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ENDOCRINE SYSTEM BMS Part II
                   Prepared and presented by:
                    Marc Imhotep Cray, M.D.




                                       Drag/Drop Hormone Match ZeroBio


See: IVMS Endo-Endocrine Secretion and Action Part I
Target Cell Receptors at Three Locations




 Textbook in Medical Physiology And Pathophysiology
Essentials and clinical problems
http://www.zuniv.net/physiology/book/content.htm
                                                      2
Section VII: Endocrine Glands
SIGNAL TRANSDUCTION
  See: G-protein Signal Transduction




                                       3
EXAMPLE: subdivisions of the adrenal gland




                                         4
Endocrine System Rapid Review
          See IVMS Endo-Endocrine Secretion and Action

• Communication system
  – Allows for cells in distant parts of body to communicate
  – Communication generally slower in onset, but longer in
    duration, compared to nervous system communication
• Consists of all the organs that secrete hormones
  (endocrine organs)




                                                         5
Hormones
• Chemical Messengers
• Produced by an endocrine gland
• Released into and carried via bloodstream to target
  tissues
   – Target tissues = tissue bearing receptors that can bind
     and physiologically respond to the chemical messenger
     in question
   – Amount of chemical messenger produced and released
     into circulation is generally very small




                                                               6
Peptide Hormones
• Majority of hormones are proteins/peptides
• Preprohormones prohormones             active
• form
• Bind to receptors located on the plasma
  membrane (surface receptors)
• Responses generally occur very rapidly and are
  short-lived, compared to steroid hormone
  responses


                                                   7
Cell Surface Receptors

1. G-protein coupled receptors
2. Enzyme receptors
3. Receptors associated with ion channels




                                            8
G-Protein Coupled Receptors
     Animation: G-protein Signal Transduction at Texas A&M



• Hormone binds to extracellular site on receptor
• On cytoplasmic side, receptor is associated with
  inhibitory or stimulatory G-Proteins (guanine-
  binding)
• Hormone binding on extracellular side activates
  intracellular G-proteins
• Activated G-Proteins interacts with effector
  proteins (ion channels and enzymes) to elicit
  physiological response

                                                             9
G-Protein Coupled Receptors




                              10
Enzyme Receptors
• Hormone binds to extracellular portion of
  receptor
• Site on cytoplasmic portion of receptor has
  enzymatic activity that is activated by hormone
  binding on the extracellular side
• Altered enzyme activity leads to chain of
  reactions that produce physiological response



                                                    11
Enzyme Receptors
   (animation)




                   12
Receptors Possessing Ion Channels

• Hormone binds to site on extracellular part
  of receptor
• Receptor itself also functions as ion channel
• Binding of hormone to extracellular portion
  of the receptor causes change in shape of
  receptor that alters open/closed ion
  channel status


                                                  13
Receptors Possessing Ion Channels




                                    14
Steroid Hormones
• Modified Cholesterol Derivatives
   – Cholesterol = precursor for their production
   – Have fused ring structures
• Are lipid soluble
   – Readily dissolve in and pass through plasma
     membrane
   – Bind to cytoplasmic or nuclear receptors
• Alter gene transcription/protein production
• Physiologic effects occur more slowly but last longer
  than peptide hormone responses

                                                          15
Steroid Hormone Production

• Adrenal glands: aldosterone, cortisol,
  and androgens
• Kidneys: 1,25-dihydroxyvitamin D3
• Gonads
  – Ovaries: progesterone and estrogens
  – Testes: androgens (testosterone)
  See Animation: Biochemistry of Cholesterol by Rodney F. Boyer




                                                                  16
Amine Hormones
• Amino acid (tyrosine) derivatives
• Includes:
    – T3 (triiodothyronine)and T4 (thyroxine) =
      thyroid hormones
    – Catecholamines
         • Epinephrine & norepinephrine = adrenal (medulla)
           hormones important in stress response
         • Dopamine (hypothalamic hormone)
Animation: Adrenaline Action University of Washington


                                                         17
Neurons vs Endocrine Cells

          Neurons                   Endocrine Cells
• Respond to environ-          • Respond to environ-
  mental changes by              mental changes by
  production and                 production of
  transmission of electrical     hormones
  signals
                               • Stimulate effector cells
• stimulate effector cells       via hormone release
  via NT release into the        into the bloodstream
  synapse

                                                       18
Neuroendocrine Cells
• Cells with properties of both neurons
  and endocrine cells
• Specialized neurons that, when
  stimulated, produce chemical
  messengers (hormones) that are
  released into the circulatory system
• Represent the site of functional overlap
  of the neural and endocrine system


                                             19
Coitus-Induced Ovulation

• Neuroendocrine Reflex
• Occurs in rabbits, cats, ferrets, camel, llama
• Ovulation is triggered by mating - does not
  occur in the absence of mating
• Neural signals initiated by mating alter
  reproductive hormones to trigger ovulation



                                                   20
Prolactin and Oxytocin
• Prolactin = hormone from the anterior
  pituitary that plays a role in milk formation

• Oxytocin = hormone from the posterior
  pituitary that plays a role in milk release
  and uterine contraction



                                                21
Milk Let-Down Reflex
• Suckling of newborn produces neural signals that
  stimulate neurons in hypothalamus to secrete
  oxytocin
• Oxytocin produces contraction of smooth muscle in
  the mammary glands the moves milk through ducts
  and expels it from the nipple, thus promotes milk
  release
• Mental stimuli can also produce neural signals that
  cause same response
   – Lactating women can experience milk let-down in
     response to crying baby


                                                        22
Links to the individual hormones


                                   23
Hypothalamic-Pituitary Axis

• Hypothalamus
  – Region of brain (diencephalon)
  – Lies below third ventricle at base of brain
  – Important regulator of endocrine action
• Pituitary Gland (hypophysis)
  – Endocrine gland connected to hypothalamus
    by infundibulum (stalk containing nerves and
    small blood vessels)

                                                   24
Animation :Thyroid Gland Functioning by Leif Saul




                                                    25
Hypothalamus
                                 • Contains neuroendocrine cells
• Contains neuroendocrine          whose
  cells that release                – cell bodies lie within
  neurohormones which                 hypothalamus
                                       • Hypothalamus = site of hormone
   1. enter the portal vessels           production
      and are transported to
                                    – axons travel through
      anterior pituitary
                                      hypothalamic-pituitary stalk
   2. regulate anterior               and terminate in posterior
      pituitary hormone               pituitary
      production                       • Posterior pituitary = site of hormone
                                         storage and release



                                                                       26
Pituitary Gland

• In humans has two lobes = distinct glands
  – Anterior (toward front of head) lobe =
    adenohypophysis
  – Posterior (toward back of head) lobe =
    neurohypophysis
• Lobes connected to hypothalamus by different
  means
  – Anterior lobe connected by (portal) blood vessels
  – Posterior lobe connected by nerves (axons)

                                                        27
Textbook in Medical Physiology And Pathophysiology
Essentials and clinical problems
http://www.zuniv.net/physiology/book/content.htm
Section VII: Endocrine Glands                         28
Pituitary Gland




                  29
Posterior Pituitary
• Outgrowth of the hypothalamus; composed of
  neural tissue
• Specific neuroendocrine cells in hypothalamus
  have axons that project through the stalk and
  into the posterior pituitary
• Secretes two important hormones
  – Oxytocin (OXY)
  – Antidiuretic hormone (ADH)


                                                  30
Oxytocin and ADH: Production and
                   Release
• Produced in cell bodies in hypothalamus

• Stored in and released from axon terminals in the
  posterior pituitary

• Both hormones are also produced in other brain
  areas and function in brain as
  neurotransmitters/neuromodulators


                                                      31
32
OXY and ADH Action
• Oxytocin
  – Acts on smooth muscle in the uterus and
    breast
  – Produces contractions that result in
    parturition and milk let-down
• ADH
  – Acts in kidney to regulate water balance and
    control blood pressure

                                                   33
RENIN-ANGIOTENSIN-ALDOSTERONE AXIS




                                 34
35
Anterior Pituitary
• Endocrine (hormone-secreting) gland containing
  several different cells types
  –   Lactotrophs; secrete prolactin
  –   Gonadotrophs; secrete LH and FSH
  –   Somatotrophs; secrete Growth hormone
  –   Thyrotrophs; secrete Thyroid stimulating hormone
  –   Corticotrophs; secrete Adrenocorticotropic Hormone
• Connected to hypothalamus by portal blood vessels


                                                           36
Hypothalamus

                           Hypophysiotrophic Hormones
Inhibitory Hormones
                        (Stimulatory ‘Releasing’ Hormones)

             Anterior Pituitary


                             ACTH, GH, PRL, TSH,
                                  FSH, LH,

             Endocrine Gland


                                                       37
Hypothalamic Releasing
                Hormones
• Produced in and released from hypothalamus

• Enter portal blood vessels and are transported to
  ANTERIOR PITUITARY

• Stimulate discrete cell types within anterior
  pituitary to secrete additional hormone(s)


                                                  38
Hypothalamic Releasing Hormones

• Corticotropin Releasing Hormone (CRH)
  – Acts on corticotrophs
  – Stimulates AP production of adrenocorticotropic
    hormone (ACTH)
• Thyrotropin Releasing Hormone (TRH)
  – Acts on thyrotrophs
  – Stimulates AP production of Thyroid Stimulating
    Hormone (TSH)
                                                      39
Hypothalamic ‘Releasing’ Hormones

• Gonadotropin Releasing Hormone (GnRH)
  – Previously known as Luteinizing Hormone
    Releasing Hormone (LHRH)

  – Acts on lactotrophs to stimulate AP production of
    Follicle-Stimulating Hormone (FSH) and Luteinizing
    Hormone (LH)



                                                     40
Hypothalamic Releasing
           & Inhibitory Hormones
• Growth Hormone Releasing Hormone (GHRH =
  somatotropin)
  – Acts on somatotrophs
  – Stimulates AP production of Growth Hormone (GH)
• Growth Hormone Inhibitory Hormone (GIH =
  somatostatin)
  – Acts on somatotrophs
  – Inhibits AP production of Growth Hormone


                                                  41
Hypothalamic Dopamine
             Production/Release

• Distinct dopamine-secreting neurons in
  hypothalamus
• Dopamine enters portal vessels and is transported to
  Anterior Pituitary
• Acts on lactotrophs to INHIBIT AP production of
  Prolactin




                                                   42
PRL vs Other AP Hormones
• With the exception of PRL, other AP hormones are
  not secreted unless stimulated by ‘releasing’
  hormones from hypothalamus

• PRL is continuously produced/secreted unless
  inhibited by hypothalamic dopamine




                                                     43
HYPOTHALAMUS SUMMARY
     TRH          GnRH                          DA    OXY
           CRH            GHRH/GHIH                            ADH



 +         +      +            +   -        -
 TSH             FSH/LH                         PRL   OXY
                                                               ADH
        ACTH                    GH

 +                +                         +
                                   +
                                        Breast           +
Thyroid        Ovary/Testes
         +                                            Breast
                              All Tissues                        +
     Adrenal Cortex
                                                                 44
Thyroid Gland
• Located in the neck; in front and on either side of
  trachea
• Secretes two hormones
   – T3 = triiodothyronine
   – T4 = thyroxine              Modified tyrosine
• T4 secretion > T3 secretion    molecules
• T4 converted to T3 in most tissues, especially liver
  and kidney
• T3 is more active hormone than T4


                                                         45
Thyroid Hormones
• Require iodine for synthesis
  – Iodine absorbed in GI tract by active transport;
    converted to iodide in process
  – Iodide is taken up by thyroid gland, by active
    transport process, and converted back to iodine
• Iodine is incorporated into T3 and T4



                                                   46
Thyroid Hormones
• Stimulate growth and metabolism
• Function in fetal/early postnatal brain
  development
  – Iodine deficiency that results in maternal or fetal
    thyroid hormone deficiency can result in severe
    mental retardation
• Functions in adult brain function



                                                      47
Diseases of Thyroid Gland
                    With eMedicine Article links:

• Hypothyroidism = underactive thyroid
  – Slowed metabolic rate, fatigue, weight gain
  – Cretinism, if present and untreated at birth
• Hyperthyroidism = overactive thyroid
  –   Increased metabolic rate
  –   Enlargement of thyroid gland (goiter)
  –   Weight loss, nervousness, irritability
  –   Intolerance to heat
  –   Bulging eyeballs
                                                    48
Adrenal Glands
                   With eMedicine Article links:

• Paired glands; located on top of kidneys
• Each adrenal gland has two parts
  – Medulla
     • Inner portion
     • Synthesizes/secretes epinephrine and norepinephrine
       (stress hormones)
     • Pheochromocytoma
  – Cortex
     • Outer portion
     • Secretes steroid hormones
     • Cushing Syndrome

                                                        49
Adrenal Cortex Steroid Hormones
• Cortisol and Corticosterone
  – Regulate metabolism during fasting
  – Glucocorticoids
• Aldosterone
  – Regulates Na+ and K+ balance; promotes Na+ reuptake
    in kidney
  – Mineralocorticoid
   – Hyperaldosteronism, Primary
• Dehydroepiandrosterone
  – Androgen (testosterone precursor)

                                                      50
Diseases of Adrenal Glands
                      With eMedicine article links:

• Cushing’s Disease
   –   hyperactive adrenal cortex
   –   rounded face & obesity
   –   Thin, frail skin    poor wound healing
   –   Hirtsuism (excess hair growth) in females
• Addison’s Disease = adrenal cortex insufficiency
   – Decreased appetite, weight loss
   – Cold intolerance
   – Stress susceptibility

                                                      51
Parathyroid Glands
• Located within thyroid gland
• Secrete parathyroid hormone (PTH)
  – regulates plasma Ca++ and PO3++ levels
  – requires Vitamin D3 as cofactor
• PTH excess      bone demineralization
• PTH insufficiency    abnormal muscle
  contraction (tetany)
                                    eMedicine Articles:
                                    Hyperparathyroidism
                                    Hypoparathyroidism
                                                          52
Hormone Production Regulation
1. Neural control
  – Hypothalamic releasing hormones
2. Plasma Constituent
  – PTH; regulated by serum Ca++ levels
  – Insulin; regulated by serum glucose levels
3. Hormonogen (hormone precursor)
  – Aldosterone; regulated by angiotensin levels


                                                   53
Hormone Production Regulation

• Ingestion or biosynthesis of precursor
• Hypothalamic-Pituitary Control




                                           54
Plasma Constituent

• PTH production by parathyroid glands
• PTH regulates serum calcium and phosphate
  levels
• PTH secretion is regulated by serum calcium
  levels
  – Increased serum calcium inhibitis PTH secretion
  – Decreased serum calcium stimulates PTH secretion


                                                 55
PTH Target Tissues
• Bone
   – Increases bone resorption; moves calcium and
     phosphate from bones into extracellular fluid
• Kidney
   – Stimulates activation of Vitamin D (converts
     25(OH)vitamin D to 1,25-dihyrdoxyvitamin D
   – Increases tubular calcium reabsorption; decreases
     tubular phosphate reabsorption
• Intestine
   – Activated Vit D increases intestinal absorption of
     calcium



                                                          56
PTH Regulation


    Intestine         Kidney        Bone

         +            +             +      Serum Ca++



Serum Ca++
             + Parathyroid Glands


                                                57
Hormonogen Regulation

• Hormonogen = (inactive) hormone precursor
  participates in physiological response to
  environmental changes

• Example: Aldosterone production by adrenal cortex

• Hormone secreted into plasma acts on hormonogen
  and converts it to active hormone

                                               58
Aldosterone
• Steroid hormone from adrenal cortex
• Regulates ion balance
  – Target tissue = collecting ducts in nephrons of
    kidney
  – Stimulates reabsorption of Na+ from ultrafiltrate
    back into bloodstream




                                                        59
Aldosterone Regulation

• Angiotensinogen = hormonogen secreted into
  blood by liver
• Angiotensinogen is converted to Angiotensin by
  Renin
  – Angiotensin = active form of hormone
     • Stimulates adrenal cortex to produce/release
       aldosterone
  – Renin = kidney hormone produced in response to
    drop in blood pressure or blood volume


                                                      60
+
                                Kidney


    Liver                                    Aldosterone

                  Renin

                                         +
                                             Adrenal
Angiotensinogen           Angiotensin
                                             Cortex




                                                       61
Ingestion or
                    Biosynthesis of Precursor
•   1,25-dihydroxyvitamin D3 production
     – Vitamin D3 ingested in diet or synthesized in skin
          • in skin, ultraviolet radiation converts cholesterol derivative to Vit D3
          • Subsequently modified by hydroxylations in liver and kidney
     – Main action of 1,25-dihydroxyvitamin D3 is to stimulate intestinal Ca++
        absorption
•   Thyroid hormones
     – Tyrosine (amino acid) ingested or produced by interconversion of other
        amino acids
     – Modified by iodinations
     – T3 and T4 regulate metabolism and affect brain development/function




                                                                                       62
Hormone Production Regulation
Hypothalamic-Pituitary Control; negative
 feedback loops
 – Hormone produced by the terminal endocrine
   gland in an endocrine axis feeds back at the level
   of the hypothalamus and/or pituitary to ultimately
   inhibit its own production
 – Examples:
    • TH in thyroid
    • Cortisol in adrenal cortex
                                                   63
Endocrine System and Aging

• Endocrine glands decrease in size with aging
• Hormonal profile changes with aging
   – Generally hormone concentrations decrease with aging
   – Some hormone concentrations increase with aging
       • e.g. adrenal glucocorticoids (cortisol/corticosterone) which,
         in higher concentrations, over time, damage brain/neural
         tissues
• Receptor numbers and/or receptor responsiveness are altered with
  aging
• Collectively, these changes decrease organisms ability to respond
  to environmental changes and cope with stress

                                                                 64
Anabolic Steroids
• Synthetic testosterone
• Clinically used to promote anabolic effects (growth)
   – Estrogen and Testosterone promote GH and IGF-I
     secretion that results in prepubertal growth spurt and
     induces closure of the bone growth plate at puberty
   – Testosterone (but not estrogen) has anabolic effect on
     protein synthesis that produces increased muscle mass
• Abused by athletes in an attempt to gain muscle
  mass and increased strength



                                                              65
Negative Side Effects of Anabolic
                   Steroids
      In men                          In women
– Decreased plasma               – Virilization
  testosterone                       • deepened voice
– Sterility                          • hirsutism
– Testicular atrophy             – Alopecia (hair loss)
– Gynecomastia                   – Acne
                       Both sexes
       –Hypertension and cardiovascular disease
       –Liver tumors
       –AIDS (via sharing needles for injection)

                                                          66
End of Session



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ALL e-books and learning tools provided
                                                                                         67

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Endocrine Secretion and Action II

  • 1. ENDOCRINE SYSTEM BMS Part II Prepared and presented by: Marc Imhotep Cray, M.D. Drag/Drop Hormone Match ZeroBio See: IVMS Endo-Endocrine Secretion and Action Part I
  • 2. Target Cell Receptors at Three Locations Textbook in Medical Physiology And Pathophysiology Essentials and clinical problems http://www.zuniv.net/physiology/book/content.htm 2 Section VII: Endocrine Glands
  • 3. SIGNAL TRANSDUCTION See: G-protein Signal Transduction 3
  • 4. EXAMPLE: subdivisions of the adrenal gland 4
  • 5. Endocrine System Rapid Review See IVMS Endo-Endocrine Secretion and Action • Communication system – Allows for cells in distant parts of body to communicate – Communication generally slower in onset, but longer in duration, compared to nervous system communication • Consists of all the organs that secrete hormones (endocrine organs) 5
  • 6. Hormones • Chemical Messengers • Produced by an endocrine gland • Released into and carried via bloodstream to target tissues – Target tissues = tissue bearing receptors that can bind and physiologically respond to the chemical messenger in question – Amount of chemical messenger produced and released into circulation is generally very small 6
  • 7. Peptide Hormones • Majority of hormones are proteins/peptides • Preprohormones prohormones active • form • Bind to receptors located on the plasma membrane (surface receptors) • Responses generally occur very rapidly and are short-lived, compared to steroid hormone responses 7
  • 8. Cell Surface Receptors 1. G-protein coupled receptors 2. Enzyme receptors 3. Receptors associated with ion channels 8
  • 9. G-Protein Coupled Receptors Animation: G-protein Signal Transduction at Texas A&M • Hormone binds to extracellular site on receptor • On cytoplasmic side, receptor is associated with inhibitory or stimulatory G-Proteins (guanine- binding) • Hormone binding on extracellular side activates intracellular G-proteins • Activated G-Proteins interacts with effector proteins (ion channels and enzymes) to elicit physiological response 9
  • 11. Enzyme Receptors • Hormone binds to extracellular portion of receptor • Site on cytoplasmic portion of receptor has enzymatic activity that is activated by hormone binding on the extracellular side • Altered enzyme activity leads to chain of reactions that produce physiological response 11
  • 12. Enzyme Receptors (animation) 12
  • 13. Receptors Possessing Ion Channels • Hormone binds to site on extracellular part of receptor • Receptor itself also functions as ion channel • Binding of hormone to extracellular portion of the receptor causes change in shape of receptor that alters open/closed ion channel status 13
  • 15. Steroid Hormones • Modified Cholesterol Derivatives – Cholesterol = precursor for their production – Have fused ring structures • Are lipid soluble – Readily dissolve in and pass through plasma membrane – Bind to cytoplasmic or nuclear receptors • Alter gene transcription/protein production • Physiologic effects occur more slowly but last longer than peptide hormone responses 15
  • 16. Steroid Hormone Production • Adrenal glands: aldosterone, cortisol, and androgens • Kidneys: 1,25-dihydroxyvitamin D3 • Gonads – Ovaries: progesterone and estrogens – Testes: androgens (testosterone) See Animation: Biochemistry of Cholesterol by Rodney F. Boyer 16
  • 17. Amine Hormones • Amino acid (tyrosine) derivatives • Includes: – T3 (triiodothyronine)and T4 (thyroxine) = thyroid hormones – Catecholamines • Epinephrine & norepinephrine = adrenal (medulla) hormones important in stress response • Dopamine (hypothalamic hormone) Animation: Adrenaline Action University of Washington 17
  • 18. Neurons vs Endocrine Cells Neurons Endocrine Cells • Respond to environ- • Respond to environ- mental changes by mental changes by production and production of transmission of electrical hormones signals • Stimulate effector cells • stimulate effector cells via hormone release via NT release into the into the bloodstream synapse 18
  • 19. Neuroendocrine Cells • Cells with properties of both neurons and endocrine cells • Specialized neurons that, when stimulated, produce chemical messengers (hormones) that are released into the circulatory system • Represent the site of functional overlap of the neural and endocrine system 19
  • 20. Coitus-Induced Ovulation • Neuroendocrine Reflex • Occurs in rabbits, cats, ferrets, camel, llama • Ovulation is triggered by mating - does not occur in the absence of mating • Neural signals initiated by mating alter reproductive hormones to trigger ovulation 20
  • 21. Prolactin and Oxytocin • Prolactin = hormone from the anterior pituitary that plays a role in milk formation • Oxytocin = hormone from the posterior pituitary that plays a role in milk release and uterine contraction 21
  • 22. Milk Let-Down Reflex • Suckling of newborn produces neural signals that stimulate neurons in hypothalamus to secrete oxytocin • Oxytocin produces contraction of smooth muscle in the mammary glands the moves milk through ducts and expels it from the nipple, thus promotes milk release • Mental stimuli can also produce neural signals that cause same response – Lactating women can experience milk let-down in response to crying baby 22
  • 23. Links to the individual hormones 23
  • 24. Hypothalamic-Pituitary Axis • Hypothalamus – Region of brain (diencephalon) – Lies below third ventricle at base of brain – Important regulator of endocrine action • Pituitary Gland (hypophysis) – Endocrine gland connected to hypothalamus by infundibulum (stalk containing nerves and small blood vessels) 24
  • 25. Animation :Thyroid Gland Functioning by Leif Saul 25
  • 26. Hypothalamus • Contains neuroendocrine cells • Contains neuroendocrine whose cells that release – cell bodies lie within neurohormones which hypothalamus • Hypothalamus = site of hormone 1. enter the portal vessels production and are transported to – axons travel through anterior pituitary hypothalamic-pituitary stalk 2. regulate anterior and terminate in posterior pituitary hormone pituitary production • Posterior pituitary = site of hormone storage and release 26
  • 27. Pituitary Gland • In humans has two lobes = distinct glands – Anterior (toward front of head) lobe = adenohypophysis – Posterior (toward back of head) lobe = neurohypophysis • Lobes connected to hypothalamus by different means – Anterior lobe connected by (portal) blood vessels – Posterior lobe connected by nerves (axons) 27
  • 28. Textbook in Medical Physiology And Pathophysiology Essentials and clinical problems http://www.zuniv.net/physiology/book/content.htm Section VII: Endocrine Glands 28
  • 30. Posterior Pituitary • Outgrowth of the hypothalamus; composed of neural tissue • Specific neuroendocrine cells in hypothalamus have axons that project through the stalk and into the posterior pituitary • Secretes two important hormones – Oxytocin (OXY) – Antidiuretic hormone (ADH) 30
  • 31. Oxytocin and ADH: Production and Release • Produced in cell bodies in hypothalamus • Stored in and released from axon terminals in the posterior pituitary • Both hormones are also produced in other brain areas and function in brain as neurotransmitters/neuromodulators 31
  • 32. 32
  • 33. OXY and ADH Action • Oxytocin – Acts on smooth muscle in the uterus and breast – Produces contractions that result in parturition and milk let-down • ADH – Acts in kidney to regulate water balance and control blood pressure 33
  • 35. 35
  • 36. Anterior Pituitary • Endocrine (hormone-secreting) gland containing several different cells types – Lactotrophs; secrete prolactin – Gonadotrophs; secrete LH and FSH – Somatotrophs; secrete Growth hormone – Thyrotrophs; secrete Thyroid stimulating hormone – Corticotrophs; secrete Adrenocorticotropic Hormone • Connected to hypothalamus by portal blood vessels 36
  • 37. Hypothalamus Hypophysiotrophic Hormones Inhibitory Hormones (Stimulatory ‘Releasing’ Hormones) Anterior Pituitary ACTH, GH, PRL, TSH, FSH, LH, Endocrine Gland 37
  • 38. Hypothalamic Releasing Hormones • Produced in and released from hypothalamus • Enter portal blood vessels and are transported to ANTERIOR PITUITARY • Stimulate discrete cell types within anterior pituitary to secrete additional hormone(s) 38
  • 39. Hypothalamic Releasing Hormones • Corticotropin Releasing Hormone (CRH) – Acts on corticotrophs – Stimulates AP production of adrenocorticotropic hormone (ACTH) • Thyrotropin Releasing Hormone (TRH) – Acts on thyrotrophs – Stimulates AP production of Thyroid Stimulating Hormone (TSH) 39
  • 40. Hypothalamic ‘Releasing’ Hormones • Gonadotropin Releasing Hormone (GnRH) – Previously known as Luteinizing Hormone Releasing Hormone (LHRH) – Acts on lactotrophs to stimulate AP production of Follicle-Stimulating Hormone (FSH) and Luteinizing Hormone (LH) 40
  • 41. Hypothalamic Releasing & Inhibitory Hormones • Growth Hormone Releasing Hormone (GHRH = somatotropin) – Acts on somatotrophs – Stimulates AP production of Growth Hormone (GH) • Growth Hormone Inhibitory Hormone (GIH = somatostatin) – Acts on somatotrophs – Inhibits AP production of Growth Hormone 41
  • 42. Hypothalamic Dopamine Production/Release • Distinct dopamine-secreting neurons in hypothalamus • Dopamine enters portal vessels and is transported to Anterior Pituitary • Acts on lactotrophs to INHIBIT AP production of Prolactin 42
  • 43. PRL vs Other AP Hormones • With the exception of PRL, other AP hormones are not secreted unless stimulated by ‘releasing’ hormones from hypothalamus • PRL is continuously produced/secreted unless inhibited by hypothalamic dopamine 43
  • 44. HYPOTHALAMUS SUMMARY TRH GnRH DA OXY CRH GHRH/GHIH ADH + + + + - - TSH FSH/LH PRL OXY ADH ACTH GH + + + + Breast + Thyroid Ovary/Testes + Breast All Tissues + Adrenal Cortex 44
  • 45. Thyroid Gland • Located in the neck; in front and on either side of trachea • Secretes two hormones – T3 = triiodothyronine – T4 = thyroxine Modified tyrosine • T4 secretion > T3 secretion molecules • T4 converted to T3 in most tissues, especially liver and kidney • T3 is more active hormone than T4 45
  • 46. Thyroid Hormones • Require iodine for synthesis – Iodine absorbed in GI tract by active transport; converted to iodide in process – Iodide is taken up by thyroid gland, by active transport process, and converted back to iodine • Iodine is incorporated into T3 and T4 46
  • 47. Thyroid Hormones • Stimulate growth and metabolism • Function in fetal/early postnatal brain development – Iodine deficiency that results in maternal or fetal thyroid hormone deficiency can result in severe mental retardation • Functions in adult brain function 47
  • 48. Diseases of Thyroid Gland With eMedicine Article links: • Hypothyroidism = underactive thyroid – Slowed metabolic rate, fatigue, weight gain – Cretinism, if present and untreated at birth • Hyperthyroidism = overactive thyroid – Increased metabolic rate – Enlargement of thyroid gland (goiter) – Weight loss, nervousness, irritability – Intolerance to heat – Bulging eyeballs 48
  • 49. Adrenal Glands With eMedicine Article links: • Paired glands; located on top of kidneys • Each adrenal gland has two parts – Medulla • Inner portion • Synthesizes/secretes epinephrine and norepinephrine (stress hormones) • Pheochromocytoma – Cortex • Outer portion • Secretes steroid hormones • Cushing Syndrome 49
  • 50. Adrenal Cortex Steroid Hormones • Cortisol and Corticosterone – Regulate metabolism during fasting – Glucocorticoids • Aldosterone – Regulates Na+ and K+ balance; promotes Na+ reuptake in kidney – Mineralocorticoid – Hyperaldosteronism, Primary • Dehydroepiandrosterone – Androgen (testosterone precursor) 50
  • 51. Diseases of Adrenal Glands With eMedicine article links: • Cushing’s Disease – hyperactive adrenal cortex – rounded face & obesity – Thin, frail skin poor wound healing – Hirtsuism (excess hair growth) in females • Addison’s Disease = adrenal cortex insufficiency – Decreased appetite, weight loss – Cold intolerance – Stress susceptibility 51
  • 52. Parathyroid Glands • Located within thyroid gland • Secrete parathyroid hormone (PTH) – regulates plasma Ca++ and PO3++ levels – requires Vitamin D3 as cofactor • PTH excess bone demineralization • PTH insufficiency abnormal muscle contraction (tetany) eMedicine Articles: Hyperparathyroidism Hypoparathyroidism 52
  • 53. Hormone Production Regulation 1. Neural control – Hypothalamic releasing hormones 2. Plasma Constituent – PTH; regulated by serum Ca++ levels – Insulin; regulated by serum glucose levels 3. Hormonogen (hormone precursor) – Aldosterone; regulated by angiotensin levels 53
  • 54. Hormone Production Regulation • Ingestion or biosynthesis of precursor • Hypothalamic-Pituitary Control 54
  • 55. Plasma Constituent • PTH production by parathyroid glands • PTH regulates serum calcium and phosphate levels • PTH secretion is regulated by serum calcium levels – Increased serum calcium inhibitis PTH secretion – Decreased serum calcium stimulates PTH secretion 55
  • 56. PTH Target Tissues • Bone – Increases bone resorption; moves calcium and phosphate from bones into extracellular fluid • Kidney – Stimulates activation of Vitamin D (converts 25(OH)vitamin D to 1,25-dihyrdoxyvitamin D – Increases tubular calcium reabsorption; decreases tubular phosphate reabsorption • Intestine – Activated Vit D increases intestinal absorption of calcium 56
  • 57. PTH Regulation Intestine Kidney Bone + + + Serum Ca++ Serum Ca++ + Parathyroid Glands 57
  • 58. Hormonogen Regulation • Hormonogen = (inactive) hormone precursor participates in physiological response to environmental changes • Example: Aldosterone production by adrenal cortex • Hormone secreted into plasma acts on hormonogen and converts it to active hormone 58
  • 59. Aldosterone • Steroid hormone from adrenal cortex • Regulates ion balance – Target tissue = collecting ducts in nephrons of kidney – Stimulates reabsorption of Na+ from ultrafiltrate back into bloodstream 59
  • 60. Aldosterone Regulation • Angiotensinogen = hormonogen secreted into blood by liver • Angiotensinogen is converted to Angiotensin by Renin – Angiotensin = active form of hormone • Stimulates adrenal cortex to produce/release aldosterone – Renin = kidney hormone produced in response to drop in blood pressure or blood volume 60
  • 61. + Kidney Liver Aldosterone Renin + Adrenal Angiotensinogen Angiotensin Cortex 61
  • 62. Ingestion or Biosynthesis of Precursor • 1,25-dihydroxyvitamin D3 production – Vitamin D3 ingested in diet or synthesized in skin • in skin, ultraviolet radiation converts cholesterol derivative to Vit D3 • Subsequently modified by hydroxylations in liver and kidney – Main action of 1,25-dihydroxyvitamin D3 is to stimulate intestinal Ca++ absorption • Thyroid hormones – Tyrosine (amino acid) ingested or produced by interconversion of other amino acids – Modified by iodinations – T3 and T4 regulate metabolism and affect brain development/function 62
  • 63. Hormone Production Regulation Hypothalamic-Pituitary Control; negative feedback loops – Hormone produced by the terminal endocrine gland in an endocrine axis feeds back at the level of the hypothalamus and/or pituitary to ultimately inhibit its own production – Examples: • TH in thyroid • Cortisol in adrenal cortex 63
  • 64. Endocrine System and Aging • Endocrine glands decrease in size with aging • Hormonal profile changes with aging – Generally hormone concentrations decrease with aging – Some hormone concentrations increase with aging • e.g. adrenal glucocorticoids (cortisol/corticosterone) which, in higher concentrations, over time, damage brain/neural tissues • Receptor numbers and/or receptor responsiveness are altered with aging • Collectively, these changes decrease organisms ability to respond to environmental changes and cope with stress 64
  • 65. Anabolic Steroids • Synthetic testosterone • Clinically used to promote anabolic effects (growth) – Estrogen and Testosterone promote GH and IGF-I secretion that results in prepubertal growth spurt and induces closure of the bone growth plate at puberty – Testosterone (but not estrogen) has anabolic effect on protein synthesis that produces increased muscle mass • Abused by athletes in an attempt to gain muscle mass and increased strength 65
  • 66. Negative Side Effects of Anabolic Steroids In men In women – Decreased plasma – Virilization testosterone • deepened voice – Sterility • hirsutism – Testicular atrophy – Alopecia (hair loss) – Gynecomastia – Acne Both sexes –Hypertension and cardiovascular disease –Liver tumors –AIDS (via sharing needles for injection) 66
  • 67. End of Session Services provided by Imhotep Virtual Medical School Individualized Webcam facilitated USMLE Step 1 Tutorials with Dr. Cray Starting at $50.00/hr., depending on pre-assessment. 1 BMS Unit is 4 hr. General Principles and some Organ System require multiple units to complete in preparation for the USMLE Step 1 A HIGH YIELD FOCUS in Biochemistry / Cell Biology, Microbiology / Immunology, the 4 P’s-Physiology, Pathophys., Path and Pharm and Intro to Clinical Medicine Webcam Facilitated USMLE Step 2 Clinical Knowledge and Clinical Skills didactic tutorials starting at $75.00 per hour /1 Unit is 4 hours, individualized one-on-one and group sessions, Including Introduction to Clinical Medicine and all Internal Medicine sub-specialities at the clerkship level. For questions or more information.. drcray@imhotepvirtualmedsch.com ALL e-books and learning tools provided 67