KEY CONCEPTS OF ENDOCRINE ANATOMY AND

PHYSIOLOGY

A. Endocrine functioning

1. Hormones - regulate metabolic functions

2. Functions:

• Rates of biochemical reactions

• Transport substances - plasma membrane
• Growth and development
• Stress response
• Reproduction

3. Classification

• Tropic
• Releasing and inhibiting
• Peripheral

4. Characteristics

• Respond to body/ environment rhythms

• Control rate of cellular activities
• Minute amounts
• 3 secretion Patterns
• diurnal
• pulsatile
• depends on circulating substances

5. Control

• Chemical - negative feedback, presence of other hormones

• Neural - cns

6. Hormonal receptors

7. Effects on the target cells

• direct effects
• permissive
• pharmacological

B. Specific Endocrine organs

1. Hypothalamus -hypophyseal system

a. Anterior lobe (adenohypophysis) hormones:

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

b. Posterior lobe (neurohypophysis): stores and releases ADH and oxytocin

2. Thyroid: neck between 2 and 3 tracheal rings

a. Hormones:

T3 & T4 : regulate protein, fat, carbohydrate metabolism; regulate heat

production, maintains growth and development
Thyrocalcitonin : lowers Calcium levels

b. Functions of Thyroid hormones:

• glucose uptake by cells

• enhance fat metabolism
• basal metabolic rate (BMR)
• HR, COP, vasodilatation
• increase O2 consumption and CO2
• beta-adrenergic receptors
• control secretion of other hormones

3. Parathyroid: Regulates serum calcium, magnesium, and phosphate

4. Pancreas

a. Cells

• Acinar cells (exocrine gland)

• Islet cells (endocrine gland)

• Alpha - secrete glucagon

• Beta - secrete insulin

transport glucose to cells (reduce blood glucose)

facilitates intracellular transport of K

• Delta - secrete somatosatin

b. Role of Insulin: Regulated by chemicals, hormones, neural

• Carbohydrate Metabolism: increase glucose transport, increase

formation of glycogen, inhibits gluconeogenesis
• Fat Metabolism: increases triglyceride synthesis, fatty acid transport,
fatty acid synthesis
• Protein Metabolism: Increases amino acid transport; Augments protein
synthesis; Inhibits proteolysis
• stimulated by : blood glucose levels, amino acids, GI hormones,
parasympathetic stimulation of beta cells
• Negative feedback - lowers insulin levels in response to high levels of
insulin
• Decreases with low blood glucose levels, sympathetic stimulation of
alpha cells, prostaglandins

5. Adrenal Glands

a. Medulla : Catecholamines

• Epinephrine
• Norepinephrine
• Dopamine

b. Cortex:

• Androgen / estrogen
• Glucocorticoids (Cortisol)
• Mineralcorticoids (Aldosterone)
 Key Points of GI Anatomy, Physiology

I. Four Major Activities of the GI Tract :

• secretion of electrolytes, hormones, and enzymes to be used in

breakdown of the ingested materials;
• movement of ingested products;
• digestion of food and fluids;
• absorption of end products into the bloodstream.

II. Gastrointestinal Secretions

A. Mouth: alpha-amylase (ptyalin)

B. Stomach: 1500 - 3000 ml of gastric juice per day.

• Cardiac glands and Neck cells: mucus

• Peptic or chief cells: mucus and pepsinogen
• Parietal (oxyntic) cells: Intrinsic factor and hydrochloric acid
• G cells of pyloric antral region: gastrin

C. Small Intestine

1. Major Hormones

• Gastrin (duodenal mucosa)

• Secretin (duodenal and jejunal mucosa):
• Cholecystokinin (CCK) (duodenal and jujunal mucosa)
• Gastric inhibitory peptide (GIP) (duodenal and jejunal mucosa)
• Vasoactive intestinal peptide (VIP) (intrinsic plexuses, stomach ->
colon)

2. Major Enzymes

• maltase: breaks maltose into glucose.

• lactase: breaks lactose into galactose and glucose.
• Sucrase: breaks sucrose into glucose and fructose
• Lipase (enzyme, found in 3 forms/locations: gastric mucosa, pancreas,
and intestines): splits fats
• Peptidases (several enzymes of intestinal mucosa); splits proteins.

D. Pancreas - Secretions: 1500-2000 ml/day of pancreatic juice; pH = 8.3

(alkaline)

1. Major Enzymes:

• Lipase: works on fats [triglycerides to fatty acids & glycerol]

• Amylase: works on starches [amylose and amylopectic to maltose and
dextrins]
• Trypsin: works on proteins [breaks amino acid bonds; activates other
enzymatic precursors]

2. Major Hormones, islets of Langerhans

• Insulin (from Beta cells)

• Glucagon (from Alpha cells)
• Somatostatin (from Delta cells, islets of Langerhans)

E. Gallbladder, an accessory organ of digestion - concentrates and stores bile

F. Liver - over 400 functions; will review separately

Key Points of GI Assessment

I. Anatomical Landmarks -

• Right upper and lower quadrants;

• Left upper and lower quadrants;
• Subcostal margins
• Epigastric hollow;
• Umbilicus;
• Midline;
• Anteriosuperior spine (of iliac crest);
• Flanks;
• Costovertebral angle

II. Cardinal Symptoms of Gastrointestinal dysfunction:

• anorexia,
• nausea,
• vomiting,
• dysphagia,
• diarrhea,
• constipation,
• abdominal and referred pain.

III. Order of Assessment:

1. Inspect:

• Skin: scars, striae, dilated or engorged veins, spider angiomata;

• Umbilicus: eversion, caput medusae;
• Masses (movable or stationary)

2. Auscultate:

• Position Supine; knees flexed or flat;

• Normal bowel sounds: 5-34/minute, random throughout abdomen.
Intensity varies; loudest when meal overdue;
• Liver edges by "scratch": stethoscope over liver, lightly run fingernail
outward; sound changes at borders
• Abnormal sounds:

• (a) Borborygmi: loud, rushing, high-pitched tinkling sounds heard

proximal to intestinal obstruction until muscles become fatigued.
• (b) Absence: immobile bowel, due to peritonitis, paralytic ileus,
advanced obstruction.
• (c) Bruit: like systolic murmur, turbulent flow through partially
occluded artery.
• (d) Venous hum: over upper abdomen, liver: liver disease, portal or
splenic vein thrombosis

3. Percuss: to establish distention, fluid, enlargement of solid organs

(viscera);

• Normal liver: dull;

• Normal spleen: dull;
 • Normal stomach: tympany when empty;
• Normal gut: hyperresonant to tympanic;
• "Test for shifting dullness" indicates free fluid in abdomen (ascites);
Fluid wave maneuver: estimate large accumulation of ascitic fluid.

4. Palpation:

• to detect/elicit tenderness or muscle guarding,

• detect abdominal masses or fluids,
• to examine individual organs:
• rebound tenderness;
• involuntary rigidity or spasm.