Endocrine 011 - Dr. Marisi (t2-d2-w1)

7/23/2019 Endocrine 011 - Dr. Marisi (t2-d2-w1)

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ENDOCRINE GLANDSKBK

BLOK 10 / 2011

MARISI H. SIREGAR, DR., PHK (K)



ENDOCRINE GLANDS



ENDOCRINE GLANDS

ORGAN YANG DIPELAJARI GLD.THYROID

GLD.ADRENAL ( SUPRARENAL ORGAN)

GLD.HYPOPHISIS

PANCREAS ( ISLETS of LANGERHANS)

GLD.PARATHYROID

GLD.PINEAL



THYROID GLAND

Lo!"#$% &"'.*"+ - $&""- "+

M*3+"$ 2 o&3# $-3&3+'!"+ o- $#4-3#+$"+' 4"5-" 4*"4 $&""- 5"4$"'o 5$5o$.

M$!o#!o*$!% T-o$ fo$! $"*$#$ *$4 #"*$#

!3&$#,3!3"+ %0,2 60,7 ,$#$ % !oo$( #3&#4"+#$'"4$+)M"#" "+"!6"+"!, "+f""4 %

*!&"+'"+ +o" #""f *3#"4

*!&"+'"+ #$#4 3#!3o#!4"D"#", "+f""4 %

4"&o$# &&"'"$ 8"$+'"+ "+ o'"+

4-o'3"#$



HISTO9ISIOLOGI

Hoo+ 34""%T-o$+ ( 44"$oo4-o+$+ (T:) "+

T$$oo4-o+$+ (T;).

T#$*"+ "" 5oo$ "+' 3*"!"+'5o*o4$+ ( 4-o'o&3$+ BM% <00.000

o.4)

M4"&o$# 3!"+% Io$+ ( Io$+ =4-o#$+ $o$+"4 4-o'o&3$+)

93+'#$ $!o+4o o- % TSH ( -*o*-#$#)



C$+$5" "**$5"4$o+ HYPERTHYROIDISM

S$*( +o+ 4o$5) 'o$4 % P&#""+ !.4-o$$#&"&!"+ &3!"+ *o## ""+' "4"3 +o*"#"

G">?# $#"# ( H*4-o$$#) % P&#""+4-o$ ( goiter ) "!$&"4 *o3!#$ -oo+ 4-o$+

&&$-"+. HYPOTHYROIDISMM" % #!#$ TSH +33+ ("#"),+'"+

'8"" "-,3"- +'"+43!,"!4$f$4"# +4""&"4,8"$+'"+ #3&534"+ "+ !3$4 +&".

C4$+$# % #!#$ TSH +33+ ( "+"!6"+"!)+'"+ '8"" *43&3-"+ 43"+'

"&"4,#*$"4o $#4##,+4" 4""4$o+.



GRA@E?S DISEASE

HYPERTHYROIDISM,B"#o?# $#"#ETIOLOGY % BELUM DIKETAHUI

KELENJARTHYROIDMEMBESAR(DI99USEGOITER )

,OPHTHALMOPATHY,DERMATOPATHY.EPITEL 9OLIKEL TINGGI DAN LAPISAN DINDING

MENEBAL

KELUHAN % LEMAS,BERAT BADAN TURUN TETAPI

NA9SU MAKAN TINGGI,BANYAK

KERINGAT,TREMOR,EOPHTHALMUS.

TERAPI% RADIOACTI@E IODINE DAN SUBTOTAL

THROIDECTOMY



ADRENAL GLANDS

Lo!"#$ % !343& "4"# !3" '$+8"B+43! % *$*$-,4$"+'3", 4&" 1 5

T$$ "$ 2 &"'$"+ % Co4 "+ M3"

O'"+ $"*$#$ o- !"*#3" 8"$+'"+ *+"&3+'*""4.

ADRENAL CORTEX 4$$ "$ "*$#"+%

o+" Go3o#"

o+" 9"#5$53"4"

o+" R4$53"$#

ADRENAL MEDULLA 4$$ "$ S 5-o"ff$+



CORTE ADRENAL

o+" Glomerulosa % o+" 44"! !"4*3!""+ !"*#3,#6# *$4$" &&+43!

!o3+".S!#$ % "o#4o+

o+" Fasciculata % o+" 44"! $4+'"-

($+4$"4),# &&+43! *o$-"

&&+43! !o3 "+8"+'.S!#$ % Co4$#o

o+" Reticularis % o+" 44"! $ &"'$"+ ""

!"4 "3",# 5o3+" &+43! 8""#"$+' &"+"#4oo#$#.

S!#$%D-o*$"+o#4o+



MEDULLA ADRENAL

T$$ "$ #6# &#" &!o*o!

!"4 +'"+ !"*$ "+ >+3".

( C-o"ff$+ C#)

S$+' $#&34 #&"'"$ o$f$!"#$

'"+'$o+ #$*-"44$5

. S!#$ % C"45-o"$+( No*$+*-$+ "+ E*$+*-$+ )



H$#4of$#$oo'$

o+".Go3o# % M$+"o5o4$5o$(Ao#4o+). M+'o+4o >o3 5"$"+ 43&3-"3$ "&#o&#$ N"4$3 '$+8".

o+".9"#5$53"4" % G35o5o4$5o$( 5o4$#o).93+'#$ % +33+!"+ #$+4#"*o4$+,+$+'!"4!"+ '35o+o'+#$#.

o+".R4$53"$# % A+o'+

( -$o*$"+o#4o+),*o4+#$ #!# -oo+!5$ $&"+$+' 4#4o#4o+.

Co4 "+" $!o+4o o- ACTH



H$#4of$#$oo'$

M3" "+" %

S!#$ C"45-o"$+ (E*$+*-$+

"+ No*$+*-$+)

R#*o+# 4-""* "#" 4"!34 "+ #4##

#-' -"4 "4 +$+'!"4,'35o# 4$+''$

D$!o+4o o- *3#"4 -*o4-""3#"3$ +>3# #*"+5-+$53# ( >$#5")



C$+$5" "**$5"4$o+

ADDISON?S DISEASE (-*of3+'#$ !o4!# "+") A!$&"4 $+f!#$ 5-o+$5,*o## "34o$3+'+"#$ !."+""+o5o4$5" $+#3ff$#$+#$ #!#$ -oo+ $+"3"4.G8"" %-*o4+#$,f"4$3,"!+##,*$'+4"#$ "&+o" !3$4.

CUSHING SYNDROM (-*f3+'#$ !o4!# "+")

A!$&"4 43o *"# $#4"$# -*-o*-$#$# #!#$ ACTH&&$-"+.G8""%-*4+#$o+,o&#$4"#,o#4o*oo#$#,-$#34$#,4&+43! '"$# !3+'3"+ *"" !3$4"&o+

4"*$ &$"#"+" $"!3!"+ !#$#$ 43o -*of$#$# "4"343o "+"



H*o*-#$# '"+( P$43$4")

Lo!"#$ $&""- o4"!,$""- #" 43#$5"P"+8"+' 1 5,4&" 0,F 5,&"4 0,F '"M+'-"#$!"+ -oo+ *43&3-"+,*o3!#$

"+ 4"&o$#T&"'$ "4"# %

1. A+o-*o*-# ( "+4$o o&)

2. N3o-*o*-# ( *o#4$o o&) A+o-*o*-# 4% P"# $#4"$#,*"#

$+4$" "+ *"# 43&"$#N3o-*-o*-# *"#+>o#" (*o#4$o

o&)



ADENOHYPOPHYSE

P"# $#4"$# 4"*"4 # chromofils "+chromophob

S Chromofils 4 %

1.# Acidophils #!#$%Go4--oo+(GH),Po"54$+ ( PRL)

2. # asophils #!#$ %

A+o5o4$5o4o*$+,TSH,9SH,LH S chromophob #4$+' #54o 5#,4$"!

&'"+3"



A+o-*-o*-#

P"# $+4$"

S!#$ MSH

( M"+o54

S4$3"4$+'Hoo+)

P"# 43&"$#T"*"4 # &&+43!

!3&$# "+ !o3+"

+"-,4$"!

&'"+3,54o*"#

+'"+3+'

'$!o'+.

Hoo+% 4$"! ""



N3o-*-o*-#

M+5"!3* &"'$"+ $"+ $++5-*o4-""3#,$+f3+$&33 "+ *"#+>o#".

B"+"! 4"*"4 "o+ ta! berm"eli# "+' &""+ #+" 4*4 *"" +353##3*"o*4$5 "+ +353# *"">+4$53".

T"*"4 # *$43$#$4M+'-"#$!"+ -oo+ O$"toci# "+

%asopressi# ' AD()



CLINICAL APPLICATION

G$'"+4$#% S!#$ GH &&$-"+ #&3 *$*-#$#

+343* *"" "#" *43&3-"+.

A5o'"$ % "!$&"4 43o *"# $#4"$#,48"$ *""

o"+' "#" #-$+''" *o3!#$ GH &&$-"+.

C3#-$+' $#"#( -*#!#$ ACTH)H**o"54$+$" ( HPL)

D$"&4# I+#$*$3#% "&+o"$4"# #!#$ >"#o*##$+

'8""% #$+' "#" -"3# "+ $+3 &"+"!( polidipsi ) #-$+''" #$+' !+5$+' 'poliuri ) !"+"

!4$"!"*3"+ '$+8" +'!o+#+4"#$!"+ 3$+.

T"*$ +'"+ $+8!#$ "4"3 o" >"#o*##$+



PANCREAS

O'"+ P"+5"# % $ '"+# (e$ocri#e "+ e#docri#e).

O'"+ &&+43! *$*$- ( *"+6&"!"+') +**"" $+$+' *o#4$o o+''" "&o+ #"*$+'

"+43 '"#4.P"+8"+' % 125 1F 5E$ocri#e %

T$*#$+,5-o4$*#$+,5"&o**4$"#,""#,"#4"#,$&o+35"# "+ 5"&o"#.

E#docri#e %I+#3$+,G35"'o+,So"4o#4"4$+,P"+5"4$5 *o$**4$



I#4# of L"+'-"+#

B"'$"+ e#do!ri# "$ o'"+ *"+5"#T$$ "$ &$&36$&3 # &!o*o!

"+' $"*$#$ #"&34 4$!3.T"*"4 : 8+$# *$4$" # "$43%

S "f" ( A65#) % G35"'o+

S &4" ( B65#) % I+#3$+

D65# % So"4o#4"4$+

965# % P"+5"4$5 *o$**4$



C$+$5" "**$5"4$o+

DIABETES MELLITUS( DM)

A!$&"4 4"&o$# I+#3$+ 4'"+''3

D3" 4* %

1. T* I ( IDDM)83>+$ $"&4# I+#3$+6

*++4 $"&4# $43#,48"$ * 331F 4-+,"34o$3+ "!$&"4+" # 3#"!$+#3$+ (6)*++4 $+#3$+ $+854$o+

2. T* II ( NIDDM) "43 o+#4 No+6$+#3$+*++4 $"&4# $43#.T8"$ * 33 :04-+ "4"3 &$-, o/! o&#$4"#,$+#3$+ $*o3!#$44"*$ $+"3"4

A534 *"+5"4$4$#



PARATHYROID GLANDS

KELENJAR BERBENTUK O@OID KECILMENEMPEL PADA BAGIAN POSTERIORGLD.THYROID.

TERDAPAT : BADAN KELENJAR UKURAN

PANJANG F MM,DIAMETER : MM TEBAL 2 MMDAN BERAT 20 6F0 MGSEKRESI PARATHYROID HORMON YANG

BEKERJA DALAM TULANG,USUS DAN GINJALYANG MENJAGA KONSENTRASI CALSIUM

DALAM DARAH DAN CAIRANEKSTRASELULER.CALSIUM JUGA BERPERANPADA KONTRAKSI OTOT,SEKRESIKELENJAR,KOAGULASI DARAH DAN AKTI9ASIBERBAGAI ENYM.



PARATHYROID GLANDS

MIKROSKOPIK % DILAPISI CAPSULA9IBROSA TIPIS.9OLIKEL LEBIH KECILDARI THYROID BERISI COLOID.

PERTUMBUHAN KELENJAR DARILAHIR SAMPAI MAKSIMUM UMUR 20THN.

TERDIRI DARI % CHIE9 CELLS ( HSL%PARATHYROIS HORMON) DANOYPHIL CELLS ( NO SECRETORY )



CLINICAL APPLICATION

HYPERPARATHYROIDISM HORMON PARATHYROID BERLEBIH AKAN

MELEPASKAN CALSIUM DARI TULANG SHG TULANGMENJADI LEMBUT,PADA SARA9 AKAN BERAKIBATRE9LEKS OTOT SKELET MELEMAH DAN DALAM

DARAH AKAN BERAKIBAT GARAM CALSIUMMENUMPUK SEHINGGA DAPAT TERJADI BATUGINJAL.

HYPOPARATHYROIDISM

DAPAT DIAKIBATKAN OLEH TRAUMA ATAU PADAAKTU DILAKUKAN THYROIDECTOMY,INI AKANBERAKIBAT SARA9 MUDAH TERANGSANG,MUSCLESPASM ( TETANY) DAN KEJANG.



PINEAL GLAND

EPIPHYSIS CEREBRI ORGAN BERUKURAN PANJANG %F6 DAN

LEBAR% ;6F TERLETAK PADA ATAPDIENCEPHALON DI GRS TENGAH OTAK.

TERDAPAT SEL PINEALOCYT YANG MENSEKRESIMELATONIN DAN SEL ASTROGLIAL.

MENGATUR 9UNGSI GONAD PADA MANUSIA TERDAPAT BADAN KHAS

ETRACELLULAR YG DISEBUT CORPORA

ARENACEA ( RAI* +A*D) MATRIKSNYA BERISICALSIUM 9OS9AT DAN CALSIUM CARBONAT BERSI9AT RADIOOPAUE RADIOLOGI UNTUKDETEKSI LOKALISASI TUMOR OTAK.



T-o$ '"+



T-o$ '"+



9o$! 4-o$

SEL 9OLLIKEL

COLLOID



T-o$

A# fo$!

B 5oo$

C #*""fo$!3"



A # *""fo$!3

B # fo$! 4-o$



I#4# of L"+'-"+#

PULAU LANGERHANS

KELENJAR EKSOKRIN



A+" '"+#



Co4 "+"

KAPSULA 9IBROSA

CORTE

MEDULLA



Co4 "+"

ONA GLOMERULOSA

ONA 9ASCICULATA

ONA RETICULARIS



H*o*-#$# '"+



H*o*-#$#/P$43$4" '"+



H*o*-#

APARS ANTERIOR/DISTALIS

B *"#$+4$"

CNEUROHIPHO9ISIS/*"#+>o#"



HYPOPHISIS PARS ANTERIOR

SEL CHROMO9OB

SEL BASO9IL

SEL ACIDO9IL



A # 5-oof$

B # 5-oofo&



S *$43$#$4 / PARS NER@OSA



P""4-o$ '"+



A+" '"+



9o$! "+ Coo$



TERIMA KASIH

SELAMAT BERKARYA

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Endocrine 011 - Dr. Marisi (t2-d2-w1)