Endocrine Surgery 2 hormones & stress

2.3.3 There is strong evidence confirming that neural signals are converted into a hormonal signal integration of two systems and the hypothalamic pituitary complex is an example and is the principle avenue of adaptation to stress and trauma(Fig. 30.4).

2.3.4 The control organs and target organs show the  mechanism of negative feed look loop. These are adrenal pituitary the insulin secretion of pancreas and thyroid hormone secretion. Excess levels bormones suppress the control organ. Fig 30.5

2.3.5 STRESS RESPONSE

      One of the common external events that puts the endocrine system into action is the series of responses initiated by the stress of injury (trauma) Fig 30.6

2.3.5.1 HYPOTHALAMO PITUITARY

      This is one of the principle mechanism involved in the metabolic response to trauma. The stimulus for this response originates from the site of injury and factors produced by the injured tissue. This results in increased production of ACTH releasing factor by the hypothalamus. This releasing factor on reaching the anterior pituatory releases increased ACTH. This in turn on reaching the cortex of the adrenal releases larger quantities of cortisol

      Plasma cortisol levels remain high for 2-3 days after injury but may persist longer if infection occurs. The above series of events can be reduced by neurogenic blockage

of the injured part

2.3.5.2 Sympatho Adrenal

      The catechslamines are also a neuro endocrine response to injury. These hormones ie. adrenaline and non-adrenaline stimulate glycogenlysis and mobilise free fatty acids and increase oxygen utilisation

2.3.5.3 Glycogon

      It is released immediatly after injury from the pancreatic alpha cells through sympathetic nerve actions. Glucogon has both glycolytisis and reduced glycrgen synthesis leading to more available glucose. All these actions results in better oxygen utilisation and provide protein and energy substrate for repair and recovery.

3. TRANSPORT

      Hormones have to be transported from the site of production to the site of cellular action and the insoluble hormones, the sex steroids (Estradiol, Testosterone) travel on a binding globulin similarly, Thyroxin too travels on TBG. (Thyroxin binding Globulin) is ample evidence that it functions as an integrated system towards its objective of maintaining the internal environment in health and disease, though it lacks anatomical continuity, it maintains the functions of reproduction, growth and development and repair of the organism

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