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Physical Assessment - Chapter 7 Endocrine System

Chapter 7: Endocrine System

The endocrine system is composed of glands that both produce and secrete hormones. The pituitary gland secretes ACTH (adrenocorticotropic hormone) and TSH (thyroid stimulating hormone). These hormones stimulate the adrenal cortex and thyroid gland to do their jobs. The adrenal gland produces epinephrine, norepinephrine, and mineralcorticoids, glucocorticoids, and androgens. These hormones prepare people for emergency situations (fight or flight), regulates fluid and electrolytes, increase glucose levels, and increases our resistance to physical stress.

Lastly, the thyroid gland secretes thyroid hormone and calcitonin. These two hormones regulate our metabolic rate and growth.

In adults, after long bone growth has ceased, if there is an endocrine problem in the pituitary gland, the bones will begin to grow outward instead of longer. This results in broadening of the skull, hands, fingers, and almost every bone in the body. This condition is known as acromegaly.

Health History Assessment

After reading the above description of the endocrine system, it is obvious why the following areas should be included in a health history of the endocrine system.

Rate of growth

Heat or cold intolerance

Changes in glove, shoe, or ring sizes

Sweating or flushing

Weakness

Sterility

Polydipsia, polyphagia, polyuria (classic signs of diabetes)

Weight changes

Abnormal pigmentations

Change in skin texture

Irregular menses

Impotence

Dryness of skin and hair

Physical Assessment

Measure shoe size and circumference of the head. Note if there has been an increase in ring size or shoe width. Pay particular attention during the skin assessment, looking for exceptionally thick or dry skin. Notice if the speech is slow (hypothyroidism) or rapid (hyperthyroidism). Inspect for body and scalp hair (people with endocrine problems often have either hirsutism or loss of body hair). Assess muscle strength.


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