Endocrine System

Endocrine glands are referred as the organ of endocrine

system.Endocrine system constituted by endocrine glands
which are situated in different part of body.These glands secrete
chemical substance which called hormones or first messengers
or chenmical messenger.CAMP (Cyclic adenosine
monophosphate) is most common second messenger inside the
cell.Other second messenger is calcium ion (Ca).Body contains
two kinds of glands such as endocrine or ductless gland and
exocrine gland.Equilibrium of the internal environment of body
is maintained partly by the ANS & partly by endocrine
glands.Hormones are chemical substance that release in onc
part of body but regulate activities of cells in other parts
body.bodu contains two kinds of glands such as endocrine or
ductless gland and exocrine gland.Equilibrium of the internal
environment of body is maintained partly by the ANS & partly
by endocrine glands

are
S. No.
Glands/Organs
Pituitary gland
(b) Posterior pituitary
Thyroid gland
Endocrine System
Para-thyroid gland
Pancreas
(a) Anterior pituitary gland 3. Adrenocorticotropic hormone
(ACTH)o
Testes
Ovaries
Pineal gland
Endocrine Glands or Organs & its Hormones -
Thymus gland
Kidney
1. Growth hormone (GH)
2. Thyroid stimulating hormone (TSH)
4. Prolactin hormones (PRL)
5. Follicle stimulating hormone (FSH)
6. Luteinizing hormone (LH)
7. Melanocyte stimulating hormone.ninss te iteh
1. Anti diuretic hormone (ADH)
2. Oxytocin hormone
1. T; (Triiodothyronine)
2. T, (Tetraiiodothyronine) or thyroxinen
3. calcitonin
1, Parathyroid hormone (PTH) or Parathorrmone
1. Insulin
2. Glucagon
Hormone
3. Somatostatin
4. Pancreatic Polypeptide (PP)
1.Testosterone
1. Estrogen
2. Progesterone
1. Melatonin
1. thymosin
2. thymin
1. Rennin

2. Erythropoietin (secreted by renal tubular cells)

3. 1, 25, dihydroxy-cholecalciferol or activated vita. D or
XI
Heart
Placenta
Adrenal gland
(a) Adrenal cortex
(b) Adrenal medulla
Classification of hormone –
ANATOMY & PHYSIOLOGY INCLUDING MEDICAL SURGICAL
NURSING| 55
Kidney hormone
1. Atrial Natriuretic peptide (ANP)
1. Human chorionic Gonodotrophin (HCG)
2. Human Chorionic Somatomammotrophin (HCS) or Humam
Placental Lactogen (HPL)
3. Estrogen
Inhibiting
4. Progesterone
1. Mineralocorticoids
Glucocorticoids
2.
3. Sex hormone (androgen)
1. Adrenaline or epinephrine
Nate – Many organ or tissue contain cells which secrete
hormone but they are exclusively not classified as endocrine
Cland e,g. hypothalamus, ovaries, kidney, stomach, small
intestine, heart and spleen ec.b
2. Nor adrenaline or nor epinephrine
3. Dopamine
Depending upon their chemical nature hormones classified into
3 types-
O Steroid Hormone – Hormone derived from cholesterol or its
derivative called steroid hormone,
Examples are corticosteroid and sex hormone.
O Protein Hormone – Hormone secreted by pituitary gland,
parathyroid gland, pancreas etc.
O Derivatives of amino acids tyrosine – These hormones are
derived from amino acid tyrosine, examples
Are thyroid hormone & adrenal medullary hormone.
Negative feedback mechanism
The regulation of secretion of hormones, controlled by negative
feedback mechanism in our body.
Hypothalamus (detector)
Secrete releasing hormone (Ex. CRH, TRH)
Pituitary gland (controller)
Secrete stimulating hormone (Ex.TSH, ACTH)
Target gland (effector)
Increased level of target gland hormone
(Ex. T, T, Glucocoticoids)
Utilization of hormone
Decreased level of target gland hormone
Stimulation
In our body except labor process, milk ejection, milk secretion &
blood coagulation process all the mechanism
Operate on negative feedback mechanism.

Hypothalannus
Many years the pituitary gland was called the naster
endocrine gland but we now know that pituitary gland itself
Has a master, the hypothalamus.Hypothalamus is an
important regulating center in the nervous system and also a
crucial endocrine gland, so it Provide major link between
nervous and endocrine system.Hypothalamus secreted
following releasing and inhibiting hormone to control anterior
pituitary gland-
 1. GHRH (Growth Hormone Releasing Homone)
2. GHIH (Growth Honone Inhibiting Hornone) /Somatostatin
3. CRH (Corticotropin Relensing Hormone)
4. TRH (Thyrotropin Releasing Hormone)
S. GnRH (Gonadotropin Releasing Hornone)
6. PH (Prolaetin Inhibiting Homone) or Dopamine
These hornones called neurohornone.

Pituitary gland
Pituitary gland also known as hypophysis (undergrowth).It lies
in hypophyseal fossa of sphenoid bone below the
hypothalamus.It attach to hypothalamus by a stalk called
infundibulum.
Size – Pea shaped.Diameter – Itol.5 cm.It has two anatomically
or functionally separate lobes.Between two portion is pars
intermedia.
A.Anterior Pituitary (Anterior love) or adenohypophysis
Sometime it also known as the master gland.It composed 75 %
of total weight of gland.
A. Anterior Pituitaty (Anterior lobe) or adenohypophysis
Sometimes it also known as the master gland.It
composed 75% of total weight of gland.Adenohypophysis
secrete 7 hormone which secretion stimulated by
 releasing homone and suppress by inhibiting hormones
of the hypothalamus

1. Growth Hormone (GH) or somatotropin (most

plentiful }-
It secreted by somatotropes cells.GH stimulates secretion of
insulin-like growth factor (IGF) from several tissues that
stimulate body growth.IGF have a wide variety of functions,
including the stimulation of cell growth and proliferation (eg. In
the Developing embryo and neonate), DNA synthesis, bone
growth and the replication of cancer cells. So GH along with IFG
is responsible for the growth of almost all tissue of body by
increasing the size and Number of cells by mitotic division. Its
release is stimulated by GHRH and inhibited by GHIH
(somatostatin) from hypothalamus in response to
Blood glucose level.GH increase blood glucose level
(hyperglycemia) which called pituitary diabetes.
Deliciency of growth hormone in children cause stunted growth
leading to dwarfism.
Excessive secretion of GH in children cause enorous growth of
the body called gigantism.
Hypersecretion of GH after stopping growth of bone in length
called acromegaly (Marie’s disease).Acromegaly is characterized
by enlargement, thickening & broadening of bones eg. Gorilla
face, prognathism (protrusion of lower jaw) & bulldog scalp.
Hyposecretion in adult cause acromicria (atrophy of the
extremities of the body).
2.Thyroid stimulating hormone (TSH) –
TSH stimulate growth & activities of the thyroid gland.It also
stimulates synthesiS and secretion of thyroid hormone.Secreted
by thyrotropes cells of pituitary gland.It release is stimulated by
thyrotropin – releasing hormone (TRH)secreted by
hypothalamus
3.Adrenocorticotropic Hormone (ACTH) or corticotrophin
hormone-
It secreted by corticotropes cells.Corticotrophin releasing
hormone (CRH) from the Hypothalamus promote the synthesis
and release of ACTH.ACTH control the production and secretion
of hormone of adrenal cortex (cortisol).ACTH also increase the
concentration of cholesterol within the gland
4.Prolactin (PRL) –
It secretes by lactotropes cells.This hormone stimulate milk
secretion (milk production by mammary gland). Sucking of
breast by baby stimulate prolactin secretion and suppressed by
PlH or dopamine. Function of prolactin in male is not known but
its hypersecretion cause erection dysfunction or impotence.In
female hypersecretion cause galactorrhea (excessive milk
production) & amenorrhea
s. Follicle Stimulating Hormone (FSH) –
Both FSH and LH secreted by gonadotropes cells of
pituitary.Action of FSH in male – Sperm production
(spermeogenesis). Action of FSH in female – Responsible for
development of Graafian follicle. It is also stimulate theca cells
of Graafian follicle to secrete estrogen.
6 Luteinizing hormone (LH)
Action in male- This hormone in male also known as interstitial
cell stimulating hormone (ICSH) because it Stimulate interstitial
cell or leydig’s cell in testes and secrete testosterone. Action in
female- Responsible for ovulation, formation of corpus luteum
and secretion of progesterone.
Note -FSH and LH together called gonadotropic hormone.
7. Melanocyte stimulating hornmone (MSH) –
It increase skin pigmentation by stimulating the dispersion of
melanin granules in melanocytes .Simmond disease or pituitary
cachexia or panhypopituitarism.Hyposecretion of the entire
anterior pituitary hormone due to atrophy, which cause senile
decay.
B. Posterior Pituitary or Neurohypophysis –
The hormones relcased by neurohypophysis are ADH and
oxytocin. These hornones are synthesized by the cells of
hypothalamus and transport through nerve
fibers(hypothalamohypophyseal tract) to posterior pituitary and
where they are store.
 1. Anti -Diuretic Hormone (ADH) or vasopressin.ADH mainly
secreted by supraoptic nucleus of hypothalamus. The
major function of ADH is retention of water in the extra
cellular fluid of body by action on kidney(decrease urine
production). In absence of ADH, urine production increase
upto 20 lit/day due to impermeability of DCT & collecting
Duct to water.ADH increases the permeability to water of
distal convoluted tubules and collecting tubules of the
nephron of kidney for reabsorption of water.ADH secretion
is influenced by osmotic pressure of blood.If osmotic
pressure of blood increases, the secretion of ADH increase
from posterior pituitary and cause more Water
reabsorption which results in decrease osmotic pressure.
Alcohol inhibit ADH secretion, thereby alcohol increase
urine output.In larger dose ADH also cause
vasoconstriction especially arteries, that is why it also
called vasopressin
2. Oxytocin
Oxytocin mainly secreted by paraventricular nucleus of
hypothalamus.eni hs Oxytocin, act on mammary gland and
uterus.
() Action of oxytocin on mammary gland
Oxytocin release by positive feedback mechanism.Oxytocin
increase contraction of myoepithelial cells of lactating brcast
and cause milk cjection (letdowm Reflex) in response to
mechanical stimulation provided by suckling infant.bodioett.It is
called neuroendocrine reflex.oh od uSucking of nipple by baby
toilhon benati &ET
Oaiioomilaieo
Stimulation of touch receptor of nipple to nocIsthmus.
Impulse to hypothalamus by afferent nerve Stimulation of
Posterior pituitary Increased secretion of oxytocin
(ü) Action of oxytocin on uterus -hat a Increased milk ejection
Oxytocin causes contraction of uterine muscles and helps in
expulsion of fetus.
Larynx (voice box) on either side of trachea.OotaksoocrAt the
end of pregnancy secretion of estrogen and progesterone
decrease and oxytocin secretion increase.During labor oxytocin
released by means of positive feedback mechanism.On the non-
pregnant uterus oxytocin helps in the transport of sperm from
vagina to fallopian tubes.Thyroid gland is butterfly shaped gland
located just inferior to the
Thyroid Thyroid gland is butterfly shaped gland located just
inferior to the larynx (voice box) on either side of trachea
Thyroid gland has two lobes which connected in the middle by
an isthmus Lodatocie.Weight 30 gm (larger into female) –
Largest endocrine gland.Thyroid gland is composed of larger
number of closed follicle.The follicles are lined with cuboidal
epithelial cells which called Follicular cells.The follicular cavity is
filled with a colloidal substance known as Thyroglobulin which
is secreted by the cuboidal epithelial cells.
Thyroglobulin contain 140 molecules of amino acid tyrosine.In
between the follicles the parafolicular cells or c (clear) cells are
situated,which secret calcitonin hormone.
Hormones of thyroid -Thyroid gland secrete 3 hormones

(i) T3 (Triiodothyronine) – 10%

(ii) T4 (Tetraiiodothyronine) or thyroxin – 90%
(iii) Calcitonin

• T3 and t4 together called thyroid hormone. lodine is required

per week or 150 microgram per day.when supply of iodine is
deficient , excess TSH is secreted which cause ement of gland
called simple goiter.common table salt is iodized with one part
of sodium iodine (NaI) with every one lac part of sodium
chloride (NaCL)

Function of thyroid hormone –

T3 and T4 essential for physical growth and mental
development.
T3 & T4 increase basal metabolic rate (BMR), the rate at which
cells utilize O, when the body is at rest. Normal Value of BMR
are-
 In terms of large calories (Cal), measurement is about 1500
to 1800 per day.
  In terms of body weight, measurement is 1 Cal/kg/hour.
 In terms of body surface, measurement is 40 Cal/m2/hour.
.T3& T4 increase motility of gastrointestinal tract (peristalsis).
T3& T4 regulate normal functioning of nervous, reproductive
and cardiovascular system.
T3 & T4 enhance action of adrenaline & nor-adrenaline which
cause increase HR and blood pressure.
Calcitonin –
It decreases blood calcium level by inhibiting activity of
osteoclast cells into bone.
Its effects are opposite to PTH.
. Calcitonin secretion stimulated when blood calcium level is
increased.

Parathyroid Gland

There are four parathyroid gland, situated immediately behind

thyroid gland at the upper and lower poles.
Measurements are6 x3 x 2 mm.
Color – Dark brown
• Weight – 40mg each gland.
Structure
• Each parathyroid gland is made up of chief (principal) cell &
oxyphil cell.
Parathyroid Gland
Chief cells secrete parathormone or parathyroid hormone
(PTH).
Functions of oxyphil cells are not known.
The secretion of PTH increases when level of ionized calcium
decrease.
The main function of PTH is to increase the blood calcium level
(normal level is 9 to lImg/dl).
Function of PTH
Our bodies contain about 1 100 gm calcium, which is 1.5% of
total body weight.
The main function of PTH is to maintain ( increase) the blood
calcium level in normal range (9-11 mg/ dl),by following
actions-

Increased resorption of ca’” from bone by increasing number

and activity of osteoclast cells.
O Decreased excretion of calcium from the kidney.
Abnormal secretion of PTH-
O PTH activate vitamin D (1, 25 dihydroxy Vitamin D or 1, 25
dihydroxycholecalciferol or calcitriol) into
Kidney, and activated vitamin D increased absorption of calcium
from the GIT, so increased absorption
Of calcium form intestine is indirect function of PTH.
Decrease secretion of PTH cause hypocalcaemia.
Hypocalcaemia cause tetany (intermittent tonic muscular
spasms that typically involve the arms or legs).
Characteristic diagnostic signs of tetany are Trousseau’s sign
and Chvostek’s sign.
OPPO Reno2 Z O Dr.Preeti Thakur

60 Competitive Handbook of. Nurslng (Comprehensive Revlew)

O Trousseau’s sign is a muscular spasm of the hand and wrist
resuiting from pressure applicd to nerves and
Vessels of the upper am.
O Chvostek’s sign is a spasm of facial muscles when taping the
facial nerve in the area of parotid glands.
Increase secretion of PTH cause hypercalcenia due to increase
resorption (removal) of ca ++ from bones which
Cause bone to become soft and easily fractured.
It also called life saving gland or essential endocrine gland.
In the absence of thcse gland deaths occur within 3-15 days,
Situated on the upper pole of cach kidney.
Size-4 x 3x lcm
Adrenal Gland or Suprarenal Gland
T is made up by two structurally, functionally and
developmentally distinct parts, called adrenal medulla and
Adrenal cortex.
Medulla is central part and constitutes 20% part of whole gland.
Adrenal cortex is outer portion which constitute 80% of whole
gland.
(A) Adrennl Cortex -Adrenal cortex has three different
layers
Zona glomerulosa- Outermost layer secrete mineralocorticoid, it
affect mineral homeostasis.
Weight- 4gm
Zona fasciculata – middle layer secrete glucocorticoid. It affects
glucose homeostasis.
Zona reticularis – innemost layer which secrete sex hormone
(androgen).
(1) Mineralocorticoid –
O Collectively these hormones called corticosteroids or
adrenocortical hormone, and it synthesis mainly by
Cholesterol.
Aldosterone is a major mineralocorticoid.
O Aldosterone is very essential for life so called life saving
homone (total absence cause death within 2-20
Days).
It regulate homeostasis of two important mineral ions of body
(Nat and K+) to maintain or regulate blood
Volume and BP (through their effect on ion transport in
epithelial cells of distal convoluted tubules resulting
In retention of Nat and excretion of K+).
It increases reabsorption of Na and excretion of K by distal
convoluted tubules.
It also excretes H+ from body by urine to prevent acidosis.
Renin -Angiotension -Aldosterone (RAA) System
Angiotensinogen
(A plasma protein)
Decreascd blood volume & BP due to hemorrhage, dehydration
& Nat deficiency.
Inhibition
Juxtaglomerular cells of Kidney secrete renin
Angiotension – I
Angiotension converting enzyme (ACE, Seereted by lungs)
Angiotension- II vasoconstriction
Increased BP
Increased secretion of aldosterone by adrenal cortex
Increased reabsorption of Na & water by distal convoluted
tubules
Increased blood volume & blood pressure
Chucocorticoid-
Glucocorticoid called lite protective hormone or hormone
essential for life because it helps to withstand us
During stress.
Main functions of glucocorticoid –
ANATOMY & PHYSIOLOGY INCLUDING MEDICAL SURGICAL
NURSING 61
O Regulation of carbohydrate metabolism, like it causes
hyperglycemia by decreasing glucose utilization by
Peripheral cells and gluconeogenesis (glucose formation by
proteins & fats).
Dass iaissei
Mineral metabolism (retention of sodium & excretion of
potassium).
O Anti-inflammatory effect by vasoconstriction and inhibiting
migration of WBC to affected site.
O Anti-allergic action by inhibiting release of histamine.
O Immunosuppressive effect by suppression of the lymphoid
tissue like lymph node & thymus that cause
Decrease number of T- lymphocytes in blood.
Delay wound healing due to decrease immunity.h nn lieentoe tl
soit
AIncreased resistance to stress (due to release of amino acid
into blood stream for new protein synthesis).
(2) Sex hormones-
There are three sex hormone among them androgen (male sex
hormone) are secreted more than estrogen and
Progesterone from adrenal cortex.
O Major androgen secreted by adrenal cortex is
dehydroepiandrosterone (DHEA).
Androgens are responsible for masculine features (male-hood
like characteristic) of the body.
The excessive secretion of androgen in female cause virilism.
(B) Adrenal Medulla –
Virilism means development or presence. Of male secondary
sexual characteristic in female, such as
Beard, hirsutism (excessive body hair in women & children),
deep voice, enlarged clitoris, atrophy of breast &
Increased muscle mass.
• It is inner part of suprarenal gland and forms 20% of mass of
whole adrenal glands.
•Medulla contains two types of chromaffin cells or pheochrom
cells.
O Adrenaline or epinephrine secreting cells (80%).
O Nor-adrenaline or norepinephrine secreting cells (20%).
Type of cells secreting dopamine is not known.
These hormone secretion regulated by sympathetic neurons of
ANS.
2. Nor-adrenaline/ Norepinephrine (also called general
vasoconstrictor)
3. Dopamine
O Medullary hormones are collectively called catecholamine.
Adrenaline or nor-adrenaline are helpful in stressful situation by
preparing the body to fight & flight response.
During stressful situation sympathetic part of ANS stimulated
and cause more release of catecholamine.
Catecholamine produces following effects into body –
O Increased heart rate & force of contraction which cause
increased BP.
O Increased blood flow to skeleton muscles, heart & liver.
Dilation of pupil.
O Decreased blood flow to digestive & reproductive organs.
O Dilation of respiratory tract.
O Increased blood glucose & fatty acid level.

62 Competitive Handbook of Nursng (Comprehensive

Review)TiOrhA
Pancreas is a both endocrine & exocrine gland.
Endocrine function of pancreas is performed by the islets of
Langerhans or Pancreatíc islets.
Pancreatic islets contain maínly three types of cells –
1. Alpha.or Acells (1 5%) secrete glucagon.
2. Beta or B-cells (80%) secrete insulin.
3. Delta or D-cells (5%) secrete somatostatin.
Insulin –
Pancreatle isletsi ed bet nd owT
Secretion of insulin increase when blood glucose and arnino
acid levels are high in blood.
Main function of insulin is to decrease blood glucose level by
following ways -z sn sg
O Inerease up take and utilization of glucose by body cells.
Increase conversion of glucose to glycogen (glycogenesis)
especially in liver and skeleton muscles, the body
Can store about 500 gm of glycogen (75% into skeleton muscle
and 25% into liver cells).
Increase protein and fat synthesis (lipogenesis) from amino
acids and fatty acids respectively.
O Decrease process of gluconeogenesis (the formation of
glucose from excess amíno acids, fats or other non-
Carbohydrate sources).
Any homone that opposes the effects of insulin called counter-
regulatory hormone, examples of these hormone
Are glucagon, epinephrine, norepinephrine, corisol and growth
hormone.
Secretion of these hormone increases during hypoglycemia and
stressful time, and cause increase blood glucose
Level.
Glucagon –
Glucagon inerease blood glucose level by-
O Conversion of store glycogen to glucose (glycogenolysis).
O Increase process of gluconeogenesis.
Somatostatin –
It is also produced by hypothalamus and stomach.
It inhibits the secretion of insulin and glucagon from pancreas,
growth hornone from the anterior pituitary and
Gastrin from the stomach.
Pineal gland or Epiphysis gland
Situated under the brain & above the hypothalamus behind 3rd
ventricle.
Weight – 0.1 to 0.2gm
Length – lcm
A peptide honone, melatonin produced by the pineal gland.
O It influences sleep-wake cycles and other circadian rhythms.
O lt also promotes sleepiness and inhibits reproductory
function till puberty.
Gland becomes atrophy after puberty.
Thymus gland
• Iis a lymphoid organ located in the mediastinal cavity anterior
and above to the heart.
It composed of two fused lobes, cach containing multiple
lobules.
Lobules divided into an outer cortex and inner medulla.
The thymus is the primary site for T-lymphocyte differentiation.

Uo bormones are secreted by thymus are thymosin & thymin

(thymopoietin).
AThynosin hommone pronmote the maturation of T-lymphocyte
Thymin (thymopoietin) inhibit acetylcholine release which
cause myasthenia gravis.
Demoval of the thymus in an adult does not cause the decrease
in immune function.
Msceulatures of atria of heart secrete atrial natriuretic peptide
(ANP) during increase BP.
Lowers blood pressure by increase excretion of Na’ & water
through urine and also by vasodilatation.
Hyperthyroidism/Thyrotoxicosis
Hyperthyroidism means excessive secretion of thyroid hormone
(T, & T).
Etiology –
Malignancy of thyroid gland and TSH producing cells of anterior
pituitary gland.
Graves Disease (also known diffuse toxic goiter) –
It is a most common cause of hyperthyroidism.
ANATOMY & PHYSIOLOGY INCLUDING MEDICAL SURGICAL
NURSING | 63
It occurs due to abnormal fomation of thyroid stimulating
immunoglobulin’s (TSI).
O TSI like TSH, stimulate enlargement of thyroids gland and
cause diffuse toxic goiter.
Sien (objective physical evidence symptoms (subjective
evidence)-
Disease.
Goiter & exophthalmos (proptosis, protruding eye ball due to
edema behind the eye) -It appear only in grave’s
Inereased heart rate, hypertension & palpitation.
Heat intolerance, weight loss, over eating (hyperphagia),
diaphoresis, smooth, soft skin & hair (all are due to
Increase BMR).
Diarrhea (due to increase peristalsis).
Diagnosis –
Nervousness, Tremors in hands, Agitation (restlessness &
anxiety) & Mood swing.
Based on CM & laboratory finding.
Heart
Increased level of T3 & T4 in blood.
Decreased level of TSH in blood.
Management –
(Normal level of T, - 5-12 ug/dl, T; - 70-220 ng/dl, TSH – 0.5 –
5.4mlu/litre (milli intenational unit per ltr).
Provide adequate rest to decrease BMR.
Provide high calorie diet.
Provide cool, non-stimulating & quiet environment.
Administer anti thyroid medication suclh as propylthiouracil
(PTU), it block synthesis of thyroid hommone.
• Administer propranolol for palpitation & anxiety.
Administer radioactive iodine
Carcinoma.
Surgery-
To destroy thyroid gland cells into toxic goiter (Graves’s disease)
and thyroid
Thyroidectomy (excision of the thyroid gland, used mainly to
treat thyroid cancers, goiters or Grave’s
Disease).
64 Competitiveandbook of Nursing (Comprehensive
Review)WRA
Monitor for sign of hypocalcaemía & tetany caused by trauma
to parathyrOid gland during surgery of thyroid
Gland.
Maintain semi-fowler’s position after surgery.
Administer calcium gluconate to prevent tetany.
Complication –
Thyroid stom -It is an acufe life-threatening condition in a
uncontrollable hyperthyroidism
Causes are manipulation of thyroids gland during surgery,
infecting & stress.t
Deficiency of thyroid honone (T, T) called hypothyroidism which
cause decrease BMR in body. Eaha
Hnobyidismm in childhood due to congenital abscnce or
atrophy of gland cause stunted mental and phvsicl
Growth which called eretinism or congenital hypothyroidism.
Hypothyroids in adulthood called myxedema which occurs five
times more in female
Etiology – there are three types of hypothyroidism based on
ctiology
I. Primary hypothyroidism -causes are
Congenital defect of thyroid gland (cretinism).
Lodine deficiency (hypothyroidism due to iodine deficiency
cause simple goiter).
O Excessive anti-thyroid drugs like propylthiouracil (PTU).
O Surgery & radiation of thyroid gland.
Hypothyroidisn/ Myxedemaol ob
O Hashimoto’s thyroiditis (autoimmune illness that cause
destruction and fibrosis of the thyroid gland).
2 Secondary hypothyroidism – Caused by malfunction of
pituitary gland.
3 Tertiarylcentral hypothyroidism – Cause if hypothalamus fail
to produce thyroid releasing hormone (TRH),
CM-
Myxedema (generalized puffiness and edema of the skin due to
deposition of muco-polysaccharides, giving it a
Waxy appcarance).
Loss of hair.
Intolerance to cold (hypothermia), weight gain, dry skin & hair,
anorexia, weakness, fatigue (all are due to
Decrease BMR).
Bradycardia and hypotension.
Constipation (due to decrease peristalsis).
Loss of memory and apathy.
Diagnosis-
Loss of libido (in male & female).
Iregular menses (in women).
Impotence (in male).
Daicl
Goiter may or may not be present.
It may cause CHF
Decreased T3 & T4 hormone level.
Increased TSH honone level.
Increase lipid & cholesterol level in blood.
Decreased radioactive iodine (I) uptake.