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Chapter 38 Endocrine system
Function & assessment
Overview
 Hypothalamus: regulates hunger, thirst, sleep, &
body temp.
 Pineal Gland: releases melatonin, which regulates
daily sleep-wake cycle
 Pituitary gland: regulates energy metabolism, &
growth
 Parathyroid gland: helps regulate calcium &
phosphorus in the blood
 Thyroid gland: regulates energy, metabolism, &
growth. Produces 3 hormones (T4, T3, calcitonin)
 Adrenal gland: Controls growth, sugar
metabolism, kidney function, & stress (released
epinephrine & norepinephrine, the fight or flight
hormones)
 Pancreas: aids in the digestion of protein, fats &
carbohydrates. Produces insulin to control blood
sugar.
 Ovaries: produces the female hormones
 Testes: produces the male hormone
Endocrine system Hormones/functions
 Posterior Pituitary Gland
o Antidiuretic hormone (ADH): Directly
increases water reabsorption by the
kidneys; Increase urine output for too little
and too much you have decreased urine
output
o Oxytocin: causes contraction of the
myometrium during labor &
 Anterior pituitary Gland
o Thyroid stimulating hormone (TSH):
stimulates growth & secretions of the
thyroid gland
o Growth Hormone (GH): Increases rate of
mitosis & rate of protein synthesis ; uses
of fats for energy
o Adrenocorticotropic hormone (ACTH):
Increases secretion of cortisol by the
adrenal cortex
o Prolactin: Stimulates milk production by
the mammary glands
o Follicle stimulating hormone (FSH): In
women: Initiates growth of ova &
increases secretion of estrogen by follicle
cells ; In men: initiates sperm production
in the testes
o Luteinizing hormone (LH) In women:
causes ovulation ; In men: increases
secretion of testosterone by the interstitial
cells of the testes
 Hormones of the thyroid gland
Thyroxine & triiodothyronine (t4, t3):
Increases energy production from all food
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types for a normal metabolic rate
Calcitonin: Decreases the reabsorption of
calcium & phosphate from bones to blood
 Parathyroid glands
o Parathyroid hormone (PTH): increases the
reabsorption of calcium from bones; raises
blood calcium levels
 Adrenal medulla
o Epinephrine: Increases HR & force of
contraction
o Norepinephrine: causes vasoconstriction
throughout body
 Pancreas
o Glucagon (alpha cells): Increases the
conversion of glycogen to glucose in the
liver between meals
o Insulin (beta cells): Increases glucose
uptake by cells & glycogen storage in the
liver
o Somatostatin delta cells): Decreases
secretion of insulin and glucagon; slows
absorption of nutrients
 Adrenal cortex
o Aldosterone: Increases the reabsorption of
sodium by the kidneys
o Cortisol: Increases the use of fats & amino
acids for energy and has an anti-
inflammatory effect
Physical assessment of endocrine system
 Inspection
o Mood & affect (emotional tone)
o Assess neck for thyroid enlargement
o Bulging eyes (exophthalmos)
o Moon like face or “buffalo hump” on the
upper back *
o LE for skin color changes that may
indicate circulatory impairment
o Turgor: sternum is good place; tent
remains in place = dehydrated
 Palpation
o Thyroid gland is the only palpable gland/
Practitioner palpates gland while pt sips
on water.
- DO NOT palpate pt w/
uncontrolled hyperthyroidism b/c
is can stimulate secretion of
additional thyroid hormone
o Peripheral pulses
o Tibial & dorsalis pedis may be diminished
in pt.’s w/ circulatory impairment
Diagnostic Test
 Hormone Test:
o Serum Hormone Levels: blood specimen
samples that are useful in diagnosing
hypo/hyper functioning gland states.
- ADH & oxytocin commonly
measured
o Stimulation test: a substance is injected to
stimulate a gland and the hormone
secreted by that gland is then measured in
blood to determine how well it responded
- EX: TRH is injected; if the
pituitary gland responds
appropriately TSH is secreted. If
the thyroid gland responds
correctly to TSH T3 and T4
levels rise. Failure of TRH to
stimulate TSH and thyroid
hormone indicates an issue.
o Suppression test: OPPOSITE of
stimulating test. A substance is injected
that is expected to suppress a hormone’s
release