Hormones lectures4/ oral surgery courses

HORMONES
INDIAN DENTAL ACADEMY
Leader in continuing Dental Education
www.indiandentalacademy.com

LEARNING OBJECTIVE
• At the end of lecture the student should be able to
• Describe Different types & functions of
Adrenal Hormone.
• Enlist clinical features of Addisons disease
• Enlist clinical features of Cushings
syndrome
• Describe Pancreatic Hormone-insulin
• Describe types of Diabetes
•.

ADRENOCORTICAL HORMONES
These hormones are secreted by adrenal glands.
There are two adrenal glands , lie at the superior poles of
the two kidneys. Each gland is composed of two distinct
parts, the adrenal medulla and the adrenal cortex.
The adrenal medulla,is functionally related to the
sympathetic nervous system; it secretes the hormones
epinephrine and nor epinephrine .
.

The adrenal cortex secretes hormones
called corticosteroids which includes
mineralocortecoids, glucocortecoids and
androgens

The adrenal cortex secretes a variety of steroid hormones
and can be subdivided into three histological zones.
The outermost zona glomerulosa is responsible for
aldosterone secretion.
Beneath it lies the zona fasciculata, while
the zona reticularis is immediately adjacent to the
medulla.

FunctionalAnatomyof AdrenalGlands
aldosterone
Cortisol
Epinephrine &
norepinephrine
androgen

These last two regions are capable of
secreting both glucocorticoids (mainly
from the zona fasciculata) and
adrenal androgens (mainly from the zona
reticularis).

Catecholamines released by adrenal medulla:
– 80% epinipherine
– 20% norepiniphrine

FUNCTIONS OF ADRENAL MEDULLARY HORMONES;-
Increases blood glucose
Liver glycogenolysis
Liver gluconeogenesis
Increases blood pressure
Heart rate
Heart muscle contractility
Increased perfusion of skeletal muscle
Arteriolar vasoconstriction, everywhere
except in muscles.Wakefulness, alertness, pupillary
dilatation, bronchodilation, free fatty acids in blood,
lactate release into blood.

FUNCTIONS OF ADRENAL CORTICAL HORMONES;-
These hormones influence or regulate many
functions such as salt, potassium and water balance in the
body (electrolyte concentration).
Controls part of the body's response to stress,
metabolism, immune system, and sexual reproductive
functions.
These hormones help the body control blood sugar, and
increase the burning of protein and fat.

Insufficeny of the adrenal cortex;-
This disease was first reported by Addison in
1855.This is referred to as hypoadrenalism or Addison’s
disease. It may be caused by a primary reduction in adrenal
gland function or arise secondary to an anterior pituitary
defect.

Clinical features-
Early manifestation includes lethargy, fatigue,
and muscular weakness that may persist for months.
Feeble heart action, general debility, vomiting,
diarrhea and severe anemia are also seen.
Hypoglycemia, dehydration, hypertension,
elevated serum potassium , and postural dizziness
develop.

ORAL MANIFESTATIONS;-
• Due to an increased level of ACTH in the blood, the
secretion of melanocyte stimulating hormone increases,
which induces the deposition of melanin in the skin &
mucous membrane.
• In the oral mucosa , a pale brown to deep choclate
pigmentation spreading over the buccal from the angles
of the mouth and/ or developing on the gingiva, tongue
and lips, may be the first sign of the disease.

Showing generalised pigmentation

Melanosis of the gingiva and some
portion off the lips

Cushing's syndrome is a hormonal disorder
caused by prolonged exposure of the body's
tissues to high levels of the hormone cortisol.
Sometimes called "hypercortisolism,"

Clinical features-
its characterised by a rapidly acquired adiposity
about the upper portion of the body,.
moon shaped .face
buffalo hump
purple striae
muscular weakness
vascular hypertension
glycosuria not controlled by insulin
albuminuria.

The oral pathologist’s primary concern with this peculiar
disease state lies in the bone changes.
In children there may be osteoporosis and
premature cessation of epiphyseal growth, while in adults
there is severe osteoporosis.

Cushing syndrome

The pancreas is a broad leaf-shaped organ that is
located at the back wall of the upper part of the
abdomen. The Greeks called it pancreas ( pan :all and
kreas :flesh or meat) because it contains no bone or
cartilage.
Pancreatic hormone- insulin

The pancreas is a mixed organ. Part of the pancreas is
an endocrine organ that produces hormones which are
released into the circulation.
The islets of Langerhans make up this
endocrine portion of the pancreas..

The human pancreas has 1-2 million islets of
langerhans , contain three major type of cells;-
"alpha cells" that produce the hormone, glucagon.
.
“ beta cells” secretes insulin.
“delta cells” which secretes stomatostatin.

What is diabetes mellitus?
Diabetes mellitus –it is a disorder of carbohydrate
metabolism characterised by hyperglycemia and
glycosuria, reflecting a distortion in the equilibrium
between utilisation of glucose by tissues.
it’s a disorder caused by relative or absolute lack of
insulin.

The two major forms are;-
Type 1/ juvenile type/ insulin dependent diabetes
mellitus (IDDM) / brittle/ ketosis prone/ labile diabetes.
Type 2 diabetes;- non insulin dependent diabetes
mellitus (NIDDM)/ adult onset/ maturity onset diabetes.

NORMALLY IN THE BODY:

DIABETES TYPE 2: INSULIN RESISTANCE

Clinical features-
glycosuria
polyuria
polydidsia
weakness and weight loss
ketoacidosis

summary
• Different types & functions of Adrenal Hormone.
• clinical features of Addisons disease
• clinical features of Cushings syndrome
• Pancreatic Hormone-insulin
• Types of Diabetes

BIBLIOGRAPHY
 Text book of oral pathology Shafer's, 5 & 6th edition
 Color Atlas of Oral Diseases Cawson, R. 2nd edition
 Oral and Maxillofacial Pathology Neville, Brad W. 2nd
 Lucas’s Pathology Of Tumor’s of the Oral Tissues
 Cawson, R. A., Bennie, W. H 5th edition

Hormones lectures4/ oral surgery courses

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