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Endocrine 1

  1. Anatomy and Physiology (illustration)
  2. The endocrine system, together with the neurological system, functions as the communication system for the body
  3. Endocrine glands secrete hormones
    1. Secreted in very small amounts
    2. Alters the rate of many physiologic activities
      1. reproduction
      2. metabolism
      3. growth and development
      4. neurological and mental functions
    3. Secreted into the blood
    4. Regulated by several methods
      1. autonomic nervous system
      2. changes in concentrations of specific substances in plasma
      3. feedback system 
  4. Glands
  5. Pituitary (illustration 1  illustration 2)
    1. Lies in sella turcica above the sphenoid bone
    2. Consists of two lobes connected by the hypothalamus
    3. Regulates the other endocrine glands by stimulating target organs
    4. Controlled by releasing and inhibiting hormones from the hypothalamus
  6. Thyroid gland (illustration)
    1. Located at the level of the cricoid cartilage in front of the trachea
    2. Two highly vascular lobes
    3. Controls the rate of the body metabolism
  7. Parathyroid glands - parathormone (PTH)
    1. Four small glands located near the thyroid gland
    2. Controls calcium and phosphorus metabolism
  8. Adrenal glands (illustration)
    1. Two small glands lying in the retroperitoneal region
    2. Functions
      1. cortex - promotes organic metabolism, regulates sodium and potassium, response to stress, preadolescent growth spurt
      2. medulla - stimulation of sympathetic nervous system, responds to stress
  9. Pancreas - insulin, glucagon secretion into the blood, an endocrine function (illustration)
    1. Lies retroperitoneally, with the head of the gland in the duodenal cavity and the tail lying against the spleen
    2. Excretion of enzymes and bicarbonate that aid digestion and controls carbohydrate metabolism as an exocrine function
  10. Gonads - ovaries, estrogen, progesterone, inhibin - decreases secretion of follicle-stimulating hormone (FSH); testes, testosterone
    1. Located: two ovaries are situated in the lower abdomen on each side of the uterus. The testes are the pair of male sex organs that form within the abdomen but descend into the scrotum
    2. Responsible for secondary sex characteristics and reproductive function
  11. General Concepts
  12. Endocrine glandsmust maintain homeostasisof about 50 billion cells.
  13. Endocrine glands are ductless, and secrete many hormones directly into the blood or lymph.
  14. These hormones regulate growth; maturation; reproduction; metabolism; the balances of electrolytes, water, and nutrients; and the balances of behavior and energy
  15. Concentration in the bloodstream of most hormones is maintained at a constant level. If the hormone concentration rises, further production of that hormone is inhibited (also known as "feedback control")
  16. Unlike the endocrine, exocrine glands secrete their products through duct(s) into the body's cavities or onto its surface. Exocrine glands produce sweat (sweat glands), skin oils (sebaceous glands), mucus (mucous membranes), and digestive juices (for example, the pancreas in its exocrine function).
  17. Disorders of the Anterior Pituitary
  18. Hypopituitarism
    1. Definition - underactivity of the front (anterior) pituitary gland
      1. classifications of pituitary tumors
        1. functioning: hormone present in insufficient quantities
        2. non-functioning: hormone absent
    2. Etiology - most common cause: neoplasms, usually benign
    3. Findings - result from hormone deficiency (hypogonadism)
      1. hypogonadism, female:
        1. amenorrhea
        2. infertility
        3. decreased libido
        4. breast and uterine atrophy
        5. loss of axillary and pubic hair
        6. vaginal dryness
      2. hypogonadism, male
        1. decreased libido
        2. impotence
        3. small, soft testicles
        4. loss of axillary and pubic hair
      3. hypothyroidism (because pituitary regulates thyroid glands by thyroid stimulating hormone (TSH))
      4. hypoadrenalism (because pituitary regulates adrenal glands by ACTH production)
      5. may see signs of increased intracranial pressure(ICP)
    1. Diagnostics
      1. history and physical exam
      2. neuro-ophthalmological exam
      3. x-rays of pituitary fossa
      4. radioimmunoassaysof anterior pituitary hormones
      5. computerized tomogram (CT) scan
    2. Management
      1. expected outcome: hormone deficiency corrected
      2. hormone replacement therapy
        1. corticosteroid therapy 
        2. thyroid hormone replacement
        3. sex hormone replacement
      3. surgical removal of tumor
    3. Nursing interventions
      1. provide for
        1. care of the client with increased ICP 
        2. care of the client undergoing surgery
      2. monitor for desired effects of administered medications as ordered
      3. provide emotional support with referral to support groups
      4. teach client
        1. medications desired effects and side effects
        2. need for lifelong hormone replacement therapy and regular checks of sirum levels