Endocrine Gland Hypothalamus - Controls the release of pituitary hormones

Function Releasing and inhibiting hormones Corticotropin-releasing hormone (CRH) o controls ACTH release Thyrotropin-releasing hormone (TRH) o controls TSH release Growth hormone-releasing hormone (GHRH) o controls GH release Gonadotropin-releasing hormone (GnRH) o tells the pituitary gland to make luteinizing hormone (LH) and follicle-stimulating hormone (FSH) Humoral Factors o These hormones help to develop the lymphoid system, which is a system throughout the body that helps it to reach a mature immune response in cells to protect them from invading bodies, like bacteria.

Disorders Hypothalamic dysfunction - In children and young adults, craniopharyngioma (benign tumor that develops near the pituitary gland ) is the most frequent cause of hypothalamic dysfunction. - Hypothalamic disturbances: disorders of thirst (dehydration or polydipsia and polyuria), appetite (hyperphagia and obesity), temperature regulation, behaviour, and consciousness (somnolence and emotional lability).

Treatment - Craniopharyngeoma is treated primarily with surgical resection and then radiotherapy.

Thymus - The thymus is a gland needed early in life for normal immune function. - It is very large just after a child is born and weighs its greatest when a child reaches puberty. Then its tissue is replaced by fat.

Thymomas and thymic carcinomas are rare tumors of the cells that are on the outside surface of the thymus. The tumor cells in a thymoma look similar to the normal cells of the thymus, grow slowly, and rarely spread beyond the thymus. On the other hand, the tumor cells in a thymic carcinoma look very different from the normal cells of the thymus, grow more quickly, and have usually spread to other parts of the body when the cancer is found. Thymic carcinoma is more difficult to treat than thymoma. - Possible signs include a cough, chest pain and difficulty in breathing - Dx: Chest X-ray, CT scan & MRI

Medical Mgt: 1. Surgery - Surgery to remove the tumor is the most common treatment of thymoma. - Treatment given after the surgery, to lower the risk that the cancer will come back, is called adjuvant therapy. 2. Radiation therapy - Radiation therapy is a cancer treatment that uses high-energy xrays or other types of radiation to kill cancer cells or keep them from growing. 3. Hormone therapy - Hormone therapy is a cancer treatment that removes hormones or blocks their action and stops cancer cells from growing. If tests show that the cancer cells have places where

hormones can attach (receptors), drugs, surgery, or radiation therapy is used to reduce the production of hormones or block them from working. Myasthenia Gravis - is a chronic autoimmune neuromuscular disease characterized by varying degrees of weakness of the skeletal (voluntary) muscles of the body. - The relationship between the thymus gland and myasthenia gravis is not yet fully understood. Scientists believe the thymus gland may give incorrect instructions to developing immune cells, ultimately resulting in autoimmunity and the production of the acetylcholine receptor antibodies, thereby setting the stage for the attack on neuromuscular transmission. Medical Mgt: 1. Anticholinesterase agents such as neostigmine and pyridostigmine, which help improve neuromuscular transmission and increase muscle strength. 2. Immunosuppressive drugs such as prednisone, cyclosporine, and azathioprine may also be used. These medications improve muscle strength by suppressing the production of abnormal antibodies. 3. Thymectomy 4. Plasmapheresis Nursing Mgt: 1. Plan exercise, meals, patient care, and activities to make the most of energy peaks. 2. When swallowing is difficult, give semi-solid foods instead of liquids to lessen the risk of choking. 3. Stay alert for signs of impending myesthenic crisis such as increased muscle weakness and difficulty talking or chewing. 4. Help the patient plan daily activities to coincide with energy peaks. 5. Stress the need for frequent rest periods.

Pineal - It produces the serotonin derivative melatonin, a hormone that affects the modulation of wake/sleep patterns and seasonal functions.

Melatonin o is a hormone secreted by the pineal gland in the brain. It helps regulate other hormones and maintains the body's circadian rhythm. The circadian rhythm is an internal 24-hour clock that plays a critical role in when we fall asleep and when we wake up. o helps control the timing and release of female reproductive hormones. It helps determine when a woman starts to menstruate, the frequency and duration of menstrual cycles, and when a woman stops menstruating (menopause). o

Delayed sleep phase syndrome (DSPS) - is a disorder in which a persons sleep is delayed by 2 or more hours beyond the socially acceptable or conventional bedtime. This delay in falling asleep causes difficulty in waking up at the desired time. - Dx: actigraph, overnight sleep study (polysomnogram)

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Good Sleeping Habits Shifting Bedtime Schedule Advancing the internal clock. Bright light therapy