SEMIFINALS

NSG_MC 1: ANATOMY AND PHYSIOLOGY Endocrine system

Chapter 10: Endocrine System
• Exocrine glands - release their secretions into ducts, or tubes
Endocrine System ⁃ Liver to Bile released into the gallbladder, then through a duct into
the small intestine
• includes the endocrine glands and their hormones.
⁃ Pancreas releases pancreatic juice into the small intestine via a duct
Function:
• Endocrine Glands - are called ductless glands; release hormones directly
- secrete hormones into the bloodstream.
into the bloodstream
- Blood transports hormones throughout the body
Hormone ⁃ Each hormone acts on only a certain kind of tissue called its target
- A Chemical messenger which targets a specific group of cells in order to tissue
cause that group of cells do some activity or stop doing an activity.
Target cells or tissue
10 FUNCTIONS OF THE ENDOCRINE SYSTEM: - Specific cells affected by a hormone
1. METABOLISM - the sum of the chemical changes that occur in tissues Endocrine
- circulated by blood to target cells
2. CONTROL OF FOOD INTAKE AND DIGESTION - regulated the level
of satiety (fullness ) and the breakdown of food into individual nutrients. Paracrine
- Hormones that affect neighboring cells
3. TISSUE DEVELOPMENT - influences the development of tissues such as
those of the nervous system. Autocrine
- Hormones that act on the cells that secrete them
4. ION REGULATION - regulates the solute concentration of the blood.
Components of Hormones:
5. WATER BALANCE - regulates water balance by controlling solutes in the
blood • Receptor site - location on a cell where hormone binds (lock)
6. HEART RATE AND BP REGULATION - helps regulate HR and BP and • Target tissues - group of cells that respond to specific hormones
helps prepare the body for physical activity
• Specificity - specific hormones bind to specific receptor sites
7. CONTROL OF BLOOD GLUCOSE AND OTHER NUTRIENTS -
regulates the level of blood glucose and other nutrients in the body. Types of Hormones:
8. CONTROL OF REPRODUCTIVE FUNCTIONS - controls the • Water soluble
development and functions of the reproductive system in male and female - includes proteins, peptides, amino acids
⁃ most common
9. UTERINE CONTRACTION AND MILK RELEASE - regulates uterine - Ex. Growth hormone, antidiuretic, prolactin, etc.
contractions during delivery and stimulates milk release from the breasts in
lactating females • Lipid hormones
⁃ includes steroids and eicosanoids
10. IMMUNE SYSTEM REGULATION - helps control the production and ⁃ Ex. LH, FSH, androgens
functions of immune cells
7 Human Endocrine Glands:
4 CATEGORIES OF CHEMICAL MESSENGERS: • Pituitary
• Thyroid
1. AUTOCRINE CHEMICAL MESSENGERS • Parathyroid
- stimulates the cell that originally secreted it. • Adrenal
- Ex. Those secreted by white blood cells during an infection. • Pancreas (Islets of Langerhans)
- they can stimulate their own replication so that the total number of WBC • Adrenal gland
increases rapidly. • Testes and Ovaries
2. PARACRINE CHEMICAL MESSENGERS Pituitary Gland
- are secreted by one cell type into the extracellular fluid and affect - a round organ about the size of a pea (~1 cm in diameter), located behind the
surrounding cells of a different type. bridge of the nose at the base of the brain
- Ex. Histamine - stimulates vasodilation in nearby blood vessels. - secretes 9 different hormones, which affect many different areas of the body,
including:
3. NEUROTRANSMITTERS a. Growth
- are secreted by neurons that activate an adjacent cell, whether it is another b. Blood pressure
neuron, a muscle cell, or a glandular cell. c. Regulation of Pregnancy
⁃ are secreted into a synaptic cleft rather than into the bloodstream. d. Breast milk production
⁃ It is a paracrine messenger, but for the purposes it is most appropriate to e. Sex organ functions in both men and women
consider them as a separate category. f. Thyroid gland function
g. Metabolism
4. ENDOCRINE CHEMICAL MESSENGERS h. Water regulation in the body (kidneys)
- are secreted into the bloodstream by certain glads and cells, which together i. Temperature regulation
constitute the endocrine system.
- affect cells that are distant from their source. A Few Pituitary Hormones:
Hormone Function
Neurotransmitter and Neuromodulators - To increase body size during
⁃ secreted by nerve cells Growth Hormone (GH) childhood and adolescence;
⁃ Ex. Nervous system function - to maintain body size during adulthood
Thyroid Stimulating
Pheromones - To stimulate the thyroid to produce thyroxin
Hormone (TSH)
- secreted into environment and modify behavior and physiology of other
- Regulate puberty, development, and
individual in same species Follicle Stimulating
reproductive processes
⁃ Ex. Women and menstrual cycles Hormone (FSH)
Stimulates the production of estrogen and
Hormones and Neurohormones Luteinizing Hormone (LH)
testosterone
- secreted into blood and bind to receptor sites
⁃ Ex. Epinephrine and insulin
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 Growth Hormone 2. Adrenal Cortex (outer portion):
- Aldosterone: Type of mineralocorticoids
• Oversecretion of growth hormone:(bones of face, hands and feet enlarge) ⁃ Target tissues: kidneys
⁃ Giantism in childhood ⁃ Functions: causes Na+ and H2O to be retained and K+ to be
- Acromegaly in adults secreted, indirectly involved with blood pressure and blood
volume
• Undersecretion of growth hormone:
⁃ Dwarfism in childhood Adrenal Glands:

Thyroid • Zona glomerulosa - outermost layer; secretes mineralocorticoids like

- Located in the neck aldosterone
- Releases hormone thyroxin
• Zona fasciculata - middle layer; secretes glucocorticoids like cortisol
Function:
- to regulate rates of metabolism in the body • Zona reticularis - innermost layer of cells; secretes sex hormones or
⁃ Essential for normal physical and mental development androgens

• Oversecretion of thyroxin:
⁃ Results in nervousness and weight loss • Inner medullary portion - Formed by chromaffin cells, responsible for
secreting catecholamines like epinephrine and norepinephrine.
• Undersecretion of thyroxin:
⁃ Results in cretinism (mental retardation, small size) in children • Adrenal cortex: Produces steroid hormones; yellowish in color.

Goiter (thyroid) • Adrenal medulla: Produces catecholamines; inner medullary; reddish-

- Iodine deficiency in your diet results in _____ brown.
- enlargement of thyroid gland
Islet of Langerhans
Abnormalities of Thyroid Gland: - Located on the pancreas
- Hormones secreted are insulin and glucagon
Hypothyroids Hyperthyroidism
⁃ decreased metabolism ⁃ increased metabolism • Insulin - stimulates glucose uptake by cells
⁃ weight gain, reduced appetite, ⁃ weight loss, increased appetite, • Glucagon - promotes conversion of glycogen (animal-based carbohydrate)
fatigue nervousness to glucose
⁃ low temperature and pulse ⁃ higher temperature and pulse
⁃ dry, cold skin ⁃ warm, flushed skin Blood Sugar Regulation
⁃ Myxedema in adults ⁃ Graves’ disease (leads to goiter) • Oversecretion of insulin results in low blood sugar
• Undersecretion of insulin results in highblood sugar; This can lead to a
condition known as diabetes
Parathyroid
- Necessary for normal nerve and muscle function, blood clotting, healthy Diabetes-Type 1
bones and teeth - Usually found in children and young adults; the body doesn't make enough
⁃ Located in back of thyroid gland (in neck) insulin
- Hormone released is patathormone - Symptoms: Frequent urination, unusual thirst, extreme hunger, Unusual
weight loss, Extreme fatigue and Irritability
Function:
- to control metabolism of calcium Diabetes- Type 2
- Either the body doesn't produce enough insulin, or the cells ignore it.
- If you consume too much sugar over a long period of time, your body has to
Undersecretion of parathormone: release large amounts of insulin. This can result in your cells building up a
- results in nerve disorders, brittle bones, and clotting problems tolerance for insulin, which means they won't be affected by it.
⁃ Symptoms: Any of the type 1 symptoms, Frequent infections, Blurred vision,
Parathyroid hormone (PTH) Cuts/bruises that are slow to heal, Tingling/numbness in the hands/feet,
⁃ Target tissues: bones and kidneys Recurring skin, gum, or bladder infections

Functions: Endocrine System Control

- regulates blood Ca2+ levels (more than calcitonin) - Regulated by feedback mechanisms

- If Ca2+ is low then osteoclasts break down bone matrix and less Ca 2+ is 2 Types of Feedback Mechanisms:
lost in urine. 1. positive feedback
- If Ca 2+ is high then osteoclasts don't break down bone matrix and more 2. negative feedback
Ca 2+ is lost in urine.
• Negative Feedback Mechanisms:
Adrenal Glands (Kidney Hats) ⁃ Act like a thermostat in a home
- Located at the top of each kidney ⁃ As the temperature cools, the thermostat detects the change and triggers the
- Hormones released are cortisone and adrenaline furnace to turn on and warm the house
⁃ Once the temperature reaches its thermostat setting, the furnace turns off
• Function of cortisone: - Example: Body sugar increases after a meal, so the pancreas secretes insulin,
- to regulate carbohydrate, protein and fat metabolism which tells the body's cells to take in glucose. Once blood 'sugar levels reach
⁃ promotes conversion of fats and proteins to glucose normal, the pancreas stops making insulin.
- Often used to maintain homeostasis
• Function of adrenaline:
- to raise blood sugar levels and increases heartbeat and breathing rates • Positive Feedback Mechanisms:
- control events that can be out of control and do not require continuous
Adrenal Glands adjustment
- On kidneys - Rarely used to maintain homeostasis
- 2 regions medulla and cortex - Example of positive feedback found in childbirth
⁃ Oxytocin stimulates and enhances labor contractions. As labor continues,
1. Adrenal Medulla (inner portion): more oxytocin is produced. Intensifies contractions until the baby is outside
- Epinephrine/Norepihephrin birth canal. Oxytocin production stops and labor contractions stop.
- Target tissues: heart, blood vessels, liver, fat cells
- Functions: released as part of fight or flight response

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 Negative Feedback Blood
- Homeostasis is often maintained by two hormones who have antagonistic - is a circulating tissue consisting of three types of cells:
effects; Each hormone does the opposite of the other. 1. Red Blood Cells - Erythrocytes
- For example, if the blood pressure drops too low, the pituitary releases ADH, 2. White Blood Cells - Leukocytes
which causes the kidneys to reabsorb more water. If the blood pressure 3. Platelets - Thrombocytes
increases too much, then the heart will release ANH, which will cause the - Each type of blood cell performs a different function.
kidneys to reabsorb less water. - The cells listed above are suspended in a liquid known as plasma.

Major Actions of Oxytocin: Composition of Blood:

- Stimulates contraction of smooth muscle cells of the uterus during childbirth - Plasma (55%)
- Stimulates contraction of myoepithelial cells in the breast to cause milk - White blood cells & platelets (<1%)
letdown - Red blood cells (45%)

TESTES AND OVARIES • Plasma - The blood is made up of cells that are suspended in this liquid
- makes up 55% of the blood.
• MALE - is made of 90% water and 10% proteins, lipids, carbohydrates, amino acids,
- main sex hormone is TESTOSTERONE (responsible for the growth and antibodies, hormones, electrolytes, waste, salts, and ions
development of the male reproductive structures, muscle enlargement, the
growth of body hair, voice changes, and the male sexual drive); secreted by • Blood cells - make up the remaining 45% of the blood.
the testes
• Red blood cells - make up 99% of the blood cells.
• FEMALE
- two main classes of sex hormones, affect sexual characteristics: • White blood cells and platelets - make up the other 1%.
 1. ESTROGEN
 2. PROGESTERONE
- These hormones contribute to the development and function of the female 55% of total blood
reproductive structures and other female sexual characteristics. PLASMA pale, yellow liquid that surrounds cells
91% water, 7% proteins, and 2% other
TWO CHARACTERISTICS: 45% of total blood
FORMED
1. enlargement of the breast cells and cell fragments
ELEMENTS
2. distribution of the adipose tissue (influences the shape of the hips, breasts erythrocytes,leukocytes, thrombocytes
and thighs). PLASMA PROTEINS:
58% of plasma proteins
female menstrual cycle - controlled by the cyclical release of estrogen and ALBUMIN
helps maintain water balance
progesterone from the ovaries 38% of plasma proteins
GLOBULINS
helps immune system
• LH and FSH - stimulate the secretion of hormones from the ovaries and 4% of plasma proteins
testes. FIBRINOGEN
aids in clot formation
• Releasing hormones from the hypothalamus - controls the rate of LH and
FSH secretion in males and females. In turn, this LH and FSH control the
Main component of erythrocytes
secretion of hormones from the ovaries and testes.
Transports O2
Each globin protein is attached to a
Chapter 11: The Blood heme molecule
HEMOGLOBIN
Each heme contains one iron atom
BLOOD
O2 binds to iron
- "river of life" that surges within us
Oxyhemoglobin: hemoglobin with an O2
- It transports everything that must be carried from one place to another
attached
within the body - nutrients, wastes and body heat through the blood vessels.
- Is a type of connective tissue that consists of a liquid matrix containing cells
and cell fragments.
- is made up of cellular material in a fluid called plasma HOMEOSTATIC IMBALANCE:

(The liquid matrix is the plasma and the cells and cell fragments are the • ANEMIA
formed elements): - a decrease in the oxygen-carrying ability of the blood, whatever the reason
Plasma - accounts for slightly more than half of the total blood volume. is. it may be the result of :
Formed elements - account for slightly less than half of the total blood 1. A lower-than-normal number of RBCs
volume. 2. Abnormal or deficient hemoglobin content in the RBC

FUNCTIONS OF BLOOD: • TYPES OF ANEMIA:

Blood is responsible for:
• Transporting gases (oxygen & carbon dioxide) DIRECT USE RESULTING FROM LEADING TO
• Transporting waste products Hemorrhagic
Sudden hemorrhage
• Transporting nutrients anemia
• Helping remove toxins from the body Lysis of RBCs as a result of bacterial Hemolytic
• Blood makes up 6-8% of our total body weight. infections anemia
Decrease in
Pernicious
RBC number Lack of vitamin B12
Total blood volume in the average adult anemia
• Female: 4-5L Depression/destruction of bone
Aplastic
• Male: 5-6L marrow by cancer, radiation, or
certain medications
anemia
• Normal adult blood volume is 5L
Lack of iron in diet or
Formation of Blood Inadequate slow/prolonged bleeding (such as
Iron-deficiency
• Hematopoiesis - the formation and development of blood cells hemoglobin heavy menstrual flow or bleeding
anemia
• In adults - the cellular elements are produced in the bone marrow. content in RBC ulcer) which depleted iron reserves
• Some WBCs - are produced in the lymphatic tissue and bone marrow. needed to make hemoglobin.
• Blood cells - need certain nutrients to form properly. (Ex. Iron, Folic acid, Genetic defect leads to abnormal
Vitamin B12) hemoglobin, which becomes sharp
• All blood cells formed come from a hematopoietic stem cell (These cells Abnormal
and sickle-shaped under conditions Sickle-cell
can become any blood cell) hemoglobin in
of increased oxygen use by the body; Anemia
RBC occurs mainly in people of African
descent.

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 LEUKOCYTES - in adults, this tissue is found chiefly in flat bones of the skull and pelvis, the
- White blood cells (WBC) ribs, sternum, and proximal epiphyses of the humerus and femur.
- Lack hemoglobin -each type of blood cell produced in different numbers in response to
- Larger than erythrocytes changing body needs and different stimuli.
- Contain a nucleus - after they mature, they are discharged into the blood vessels surrounding the
area.
• Functions:
⁃ fight infections THE DEVELOPMENT OF BLOOD CELL FORMATION:
⁃ remove dead cells and debris by phagocytosis • All blood cells differentiate from a common source, hematocytoblast stem
cells in red bone marrow.
GRANULOCYTES • The population of stem cells renews itself by mitosis.
- they have lobed nuclei, which typically consist of several rounded nuclear • Some of these cells become lymphoid stem cells, which then develops into
areas connected by thin strands of nuclear material. It includes: two classes of lymphocytes that function in the immune response.
• Neutrophils • All other blood cells differentiate from myeloid stem cells, also derived
- have a multilobed nucleus and very fine granules that respond to from the stem cells.
both acid and basic stains.
- consequently, the cytoplasm stains pink. HEMOSTASIS
- are avid phagocytes at sites of acute infection. • Normally, blood flows smoothly past the intact lining (endothelium) of
blood vessel walls. But if a blood vessel wall breaks, a series of reactions is
• Eosinophils set in motion to accomplish hemostasis (hem=blood; stasis=standing still), or
- have a blue-red nucleus that resembles an old-fashioned stoppage of blood.
telephone receiver and sport large brick-red cytoplasmic granules
⁃ their number increases rapidly during allergies and infections by 3 Major Phases:
parasitic worms (flatworms, tapeworms, etc.) 1. Platelet Plug Forms
- platelets are repelled by an intact endothelium, but when it is
• Basophils broken so that the underlying collagen fibers are exposed, the
- the rarest of the WBC's, contain large histamine-containing platelets become "sticky" and cling to the damaged site.
granules that stain dark-blue. -anchored platelets release chemicals that attract more platelets to
> histamine - is an inflammatory chemical that makes blood the site, and as more and more platelets pile up, a small mass
vessels leaky and attracts other WBC's to the inflammatory sites. called a platelet plug or white thrombus is formed.

AGRANULOCYTES 2. Vascular Spasms Occur

- lack visible cytoplasmic granules - the anchored platelets also release serotonin, which causes that
- their nuclei are closer to the norm - that is, they are spherical, oval, or blood vessel to go into spasms.
kidney-shaped. - the spasm narrow the blood vessel at that point, decreasing the
blood loss until clotting can occur.
• Lymphocytes - eg. Direct injury to the smooth muscle cells and stimulation of
- have a large dark purple nucleus that occupies most of the cell local pain receptors.
volume.
- only slightly larger than RBCs, tend to take up residence in 3. Coagulation Events Occur
lymphatic tissues, where they play an important role in the - the injured tissues are releasing thromboplastin (a factor that
immune response. plays an important role in clotting).

• Monocytes • PF3 - a phospholipid that coats the surfaces of the platelets, interacts with
- are the largest of the WBCs, except for their more abundant thromboplastin, other blood protein clotting factors, and calcium ions to form
cytoplasm and indented nucleus, they resemble large lymphocytes. an activator that triggers the clotting cascade.
- they migrate into the tissues, they change into macrophages with
huge appetites. • This prothrombin activator - converts prothrombin present in the plasma
- macrophages are very important in fighting chronic infections to thrombin, an enzyme.
such as tuberculosis.
• Thrombin - then joins soluble fibrinogen proteins into a hairlike molecules
HOMEOSTATIC IMBALANCE: of insoluble fibrin, which forms a meshwork that traps the RBCs and forms
the basis of the clot.Within the hour, the clot begins to retract, squeezing
• Leukocytosis serum from the mass and pilling the ruptured edges of the blood vessel closer
- is a normal and desirable response to infectious threats to the body. together.
- By contrast, the excessive production of abnormal WBCs in infectious
mononucleosis and leukemia is distinctly pathological. HOMEOSTATIC IMBALANCE

• Leukemia 1. Undesirable Clotting

- literally "white blood,” the bone marrow becomes cancerous, and huge • Thrombus - a clot that develops and persist in an unbroken
numbers of WBCs are turned out rapidly. Although this might not appear to blood vessel. If large enough, it may prevent blood flow to the
present a problem, the "newborn" WBCs are immature and incapable of cells beyond the blockage.
carrying out their normal protective functions. • Ex. If a thrombus forms in the blood vessel serving the heart
- consequently, the body becomes the easy prey of disease-causing bacteria (coronary thrombosis), the consequences may be death of heart
and viruses muscle and a fatal heart attack. If a thrombus breaks away from
the vessel wall and floats freely in the bloodstream, it becomes an
PLATELETS embolus.
⁃ Thrombocytes or PLTs
⁃ Formed in the bone marrow • Embolus - is usually no problem unless or until it lodges in a
⁃ Fragments from the cytoplasm of megakaryocytes blood vessel too narrow for it to pass through
⁃ Smallest of the blood cells • Ex. A cerebral embolus may cause a stroke
⁃ 1-4 micrometers in diameter
⁃ Shape can be round, oval, or appear spiky 2. Bleeding Disorders
⁃ Life span of around 8-12 days • Thrombocytopenia
⁃ Involved in the clotting process - results from an insufficient number of circulating platelets. Even
⁃ Seal wounds and prevent blood loss normal movements cause spontaneous bleeding from small blood
⁃ Help repair damaged vessels vessels.
⁃ 150,000 - 400,000 per microliter of blood - evidenced by many small purplish blotches, called petechiae on
⁃ Platelets stain bluish with reddish or purple granules the skin

HEMATOPOIESIS (blood cell formation) • Hemophilia - applies to several different hereditary bleeding
- occurs in red bone marrow, or myeloid tissue disorders that result from lack of any factors for clotting.
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 BLOOD GROUPS AND TRANSFUSIONS Example of Rh Reaction:
• If mother is Rh- and fetus is Rh+ the mother can be exposed to Rh+ blood if
• ANTIGEN - is a substance that the body recognizes as foreign; it stimulates fetal blood leaks through placenta and mixes with mother's blood.
the immune system to release antibodies or use other means to mount a • First time this occurs mother's blood produces antibodies against antigens.
defense against it. • Any repeated mixing of blood causes a reaction.

• RECOGNIZERS - are antibodies present in the plasma that attach to RBCs

bearing surface antigens h different from those on the blood recipients RBCs.

• AGGLUTINATION - phenomenon caused by the binding of the antibodies

that causes the RBC to clump.

TWO BLOOD GROUPS

1. ABO BLOOD GROUP

- are based on which of two antigens, type A or type B, a person
inherits.
- absence of both an&gens results in type O blood
- presence of both antigens lead to type AB
- possession of either A or B antigen yields type A or B blood,
respectively.
- antibodies are formed during infancy against the ABO antigens not
present on your own RBC.

2. Rh BLOOD GROUP
• Rhesus (Rh) factor - is an inherited protein found on the surface of
red blood cells.
- If your blood has the protein, you're Rh positive. If your blood lacks
the protein, you're Rh negative.
• Rh positive - is the most common blood type.
• Rh negative blood type - is not an illness and usually does not affect
the health. However, it can affect pregnancy.

• Pregnancy needs special care if Rh negative and the baby is Rh

positive (Rh incompatibility). A baby can inherit the Rh factor
from either parent.
• The health care provider will recommend a blood type and Rh
factor screening test during first prenatal visit. This will identify
whether one’s blood cells carry the Rh factor protein.

Mother’s Rh Father’s Rh Baby’s

Precautions
Factor Factor Rh Factor
Rh positive Rh positive Rh positive None
Rh negative Rh negative Rh negative None
Could be Rh positive
Rh positive Rh negative None
or Rh negative
Rh immune
Could be Rh positive
Rh negative Rh positive globulin
or Rh negative
injections

BLOOD GROUP
• Red blood cells (erythrocytes) - have certain proteins on their surface,
called antigens.
• Plasma - contains antibodies (will attack certain antigens if they are
present).
• ABO and rhesus - are both types of antigens found on the surface of red
blood cells. (There are lots of other types but these are the most important)

BLOOD GROUPS
A+ (A positive) if you have A and rhesus antigens.
if you have A antigens but don't have rhesus
A- (A negative)
antigens.
B+ (B positive) if you have B and rhesus antigens.
if you have B antigens but don't have rhesus
B- (B negative)
antigens.
AB+ (AB positive) if you have A, B and rhesus antigens.
if you have A and B antigens but don't have rhesus
AB- (AB negative)
antigens.
if you have neither A nor B antigens but you have
O+ (O positive)
rhesus antigens.
O- (O negative) if you don't have A, B or rhesus antigens.

ANTIGENS & ANTIBODIES

Blood Group Antigens on RBCs Antibodies in Serum Genotypes
A A Anti-B AA or AO
B B Anti-A BB or BO
AB A and B Neither AB
O neither Anti-A and Anti-B OO