crease the overall metabolic rate.

Not only does this action

The sex hormones secreted by the adrenal cortex do not

influence the rate at which cells use nutrient molecules and

contribute to homeostasis.

O2 within the internal environment, but it also produces heat,

which helps maintain body temperature.

nephrine, generally reinforces activities of the sympathetic

The adrenal cortex secretes three classes of hormones. Al-

The major hormone secreted by the adrenal medulla, epi-

nervous system. It contributes to homeostasis directly by its

dosterone, the primary mineralocorticoid, is essential for Na1

role in blood pressure regulation. Epinephrine also contrib-

and K balance. Because of Na s osmotic effect, Na bal-

utes to homeostasis indirectly by helping prepare the body

ance is critical to maintaining the proper ECF volume and ar-

for peak physical responsiveness in fight-or-flight situations.

terial blood pressure. This action is essential for life. Without

This includes increasing the plasma concentrations of glu-

aldosterones Na1- and H2O-conserving effect, so much

cose and fatty acids above normal, which provides additional

plasma volume would be lost in the urine that death would

energy sources for increased physical activity.

quickly ensue. Maintaining K1 balance is essential for homeo-

stasis because changes in extracellular K1 profoundly affect

creas, insulin and glucagon, are important in shifting meta-

neuromuscular excitability, jeopardizing normal heart func-

bolic pathways between the absorptive and postabsorptive

tion, among other detrimental effects.

states, which maintains the appropriate plasma levels of nu-

Cortisol, the primary glucocorticoid secreted by the adre-

The two major hormones secreted by the endocrine pan-

trient molecules.

nal cortex, increases the plasma concentrations of glucose,

fatty acids, and amino acids above normal. Although these

cal to maintaining plasma concentration of Ca21. PTH is es-

actions destabilize the concentrations of these molecules in

sential for life because of Ca21s effect on neuromuscular

the internal environment, they indirectly contribute to ho-

excitability. In the absence of PTH, death rapidly occurs

meostasis by making the molecules readily available as en-

from asphyxiation caused by pronounced spasms of the re-

ergy sources or building blocks for tissue repair to help the

spiratory muscles.

Parathyroid hormone from the parathyroid glands is criti-

body adapt to stressful situations.

Review Exercises

Answers begin on p. A-50

Reviewing Terms and Facts

1. The response to thyroid hormone is detectable within a
few minutes after its secretion. (True or false?)
2. Adrenal androgen hypersecretion is caused by a deficit of
an enzyme crucial to cortisol synthesis. (True or false?)
3. Excess glucose and amino acids as well as fatty acids can
be stored as triglycerides. (True or false?)
4. Insulin is the only hormone that can lower blood glucose
levels. (True or false?)
5. The most life-threatening consequence of hypocalcemia is
reduced blood clotting. (True or false?)
6. All ingested Ca21 is indiscriminately absorbed in the intestine. (True or false?)
7. The Ca3(PO4)2 bone crystals form a labile pool from which
Ca21 can rapidly be extracted under the influence of PTH.
(True or false?)
8. The lumen of the thyroid follicle is filled with
, the
chief constituent of which is a large protein molecule known
as
.
9.
is the conversion of glucose into glycogen.
is
the conversion of glycogen into glucose.
is the conversion of amino acids into glucose.

10. The three major tissues that do not depend on insulin for
their glucose uptake are
,
, and
.
11. The three compartments with which ECF Ca21 is exchanged are
,
, and
.
12. Among the bone cells,
are bone builders,
are
bone dissolvers, and
are entombed.
13. Which of the following hormones does not exert a direct
metabolic effect?
a. epinephrine
b. growth hormone
c. aldosterone
d. cortisol
e. thyroid hormone
14. Which of the following are characteristic of the postabsorptive state? (Indicate all that apply.)
a. glycogenolysis
f. triglyceride synthesis
b. gluconeogenesis
g. protein degradation
c. lipolysis
h. increased insulin secretion
d. glycogenesis
i. increased glucagon secretion
e. protein synthesis
j. glucose sparing
The Peripheral Endocrine Glands 713

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Understanding Concepts
(Answers at www.cengagebrain.com)

1. Describe the steps of thyroid hormone synthesis.

2. What are the effects of T3 and T4? Which is the more potent? What is the source of most circulating T3?
3. Describe the regulation of thyroid hormone secretion.
4. Discuss the causes and symptoms of both hypothyroidism
and hyperthyroidism. For each cause, indicate whether a goiter occurs, and explain why.
5. What hormones are secreted by the adrenal cortex? What
are the functions and control of each of these hormones?
6. Discuss the causes and symptoms of each type of adrenocortical dysfunction.
7. What is the relationship of the adrenal medulla to the
sympathetic nervous system? What are the functions of epinephrine? How is epinephrine release controlled?
8. Define stress. Describe the neural and hormonal responses
to a stressor.
9. Define fuel metabolism, anabolism, and catabolism.
10. Indicate the primary circulating form and storage form of
each of the three classes of organic nutrients.
11. Distinguish between the absorptive and postabsorptive
states with regard to the handling of nutrient molecules.
12. Name the two major cell types of the islets of Langerhans,
and indicate the primary hormonal product of each.
13. Compare the functions and control of insulin secretion
with those of glucagon secretion.
14. What are the consequences of diabetes mellitus?
15. Why must plasma Ca21 be closely regulated?
16. Explain how osteoblasts influence osteoclast function.
17. Discuss the contributions of parathyroid hormone, calcitonin, and vitamin D to Ca21 metabolism. Describe the source
and control of each of these hormones.
18. Discuss the major disorders in Ca21 metabolism.

Applying Clinical Reasoning

Najma G. sought medical attention after her menstrual periods ceased and she started growing excessive facial hair. Also,

she had been thirstier than usual and urinated more frequently. A clinical evaluation revealed that Najma was hyperglycemic. Her physician told her that she had an endocrine
disorder dubbed diabetes of bearded ladies. What underlying
defect do you think is responsible for Najmas condition?

Thinking at a Higher Level

1. Iodine is naturally present in salt water and is abundant in
soil along coastal regions. Fish and shellfish living in the ocean
and plants grown in coastal soil take up iodine from their environment. Fresh water does not contain iodine, and the soil
becomes more iron poor the farther inland it is. Knowing this,
explain why the midwestern United States was once known as
an endemic goiter belt. Why is this region no longer an endemic goiter belt even though the soil is still iodine poor?
2. Why do doctors recommend that people who are allergic
to bee stings and thus at risk for anaphylactic shock (see
p. 438) carry a vial of epinephrine for immediate injection in
case of a sting?
3. Why would an infection tend to raise the blood glucose
level of a diabetic individual?
4. Tapping the facial nerve at the angle of the jaw in a patient
with moderate hyposecretion of a particular hormone elicits a
characteristic grimace on that side of the face. What endocrine
abnormality could give rise to this so-called Chvosteks sign?
5. Soon after a technique to measure plasma Ca21 levels was
developed in the 1920s, physicians observed that hypercalcemia accompanied a broad range of cancers. Early researchers
proposed that malignancy-associated hypercalcemia arose
from metastatic (see p. 432) tumor cells that invaded and destroyed bone, releasing Ca21 into the blood. This conceptual
framework was overturned when physicians noted that hypercalcemia often appeared in the absence of bone lesions. Furthermore, cancer patients often manifested hypophosphatemia
in addition to hypercalcemia. This finding led investigators to
suspect that the tumors might be producing a PTHlike substance. Explain how they reached this conclusion. In 1987, this
substance was identified and named parathyroid hormone
related peptide (PTHrP), which binds to and activates PTH
receptors.

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714 CHAPTER 19
Copyright 2016 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s).
Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.