ADVANCED PATHOPHYSIOLOGY NURS 5060 LATEST
REVISED STUDY GUIDE CHAPTER 21,22,23
Chapter 21
1. Functions of the Endocrine System
• Regulates development, growth, reproduction, metabolism, fluid and electrolyte balance,
and adaptive stress responses.
2. Hormone Characteristics
• Secreted in specific patterns (diurnal, pulsatile, cyclic)
• Feedback regulation (primarily negative feedback)
• Only affect target cells with appropriate receptors
• Inactivated in liver/kidneys; excreted via bile or urine
3. Hormone Classification
• By chemical structure:
o Peptides/Proteins: Insulin, GH, ADH
o Steroids: Cortisol, estrogen, testosterone
o Amines: Epinephrine, norepinephrine, T3/T4
• By solubility:
o Water-soluble: Cannot cross membrane; bind surface receptors (e.g., insulin)
o Lipid-soluble: Diffuse through membrane; bind intracellular receptors (e.g.,
cortisol)
4. Hormone Receptors and Regulation
• Surface receptors: GPCRs, tyrosine kinase (e.g., insulin)
• Intracellular receptors: Affect gene transcription (e.g., steroids)
• Up/downregulation alters cell sensitivity
5. Mechanism of Hormone Action
• First messenger: Hormone binds receptor
• Second messengers: cAMP, IP3, DAG, calcium
• Intracellular signaling: Enzyme activation, gene transcription, metabolic modulation
6. Hypothalamic–Pituitary Axis (HPA)
• Hypothalamus: Master controller
o TRH, CRH, GnRH, GHRH, somatostatin, PIF
• Anterior Pituitary Hormones:
o ACTH: Stimulates adrenal cortex → cortisol
o TSH: Stimulates thyroid → T3/T4
o FSH/LH: Regulate gonads
, o GH: Stimulates growth via IGF-1
o Prolactin: Breast development and lactation
o MSH: Skin pigmentation
o β-Endorphins: Pain modulation
• Posterior Pituitary Hormones:
o ADH (Vasopressin): Water reabsorption in kidneys
o Oxytocin: Uterine contraction, milk ejection, emotional bonding
7. Pineal Gland
• Produces melatonin in response to darkness
• Regulates circadian rhythms and reproductive maturation
8. Thyroid Gland
• Regulated by TSH from pituitary
• Follicular cells produce:
o T4 (thyroxine): Inactive form; converted to T3
o T3 (triiodothyronine): Active form
• Increases metabolism, growth, temperature regulation
• Parafollicular cells produce calcitonin: Lowers calcium by inhibiting osteoclasts
9. Parathyroid Glands
• Parathyroid Hormone (PTH):
o Increases serum calcium via:
▪ Bone resorption
▪ Renal calcium reabsorption
▪ Activation of vitamin D → increased GI calcium absorption
• PTH-related peptide (PTHrP): Involved in development and cancer
10. Pancreas (Islets of Langerhans)
• Alpha cells: Glucagon → raises glucose
• Beta cells:
o Insulin: Lowers glucose, increases cell uptake, promotes
glycogenesis/lipogenesis
o Amylin: Inhibits glucagon, delays gastric emptying
• Delta cells: Somatostatin → suppresses insulin/glucagon
• F cells: Pancreatic polypeptide → regulates digestion
• Incretins (GLP-1, GIP): Gut hormones that stimulate insulin, suppress glucagon
• Ghrelin: Stimulates appetite, GH release, improves insulin sensitivity
11. Adrenal Glands
REVISED STUDY GUIDE CHAPTER 21,22,23
Chapter 21
1. Functions of the Endocrine System
• Regulates development, growth, reproduction, metabolism, fluid and electrolyte balance,
and adaptive stress responses.
2. Hormone Characteristics
• Secreted in specific patterns (diurnal, pulsatile, cyclic)
• Feedback regulation (primarily negative feedback)
• Only affect target cells with appropriate receptors
• Inactivated in liver/kidneys; excreted via bile or urine
3. Hormone Classification
• By chemical structure:
o Peptides/Proteins: Insulin, GH, ADH
o Steroids: Cortisol, estrogen, testosterone
o Amines: Epinephrine, norepinephrine, T3/T4
• By solubility:
o Water-soluble: Cannot cross membrane; bind surface receptors (e.g., insulin)
o Lipid-soluble: Diffuse through membrane; bind intracellular receptors (e.g.,
cortisol)
4. Hormone Receptors and Regulation
• Surface receptors: GPCRs, tyrosine kinase (e.g., insulin)
• Intracellular receptors: Affect gene transcription (e.g., steroids)
• Up/downregulation alters cell sensitivity
5. Mechanism of Hormone Action
• First messenger: Hormone binds receptor
• Second messengers: cAMP, IP3, DAG, calcium
• Intracellular signaling: Enzyme activation, gene transcription, metabolic modulation
6. Hypothalamic–Pituitary Axis (HPA)
• Hypothalamus: Master controller
o TRH, CRH, GnRH, GHRH, somatostatin, PIF
• Anterior Pituitary Hormones:
o ACTH: Stimulates adrenal cortex → cortisol
o TSH: Stimulates thyroid → T3/T4
o FSH/LH: Regulate gonads
, o GH: Stimulates growth via IGF-1
o Prolactin: Breast development and lactation
o MSH: Skin pigmentation
o β-Endorphins: Pain modulation
• Posterior Pituitary Hormones:
o ADH (Vasopressin): Water reabsorption in kidneys
o Oxytocin: Uterine contraction, milk ejection, emotional bonding
7. Pineal Gland
• Produces melatonin in response to darkness
• Regulates circadian rhythms and reproductive maturation
8. Thyroid Gland
• Regulated by TSH from pituitary
• Follicular cells produce:
o T4 (thyroxine): Inactive form; converted to T3
o T3 (triiodothyronine): Active form
• Increases metabolism, growth, temperature regulation
• Parafollicular cells produce calcitonin: Lowers calcium by inhibiting osteoclasts
9. Parathyroid Glands
• Parathyroid Hormone (PTH):
o Increases serum calcium via:
▪ Bone resorption
▪ Renal calcium reabsorption
▪ Activation of vitamin D → increased GI calcium absorption
• PTH-related peptide (PTHrP): Involved in development and cancer
10. Pancreas (Islets of Langerhans)
• Alpha cells: Glucagon → raises glucose
• Beta cells:
o Insulin: Lowers glucose, increases cell uptake, promotes
glycogenesis/lipogenesis
o Amylin: Inhibits glucagon, delays gastric emptying
• Delta cells: Somatostatin → suppresses insulin/glucagon
• F cells: Pancreatic polypeptide → regulates digestion
• Incretins (GLP-1, GIP): Gut hormones that stimulate insulin, suppress glucagon
• Ghrelin: Stimulates appetite, GH release, improves insulin sensitivity
11. Adrenal Glands
