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Endocrine System

Dive into the body's regulating system closely linked to the nervous system, using glands and tissues to regulate growth, energy use, and more. Learn about hormones' role, secretion, and common disorders.

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Endocrine System

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  1. Endocrine System I’m hot, I’m cold, I’m fast, I’m slow. EMT-Paramedic Program

  2. The System Itself • The other regulating system of the body • Closely linked to nervous system • Uses glands and tissues • Via hormones, the system regulates: • growth • the use of foods for energy • pH of body fluids • fluid balance • reproduction • provides resistance to stress

  3. Chemical messengers to either: Body organs Tissues Or Both Binding depends on: Quantity Quality of receptor sites They may be divided into three groups: Amines Tyrosine, epi, norepi Proteins amino acids; insulin, GH, calcitonin, ADH, oxytocin Steroids cholesterol; cortisol, aldosterone, estrogen, progesterone, and testosterone Hormones

  4. Hormone Secretion • Negative feedback mechanism • Endocrine glands respond to blood level changes or other hormones present • Secretion of hormone until stimulus is negated or changed

  5. Pituitary “Master Gland” • Posterior holds hypothalamus hormones ADH and oxytocin • Anterior produces GH, TSH, ACTH, prolactin, FSH, LH

  6. Specific Hormones • ADH • maintains BP by reabsorption of water by kidney tubules and vasoconstriction • Oxytocin • stimulates contraction of uterus and release of milk

  7. Specific Hormones Thyroid Stimulating Hormone Growth Hormone Anterior Pituitary Adrenocorticotropic Hormone

  8. Thyroid Gland • Produces: • T4 - Thyroxine • T3 – Triiodothyronine • Contain Iodine • Regulate energy production & growth • Calcitonin – • Regulates calcium • Maintains strong bones… • Also feeds back through pituitary

  9. Parathyroid Glands • “Pair-a-thyroids?”  • Produces parathyroid hormone • Also involved in calcium & blood phosphate levels

  10. Disorders Associated with Thyroid Gland • Issues directly associated with gland • Tumor • Pituitary malfunction indirectly affecting • Hypothyroidism (Myxedema) • Hyperthyroidism (Grave’s Disease) • Thyrotoxicosis • Thyrotoxic Crisis (Thyroid Storm)

  11. Disorders of the Thyroid Gland • Thyroid Storm • Severe Tachycardia, Dysrhythmias • Heart Failure • Shock • Hyperthermia • Restlessness, Agitation & Paranoia • Abdominal pain • Delirium, Coma • What else does this look like? • What could help you distinguish? • Danger in becoming a cynic?

  12. Adrenal Glands Each adrenal has: • Medulla • -Epinephrine • -Norepinephrine • Cortex • -Aldosterone • -Cortisol

  13. Trouble Associated with Adrenal Gland Cushing’s Syndrome • ACTH Levels too high • Enlarges adrenal gland • May be associated with pituitary tumor

  14. Addison’s Disease Deficiency of cortisol & aldosterone Slow, gradual onset Progressive Fluid volume deficit Hyperpigmentation (bronze) Disorders Associated with Adrenal Glands

  15. Adrenal Gland Disorders Addisonian Crisis • Acute episode preceded by: • Physical or emotional stress • Surgery • Alcohol intoxication • Trauma • Infection • Hypoglycemia • Adrenal cortex cannot comply with body’s increased demand

  16. Ovaries Secrete • Estrogen • Progesterone progesterone

  17. Testes Secrete • Testosterone • Inhibin

  18. Pancreas • U R&L Q • Islets of Langerhans • Produce Glucagon & Insulin

  19. Pancreatic Hormones • Glucagon – Alpha Cells • stimulates liver to change glycogen to glucose • raises blood glucose levels • Insulin – Beta Cells • lowers blood glucose levels by increasing transport of glucose into the cells

  20. Glucose/Dextrose (D-glucose) • An intermediate in metabolism of carbohydrates • The most important carbohydrate, and is formed during digestion; absorbed from intestines into blood of portal vein; in passage through liver, is converted into glycogen

  21. Glucose • May be: • Used immediately • Stored in muscles • Stored in fat • Brain cannot store it’s food • Requires continuous circulating volume • Reason neuro s/s develop quickly

  22. Disorders Associated with Pancreatic Dysfunction Diabetes Mellitus • Hyperglycemia • Hypoglycemia • DKA • HHNK

  23. Diabetes Mellitus • 16 million in North America. & rising • 3 diagnostic types: • IDDM Type I • NIDDM Type II • Other (Secondary) DM

  24. Diabetes Mellitus • IDDM type 1 • Most commonly occurs in children and young adults • Genetic predisposition; Immune mediated destruction of insulin-producing cells

  25. Diabetes Mellitus • NIDDM type II • Usually occurs after age 30. • A strong genetic predisposition is evident but pathogenesis is different. • Most individuals obese • Resistance to insulin action is present. • Exogenous insulin not required.

  26. Promotion of Hyperglycemia • Increased dietary intake (esp. carbohydrates) • Limitation of physical activity • Reduction of hypoglycemic therapy • Limitation of endogenous insulin production • Pancreatic diseases • Drug treatment • Electrolyte disorders

  27. Diabetes Mellitus • Other (secondary) DM • Associates hyperglycemia to another cause including: • Pancreatic disease/Pancreatectomy • Drugs or chemical agents • Others too • Gestational diabetes • Develops during pregnancy and resolves with birth but increased risk of DM later.

  28. Development of Insulin Resistance • Infection • Inflammation • Myocardial ischemia or infarction • Trauma • Surgery • Emotional stress • Pregnancy • Drug treatment

  29. S/S of Hyperglycemia/Insulin Insufficiency or Resistance • Polyuria • Polydipsia • Nocturia • Weight Loss • Fatigue • Blurred vision

  30. Control • Oral • Transplant • Islet cells • Pancreas

  31. Oral Hypoglycemic Drugs Metformin 500-1000 mg PO tid Avandia 4 mg PO qd

  32. Insulin

  33. Diabetic Ketoacidosis • A result of severe insulin insufficiency and an excess of glucagon. Type I • Common causes: • Interruption of insulin therapy • Stress, infection • Non-compliance frequently a factor • Onset slow, from 12-24 hours.

  34. Diabetic Ketoacidosis • Transition from glucose to lipid metabolism • Forms ketones & increase to toxic levels (diuresed) • Metabolic Acidosis • Symptoms • Causes severe osmotic diuresis and severe dehydration • Tx: Requires close monitoring • Draw red-top • Give IV fluids (Typically 3-5 L Low) • Consider thiamine • All vitamins & Electrolytes grossly deranged

  35. Non-Ketotic Hyperglycemic Hyperosmolar Coma (HHNK) • Complication of Type II • Typically preceded by infection &/or diuretics • Hyperglycemic state causes hyperosmolar diuresis • Pronounced volume loss (Towards 10L) • CBG (PG) levels 1000 & higher • Only mild metabolic acidosis • Non-Ketotic • Many electrolytes within normal levels

  36. Hypoglycemia • Common causes • Excessive insulin • Stress • Overexertion • Infection • Under eating • Symptoms • Treatment • O2, IV, CBG (Red Top), 50% dextrose IV

  37. Endocrine Summary • A VERY complicated system • A specialty of it’s own • Much of EMS treatment is symptom oriented • Much of care is cause oriented • Important distinction

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