Endocrine System

1. Endocrine System Spring 2012 FINAL

2. Endocrine Glands • Pituitary gland • Pineal gland • Adrenal glands • Thyroid gland • Parathyroid gland • Thymus gland • Pancreas • Gonads • Hypothalamus 1

3. Pituitary Gland • Anterior • FSH • LH • TSH • ACTH • PRL • MSH • Endorphins • GH • Posterior • ADH • Oxytocin 2

4. Pineal Gland Melatonin 3

5. Adrenal Glands • Adrenal Cortex • Mineralocorticoids • Glucocorticoids • Androgens • Adrenal Medulla • Epinephrine • Norepinephrine 4

6. Thyroid Gland • TH • Thyroxine • Triiodothyronine • Calcitonin 5

7. Parathyroid Gland • PTH 6

8. Thymus • Lymphocytes • Thymosin 7

9. Pancreas • Glucagon • Alpha cells • Insulin • Beta Cells 8

10. 9

11. Gonads • Females • Estrogen • Progesterone • Males • Testosterone 10

12. Hypothalamus • TRH • GnRH • GHRH • CRH • Somatostatin • Dopamine 11

13. Osteoporosis • Classified by age groups • Most common is postmenopausal • Decrease in bone density (subtractive) • Treatment increase calcium and vitamin D in comination with hormone therapy 12

14. Osteoporosis 13

15. Osteomalacia • Lack of calcium in the tissues & a failure of the bone tissue to calcify • Caused by malabsorption of fats • If it occurs after growth plate closure it is called Rickets 14

16. Demonstrates as osteopenia on x-ray. Appears similar to osteoporosis Except for the presence of bands Of radiolucency within the bone Osteomalacia 15

17. X-ray of affected bones show cortical thickening with a coarse Thickened trabecular pattern Often called “cotton wool” Appearance Mixed areas of radiolucency & radiopaque areas Paget’s Disease 16

18. Paget’s Disease • Metabolic disorder of unknown cause • Has two stages: • Osteolytic • Osteo blastic • Fairly common in elderly • Affects men twice as frequently as women 17

19. Pituitary Gland Disorders 18

20. Acromegaly X-ray demonstrates an enlarged sella Turcica and changes in the skull Obliterates diploe found between inner & outer tables of the cortical bone 19

21. Acromegaly • Endocrine disorder caused by a disturbance of the pituitary gland • Primarily affects skeletal system • Have a prominent forehead & jaw, widened teeth, abnormally large hands, coarsening of facial features 20

22. Hypopituitarism • Decreased levels of pituitary hormones • Most common cause is pituitary infarction • Caused by ischemic pituitary necrosis, postpartum hemorrhage, shock, sickle cell disease, meningitis, shock, syphilis, and head trauma • CT, MRI and angiography can be used for radiographic evaluation 21

23. Hypopituitarism • Short stature with protruding abdomen • Sparse hair • Coarse facial features • Wide-set eyes • Broad nose • Protruding tongue 22

24. Diabetes Insipidus • Deficiency in vasopressin • Insufficient ADH • Usually secondary to intereference with ADH production • Can be hereditary • Nephrogenic D.I. • Symptomes • Polyuria • Increased thirst • Low urine osmolality • Treatment • Hormone therapy 23

25. Adrenal Gland Disorders 24

26. Cushing’s Syndrome http://www.youtube.com/watch?v=vxSAhLyKVqw 25

27. Cushing’s Syndrome • Have a “moon” face with excess fat deposits in neck and trunk • Skin is thin and does not heal well • CT and MRI demonstrates pituitary adenomas 26

28. Addison’s Syndrome 27

29. Addison’s Syndrome 28

30. Pancreatic Disorders 29

31. Pancreas Anatomy 30

32. Diabetes Mellitus • Syndrome characterized by chronic hyperglycemia is combination with glucose intolerance • Alteration is metabolism of carbs, fats and proteins 31

33. Type 1 • Produce little to no insulin • Symptoms • Increase urination • Excessive thirst • Increase in appetite • Treatment 32

34. Type 2 • Inadequate secretion of insulin • More common in women than men • Treatment is similar to DM 1 33

35. Thyroid and Parathryroid Gland Disorders 35

36. Thyroid Anatomy 36

37. Hyperthyroidism 36

38. Hyperthyroidism • Autoimmune disorder • Thyroid gland secretes excess amounts of TSH • Enlarged thyroid and protruding eyes • Hyper and nervous • Treatment includes: medical management, surgical resection Administration of radioactive iodine

39. Hypothyroidism • TH deficiency • Commonly seen in PT’s with Hashimoto’s syndrome • May be caused by iodine insufficiency • Symptoms: • decreased energy levels • hot & cold intolerance • personality changes • weight gain • Treatment is hormone replacement therapy

40. Thyroid Cancers

41. Parathyroid Glands

42. Hyperparathyroidism X-ray demonstrates osteopenia, especially in the diaphyses of the phalanges and clavicles Pathologic fractures may exist as a consequence of the softened bony matrix

43. Hyperparathyroidism Disrupts the calcium Phosphate ration and Results in increased Levels of PTH.

44. Nephrocalcinosis Tiny deposits of calcium dispersed through renal parenchyma Can be seen on an IVU and plain radiographs

45. Radiography • Useful in diagnosing some disorders • Metabolic diseases of the skeletal system • Cushing's’ • Decrease in CA in osteomalacia & osteoporosis • Disorders of pituitary gland • Changes in sella turcica • Acromegaly

46. Bone Mineral Densitometry • Determines mineral and calcium content in bone • Can assist in the diagnosis of • Osteoporosis • Osteomalacia

47. MRI • Useful in evaluating pituitary disorders • Pituitary adenomas • Presence of progress • With Gadolinium • Microadenomas

48. CT • Useful in diagnosis and follow-up of pituitary disorders • Pineal gland • Neoplastic diseases of thyroid , adrenal glands & parathyroid glands • Enlargement of adrenal glands • Biopsies frequently performed under CT

49. Nuclear Medicine • Diagnosing thyroid function • Detecting nonpalpable nodules • Evaluate remaining thyroid tissue • After surgical resection or ablation • Localize medullary tumors of adrenal glands • Using radioisotopes to treat this tumor of the medullary portion of the adrenal glands