Beruflich Dokumente
Kultur Dokumente
Modified from: Brown TA, Brown D. USMLE Step 1 Secrets, 3rd Ed. Saunders, 2013
Marc Imhotep Cray, MD
Autonomic Nervous System
vs Endocrine System in Homeostasis
Autonomic nervous system (ANS) is the moment-to-moment regulator of
the internal environment, regulating specific functions that occur without
conscious control:
respiration,
circulation,
digestion,
body temperature,
metabolism,
sweating, secretions of certain endocrine glands
Wired Wireless
Neurotransmitters Hormones
Hormones
Short Distance
Short Distance Long
Long Distance
Distance
COMPARATOR +
SENSOR
ERROR
stretch receptors, chemo-, SET EFFECTOR
baro-, osmo-, and thermo- SIGNAL
POINT
receptors etc
-
Negative feedback: Initiation of
responses that counter deviations
CONTROLLED
of controlled variables from their
VARIABLE
(SEE NEXT SLIDE)
-
NEGATIVE
normal range
FEEDBACK
Important variable maintained
within a normal range Effector opposes stimulus
12
Redrawn after: Kibble JD, Halsey CR, Homeostasis: In Medical Physiology -The Big Picture; McGraw-Hill ,2009:2
Examples of Physiologic Controlled Variables
Controlled Variable Typical Set Point Value
(Arterial Blood Sample)
From Carroll RG Elsevier’s Integrated Physiology Mosby, Inc. 2007; TABLE 1-3, Pg 5
Hormones:
Affect metabolism of target organs
reproduction
NE, Epi, T4
ADH
Protein hormones:
Growth hormone
Testosterone
Estradiol
Cortisol
Progesterone
Glycoproteins:
Long polypeptides (>100) bound to 1 or more
carbohydrate (CHO) groups
FSH and LH
Fox SI. Human Physiology 12th ed. New York: McGraw-Hill, 2011
Marc Imhotep Cray, MD 20
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H20 soluble
Nonpolar (lipophilic):
H20 insoluble
hormones
Preprohormone:
Prohormone derived from larger precursor molecule
Preproinsulin
Prehormone:
Molecules secreted by endocrine glands that are inactive
until changed into hormones by target cells
T4 converted to T3
Hormonal Interactions
Synergistic:
Two hormones work together to produce a result
Additive:
Each hormone separately produces response, together
Complementary:
Each hormone stimulates different step in process
FSH and testosterone
to second hormone
Increases activity of a second hormone
Prior exposure of uterus to estrogen induces
Half-life:
Time required for blood [hormone] to be reduced to ½
reference level
Minutes to days
To respond to a hormone:
Target cell must have specific receptors for that hormone
(specificity)
Hormones exhibit:
Marc Imhotep Cray, MD Fox SI. Human Physiology 12th ed. New York: McGraw-Hill, 2011 29
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*Dimerization = Process of 2
receptor units coming together
at the 2 half-sites.
Fox SI. Human Physiology 12th ed. New York: McGraw-Hill, 2011
Marc Imhotep Cray, MD 31
Copyright © The McGraw-Hill Companies, Inc Permission required for reproduction or display
Adenylate Cyclase-cAMP
Polypeptide or glycoprotein hormone binds to
receptor protein causing dissociation of a subunit of
G-protein
G-protein subunit binds to and activates
adenylate cyclase
ATP cAMP + PPi
cAMP attaches to inhibitory subunit of protein kinase
Adenylate Cyclase-cAMP
Phosphorylates enzymes
within cell to produce
hormone’s effects
Modulates activity of
enzymes present in cell
Phospholipase-C-Ca2+
Binding of epinephrine to α-adrenergic receptor in
plasma membrane activates a G- protein intermediate,
phospholipase C
Phospholipase C splits phospholipid into IP3 and DAG
Both derivatives serve as 2
nd messengers
Phospholipase-C-Ca2+ cont.
Ca2+ diffuses into
cytoplasm
Ca2+ binds to calmodulin
Calmodulin activates
specific protein kinase
enzymes
Alters metabolism of cell,
producing hormone’s
effects
Fox SI. Human Physiology 12th ed. New York: McGraw-Hill, 2011
Fox SI. Human Physiology 12th ed. New York: McGraw-Hill, 2011
Tyrosine Kinase
Insulin receptor consists of 2 units that dimerize when
they bind with insulin
Insulin binds to ligand–binding site on plasma membrane,
activating enzymatic site in cytoplasm
Fox SI. Human Physiology 12th ed. New York: McGraw-Hill, 2011
Pituitary Gland
Pituitary gland is located
in diencephalon
Structurally and
functionally divided into:
Anterior lobe
Posterior lobe
Fox SI. Human Physiology 12th ed. New York: McGraw-Hill, 2011
Pituitary Hormones
Anterior Pituitary:
Trophic effects:
High blood [hormone]
Fox SI. Human Physiology 12th ed. New York: McGraw-Hill, 2011
Marc Imhotep Cray, MD 43
Copyright © The McGraw-Hill Companies, Inc Permission required for reproduction or display
Oxytocin:
Milk-ejection reflex
Transported along
hypothalamo-hypophyseal
tract
Release controlled by
neuroendocrine reflexes Fox SI. Human Physiology 12th ed. New York: McGraw-Hill, 2011
Positive feedback
effect:
During menstrual cycle,
estrogen stimulates LH surge
Fox SI. Human Physiology 12th ed. New York: McGraw-Hill, 2011
Menstrual cycle
Adrenal Glands
Paired organs that cap kidneys
Adrenal medulla:
Derived from embryonic neural crest ectoderm (same tissue
that produces sympathetic ganglia)
Synthesizes and secretes:
Catecholamines (mainly Epi but some NE)
return
Stimulate glycogenolysis
Stimulate lipolysis
Adrenal Glands
Adrenal cortex:
Does not receive neural
innervation
Must be stimulated
hormonally (ACTH)
Consists of 3 zones:
Zona glomerulosa
Zona fasciculata
Zona reticularis
Secretes corticosteroids
Fox SI. Human Physiology 12th ed. New York: McGraw-Hill, 2011
Zona fasciculata:
Glucocorticoids (cortisol):
Marc Imhotep Cray, MD Fox SI. Human Physiology 12th ed. New York: McGraw-Hill, 2011 54
Copyright © The McGraw-Hill Companies, Inc Permission required for reproduction or display
Thyroid Hormones
Thyroid gland is located just below
larynx
Fox SI. Human Physiology 12th ed. New York: McGraw-Hill, 2011
Marc Imhotep Cray, MD 59
Copyright © The McGraw-Hill Companies, Inc Permission required for reproduction or display
Actions of T3
Stimulates protein synthesis
Promotes maturation of nervous system
Stimulates rate of cellular respiration by:
Production of uncoupling proteins
other molecules
Marc Imhotep Cray, MD 60
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Diseases of Thyroid
Iodine-deficiency (endemic)
goiter:
Abnormal growth of thyroid
gland
In absence of sufficient iodine,
Fox SI. Human Physiology 12th ed. New York: McGraw-Hill, 2011
Marc Imhotep Cray, MD 61
Copyright © The McGraw-Hill Companies, Inc Permission required for reproduction or display
tissue
Symptoms:
Decreased metabolic rate
Weight gain
Cretinism:
Hypothyroid from end of 1st trimester to 6 months postnatally
Parathyroid Glands
Embedded in lateral lobes of thyroid
gland
Parathyroid hormone (PTH):
Only hormone secreted by parathyroid
glands
Single most important hormone in
control of blood [Ca2+]
Stimulated by decreased blood [Ca2+]
Promotes rise in blood [Ca2+] by
acting on bones, kidney and
intestines
Fox SI. Human Physiology 12th ed. New York: McGraw-Hill, 2011
Marc Imhotep Cray, MD 64
Copyright © The McGraw-Hill Companies, Inc Permission required for reproduction or display
Pineal Gland
Secretes melatonin:
Production stimulated by suprachiasmatic nucleus (SCN) in
hypothalamus
SCN is primary center for circadian rhythms
Light/dark changes required to synchronize
Melatonin secretion increases with darkness and peaks in
middle of night
May inhibit GnRH
May function in onset of puberty (controversial)
Fox SI. Human Physiology 12th ed. New York: McGraw-Hill, 2011
67
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Thymus
Site of production of T cells (thymus- dependent cells), which
are lymphocytes
Lymphocytes are involved in cell-mediated immunity
Testosterone
Estradiol 17-β
Progesterone
Placenta:
Secretes large amounts of estriol, progesterone, hCG, hCS
Paracrine:
Produced within one tissue and regulate a different tissue of same organ
Cytokines (lymphokines):
Regulate different cells (interleukins)
Growth factors:
Promote growth and cell division in any organ
Neutrophins:
Guide regenerating peripheral neurons
Prostaglandins
Most diverse group of autocrine regulators
Produced in almost every organ
Wide variety of functions
Different prostaglandins may exert antagonistic effects in some
tissues
Immune system:
Promote inflammatory process
Reproductive system:
Play role in ovulation
Digestive system:
Inhibit gastric secretion
Prostaglandins
Marc Imhotep Cray, MD Fox SI. Human Physiology 12th ed. New York: McGraw-Hill, 2011 72
Copyright © The McGraw-Hill Companies, Inc Permission required for reproduction or display
Prostaglandins cont.
Respiratory system:
May bronchoconstrict or bronchodilate
Circulatory system:
Vasoconstrictors or vasodilators
Urinary system:
Vasodilation
Textbooks
Fox SI. Human Physiology 12th ed. New York: McGraw-Hill, 2011