Endocrine system

Dr. A.R. Joshi

Professor of Physiology

Control systems of body Nervous control Quick action,short duration

Hormonal control Slow action,long duration

Hormone

A chemical messenger,protein/polypeptide or steroid,secreted by ductless gland,directly poured in blood and acts on target organ.

Types of hormones General

Local Paracrine Autocrine

Thyroid hormones T 3

T 4

Thyrocalcitonin

Actions of T 3 and T 4 Metabolic actions- General cellular Carbohydrate Protein Fat Cholesterol

Actions of T 3 and T 4…cont Systemic actions- CVS RS GIT Bone marrow Reproductive CNS

Regulation of T 3 and T 4 TSH from ant pituitary

Blood iodine level

Climatic temperature

Hyperthyroidism Intolerance to warmth Weight loss Exophtholmos Tremors Tachyrrhythmia Secondary diabetes

Intolerance to cold Weight gain Non pitting oedema Bradycardia Atrophy of gonads Sluggish mental activity

Myxoedema

Cretinism Delayed mile-stones

Stunted growth

Mental retardation

Repeated infections

T 3 and T 4 levels TSH levels Radioactive iodine uptake Serum cholesterol Specific tests

Thyroid function tests

Mechanism of action of insulin

Acts on membrane receptor Stimulates protein kinase enzyme Makes Glut4 protein available Carrier mediated diffusion of

glucose Glucose moves inside the cell Blood glucose level reduced

Carbohydrate metabolism

Glucose made available inside cell

Glycogenesis stimulated

Glycogenolysis inhibited

Gluconeogenesis inhibited

Protein metabolism Amino-acids move inside the cell Protein synthesis stimulated Cellular growth stimulated Tissue repair stimulated Catabolism prevented

Fat metabolism Lipogenesis stimulated

Lipolysis inhibited

Regulation of insulin Regulated by blood glucose level Increase in blood glucose increases insulin secretion Secretion occurs in 2 phases Rapid phase Delayed phase

Hormonal regulation of BGLInsulin group Insulin decreases

blood glucose level

Anti-insulin group Glucagon T3 and T4 Glucocorticoids Catecholamines Growth hormone ( They increase blood

glucose level )

Diabetes mellitus Juvenile DM

Maturity onset DM IDDM (Type 1 ) NIDDM (Type 2 )

Secondary DM

Metabolism in DM Hyperglycemia and glycosuria Increased catabolism Lipolysis stimulated FFA are burned by beta oxidation Ketone bodies formed Ketoacidosis and coma

Detection of DM Urine examination Blood glucose level Fasting P P P G ( OGTT ) G T T Glycated Hb

Management of DM Diet Exercise Drugs Insulin injections Oral anti-diabetic drugs

Adrenal hormonesAdrenal cortex Aldosterone

Gluco-coticoids

Sex hormones

Adrenal medulla Adrenaline

Nor-adrenaline

Dopamine

Gluco-corticoids Metabolic actions Increase in BSL,AA & FFA Systemic actions CVS,RS,Bone marrow,GIT,Renal, Musculo-skeletal & CNS

Pharmacological actions…. Anti-inflammatory

Anti-allergic

Anti-stress

Immuno-suppressive

Side effects of gluco-corticoids Reduced immunity Secondary DM Hypertension Hyperacidity Osteoporosis Retaintion of salt and water

Actions of catecholamines Increase in HR and BP Broncho-dialatation Decreased GIT motility & secretions Relaxation of bladder Rise in BSL & FFA level Pupillary dilatation CNS stimulation

Uses of adrenaline Sudden cardiac arrest

Acute bronchial asthma

Anaphylactic shock

Role of dopamine Relation with schizophrenia

Relation with parkinsonism

Drug of choice in hypovolemic shock

Relation with vomiting center

Polycystic ovary syndrome ( Hyper androgenic anovulation )

Incidence – 5% to 10%

Age – 18 to 44 years

PCOS……symptomatology Irregular or no menstruation Excess body or facial hairs Acne Pelvic pain Infertility

PCOS……aetiology Familial tendency Sedentary life style High faty,salty & rich carbohydrate

diet Associated obesity Associated type 2 DM

PCOS……diagnostic triad No ovulation

High androgen level

Ovarian cysts

PCOS…….. management Lifestyle modifications Physical exercise to reduce weight Diet restrictions OCP for regularization of cycles Metformin Anti-androgen drugs

Infertility…….. causesMales Mumps Undescended testis STDs Exposure to high

temperature Heavy metal toxicity Systemic illnesses Endocrinal

abnormalities

Females Anovulation TB of endometrium Tubal block Uterine abnormalities Mumps STDs Systemic illnesses Endocrinal

abnormalities

Infertility…..investigations Semen examination Endometrial biopsy Hystero-salpingo-graphy USG Laproscopic examination Special tests

Infertility…..management Treat the basic cause Drugs to stimulate gamatogenesis Surgical procedures Artificial insemination from sperm

bank Invitro-fertilization Surrogate mother

Role of ayurveda…. Early prediction by study of prakruti Measures to modify membrane

responses Long term medication without side

effects Modification of hypothalamo- hypophysial-gonadal axis

For assistance in Clinical Physiology

Dr. A.R. Joshi Professor of Physiology (mobile :+919423523322) email: aniruddharj@hotmail.com