XVII.

DISEASES OF THE

ENDOCRINE GLANDS

A. Pituitary Gland

– called the master gland

– found under the circle of willis

– it is composed of two parts

– Anterior pituitary controls skeletal growth, the thyroid and adrenal glands, and sexual development

– Posterior controls smooth muscle contraction, as in birth and peristalsis

1. Anterior Pituitary

– also known as the adenohypophysis

– one of the secretions is somatotropin or the human growth hormone (HGH)

– stimulates the growth of bone and soft tissues

– problems with the secretion of this hormone will possibly lead to one of the following conditions:

a. Giantism or Gigantism

– the result of a condition of hyper-pituitarism during childhood

– a hypersecretion of somatotropin that occurs while a child is still actively growing

– giants are usually sexually impotent and frequently die of diabetes

– leads to growth into a giant or abnormally tall person

b. Acromegaly

– the result of hyperpituitarism during adulthood

– a hypersecretion of somatotropin after bones have solidified and can no longer grow

– characterized by enlargement of the bones and soft tissues of the hands, feet, and head

– especially the frontal bone, jaws, nose, lips, and ears

– gives a "lion face" appearance

– will eventually lead to sexual impotence, drowsiness, and possibly obesity

Both of the above conditions are typically caused by the growth of an adenoma

c. Dwarfism

– the result of hypopituitarism during early life

– a hyposecretion of somatotropin from the adenohypophysis

– person remains quite small and never develops any secondary sex characteristics

– leads to mental dullness and lethargy in adults

d. Adult onset hypopituitarism

– a hyposecretion of somatotropin in adulthood

2. Posterior Pituitary

– the result of hypofunction of the posterior lobe of the pituitary

– Diabetes Insipidus

– a hyposecretion of the antidiuretic hormone occurs

– found to be idiopathic in half of the cases

– leads to the passing of large quantities of urine

– accompanied by excessive thirst

– trauma to the head or a tumor in that area causes the remainder of cases

(polyuria)

(polydipsia)

– there is necrosis of the gland

– also known as pituitary cachexia

– a condition in which there is complete atrophy of the pituitary gland

3. Entire Pituitary

– leads to a loss of function of the thyroid, adrenal and gonad glands

– Simmond's Disease

– characterized by the following:

– considerable weight loss

– atrophy of internal organs

– loss of sexual function

– premature aging to include:

– mental changes

– loss of hair and teeth

B. Thyroid Gland

– secretes the hormone thyroxin

– consists of two lateral lobes

– found on either side of the windpipe

– which regulates general body metabolism

– it influences body growth and development

– exerts an influence over the nervous system

– secretes the hormone thyroxin

– enlargement of the thyroid gland

1. Goiter

– can be due to lack of iodine in diet, inflammation from infection, tumors, hyper or hyposecretion of thyroxin

2. Hypothyroidism

– caused by a lack of iodine in the diet

– this enlargement is known as endemic goiter

– the gland enlarges in an effort to compensate and secrete more thyroxin

2 conditions of hypothyroidism:

– characterized by a lack of physical and mental development

a. Cretinism

– the condition resulting from congenital hypofunction of the thyroid gland

To include:

– dwarfism

– slow bone development

– low body temperature

– retarded mental activity

b. Myxedema

the condition resulting from hypo-function of the thyroid gland in adulthood

– due to the presence of a mucous-like edema

– weight gain

– mental dullness

– swelling of eyelids & other soft tissues

– thickening of the tongue and lips

– body temperature and metabolism fall

– general sluggishness

– characterized by:

BEFORE

TREATMENT

AFTER

TREATMENT

– will likely lead to the following condition:

3. Hyperthyroidism

– an over-active thyroid

– a goiter could develop due to hyperplasia

a. Grave's Disease

– the condition resulting from prolonged hyperthyroidism

– also known as exopthalmic goiter

– more prevalent in females

– weakness

– tachycardia

– nervous excitability

– the gland enlarges and produces excessive amounts of thyroxin

– characterized by:

– low body weight because of a very high BMR

– profuse sweating

– eyeball protrusion

– due to edema in the back of the eyesocket

– frequent in young adults and can lead to heart damage because of fibrillation

C. Parathyroid Glands

– regulate blood calcium levels

– with the secretion of parathormone

– calcium levels in the blood are reduced

1. Parathyroid Tetany

– a condition due to hypofunction of the parathyroid glands

– lowered amounts of parathormone are secreted

– causing nerve cells to become irritable and overactive

– also slows blood coagulation

– this then leads to spasmatic muscular twitching, abnormal reflexes and convulsive seizures

– usually fatal due to constant contractions of the heart muscle

– increased amount of parathormone is secreted

– calcium is drawn out of the bones and into the bloodstream

2. Hyperparathyroidism

– results in hypercalcemia and bone absorption

– which could lead to:

– fibrous cysts may form in the bones causing a condition known as

– softening and deformation of bones

– formation of kidney stones

– hardening of the arteries

– heartbeat irregularities

– osteitis fibrosa cystica or

von Recklinghausen’s disease

– the inner layer called the medulla

– the outer portion called the cortex

D. Adrenal Glands

– located on top of the kidneys

– composed of two layers

– it secretes several hormones that regulate:

– salt levels in the blood

– blood glucose levels

– production of some mild sex hormones

– the cortex is the part of the gland that is essential to life

– a condition due to the hypofunction of the adrenal cortex

– characterized by a bronze pigmentation

– weakness and loss of weight

– low blood pressure

– gastro-intestinal disturbances

1. Addison's Disease

– affects the hormones that regulate metabolism and blood pressure

– usually caused by a chronic adrenal cortical insufficiency as a part of an autoimmune disorder

2. Waterhouse-Friderichsen Syndrome

– caused by a meningococcal infection of the blood

– causes acute adrenal insufficiency due to hemorrhage into the adrenal gland

– a condition due to hyperfunction of the adrenal cortex

3. Cushing's Disease

– due to excess exposure to hormones called glucocorticoids (steroids)

– most often a complication of steroid treatments for inflammation

– adiposity- fatigue

impotence- excess hair growth

– purplish skin discolorations

– the build-up of a fatty pad over the shoulders and upper back

– creates a “moon-shaped” facial appearance

– characterized by

E. Pancreas

– the endocrine function takes place in the Islets or Islands of Langerhans

– a heterocrine gland

– insulin lowers blood sugar levels

– glucagon raises blood sugar levels

– produces two hormones

– a condition caused by a deficiency in insulin secretion

– causes a disorder in carbohydrate metabolism

– called hyperglycemia or sugar diabetes

– Diabetes Mellitus

– sugars cannot be carried into the cells and a buildup in the bloodstream ensues

– with excess fat in the bloodstream, several of the following complications occur:

– when the cells have no glucose to use, they begin metabolizing fats and proteins

1. Atherosclerosis

– predisposes to myocardial infarctions, gangrene, blindness

2. Poor wound healing

3. Vascular Obstructions

4. Hemorrhage

5. Gangrene

– Juvenile-onset diabetes is the most serious

– usually requires hypodermic injections of insulin and special diet

– Adult-onset diabetes is not as serious

– can be controlled with diet and oral medications

– appears to be premature puberty

– hypersecretion of estrogen in females and androgen in males

F. Gonad Glands

– actually a part of the adrenal cortex

– has to do with the secretion of androgen and estrogen

1. Precociousness

– a condition caused by a hyper-function of the gonads

– involves a hypersecretion of androgen in females and estrogen in males

2. Androgenital syndrome

– a condition caused by a hyperfunction of the gonads

– in females it leads to:

– excessive hair growth

– deepened voice

– decreased breast size

– amenorrhea

– in males it leads to:

– testicular atrophy

– decreased libido

– gynecomastia

– excessive breast development

3. Senile Involution

– atrophy of the testes or ovaries due to old age

XVIII. DISEASES OF THE

INTEGUMENTARY SYSTEM

A. Acne

– an inflammatory disease of the sebaceous glands and hair follicles

– the result of an abnormal or profuse production of oil in the sebaceous glands

– this leads to the pores of the skin becoming clogged with sebum

B. Abscess

– many different types seen here

– in the secondary stage a skin rash and lesions on the mucous membranes form to be the primary symptom

C. Syphilis

D. Superficial fungal infections

– known as dermatomycoses

– commonly known as ringworm or tinea

– these infections are characterized by red, scaly, and itchy lesions

– tend to localize in certain body areas

Tinea cruris

– a fungal infection of the groin area

– commonly known as “jock itch”

Tinea pedis

– a fungal infection of the feet

– commonly known as athlete’s foot

E. Dermatitis

– inflammation of the skin

– caused by a variety of agents like poison ivy, soaps, fabrics, dyes, formalin

– results when the skin is exposed to agents to which it has become sensitized

– Contact Dermatitis or Eczema

F. Seborrheic dermatitis

– inflammatory skin disease beginning on the scalp

– characterized by rounded, irregular lesions covered with yellow or brown-gray greasy scales

– these are caused by an excessive secretion of sebum(oil) from the sebaceous glands

– will spread to the face, neck and eyebrows if not cared for properly

– tuberculosis of the skin

G. Lupus vulgaris

– characterized by ulcerations that leave scars when healed

H. Other skin diseases or changes

1. Senile changes – old age changes in the skin

2. Melanocytic nevus – any nevus thatcontains melanin

3. Malignant melanoma

4. Squamous cell carcinomas

I. Postmortem Conditions of Skin Diseases

Discolorations

Dehydration/dryness/scales

Burns

Lesions

Pigmented or depigmented spots

Edema

XIX.

DISEASES OF THE

LYMPHATIC SYSTEM

– usually due to infection by a pyo-genic strepto-cocci

A. Tonsillitis

– a mass of lymphatic tissue found in the very back of the oral cavity

– inflammation of a

tonsil

– the enlargement of a lymph node

B. Lymphadenopathy

– caused by a variety of conditions

– some may be signs of serious disease

C. Lymphadenitis

– inflammation of a lymph node

D. Lymphangitis

– inflammation of the lymphatic channels or vessels

– usually occurs secondary to lymphadenitis

– enlargement of the spleen

E. Splenomegaly

– caused by many, many diseases

– the biggest danger is that an enlarged spleen is much easier to rupture

– edema due to an obstruction of the lymphatic vessels

F. Lymphedema

H. Postmortem Conditions

G. Lymphoma – see Tumors & Cysts

Edema

Emaciation

Dehydration

Metastasis

PathologyWeek8Presentation2023.pptx

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