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Medical Terminology for Health Care Professionals

Tenth Edition

Chapter 12

Endocrine System

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Learning Objectives (1 of 2)

12.1 Describe the major function of the endocrine system.

12.2 Identify the primary functions of the organs of the endocrine system.

12.3 Identify the various hormones secreted by the endocrine glands and their hormonal function.

12.4 Analyze, build, spell, and pronounce medical words.

Learning Objectives (2 of 2)

12.5 Classify the drugs highlighted in this chapter.

12.6 Describe diagnostic and laboratory tests related to the endocrine system.

12.7 Identify and define selected abbreviations and acronyms.

Anatomy and Physiology (1 of 9)

The endocrine system is made up of glands and the hormones they secrete into the bloodstream.

Endocrine glands are the body's main hormone producers; some other organs produce and release hormones as well:

Brain

Heart

Lungs

Liver

Anatomy and Physiology (2 of 9)

Endocrine glands are the body's main hormone producers; some other organs produce and release hormones as well:

Skin

Thymus

Gastrointestinal mucosa

Placenta during pregnancy

Anatomy and Physiology (3 of 9)

Primary glands of the endocrine system:

Pituitary

Pineal

Thyroid

Parathyroid

Pancreas (pancreatic islets)

Adrenals

Ovaries in the female

Testes in the male

Anatomy and Physiology (4 of 9)

Figure 12.1 Glands of the endocrine system.

The diagram of the endocrine system reads as follows. • A man’s body shows the endocrine organs. • The hypothalamus is in the front of the brain. • The pineal gland sits in the center of the brain. • The pituitary gland sits in the front of the brain below the hypothalamus. • The thyroid gland is a butterfly shaped gland in the throat. • The parathyroid gland is inside the thyroid gland. • The thymus sits in the center of the chest. • The adrenal glands sit on top of the kidneys. • The pancreas sits on the left side of the body near the kidney. • The kidneys sit on either side of the spine at the base of the ribs.

Anatomy and Physiology (5 of 9)

Vital function of the endocrine system: Production and regulation of chemical substances called hormones.

Anatomy and Physiology (6 of 9)

Hormones

Chemical transmitters released in small amounts and transported via the bloodstream to a target organ or other cells.

Transfer information and instructions from one set of cells to another.

Regulate growth, development, mood, tissue function, homeostasis, metabolism, and sexual function in male and female.

Table 12.1 Endocrine System at-a-Glance (1 of 3)

Gland	Primary Functions/Description
Pituitary (hypophysis)	Master gland; has regulatory effects on other endocrine glands
Anterior lobe (adenohypophysis)	Influences growth and sexual development, thyroid function, adrenocortical function; regulates skin pigmentation
Posterior lobe (neurohypophysis)	Stimulates the reabsorption of water and elevates blood pressure; stimulates the uterus to contract during labor, delivery, and parturition (childbirth); stimulates the release of milk during suckling
Pineal	Helps regulate the release of gonadotropin and influences the body’s internal clock

Table 12.1 Endocrine System at-a-Glance (2 of 3)

Gland	Primary Functions/Description
Thyroid	Plays vital role in metabolism; regulates the body’s metabolic processes; influences bone and calcium metabolism; helps maintain plasma calcium homeostasis
Parathyroid	Maintains normal serum calcium level; plays a role in the metabolism of phosphorus
Pancreas (pancreatic islets)	Regulates blood glucose levels; plays a vital role in metabolism of carbohydrates, proteins, and fats

Table 12.1 Endocrine System at-a-Glance (3 of 3)

Gland	Primary Functions/Description
Adrenals (suprarenals)	blank
Adrenal cortex	Regulates carbohydrate metabolism; anti-inflammatory effect; helps body cope during stress; regulates electrolyte and water balance; promotes development of male characteristics
Adrenal medulla	Synthesizes, secretes, and stores catecholamines (sympathomimetic hormones: dopamine, epinephrine, norepinephrine)
Ovaries	Promote growth, development, and maintenance of female sex organs
Testes	Promote growth, development, and maintenance of male sex organs

For Your Information (F Y I) 1

Most of the structures and glands of the endocrine system develop during the first 3 months of pregnancy.

The endocrine system of newborn is supplemented by hormones that cross the placental barrier.

Both male and female newborns may have swelling of the breasts and genitalia from maternal hormones.

Anatomy and Physiology (7 of 9)

Hyposecretion or hypersecretion of specific hormones cause or are associated with pathological conditions.

Controlling the production of or replacing specific hormones can treat many hormonal disorders and/or conditions.

Anatomy and Physiology (8 of 9)

Hypothalamus

A collection of specialized cells located in the lower central part of the brain.

Is the primary link between the endocrine and nervous systems.

Nerve cells control the pituitary gland by producing chemicals that either stimulate or suppress hormone secretions from the pituitary.

Anatomy and Physiology (9 of 9)

Exerts direct nervous control over the pituitary and the adrenal medulla.

Controls the secretion of the hormones epinephrine and norepinephrine.

Table 12.2 Summary of the Endocrine Glands, Hormones, and Hormonal Functions (1 of 13)

Endocrine Glands	Hormones	Hormonal Functions
Pituitary gland	blank	blank
Anterior lobe	Growth hormone (G H) (also called somatotropin hormone [S T H])	Promotes growth and development of bones, muscles, and other organs; enhances protein synthesis, decreases the use of glucose, and promotes fat destruction (lipolysis)
blank	Adrenocorticotropin hormone (A C T H)	Stimulates growth and development of the adrenal cortex
blank	Thyroid-stimulating hormone (T S H)	Stimulates growth and development of the thyroid gland
blank	Follicle-stimulating hormone (F S H)	Stimulates the growth of ovarian follicles in the female and sperm in the male

Table 12.2 Summary of the Endocrine Glands, Hormones, and Hormonal Functions (2 of 13)

Endocrine Glands	Hormones	Hormonal Functions
Pituitary gland Anterior lobe	Luteinizing hormone (L H)	Stimulates the development of the corpus luteum in the female and the production of testosterone in the male
blank	Prolactin hormone (P R L) (also called lactogenic hormone [L T H])	Stimulates the development and growth of the mammary glands; important in the initiation and maintenance of milk production during pregnancy. Following childbirth, the act of suckling provides the stimulus for prolactin synthesis and release. When suckling ceases, prolactin secretion slows and milk production decreases and then stops.
blank	Melanocyte-stimulating hormone (M S H)	Regulates skin pigmentation and promotes the deposit of melanin in the skin after exposure to sunlight

Table 12.2 Summary of the Endocrine Glands, Hormones, and Hormonal Functions (3 of 13)

Endocrine Glands	Hormones	Hormonal Functions
Pituitary gland Posterior lobe	Antidiuretic hormone (A D H) (also called vasopressin [V P])	Stimulates the reabsorption of water by the renal tubules and has a pressor (stimulating) effect that elevates the blood pressure
blank	Oxytocin	Stimulates the uterus to contract during labor, delivery, and parturition; stimulates the release of milk during suckling
Pineal gland	Melatonin	Helps regulate the release of gonadotropin and influences the body’s internal clock
blank	Serotonin	Stimulates neurotransmitter, vasoconstrictor, and smooth muscle; acts to inhibit gastric secretion

Table 12.2 Summary of the Endocrine Glands, Hormones, and Hormonal Functions (4 of 13)

Endocrine Glands	Hormones	Hormonal Functions
Thyroid gland	Thyroxine (T4)	Maintains and regulates the basal metabolic rate (B M R); influences growth and development, both physical and mental, and the metabolism of fats, proteins, carbohydrates, water, vitamins, and minerals; can be synthetically produced or extracted from animal thyroid glands in crystalline form to be used in the treatment of thyroid dysfunction, especially congenital hypothyroidism, myxedema, and Hashimoto disease

Table 12.2 Summary of the Endocrine Glands, Hormones, and Hormonal Functions (5 of 13)

Endocrine Glands	Hormones	Hormonal Functions
Thyroid gland	Triiodothyronine (T3 )	Influences the basal metabolic rate and is more biologically active than thyroxine
blank	Calcitonin	Influences bone and calcium metabolism and helps maintain plasma calcium homeostasis; also known as thyrocalcitonin
Parathyroid glands	Parathyroid hormone (P T H) (also called parathormone)	Plays a role in maintenance of a normal serum calcium level and in the metabolism of phosphorus

Table 12.2 Summary of the Endocrine Glands, Hormones, and Hormonal Functions (6 of 13)

Endocrine Glands	Hormones	Hormonal Functions
Pancreas Pancreatic islets (islets of Langerhans)	Glucagon	Facilitates the breakdown of glycogen to glucose
blank	Insulin	Plays a role in maintenance of normal blood sugar; it promotes the entry of glucose into the cells, thereby lowering the blood glucose (B G) level
blank	Somatostatin	Suppresses the release of glucagon and insulin

Table 12.2 Summary of the Endocrine Glands, Hormones, and Hormonal Functions (7 of 13)

Endocrine Glands	Hormones	Hormonal Functions
Adrenal glands Cortex	Cortisol	Regulates carbohydrate, protein, and fat metabolism; needed for gluconeogenesis; increases blood sugar level; provides anti-inflammatory effect; helps body cope during times of stress
blank	Corticosterone	Necessary for normal use of carbohydrates, the absorption of glucose, and gluconeogenesis; also influences potassium (K) and sodium (Na) metabolism

Table 12.2 Summary of the Endocrine Glands, Hormones, and Hormonal Functions (8 of 13)

Endocrine Glands	Hormones	Hormonal Functions
Adrenal glands Cortex	Aldosterone	Essential in regulating electrolyte and water balance by promoting sodium and chloride reabsorption and potassium excretion
blank	Testosterone	Influences development of male secondary sex characteristics
blank	Androsterone	Influences development of male secondary sex characteristics

Table 12.2 Summary of the Endocrine Glands, Hormones, and Hormonal Functions (9 of 13)

Endocrine Glands	Hormones	Hormonal Functions
Adrenal glands Medulla	Dopamine	Dilates systemic arteries, elevates systolic blood pressure, increases cardiac output, increases urinary output
blank	Epinephrine (also called adrenaline)	Acts as vasoconstrictor, vasopressor, cardiac stimulant, antispasmodic, and sympathomimetic
blank	Norepinephrine (also called noradrenaline)	Acts as vasoconstrictor, vasopressor, and neurotransmitter

Table 12.2 Summary of the Endocrine Glands, Hormones, and Hormonal Functions (10 of 13)

Endocrine Glands	Hormones	Hormonal Functions
Ovaries	Estrogens (estradiol, estrone, and estriol)	Necessary for the growth, development, and maintenance of female sex organs and secondary sex characteristics; promote the development of the mammary glands; play a vital role in a woman’s emotional well-being and sexual drive
blank	Progesterone	Prepares the uterus for pregnancy

Table 12.2 Summary of the Endocrine Glands, Hormones, and Hormonal Functions (11 of 13)

Endocrine Glands	Hormones	Hormonal Functions
Testes	Testosterone	Necessary for normal growth and development of the male accessory sex organs; plays a vital role in the erection process of the penis and thus is necessary for the sexual act, copulation (sexual intercourse)

Table 12.2 Summary of the Endocrine Glands, Hormones, and Hormonal Functions (12 of 13)

Endocrine Glands	Hormones	Hormonal Functions
Thymus gland	Thymosin	Promotes the maturation process of T lymphocytes
blank	Thymopoietin	Influences the production of lymphocyte precursors and aids in their process of becoming T lymphocytes

Table 12.2 Summary of the Endocrine Glands, Hormones, and Hormonal Functions (13 of 13)

Endocrine Glands	Hormones	Hormonal Functions
Gastrointestinal mucosa	Gastrin	Stimulates gastric acid secretion
blank	Secretin	Stimulates pancreatic juice, bile, and intestinal secretion
blank	Cholecystokinin	Causes contraction and emptying of the gallbladder and secretion of pancreatic enzymes, increases bile acid production in the liver, delays gastric emptying, and induces digestive enzyme production in the pancreas
blank	Enterogastrone	Regulates gastric secretions

Pituitary Gland (Hypophysis) (1 of 5)

A small gray gland located at the base of the brain.

Lies or rests in a shallow depression of the sphenoid bone known as the sella turcica.

Attached by the infundibulum stalk to the hypothalamus.

Pituitary Gland (Hypophysis) (2 of 5)

Divided into the anterior lobe and the posterior lobe.

Also called the master gland of the body because of its regulatory effects on the other endocrine glands.

Pituitary Gland (Hypophysis) (3 of 5)

Anterior Lobe

Also called the adenohypophysis.

Secretes several hormones essential for growth and development of bones, muscles, other organs, sex glands, the thyroid gland, and the adrenal cortex.

Pituitary Gland (Hypophysis) (4 of 5)

Figure 12.2 The pituitary gland with examples of the pituitary hormones it produces, showing their target cells, tissues, and/or organs.

The diagram of the pituitary gland reads as follows. • The hypothalamus sits in the brain. It regulates blood levels. • Vessels lead to the anterior pituitary. Other vessels lead to the posterior pituitary. • Hormones from the anterior pituitary gland spread throughout the body. • GH goes to the liver. The liver feeds fat tissue, bone, muscle, and organs, growth. • Prolactin goes to the breast to aid in milk production. • LH goes to the ovary, which produces estrogen and progesterone, and to the testis. • FSH goes to the testis to produce testosterone and to the ovaries. • ACTH goes to the adrenal cortex to produce cortical hormones. • TSH goes to the thyroid gland to produce thyroid hormones.

Pituitary Gland (Hypophysis) (5 of 5)

Posterior Lobe

Also called the neurohypophysis.

Stores and secretes two important hormones, ADH and oxytocin, that are synthesized in the hypothalamus.

Pineal Gland

Small, pine cone-shaped gland located near the posterior end of corpus callosum.

Secretes hormones melatonin and serotonin.

Melatonin influences the sleep-wake cycle and regulates the release of gonadotropin.

Serotonin is a neurotransmitter, vasoconstrictor, and smooth muscle stimulant and acts to inhibit gastric secretion.

Thyroid Gland (1 of 3)

Large, bilobed gland located in the neck.

Plays a vital role in metabolism and regulates the body's metabolic processes.

Figure 12.3 Thyroid Gland

The diagram of the thyroid gland reads as follows. • The thyroid gland is a butterfly shaped gland in the throat. It straddles the trachea. • The thyroid cartilage of the larynx, Adam’s apple, sits just above the thyroid gland. • The isthmus is the center piece of the thyroid gland. • The trachea leads from the throat. • A closeup shows the inside of the thyroid gland. • The follicle is an oblong section of the gland. It is surrounded by a ring of small bumps called the site of hormone synthesis. • Colloidal material, storage of hormone, is the center of the ring. • Capillaries run through the gland.

Thyroid Gland (2 of 3)

Hypersecretion of T3 and T4 results in

Congenital hypothyroidism during infancy

Myxedema during adulthood

Hashimoto disease

Thyroid Gland (3 of 3)

Hypersecretion of T3 and T4 results in hyperthyroidism.

Causes of hyperthyroidism include:

Graves disease

Thyroid nodules

Thyroiditis

Too much iodine

Too much synthetic thyroid hormone

Simple or endemic goiter is an enlargement of the thyroid gland caused by a deficiency of iodine in the diet.

Parathyroid Glands (1 of 3)

Small, yellowish-brown bodies occurring as two pairs located on the posterior surface of the thyroid gland.

Secrete parathyroid (P T H), or parathormone.

Figure 12.4 Parathyroid Glands

The diagram of the parathyroid glands reads as follows. • The lobes of the thyroid glands, posterior view, sit on either side of the trachea. • The parathyroid glands are small, circular glands inside the thyroid. • The trachea runs between the lobes of the thyroid gland. • The aorta curves below and slightly in front of the thyroid gland.

Parathyroid Glands (2 of 3)

Hyposecretion of P T H can result in hypoparathyroidism, which can result in tetany (intermittent cramp or tonic muscular contractions).

Hypersecretion of P T H can result in hyperparathyroidism, which may result in osteoporosis, kidney stones, and hypercalcemia.

Parathyroid Glands (3 of 3)

Figure 12.5 Tetany of the hand as a result of hypoparathyroidism.

Pancreas (Pancreatic Islets) (1 of 4)

The pancreatic islets, also called the islets of Langerhans, are small clusters of cells located within the pancreas.

The pancreatic islets are composed of three major types of cells:

Alpha cells secrete glucagon, elevating blood sugar.

Beta cells secrete insulin, maintaining normal blood sugar.

Delta cells secrete somatostatin, which suppresses release of glucagon and insulin.

Pancreas (Pancreatic Islets) (2 of 4)

Figure 12.6 Pancreas-an endocrine and exocrine gland. The inset shows the pancreatic islets. The alpha cells secrete glucagon, which raises the blood glucose level. The beta cells secrete insulin, which lowers the blood glucose level.

The diagram of the pancreas reads as follows. • The pancreas is a long, thin organ. • An accessory duct runs through the center of the organ longways. • The ampulla of vater is a duct at the wide end of the pancreas. • A closeup shows the parts of the inner pancreas. • The exocrine portion of the gland contains cells that secrete digestive juices. These are flower shaped cells. A duct runs through their center. • The endocrine portion of the pancreas contains the pancreatic islets, islets of Langerhans, which are small, irregularly shaped cells. • The endocrine portion of the pancreas contains beta cells, insulin-secreting cells. • The endocrine portion of the pancreas contains alpha cell, glucagon-secreting cells.

Pancreas (Pancreatic Islets) (3 of 4)

Hyposecretion or inadequate use of insulin may result in diabetes mellitus (D M).

Hypersecretion of insulin may result in hyperinsulinism.

Untreated diabetes or complications of diabetes can result in multisystem effects, including diabetic ketoacidosis, insulin shock, coma, and death.

Pancreas (Pancreatic Islets) (4 of 4)

Figure 12.7 Multisystem effects of diabetes mellitus.

For long description, see slide 98, Appendix A

The multisystem effects of diabetes mellitus are as follows. • A man stands with his organs and muscles exposed. • Early manifestations. • Type 1 DM. Polyuria. Polydipsia. Polyphagia. Weight loss. Glycosuria. Fatigue • Type 2 DM. Polyuria. Polydipsia. Blurred vision • Progressive complications • Hyperglycemia • Diabetic ketoacidosis • Hyperglycemic hyperosmolar nonketotic coma • Hypoglycemia

For Your Information (F Y I) 2

Type 1 diabetes mellitus is the most common endocrine system disorder of childhood.

Symptoms include:

Polyuria

Polydipsia

Polyphagia

For Your Information (F Y I) 3

Rate of occurrence of D M is higher among 5- to 7-year-old and 11- to 15-year-old children.

Childhood obesity predisposes individuals to insulin resistance and type 2 D M.

Childhood obesity prevalence has increased significantly in recent years.

Adrenal Glands (Suprarenals) (1 of 8)

Figure 12.8 Adrenal glands.

Adrenal Glands (Suprarenals) (2 of 8)

Adrenal Cortex

The cortex is necessary to life due to its secretion of a group of hormones:

Glucocorticoids

Mineralocorticoids

Androgens

Adrenal Glands (Suprarenals) (3 of 8)

Glucocorticoids

Cortisol: Principal steroid hormone secreted by the cortex.

Hyposecretion of cortisol can result in Addison disease.

Hypersecretion can result in Cushing disease.

Adrenal Glands (Suprarenals) (4 of 8)

Corticosterone: Steroid hormone secreted by the adrenal cortex.

Necessary for:

Normal use of carbohydrates

Absorption of glucose

Formation of glycogen in the liver and tissues

Also influences potassium and sodium metabolism.

Adrenal Glands (Suprarenals) (5 of 8)

Mineralocorticoids

Aldosterone is the principal mineralocorticoid secreted by the adrenal cortex.

Aldosterone is nessecary in regulating electrolyte and water balance by promoting sodium and chloride reabsorption and potassium excretion.

Adrenal Glands (Suprarenals) (6 of 8)

Hyposecretion of aldosterone can result in a reduced plasma volume.

Hypersecretion can result in a condition known as primary aldosteronism.

Adrenal Glands (Suprarenals) (7 of 8)

Androgens

Hormones that promote the development of male characteristics.

The two main androgen hormones essential for the development of the male secondary sex characteristics are:

testosterone

androsterone

Adrenal Glands (Suprarenals) (8 of 8)

Adrenal Medulla

Synthesizes, secretes, and stores catecholamines, specifically the following:

Dopamine: Dilates systemic arteries, increases cardiac output, and increases urinary output.

Epinephrine (adrenaline): Acts as a vasoconstrictor, vasopressor, cardiac stimulant, antispasmodic, and sympathomimetic.

Norepinephrine (noradrenaline): Acts as a vasoconstrictor, vasopressor, and neurotransmitter.

Ovaries

Ovaries produce estrogens (estradiol, estrone, estriol) and progesterone.

Estrogen is the female sex hormone secreted by the graafian follicles of the ovaries.

Progesterone is a steroid hormone secreted by the corpus luteum.

Testes

Produce the male sex hormone testosterone, which is important for:

Sexual development

Sexual behavior

Libido

Supporting spermatogenesis

Erectile function

Placenta

During pregnancy, the placenta, containing separate vascular systems of the mother and fetus, serves as an endocrine gland.

It produces chorionic gonadotropin hormone, estrogen, and progesterone.

Gastrointestinal Mucosa

The mucosa secretes the following hormones:

Gastrin: Stimulates gastric acid secretion.

Secretin: Stimulates pancreatic juice, bile, and intestinal secretion.

Cholecystokinin: Stimulates the pancreas.

Enterogastrone: Regulates gastric secretions.

Thymus (1 of 2)

A bilobed body located in the mediastinal cavity in front of and above the heart.

Composed of lymphoid tissue and is a part of the lymphatic system.

This ductless, glandlike body secretes:

Thymosin

Thymopoietin

Thymus (2 of 2)

Figure 12.9 Thymus gland. (A) Appearance and position; (B) with anatomic structures.

A two part diagram of the thymus gland reads as follows. Part A. Appearance and position. • The thyroid gland straddles the trachea. • The trachea runs down to the lungs. • The thymus sits nestled between the lungs. Part B. With anatomic structures. • The thymus appears somewhat butterfly shaped. • The right and left lobes sit at the top of the gland. • The lobules are small, round, raised structures on the gland. • The septae are the spaces between the lobules.

Leptin and Ghrelin

Leptin and ghrelin are two hormones that have a major influence on energy level.

Leptin and ghrelin are secreted by adipose tissue.

Leptin plays a role in body weight regulation by acting on the hypothalamus to suppress appetite and burn fat.

Ghrelin plays a role in meal initiation.

Leptin is increased in obese subjects, and many obese patients are leptin-resistant.

Obesity

A M A has reclassified obesity from a condition to a disease.

More than one-third of the adult U.S. population is obese.

The CDC now defines weight categories by body mass index (B M I).

B M I is weight in kg divided by height in meters squared.

Overweight is BMI between 25 and 29.9.

Obesity is excessive amount of body fat with BMI of 30.

Building Your Medical Vocabulary 1

Acidosis

acid = acid

-osis = condition

Figure 12.10 Acromegaly

For Your Information (F Y I) 4

Overproduction of growth hormone from the pituitary gland causes excessive growth.

In adults, the condition causes acromegaly with enlarged and elongated bones.

In children, the condition causes gigantism, which is characterized by great stature.

Diagnosis is based on blood tests and imaging of the skull and hands.

Surgery, radiation therapy, and drug therapy are treatments.

Building Your Medical Vocabulary 2

Androgen

andr/o = man

-gen = formation, produce

Figure 12.11 Cushing Disease

A woman with Cushing syndrome A before and B after treatment.

For Your Information (F Y I) 5

Egyptian physicians used a Greek word, diabetes (meaning that which passes through) to define a condition in a patient with polyuria.

Polyuria was later combined with mellitus, a Latin word that means “honey,” referring to patients with sweet-tasting urine.

Persistently elevated blood glucose levels can cause damage to the nerves, resulting in sensory neuropathy.

Figure 12.12 Dwarfism

Building Your Medical Vocabulary 3

Endocrinology

endo- = within

crin/o = to secrete

-logy = study of

Figure 12.13 Hirsutism

(Courtesy Jason L. Smith, MD)

Figure 12.14 Hyperthyroidism

Figure 12.14 Multisystem effects of hyperthyroidism.

For long description, see slide 101, Appendix B

Figure 12.15 Hypothyroidism

Figure 12.15 Multisystem effects of hypothyroidism.

A diagram of the effects of hypothyroidism reads as follows. • A woman stands with her organs and muscles exposed. • Endocrine. Goiter. • Respiratory. Pleural effusion. • Neurologic. Hand and foot paraesthesia. Lethargy. Somnolence. Confusion. Slow speech. Memory impairment. • Sensory. Periorbital edema. • Cardiovascular. Hypotension. Bradycardia. Dysrhythmias. Enlarged heart. Anemia. • Reproductive. Menorrhagia, female. Infertility, female. Decreased libido, male. • Integumentary. Hair loss. Brittle nails. Coarse, dry skin. Nonpitting edema. • Metabolic processes. Hypothermia. Anorexia. Weight gain. Systemic edema. • Gastrointestinal. Constipation. • Musculoskeletal. Muscle stiffness. Weakness. Fatigue.

For Your Information (F Y I) 6

Untreated hypothyroidism can lead to goiter, Hashimoto thyroiditis, and endemic goiter.

Figure 12.16 A man with goiter due to iodine deficiency.

Goiters may result from untreated hypothyroidism. An endemic goiter may develop in geographic regions where the iodine content in food and water is deficient.

Building Your Medical Vocabulary 4

Myxedema

myx = mucus

edema = swelling

Myxedema

Figure 12.17 (A) A 62-year-old patient with myxedema exhibiting marked edema of the face and a somnolent look. The hair is stiff and without luster. (B) The same patient after 3 months of treatment with thyroxine. Source: Pearson Education, Inc.

For Your Information (F Y I) 7

Metabolic syndrome often occurs before developing type 2 diabetes.

Underlying causes include being overweight, obesity, physical inactivity, and genetics.

It can cause increased risk of heart disease, stroke, peripheral vascular disease, and type 2 diabetes.

It is associated with insulin resistance syndrome.

Figure 12.18 Thyroid

Figure 12.18 Palpating the thyroid gland from behind the patient is a most effective way of assessing the gland for abnormality. Source: Pearson Education, Inc.

Figure 12.19 Thyroidectomy

Drug Highlights (1 of 2)

Thyroid hormones

Antithyroid hormones

Drug Highlights (2 of 2)

Insulin preparations for injection

Oral hypoglycemic agents

Hyperglycemic agents

Diagnostic and Laboratory Tests (1 of 8)

Catecholamines

Test performed on urine to determine the amount of epinephrine and norepinephrine present.

Corticotropin, corticotropin-releasing factor (C R F)

Test performed on blood plasma to determine the amount of corticotropin present.

Diagnostic and Laboratory Tests (2 of 8)

Fasting blood sugar (F B S)

Test performed on blood to determine the level of sugar in the bloodstream.

Also referred to as fasting blood glucose (F B G).

Glucose tolerance test (G T T)

Blood sugar test performed at specified intervals after the patient has been given a significant amount of glucose.

Diagnostic and Laboratory Tests (3 of 8)

H b A 1 C test

Blood test used to:

Diagnose diabetes

Identify people at risk of developing diabetes

Monitor how well blood sugar levels are being controlled by the diabetic patient

Diagnostic and Laboratory Tests (4 of 8)

17-hydroxycorticosteroids (17-O H C S)

Test performed on urine to identify adrenocorticosteroid hormones and to determine adrenal cortical function.

17-ketosteroids (17-K S)

Test performed on urine to determine the amount of 17-K S present, the end product of androgens that are secreted from the adrenal glands and testes.

Diagnostic and Laboratory Tests (5 of 8)

Protein-bound iodine (P B I)

Test performed on serum to indicate the amount of iodine that is attached to serum protein.

Radioactive iodine uptake (R A I U)

Test to measure the ability of the thyroid gland to concentrate ingested iodine.

Diagnostic and Laboratory Tests (6 of 8)

Thyroid scan

Test to detect tumors of the thyroid gland. Patient is given radioactive iodine131, which localizes in the thyroid gland, which is then visualized with a scanner device.

Thyroxine T4

Test performed on blood serum to determine the amount of thyroxine present.

Diagnostic and Laboratory Tests (7 of 8)

Total calcium

Test performed on blood serum to determine amount of calcium present.

Triiodothyronine uptake

Test performed on blood serum to determine the amount of triiodothyronine present.

Diagnostic and Laboratory Tests (8 of 8)

Ultrasonography

Use of high-frequency sound waves as a screening test or as a diagnostic tool to visualize the structure being studied.

Abbreviations (1 of 4)

Abbreviation	Meaning	Abbreviation	Meaning
7 - K S	17-ketosteroids	M I F	melanocyte-stimulating hormone release-inhibiting factor
1 7 - O H C S	17-hydroxycorticosteroids	M R F	melanocyte-stimulating hormone-releasing factor
A C T H	adrenocorticotropin hormone	M S H	melanocyte-stimulating hormone
A D H	antidiuretic hormone	N a	sodium
B G	blood glucose	N I D D M	non-insulin-dependent diabetes mellitus
B M I	body mass index	NPO, npo	nothing by mouth

Abbreviations (2 of 4)

Abbreviation	Meaning	Abbreviation	Meaning
B M R	basal metabolic rate	P B I	protein-bound iodine
c m	centimeter	P I F	prolactin release-inhibiting factor
C R F	corticotropin-releasing factor	P R F	prolactin-releasing factor
D I	diabetes insipidus	P R L	prolactin hormone
D M	diabetes mellitus	P T H	parathyroid hormone
F B G	fasting blood glucose	R A I U	radioactive iodine uptake

Abbreviations (3 of 4)

Abbreviation	Meaning	Abbreviation	Meaning
F B S	fasting blood sugar	S T H	somatotropin hormone
F S H	follicle-stimulating hormone	T3	triiodothyronine
g	gram	T3U	triiodothyronine uptake
G H	growth hormone	T4	thyroxine
G H R F	growth hormone-releasing factor	T H	thyroid hormone
G n R F	gonadotropin-releasing factor	T R H	thyrotropin-releasing hormone

Abbreviations (4 of 4)

Abbreviation	Meaning	Abbreviation	Meaning
G T T	glucose tolerance test	T S H	thyroid-stimulating hormone
I D D M	insulin-dependent diabetes mellitus	V P	Vasopressin
K	potassium	blank	blank
kg	kilogram	blank	blank
L H	luteinizing hormone	blank	blank
L T H	lactogenic hormone	blank	blank

Appendix A (1 of 3)

The multisystem effects of diabetes mellitus are as follows.

Late complications

System	Image	Effects
Neurologic	Brain	Somatic neuropathies Paresthesias Pain Loss of cutaneous sensation Loss of fine motor control Visceral neuropathies Sweating dysfunction Pupillary constriction Fixed heart rate Constipation Diarrhea Incomplete bladder emptying Sexual dysfunction
Sensory	Eyes	•Diabetic retinopathy • Cataracts • Glaucoma

Appendix A (2 of 3)

The multisystem effects of diabetes mellitus are as follows.

Late complications

System	Image	Effects
Cardiovascular	Heart and Blood Vessels	• Orthostatic hypotension • Accelerated atherosclerosis • Cerebrovascular disease, stroke • Coronary artery disease, MI • Peripheral vascular disease • Blood viscosity and platelet disorders
Renal	Kidneys	• Hypertension • Albuminuria • Edema • Chronic renal failure

Appendix A (3 of 3)

The multisystem effects of diabetes mellitus are as follows.

Late complications

System	Image	Effects
Musculoskeletal	Leg Muscles	• Joint contractures
Integumentary	Knee	• Foot ulcers • Gangrene of the feet • Atrophic changes
Immune System	White Blood Cell	• Impaired healing • Chronic skin infections • Periodontal disease • Urinary tract infections • Lung infections • Vaginitis

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Appendix B (1 of 3)

A diagram of the multisystem effects of hyperthyroidism reads as follows.

System	Image	Effects
Endocrine	Thyroid	• Goiter
Respiratory	Lungs	• Dyspnea
Neurologic	Brain	• Hand and eye tremors • Nervousness • Insomnia • Emotional lability • Anxiety •Increased reflexes
Sensory	Eyes	• Blurred vision • Photophobia • Lacrimation • Exophthalmos, Graves disease

Appendix B (2 of 3)

A diagram of the multisystem effects of hyperthyroidism reads as follows.

System	Image	Effects
Cardiovascular	Heart	• Hypertension • Tachycardia • Dysrhythmias • Palpitations
Gastrointestinal	Intestines	• Vomiting • Diarrhea • Abdominal pain • Nausea
Reproductive	Testes and Penis	• Amenorrhea, female • Decreased fertility, female • Impotence, male • Decreased libido, male and female • Azoospermia, male •Erectile dysfunction, male

Appendix B (3 of 3)

A diagram of the multisystem effects of hyperthyroidism reads as follows.

System	Image	Effects
Musculoskeletal	Leg Muscles	• Muscle wasting • Loss of strength • Fatigue
Integumentary	Knee	•Hair loss •Increased perspiration
Metabolic Processes	Blank	• Hyperthermia • Diaphoresis • Hunger • Weight loss • Fluid volume deficit

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