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ENDOCRINE FUNCTION: Assessment and Management of ACTION OF HORMONES
Patients with A. PARACRINE ACTION
ENDOCRINE DISORDERS ▪ hormones will act locally in the area where they are
released
ASSESSMENT OF THE ENDOCRINE SYSTEM ▪ example: effect of sex hormones on the ovaries
Anatomic and Physiologic Overview B. AUTOCRINE ACTION
▪ hormones will act on the actual cells from which
ENDOCRINE SYSTEM they were released
▪ example: effect of insulin from pancreatic beta cells
▪ interconnected network of glands is closely linked with the on those cells
nervous and immune systems → regulating the functions of
multiple body organs. Assessment
▪ works closely with the nervous system & immune system 1. HEALTH HISTORY
▪ inquire for any changes such as: energy
ENDOCRINE SYSTEM FUNCTION level, tolerance to heat or cold, weight,
▪ Transportation of chemicals across cell membranes thirst, frequency of urination, menstrual
cycle, memory, concentration, sleep
Has a vital role in: patterns, mood, vision, joint pain, and
▪ Growth and development sexual dysfunction.
▪ Metabolism 2. PHYSICAL ASSESSMENT
▪ Fluid and electrolyte balance ▪ vital signs; head-to-toe inspection; and palpation of
▪ Acid–base balance skin, hair, and thyroid.
▪ Adaptation ▪ physical, psychological, and behavioral changes
▪ Reproduction ▪ physical changes: facial hairs in women, “moon
face,” “buffalo hump,” exophthalmos, vision change,
etc.
▪ mood and behavior changes: nervousness,
lethargy, and fatigue
EXOPHTHALMOS, MOON FACE, BUFFALO HUMP
Diagnostic Evaluation
Blood Tests: Pituitary Function
GLANDS OF THE ENDOCRINE SYSTEM 1. SERUM GROWTH HORMONE
➢ Pituitary Gland ▪ direct measurement of human growth
➢ Thyroid Gland hormone (GH)
➢ Parathyroid Glands INDICATIONS:
➢ Adrenal Glands ▪ Acromegaly or gigantism
➢ Pancreatic Islets ▪ Pituitary tumors
➢ Ovaries & Testes ▪ Pituitary-related growth failure in children
▪ GH deficiency in adults
HORMONES
▪ chemical transmitter substances (chemical messengers) NORMAL RANGE:
▪ regulated by the negative feedback system ▪ Males (less than 5 ng/mL)
▪ Females (less than 8 ng/mL)
FOUR CATEGORIES ACCORDING TO THEIR STRUCTURE
1. amines and amino acids (epinephrine, norepinephrine, & 2. SERUM PROLACTIN
thyroid) ▪ direct measurement of prolactin
2. peptides, polypeptides, proteins, and glycoproteins (TRH, NORMAL RANGE:
FSH, GH) ▪ Men – 1 to 20 ng/mL
3. steroids (corticosteroids) ▪ Women – 1 to 25 ng/mL
4. fatty acid derivatives (eicosanoid, retinoids) INTERPRETATION:
SOURCES OF HORMONES ▪ above 300 ng/mL – pituitary tumor
➢ ENDOCRINE GLANDS (elevated values may be caused by
➢ GI MUCOSA exercise or by breast stimulation, such as
▪ gastrin, enterogastrone, secretin, cholecystokinin from friction)
➢ KIDNEYS
▪ erythropoietin (stimulates bone marrow to produce 3. ADRENOCORTICOTROPIC HORMONE
RBCs) ▪ Direct measurement of ACTH concentration in the
➢ WHITE BLOOD CELLS bloodstream
▪ cytokines (hormonelike proteins – inflammatory & CONTRAINDICATIONS: High stress levels
immune response role) INTERPRETATIONS:
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