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ENDOCRINOLOGY

Acmad aminuddin

ENDOCRINE GLANDS
EXOCRINE GLANDS
ENDOCRINE GLANDS
HORMONE-SECRETING CELLS

Fig 18.1

HORMONE ACTIVITY
The role of hormone receptors
- Only teh target cels for a given
hormone have receptors that bind
and recognize that hormone.
- Receptors
- A target cell has 2000 to
100.000 receptors.
- Down-regulation
- Up-regulation

CIRCULATING HORMONES
Fig 18.2

HORMONE TRANSPORT IN THE


BLOOD
Most water soluble hormone
molecule circulate in the watery
blood plasma in a free form, but
most lipid soluble hormone
molecules are bound to transport
protein.
The transport proteins, which are
synthesized by cells in the liver, have
three function

TRANSPORT PROTEIN
They make lipid-soluble hormone
temporarily water-soluble, thus increasing
their solubility in blood.
They retard passage of small hormone
molecules through the filtering mechanism
in the kidney, thus slowing the the rate of
hormone loss in the urine.
They provide a ready reserve of hormone ,
already present in the blood stream.

Table 18.2

fig 18.3

fig 18.4

HORMONE INTERACTIONS
Hormone interactions
The responsiveness of a target cell
depends on
1. The hormone concentration
2. The abundance of the target cells
hormone receptors.
3. Influences exerted by other
hormones

CONTROL OF HORMONE
SECRETION
SIGNAL FROM THE NERVOUS
SYSTEM
CHEMICAL CHANGEES IN THE
BLOOD.
OTHER HORMONES
MOST HORMONAL REGULATORY
SYSTEM VIA NEGATIVE FEED BACK

HYPOTHALAMUS

HYPOTHALAMUS
The major link between the nervous
system and endocine system.
Receives input from the limbic system,
cerebral cortex, thalamus and reticular
activating system.
Receives sensory impuls from internal
organs and from the retina.
Controls the autonomic nervous system
and regulates body temperature, thirst,
hunger, sexual behavior and defensive
reactions

HYPOTHALAMUS
Hypothalamus hormones are release into capillary
networks in the median eminence. The blood
strean carries these hormones directly to the
anterior lobe of pituitay, where they stimulate or
inhibit secretio of anterior pituitary hormones.
Axon extend from the paraventricular and
supraoptic nuclei through the infundibulum into
the posterior lobe of the pitutary. The cll bodies of
these axons make one of twohormones ( oxytocin
or antidiuretic hormone ). Their axons transport
the hormones to the posterior pituitary, where
they are released.

HYPOTHALAMUS
Thyrotropin-Releasing Hormone.
Corticotropi-Releasing Hormone.
Gonadotropin-Releasing Hormone.
Growth Hormone-Releasing Hormone
Growth Hormone-Inhibiting Hormone
Prolactin-Releasing Hormone.
Prolactin-Inhibiting Hormone

fig, page 627

table 18.3 , pg 627

fig 18.6

fig 18.7

THE ACTIONS OF ANTERIOR


PITUITARY HORMONES
Human growth hormone or somatotropin
Stimulates liver, muscle, cartilage,
bone and other tissue to synthesize
and secrete insulinlike growth factors ;
IGFs promote growth of body cells, protein
synthesis, tissue repair, lipolysis and
elevation of blood glucose concentration
Thyroid-stimulating hormone or
thyrotropin
Stimulates synthesis and secretion of
thyroid hormones by tgyroid gland.

THE ACTION OF ANTERIOR


PITUITARY HORMONES
Follicle-stimulating hormone
In female initiates development of oocytes
and induces ovarian secretion of estrogen.
In males stimulates testes to produce
sperm.
Luteinizing hormone
In females, stimulates secretion of
estrogen and progesterons, ovulation, and
formation of corpus luteum.
In males stimulates testes to produce
testosterone

THE ACTION OF ANTERIOR


PITUITARY HORMONES
Prolactin
Together with another hormone, promotes
milk secretion by the mammary glands.
Adrenocorticotropic hormone or
corticotropin
Stimulates secretion of glucocorticoid
( mainly cortisol ) by adrenal cortex
Melanocyte-stimulating hormone
Exact role in humans is unknown but may
influence brain activity, when present in
excess, can cause darkening of skin.

POSTERIOR PITUITARY
Consists of pituicytes and axon terminals
of hypothalamic neurosecretory cells.
The cell bodies of the neurosecretoy cells
are in the paraventricular and supraoptic
nuclei of the hypothalamus; their axon
form the hypothalamohypophyseal tract.
This tract begins in the hypothalamus and
ends near blood capillaries in the posterior
pitutary

POSTERIOR PITUITARY
The paraventricular nucleus synthe size the
hormone oxytocin ; and the supraoptic nucleus
produces antidiuretic hormone ( vasopressin ).
Oxytocin and antidiuretic hormone are packaged
into secretory vesicles, which move by fast axonal
transport to the axon terminals in the posterior
pituitary, where they are stored until nerve
impulses trigger exocytosis and release of the
hormone
The capillary plexusof the infunibular process
receives secreted oxytocin and ADH hormone.
From this plexus hormones pass into the
posterior hypophyseal veins for distribution
totarget cells

THYROID GLAND

THYROID GLAND
LIES DEEP TO THE STERNOTHYROID
AND STERNOHYOID MUSCLES, ANTE
RIORLY IN THE NECK AT THE LEVEL
OF C5 T1 VERTEBRAE.
CONSIST OF RIGHT AND LEFT LOBE,
ANTEROLATERAL TO THE LARYNX
AND TRACHEA, ISTHMUS UNITES
THE LOBES OVER THE TRACHEA.

ARTERIES OF THE THYROID


GLAND

VEINS OF THE THYROID


GLAND
THYROID PLEXUS OF VEINS
- SUPERIOR THYROID Vs --- IJVs.
- MIDDLE THYROID Vs
--- IJVs.
- INFERIOR THYROID Vs --- BRACHI
CPH Vs.

LYMPHATIC DRAINAGE OF
THE THYROID GLAND
PRELARYNGEAL L.N SUPERIOR DEP
CERVICAL LN.
PRETRACHEAL LN - INFERIOR DEEP
CERVICAL L.N.
PARATRACHEAL LN INFERIOR DEEP
CERVICAL L.N.

NERVES OF THE THYROID


GLAND
FROM THE SUPERIOR, MIDDLE AND
INFERIOR CERVICAL SYMPATHETIC
GANGLIA
- VASOMOTOR,
- NOT SECRETOMOTOR.

HORMON KELENJAR THYROID


TIROKSIN
TRIIODOTIRONIN
kedua hormon diatas meningkatkan
kecepatan reaksi kimia dalam ham
pir semua sel tubuh.
KALSITONIN
memacu pengendapan Ca didalam
tulang sehingga menurunkan konsentrasi
Ca dalam cairan ekstraselular.

FORMATION OF THYROID
HORMON
FOLLICULAR CELLS PRODUCE
- THYROXINE = tetraiodothyronin =
T4.
- TRIIODOTHYRONIN = T3.
PARA FOLLICULAR CELLS = C CELL
PRODUCE CALCITONIN

ACTION OF THYROID HORMON


INCREASE BASAL METABOLIC RATE
STIMULATE SYNTHESIS OF Na/K ATP ase.
INCREASE BODY TEMPERATURE.
STIMULATE PROTEIN SYNTHESIS.
INCREASE THE USE OF GLUCOSE AND
FATTY ACIDS FOR ATP PRODUCTION.
STIMULATE LIPOLYSIS.
ENHANCE SOME ACTION OF THE
CATECHOLAMINE (epinephrine and
norepinephrine ).
REGULATE DEVELOPMENT AND GROWTH
OF NERVOUS TISSUE AND BONE.

PARATHYROID GLANDS
LIE EXTERNAL TO THE THYROID CAPSULE
ON THE MEDIAL HALF OF THE POSTERIOR
SURFACE OF EACH LOBE OF THE THYROID
GLAND.
MOST PEOPLE HAVE 4 PARATHYROID
GLANDS,
- 2 SUPERIOR PARATHYROID
GLANDS.
- 2 INFERIOR PARATHYROID
GLANDS.

VESSELS OF THE PARATHYROID


GLANDS
INFERIOR THYROID A.
may also from, superior thyroid a.,
thyroid ima a.
PARATHYROID Vs drain into the thyroid
plexus of veins.
LYMPHATIC VESSELS drain into
- deep cervical l.n.
- paratracheal l.n.

NERVE OF THE
PARATHYROID GLANDS
THYROID BRANCHES OF THE CERVI
CAL SYMPATETHIC GANGLIA
HORMONALLY REGULATED.

HORMON KELENJAR
PARATHYROID
PARATHORMON
MENGATUR KONSENTRASI ION Ca
DALAM CAIRAN EKTRASELULAR
DENGAN CARA MENGATUR ;
- ABSORPSI Ca DARI USUS.
- EKSKRESI Ca OLEH GINJAL.
- PELEPASAN Ca DARI TULANG.

SUPRARENAL GLANDS
LOCATED BETWEEN THE SUPERO MEDIAL
ASPECT OF THE KIDNEYS AND THE
DIAPHRAGM,ATTACHED TO THE CRURA OF THE
DIAPHRAGM GY RENAL FASCIA.
THE SHAPE PYRAMYDAL RIGHT GLAND.
- CRESCENT LEFT GLAND.
HAS TWO PART
- THE SUPRARENAL CORTEX
- FROM MESODERM.
- THE SUPRARENAL MEDULLA
- FROM NEURAL CREST CELLS ASSOCIATED WITH THE SYMPATHETIC NERVOUS SYST

THE SUPRARENAL ARTERIES


AND VEINS
SUPERIOR SUPRARENAL A from
- inferior phrenic a.
MIDDLE SUPRARENAL A. from
- abdominal aorta.
INFERIOR SUPRARENAL A. from
- renal a.
RIGHT SUPRARENAL V. drain to
- I.V.C.
LEFT SUPRARENAL V. drain to
- left renal v.

LYMPHATICS AND NERVES OF


THE SUPRARENAL GLANDS
LYMPHATICS DRAIN TO THE LUMBAR
LYMPH NODES.
NERVE SUPPLY FROM THE CELIAC PLEXUS
AND ABDOMINOPELVIC SPLANCHNIC
NERVES.
PRESYNAPTIC SYMPATETHETIC FIBERS,
MAINLY DERIVED FROM THE
INTERMEDIOLATERAL CELL COLUMN OF
GRAY MATTER OF THE SPINAL CORD
(T10-L1) TRAVERSE BOTH THE PARAVER
TEBRAL AND THE PREVERTEBRAL GANGL
WITHOUT SYNAPSE, THEN TO THE
CHROMAFIN CELLS IN THE SUPRARENAL
MEDULLA.

THE HORMONES OF THE


SUPRARENAL GLANDS
THE SUPRARENAL CORTEX, secretes
corticosteroids and androgens, these hormon
cause the kidneys to retain sodium and water in
response to stress, increasing the blood volume
and blood pressure. They also affect muscles and
organ such as heart and lungs.
THE SUPRARENAL MEDULLA, secretes
cathecholamines ( mostly epinephrine ) in
response to the signals from presynaptic neuron.
Epinephrine and norepinephrine activate the body
to a flight-or fight status inresponse to traumatic
stress. They also
- increase heart rate and blood pressure.
- dilatate the bronchiolus.
- change blood flow patterns,preparing
for physical exertion

PANCREATIC ISLET
FIG 18.18
b and c
T.D

CELL TYPES IN THEPANCREATIC


ISLETS
Alpha or A cells, constitute about 17 % of
pancreatic islet cells and secrete glucagon.
Beta or B cells constitute about 70 % of
pancreatic islet cels, and secrete insulin.
Delta or D cells constitute about 7 % of
pancreatic islet cells and secrete
somatostatin.
F cells constitute the remainder of
pancreatic islet cells and secrete
pancreatic polypeptide

fig 18.19 T.D

GLUCAGON from alpha cells


Control of secretion
Decreased blood level of glucose, exercise
and mainly protein meals stimulate
secretion.
Somatostatin and insulin inhibit scrt
Principle actions
Raises blood glucose level by accele rating
breakdown of glycogen into glucose in
liver, converting other nutrients into
glucose in liver, and releasing glucos into
the blood.

INSULIN from beta cells


Control of secretion
Increased blood level of glucose,
acetylcholine, arginine and leucine,
glucagon,GIP, Hgh and ACTH stimulate
secretion ; somatostatin inhibit secretion.
Principal actions
Lowers blood glucose level by accelerating
transport of glucose into cells, converting
glucose into glycogen, and decreasing
glycogenolysis and gluconeogenesis ; also
increases lipogenesis and stimulates
protein synthesis.

SOMATOSTATIN from delta cells


Control of secretion
- pancreatic polypeptide inhibits
secretion.
Principal action
- inhibits secretion of insulin and
glucagon and slow absoption of
nutrients from g.i. tract

PANCREATIC POLYPEPTIDE
from F cells
Control of secretion
Meals containing protein, fasting, exercise,
and acute hypoglycemia stimulate
secretion ; somatostatin and elevated
blood glucose level inhibit secretion
Principal actions
Inhibits somatostatin secretion, gall
bladder contraction, and secretion of
pancreatic digestive enzymes.

DIABETES MELLITUS
D.M is caused by an inability to produce or use insulin.
Hakmarks of diabetes mellitus are : polyuria ; polydipsia ;
and poltphagia
Type I DM , insulin level is low because the person`s
immune system destroys the pancreatic beta cells. Most
commonly IDDM develops in people younger than age 20,
though it persists throughout life. By the time symptoms of
IIDM arise, 80 90 % of the islet beta cells have been
destroyed. Because insulin is not present to aid the entry of
glucose into body cells, most cells use fatty acids to
produce ATP. Stores of triglyceride in the adipose tissue are
catabolized to yield fatty acid and glycerol. The byproducts
of fatty acid breakdown keton bodies --- ketoacidosis

DIABETES MELLITUS
Type 2 DM is a heterogeneous group of
disorder chracterized by variable degrees
of insulin resistance, impaired insulin
secretion, and increased glucose
production.
90 % of all cases.
Most occur in obese, over age 35, the
number of obese children and teen agers
with type 2 diabetes is increasing.

OVARIUM

OVARIAN HORMONES
ESTROGEN AND PROGESTERON
together with gonadotropic hormone
of the anterior pituitary, regulate the
female reproductive cycle, regulate
oogenesis, maintain pregnancy prepare the mammary glands for lactation, and promote the development and
maintenance of female secondary sex
characteristics
RELAXIN
INHIBIN

TESRIS

TESTICULAR HORMONES
TESTOSTERON
stimulates descent of testis before
birth, regulates spermatogenesis,
and promotes development and maintenance of male secondary sex cha
racteristics.
INHIBIN
inhibits secretion of f.s.h. from anterior pituitary.