ENDOCRINE GLANDS

PITUITARY GLAND

An endocrine gland

Relations: Anterior division and posterior part are of different functions

The pituitary gland weight is approximately one gram. Ovoid in shape.

Size 1.5cm ~ 1cm ~ 0.75cm. In size

Location: It lies on the sella turbica of sphenoid bone.

Relations: Above the gland is DURA MATER which is called the
DIAGHRAGMATIC sellA which is pierced centrally by the pituitary stalk
which is the attachment of pituitary to brain. The cavernous sinus is
bilateral and connects one side with the other in front of the gland as
well as behind. Above the gland are optic chiasma and the thalamus
and hypothalamus.

The thalamus is bilateral and the 3rd ventricle. A collections of neurons

(grey matter)

The thalamus is located in the lateral walls of 3rd ventricle.

In the lateral walls of 3rd ventricle on both sides this small ventricle are
large collections of neurons.

The 2 neuron centers are together the THALAMUS.

The hypothalamus is the floor of the same 3rd ventricle.

The pituitary gland also called HYPOPHYSIS.

1. Anterior part is the adenohypophysis

Embryologically this part of the pituitary grows upwards from the
Buccal cavity.
NOTE: How closely related this gland is to the Nasopharynx.
2. Posterior part is the neurohypophysial and this part is a downward
growth from the region of the brain behind the optic chiasma
Blood supply to the pituitary consists of many branches from the
internal carotid artery located within cavernous sinus.
Venous drainage- many vessels pass from surface of gland to the
cavernous sinus
 FUNCTION: The anterior part produces many hormones. Some of
which exert a trophic influence on other endocrine glands, namely the
thyroid, the adrenal, the cortex and the gonads.

3. Otherhormones produced in ADENOHYPHISIS affect growth

4. Lactation
Over secretion of growth hormone in childhood leads to
-Giantism and in adult
-The result is ACHROMEGALY.

Under secretion in child- DWARF

The function of the posterior part or neurohypophysis

Function of posterior part of pituitary known as the neurohypophsis.

Non myelinated axons supported by ganglia CT cells extend from the

Hypothalamus and the Hypothalamus and neurohypophysis where they
terminate, adjacent to blood.

Non myelinated axons from Hypothalamus extend down through the

pituitary stalk to terminate in neurohypophysis adjacent to capillaries.
These axons arise from neuro centers in the hypothalamic which in
floor of 3rd ventricle- active hormones are produced at the termination
of these axons in the capillaries bed of neurohypophysis.

The names of these hormones are;

 Oxytocin
 Vasol pression (Anti diuretic)

THE PINEAL GLAND (EPIPHYSIS)

This gland arises a midline growth of epithelial growth in the 3 rd
ventricle. The pineal gland consists of

1. Epitheal secretory glands.

2. Blood capillaries
3. Connective tissue support
4. Non myelinated nerve fibers run through the gland.
5. Size to pineal smaller than the pituitary 5 to 9mm~3 to 6mm ~3 to
5mm.

The pineal gland receives sympathetic impulses when the eye is in

darkness. The sympathetic impulses are suppressed when the retina is
responding to light. In response to sympathetic stimulation (darkness)
the pineal secretes a hormone called MELATONIN. If you read about
pineal gland in an OLD textbook you will not read about MELATONIN
because this is a new finding.

The synthesis and secretion of melatonin vary within the 24hours

period. Melatonin can be measured in blood and urine and the amount
corrected with waking hours and sleep time. This it can be seen that the
body has a clock, built into the endocrine system.

ENNERVATION of pineal is from sympathetic fibers arising from cells in

the SUPERIOR Cervical GANGLION

Environmental light conditions exert tremendous effects on this neuro

endocrine apparatus in the brain.

The pineal gland is a TRANSCER.

When mammals are exposed to light the increase in the optic nerve
impulses from retina causes a decrease the sympathetic outflow and
suppresses synthesis and secretion of melatonin. There is a definite
DIURNAL variation in amount of melatonin.

Practical application of these facts are:

1) Light modifies the rate of sex sexual maturation

A girl who is blind since birth- with no stimulation from retina she
has early onset of menses.
2) Girls from area of the world with more day-light during their
period will be very different from girls in areas with more
darkness.
3) When a person has a daytime job and he is made to change his
job to a night time job he might have a difficult time making the
change to sleeping days and staying awake all night.
4) Jet lay-very difficult for some travel.
5) Pineal tumor consort the pathology book.
6) The pineal gland after a few years of great activity becomes active
but remains functional even when it appears to be calcified in x-
ray it still functions.
7) This gland is concerned with birds migration, heartburns and
caribous migrations and with the seasonal building activities of
many species of mammals.

LOCATIONS OF PINEAL

Location/ roof of the 3rd ventricle (EPIPHYSIS) the information about

light in the persons environment travels to the pineal gland by the
following pathway:
  Optic nerve fibers from retina
 Nerve centers in the brain and cord that regulate the
sympathetic division of autonomic nerve system.
 The sympathetic nerve fibers that originate from
neurons in superior cervical ganglion and from there
to pineal gland in the roof of 3rd ventricle of brain.

THYROID GLAND

Is attached by the PRETRACHEAL fascia to the lower part of larynx and

the upper part of trachea moves with swallowing.

Relations: The glands consists of two lobes, one on each side of trachea
with a connecting isthmus at level of 2nd 3rd and 4th trachea rings.

The lobes extend upwards and end under the sternogold muscles.

Inferiorly the lobes extend down to 5th trachea ring. An enlarged thyroid
will go beyond these points.

Posterial- laterally. Thyroid adjacent to carotid sheath

Medially-adjacent to;

 Inferior constrictor muscle of pharynx

 Crico thyroid muscles
 Larynx
 Upper part of trachea
 Oesophagus

In relation to isthmus these are:

 Superior thyroid artery

 Inferior thyroid venous plexus
 ANTERIOR RELATIONS

Similar to relations of larynx and trachea anteriorly over the thyroid;

 Skin
 Superficial fascia of neck
 Laterally the platysman muscles
 Anterior part of SCM

Muscle of the sternal attachment of SCM, central anterior

 Deep cervical fascia

 Sternohyoid muscle
 Omohyoid muscle
 Sterno thyroid muscle

Antero-laterally-External jugular vein

BLOOD SUPPLY TO THYROID

a) Superior thyroid artery – a branch of external carotid
b) Inferior thyroid artery – a branch of thyrocervical trunk from the
subclanial arteries Rt and Lt

VENOUS DRAINAGE BY 3 ROOTS

i. Superior thyroid veins –Internal jugular veins

ii. Middle thyroid – Internal jugular veins
iii. Inferior thyroid veins – Downward to the brachio-cephalic veins

These areas are extremely important especially in surgery of this area.

Thyroid veins are without valves so that severe haemorrhage follows
cutting of veins lymphatics lymph vessels accompanied the arteries.

Drainage into the deep cervical lymph nodes.

Nerve supply sympathetic fibers from the superior middle and inferior
cervical ganglia distributed mainly to the blood vessels in the gland.

Parasympathetic by way of vagus N (X)

Functions

 For storage of follicular in the follicles.

 To the capillaries for circulations in the blood stream.

ACTIVITIES: Influenced by thyroid hormones (these are many hormones

put out by thyroid)

 The metabolic activities include the following

 Growth
 Reproductive
 Mental processes- heart action
 Condition of skin nails and hair
 Chemical activities are concerned with
1) Calcium
2) Phosphorous

EMBRYOLOGY

The gland arises from floor of pharynx.

The site of this midline outgrowth is marked by a small pit, the foramen
cecum, tongue at the junction of the anterior 2/3 and posterior 1/3.

The thyroid glossal duct normally disappears. The lower part of may
differentiate to form the pyramidal lobe.
Persistence of the duct may be lead to abnormalities such as cyst or
aberrant, thyroid tissue sometimes extends down into superior
mediastinum.

Secretory activity of thyroid is under control of TSH which comes from

the anterior pituitary gland (ADENAL)

This is called thyrotrophic hormone of anterior pituitary.

A goiter occurs when excess colloid is stored in large quantities.

Symptoms hypothyroidism or hyperthyroidism.

THE PARATHYROIDS

Are four oval shaped bodies located on posterior surface of the lateral
lobes of thyroid size variable approximately 3~8mm~ 2.5mm~ 0.5-
2mm. Sometimes they are attached to capsule of thyroid.

Sometimes they are in closed in the pretracheal fascia adjacent to

thyroid sometimes they are found in the neck or in mediastinum
adjacent to respiratory passage or to digestive passage; anywhere
between bifurcation of common carotid in neck and down as far as the
pericardium.

Blood supply: Branches of the thyroid artery anastomosis with arteries

that supply muscles, pharynx and oesophagus.

Function: Synthesis of hormone called parathormone which is essential

in metabolism of calcium and phosphorous

THYMUS GLAND

Located in superior mediastinum

The gland may extend upwards in neck to the level of thyroid gland and
below it reaches the heart. size; The width at birth extends across the
entire with of superior mediastinum and even the anterior
mediastinum.

Normally reaches the greatest size at puberty after puberty growth is

stopped and then involution occurs.

Relations: The upper surface is adjacent to anterior surface of left

brachio-cephalic vein.

Laterally and below it lies in front of SVC, the arch of aorta and the
heart.

Blood supply: The internal thoracic arteries coming from the thoracic
aorta and from the inferior thyroid artery.

Vein- drains up and lateral to join internal thoracic veins and the
brachio-cephalic vein.

Nerve- sympathetic fibers which accompany blood vessels. These fibers

are vasomotor infuction.

The thymus gland is part of lymphomyeloid system. The thymus is

involved in the cellular migration stream of the lymplomyeloid complex.
The IMMUNOLOGY system of body depends upon migration of
lymphocytes.

Thymus intestinal tract spleen and bone.

These four areas plus the blood lymph and lymph nodes make up the
anatomy of immunology.
These is a constant migration stream of lymphocytes connecting these
structure also called the lymph myeloid complex

The “T” cells responsible for cell mediated immune response.

“B” cells are precursors of plasma cells that synthesize immune

globulins ig

THE ISLETS OF LANGERHANS

These are aggregated of cells or islands (or collections) of endocrine

secreting cells.
The islets are located within the substance of pancreas. The number of
islets are estimated to be between one or two million scattered
through to substance of pancreas the endocrine (hormones) secreted
by these islets are;

 Insulin.
 Glucagon.
 Gastrin
 Secretin

These are secreted directly into capillary bed or taken into blood
stream. There is a very rich blood supply in the islets tissue

The 3 hormones have different functions. Each islet is composed of:

1. Epithelial cells which synthesize the hormones.

2. Blood capillaries which take the hormones into circulation
3. Connective tissue network inside the islet.

Islets of larger have composed of

 Beta cells
 Alpha cells
 Delta cells

Which synthesize hormones

The hormones that have identified are:

 Insulin
 Glucagon
 Gastrine
 Secretin (there are probably many more)
 FUNCTIONS OF THESE ARE

 Insulin(beta cells)- promotes storage of glucose in liver and in

muscle and in fat

Promotes the uptake of amino acids by muscle. Increases

protein synthesiss

Increases fat synthesis (lipid synthesis)

Inhibits lipolysis- breakdown of fat

Inhibits gluconeogeneis

Insulin is necessary for carbohydrates, fats and protein

metabolism.

 Glucagon (secreted by alpha cells)

Stimulates glucagolysis in liver by activation of enzymes- or
splitting of glycogen to yield glucose, thus raising the blood sugar.
Glucagon synthesis is stimulated by anterior pituitary. If you have
a patient in HYPOGLYCEMIA.
 Gastrin-This hormone is secreted in several places in the G.I.T –
not only in islets cells of pancreas
Gastrin stimulates secretion of gastric acid. It modifies gastric
motor activity or also affects motor activity of oesophagus and of
the gall bladder.

 Secretin – stimulates the secretion of pancreatic juice. Stimulates

the flow of bile and of secretions in small bowel – for DIGESTION
pancreatic juices may be called digestive juices
 NERVE Neurons stimulation is not necessary for the synthesis of
these hormones no for their release into the capillary bed.
However, the vagus nerve conducts parasympathetic impulses to
the pancreas which are secretory in function. Probably more
important to pancreas excluding islets cells.
The same applies to sympathetic enervation which comes from
T4, 5, 6, 7, 8, 9, (splenic nerve)
Hyperglycaemia in a healthy person stimulates the release of
insulin into his circulatory system.
Hypoglycaemia stimulates production of glucagon.

THE ADRENAL (also called supro-renals)

Are on the upper poles of the kidney. One on each in closed in a

common fascia covering but separated from the kidneys by connective
tissue usually found at the level of T12.

The adrenals and kidneys are in the RETRO PERITONEAL SPACE in

posterior abdominal cavity.

The adrenals touch the diaphragm and therefore move with

respiration.

The adrenal consists of two distinct types of tissue;

 The adrenal cortex (cortical)

 The adrenal medulla (medullary)

The adrenal cortex is arranged in three layers, thickness of these layers,

varies with glandular cavity. Cells in the cortex (cortical cells) synthesize
adrenal cortical steroids by anterior pituitary gland or by an injection of
ACTH.

The adrenal medulla is chiefly composed of phaechromocytes which

synthesize and secretes ADRENALIN. The secretory activity of adrenal
medulla is. Closely related to activity of sympathetic division of
autonomic nervous system.

The adrenal medulla or the sympathetic division of the autonomic

nervous system both rapidly respond to situations of sudden stress. The
hormone adrenalin affects vascular tone. Cardiac activity and blood
sugar regulates e.g. blood sugar increases as a practical application of
this information. Consider a diabetic pt who lacks natural insulin.

TESTIS

In the testis are approximately 250 compartment of lobules.

Separated by septa. Each compartment or lobules. These loops of

tubules are convoluted and each end of the loop join the straight
tubules.

These are tubules called the semiferous tubules. The epithelium in

these tubules is the germinal epithelium that gives to the spermatozoa
is called spermatogenesis. The pituitary gonadotrophic hormone
control spermatogenesis.
Within each of the lobes of the testis the seminiferous convoluted
tubules are embedded CT in which are found the INTESTITIAL cells
leydig. These cells synthesize testosterone an secrete it into blood
circulation. This function of testis continues whether or not normal
sperms are being ejaculated, a normal “sperm count” is about one
hundred million per ml. However if the patient has a count too low to
produce offspring he still maintains all the sex characteristics normal in
the male.

Absent sperms if the testis is undescended. If the testis remain in

abdomen, instead of descending into scrotum there will be no
spermatogenesis because the temperature is higher inside the
abdominal cavity than it is outside in the scrotum. If undescended testis
is brought down after puberty there will be no sperm because the
germinal epithelium did not mature when it was supposed to. At
puberty

The male sex hormone are ANDROGES testosterone secrete controlled

by luteinizing hormone. Testosterone also produced in small amount in
adrenal cortex also the ovary and adrenal cortex and small amounts of
estrogen are found in the male.

Testosterone secreting rate about 4-9mgm a day in male.

Excretion by passing into liver where it is converted in 17 keto-steroids

and excreted into urine or can be measured.
TO SHOW THE INTERELATIONSHIP BETWEEN HYPOTHALAMUS ANT
OUTPUT A ND TESTIS

ACTION OF ANROGENS(male hormone)

1) These hormone develop and maintain all the secondary sex

characteristics.
2) The exert protein anabolic growth- promoting effect
 3) Spermatogenesis

Secondary sex characteristics

Hair distribution on the body and on scalp bald unless he has

normal testosterone.
Blood supply to the testis
The testicular arteries originate from abdominal aorta just below
the origin of Renal arteries about at level of L1.
NOTE: How high in the abdominal cavity the testicular artery
begins. This is due to embroyological origin, adjacent to the
kidneys. Hence the genito renal system being kidneys and
reproductive system together.

Venous drainage of testis into testicular vein and testicular veniform

right testis drain into the IVC.

Testicular veinform left testis drains in left renal vein.

Androgenic

Anabolic} There are functions of testosterone

Spermatogenis

OVARIES

Size 4cm ~2cm~1cm

Location in the true pelvis against the lateral wall below the bifurcation
of common iliac artery;
Structure: The ovary consists of cortex and medulla. In the cortex is
germinal epithelium responsible for the generation of Ova.

Hormones are synthesized in the ovarian follicles and in corpus luteum.

Both found in cortex the female hormone are estrogens and
progesterone (progesterone).

The production is under control of FSH or LH from anterior pituitary.

Another way of saying the something is follicular maturation and
lutenization are controlled by gonadotrophic from anterior pituitary.

Ovulation is the release of an ovum from a mature follicle. Ovulation is

due to combined action of FSH and LH

Once ovulation has occurred further development in other follicles is

suppressed.

Most of the time only one follicle ruptures releasing ovum. This single
one at a time. Ovulation is controlled by the amount of gonado trophic
produced by anterior pituitary.

Sometimes synthetic gonado trophic may be administered in very large

amount and multiple ovulation occur resulting in a multiple birth. All
born sometime.

There is no possibility of a normal baby following by only a few months

because as soons as the ovum is fertilized. Hormone production will
prevent further ovulation. Ovulation will not occur during a pregnancy.

The hormones secreted by the ovaries are steroids.

These same hormones are also secreted by the placenta or adrenal

cortex or also by testis (smaller amounts than in ovary)
Also the testis produces a small amount of estrogen. A male patient
with chronically impaired liver cells might develop feminizing traits
because his diseased liver allows estrogen accumulate and cause breast
enlargement. In the normal female the secretion rate has been
estimated 200- 500mgm per day at the time of ovulation. This secretion
varies a great deal but is continuous.

In the liver cells estrogens are oxidized and some of this is secreted into
bile and excreted in urine

Actions of female hormone – there are many

i. Stimulates growth of ovarian follicle

ii. Stimulates motility of fallopian tubes
iii. Stimulates changes in endometrium, cervix and vagina.
iv. Increases blood flow to uterus.

Act upon myometrium. Inhibit secretion of FSH and LH. This is called
negative feedback. It may increase LH. This is called positive feedback.

Has an effect on thyroid gland function has an effect on adrenal cortical

function anabolic function (the testosterone also anabolic activity)

Male and female hormones both promote closure of epiphyseal lines.

Epiphyseal closure are different bones, x-ray a doctor tell the age of the
patient by determination of what epiphyses have closed. This
epiphyseal closure marks the end of linear growth of the body. The
hormone stimulate growth of ducts in breast and enlargement of
breast at puberty, the male breast sometimes enlarges at puberty but
regresses.
This hormone produces pigment change of areola and nipple and
produces changes during pregnancies.

The female hormone is responsible for changes in body form or shape.

The female shoulders, hips and thighs are very different from the male.

Also affects distribution of fat, not the amount of fat – only the places
when it will be deposited.

In a castrated male his fat deposits will be changed so he might appear

female.

Hair distribution in female controlled by her hormones also the shape

of larynx is affected by female hormone.

Estrogen affects salt and water retention. In some females at gain 2.5-
5kg due to this during part of cycle.

There are marked skin changes. A child of 10 – 12 has smaller

sebaceous glands. She might have no axilliary sweat glands no axilliary
hair. Then at puberty there is a growth spuit and many sex
characteristics develops quickly estrogen inhibits also formation.

Testosterone promotes also formation estrogen lowers plasma

cholesterol and thus inhibits hardening of the arteries and coronary
arteries disease. Thus higher estrogen level in female may account for
the fact that generally women live longer than men in some cases.
Women are seen to have less trouble with arteries and diseases due to
hardening of arteries.

Progesterone is responsible for changes in the endometrium, the cervix

and vagina.
Progesterone stimulate development of lobules and alveoli in the
mammary gland.

Progesterone inhibits LH. Large amounts injected will inhibit ovulation.

Vascular supply

Ovarian artery each side come from high in abdomen from the front of
aorta immediately below origin of the renal arteries, also the from
branches of uterine artery by anastomous.

Venous drainage- No valves (have veins, have many valves)

Right ovary vein – IVC

Left ovary vein – left renal vein

Lymphatic vessel – ascend along ovarian blood vessels to reach AORTIC

lymph nodes.

Ovarian lymphatics uterus and fallopian tube libs.NB: The thoracic duct
empties in the circulation system in the angle formed by internal
jugular veins and branchio- cephalic vein bringing lymph directly
upward from aortic nodes that have drained the ovary.

Sometimes the first sign indication of cancer of ovary is a large lymph

node in neck.