth and development.

 Regulate reproduction processes.

 Diagnostic Evaluation of Endocrine Disorders

 A variety of diagnostic studies are used to

evaluate the endocrine system.
 Blood tests are used to determine hormone

blood levels.
 Urine tests may be used to measure the

amount of hormones or the end products of

hormones excreted by the kidneys.
 Stimulation tests –
 Can determine how a gland responds to the

admin of stimulating hormones normally

produced/released by the hypothalamus or
pituitary gland.
 If the gland responds to this stimulation, the

specific disorder may be in the

hypothalamus or pituitary.
  Failure of the gland to respond to this
stimulation helps identify the problem as
being in the endocrine gland itself.
 Suppression tests –

 May be used to determine whether

negative feedback control mechanisms from

the hypothalamus or pituitary gland are
intact.
 These tests the effect of admin of an
exogenous dose of the hormone on the
endogenous secretion of the hormone or on
the secretion of stimulation hormones from
the hypothalamus or pituitary gland.
 Assessment

 History –
 Pts with diseases of the ES commonly report

nonspecific complaints.
 Common symptoms may reflect changes in

general well-being –
Fatigue, weakness
Weight change, appetite
Sleep patterns or psychiatric status
 A thorough review of systems is necessary to
detect changes in various body systems
caused by an endocrine disorder.
 Physical Examination –

 Observe the general appearance and

development, height, weight, posture, body

build, proportionality of body parts, and
distribution of body fat and hair
 Note affect, speech, LOC, orientation,
appropriateness of behavior, grooming and
dress, and activity level.
 Assess overall skin color, turgor, and
moisture and, for areas of abnormal
pigmentation, note any bruising, lesions,
petechiae, or striae.
 Assess the face for erythematous areas,
noting facial expression, shape, and
symmetry of the eyes; note abnormal lid
closure, eyeball protrusion, and periorbital
edema.
 Inspect the tongue for color, size, lesions,
tremor, and positioning
 Inspect the neck area for symmetry
 Evaluate the overall size, shape, and
symmetry of the chest, noting any
deformities, esp around the nipples.
 Check for truncal obesity, supraclavicular fat
pads, and buffalo hump
 Inspect the external genitalia for normal
development
 Inspect the arms and legs for tremors,
muscle development and strength,
symmetry, color, hair distribution, and
edema
 Examine the feet, noting size, deformities,
lesions, marks from shoes and socks,
maceration, dryness, or fissures
 Palpation
 Palpate thyroid gland for size, symmetry,

and shape; note any nodules or

irregularities
 Palpate the testes for size, symmetry, and

shape; note any nodules or deformities

 Auscultation

 Auscultate the thyroid gland to identify

systolic bruits
 Auscultate the heart, noting heart rhythm
disturbances that may occur in endocrine
disorders