THE ENDOCRINE
SYSTEM
Basic Anatomy
COURSE COORDINATOR: DR. SALMA MOHSIN
MBBS (RMP), MSPH
ENDOCRINE SYSTEM:
Consists of glands widely separated from each other with no physical connections
A chemical messenger or hormone produced by the gland is released into
circulation to produce an effect on a distant target organ.
It is an integrated network of multiple organs derived from different embryologic
origins that release hormones ranging from small peptides to glycoproteins
This endocrine network of organs and mediators are closely integrated with
central and peripheral nervous systems and with immune systems, leading to
currently used terminology such as “neuroendocrine” or “neuroendocrine-
immune” systems for describing their interactions.
ENDOCRINE GLANDS
Commonly referred to as ductless glands -
hormones diffuse directly into the bloodstream.
Groups of secretory cells surrounded by an
extensive network of capillaries that facilitates
diffusion of hormones from the secretory
cells into the bloodstream.
Hormones are carried in the bloodstream to
target tissues and organs that may be quite
distant, where they produce their effects
Functions of Endocrine System
Regulation of sodium and water balance and control of blood volume and
pressure
Regulation of calcium and phosphate balance to preserve extracellular fluid
concentrations required for cell membrane integrity and intracellular signalling
Regulation of energy balance and control of fuel mobilization, utilization, and storage
to ensure that cellular metabolic demands are met
Coordination of the host hemodynamic and metabolic counter-regulatory responses to
stress
Regulation of reproduction, development, growth, and senescence (loss of cell power to
divide and grow-aging)
Homeostasis of the internal environment is maintained partly by the autonomic
nervous system and partly by the endocrine system.
The autonomic nervous system is concerned with rapid changes, while endocrine control
is mainly involved in slower and more precise adjustments.
Hypothalamus is a part of the brain rather than an endocrine, it controls the pituitary
gland and has an indirect effect on many others.
The ovaries and the testes secrete hormones associated with the reproductive system
after puberty.
The placenta that develops to nourish the developing foetus during pregnancy also has an
endocrine function
Pituitary gland and hypothalamus
ANATOMY:
Pituitary gland and hypothalamus act as a unit, regulating the activity of most of the other
endocrine glands. The pituitary gland lies below the hypothalamus in the Hypophyseal fossa
of the sphenoid bone, to which it is attached by a stalk .
It is the size of a pea, weighs about 500 mg and consists of three distinct parts that
originate from different types of cells.
The anterior pituitary (adenohypophysis) is an up-growth of glandular epithelium from the
pharynx and the posterior pituitary (neurohypophysis) is a down-growth of nervous tissue
from the brain.
There is a network of nerve fibres between the hypothalamus and the posterior pituitary.
Between these lobes is a thin strip of tissue called the intermediate lobe and its function
in humans is not known.
Blood supply
Arterial blood
Branches from the internal
carotid artery. The anterior lobe
is supplied indirectly by blood
that has already passed through
a capillary bed in the
hypothalamus but the posterior
lobe is supplied directly.
Venous drainage
This comes from both lobes,
containing hormones, and leaves
the gland in short veins that
enter the venous sinuses
between the layers of dura
mater.
The influence of Hypothalamus on
the Pituitary gland
The Anterior Pituitary:
This is supplied indirectly with arterial blood that has already passed through a
capillary bed in the hypothalamus . This network of blood vessels forms part of the
pituitary portal system, which transports blood from the hypothalamus to the
anterior pituitary where it enters thin-walled sinusoids that are in close contact with
the secretory cells.
As well as providing oxygen and nutrients, this blood transports releasing and
inhibiting hormones secreted by the hypothalamus.
These hormones influence secretion and release of other hormones formed in the
anterior pituitary.
Hypothalamus Anterior pituitary Target gland or tissue
GHRH GH Most tissues
Many organs
GHRIH GH inhibition Thyroid gland
TSH inhibition Pancreatic islets
Most tissues
TRH TSH Thyroid gland
CRH ACTH Adrenal cortex
PIH PRL inhibition Breast
PRH PRL Breast
LHRH or GnRH FSH Ovaries and testes
LH
The posterior pituitary
This is formed from nervous tissue and consists of nerve cells surrounded by supporting
cells called Pituicytes.
These neurones have their cell bodies in the supra-optic and paraventricular nuclei of the
hypothalamus and their axons form a bundle known as the hypothalamo-hypophyseal
tract.
Posterior pituitary hormones are synthesised in the nerve cell bodies, transported along
the axons and stored in vesicles within the axon terminals in the posterior pituitary.
Their release by exocytosis is triggered by nerve impulses from the hypothalamus.
Anterior pituitary
Some of the hormones secreted by the anterior
lobe stimulate or inhibit secretion by other
endocrine glands (target glands) while others
have a direct effect on target tissues.
The release of an anterior pituitary hormone
follows stimulation of the gland by a specific
releasing hormone produced by the
hypothalamus and carried to the gland through
the pituitary portal system of blood vessels.
The whole system is controlled by a negative
feedback mechanism..
Posterior
pituitary
Oxytocin and antidiuretic
hormone (ADH or
vasopressin) are the
hormones synthesised in nerve
cell bodies in the
hypothalamus and then stored
in the axon terminals within
the posterior pituitary gland.
These hormones act directly on
non-endocrine tissue and their
release from synaptic vesicles
by exocytosis is stimulated by
nerve impulses from the
hypothalamus.
Thyroid Gland
Thyroid gland is an endocrine organ found in the neck.
It plays a key role in regulating the body’s metabolic
rate via hormones it produces.
A ductless alveolar gland found in the anterior neck
Located anterior to the larynx and trachea, just below the
laryngeal prominence (Adam’s apple) at the level of C5,
C6, C7, C8, T1
It is roughly butterfly-shaped, with two lobes wrapping
around the cricoid cartilage and upper rings of trachea
and connected in the middle by an isthmus.
Anatomy
Thyroid gland secretes hormones directly into the
circulation and is highly vascularised.
Has a fibrous capsule
The thyroid gland is not usually palpable.
The gland is located within the visceral compartment of
the neck (along with the trachea, oesophagus and
pharynx). This compartment is bound by the PRE-
TRACHEAL FASCIA.
BLOOD SUPPLY:
ARTERIAL SUPPLY-
Superior and inferior thyroid arteries –
branches of external carotid A. & Subclavian A.
respectively
In small proportion of people (10%) additional
artery – thyroid ima Artery.
VENOUS DRAINAGE-
Superior, middle and inferior thyroid veins -
drain in Internal jugular vein
Innervation
The thyroid gland is innervated by branches derived from
the sympathetic trunk.
These nerves do not control the secretory function of the
gland – the release of thyroid hormones is regulated by
the pituitary gland.
Lymphatic Drainage
The lymphatic drainage of the thyroid is to the para-
tracheal and deep cervical nodes.
Clinical Relevance:
Recurrent Laryngeal Nerve
The left and right recurrent laryngeal
nerves lie in close proximity to the thyroid
gland and care must be taken not to damage
them during thyroid surgery.
They branch from their respective vagus
nerve within the chest and hook around the
right subclavian artery (right RL nerve), or the
arch of aorta (left RL nerve).
The recurrent laryngeal nerve then travels
back up the neck, running between the
trachea and oesophagus in
the tracheoesophageal groove. It then
passes underneath the thyroid gland to
innervate the larynx.
Cellular Structure
Function of Thyroid gland is to produce and store thyroid
hormones.
Thyroid epithelia form follicles filled with colloid – a protein-
rich reservoir of the materials needed for thyroid hormone
production.
These follicles range in size from 0.02-0.3mm and the
epithelium may be simple cuboidal or simple columnar.
In the spaces between the follicles, Parafollicular cells(C-
cells) can be found. These cells secrete calcitonin, which is
involved in the regulation of calcium metabolism in the
body.
Function
Thyroid gland is one of the main regulators of metabolism.
This is achieved in a number of ways, such as increasing the size and number
of mitochondria within cells, increasing Na-K pump activity. Metabolic processes increased
by thyroid hormones include:
Basal Metabolic Rate
Gluconeogenesis
Glycogenolysis
Protein synthesis
Lipogenesis
Thermogenesis
T3 and T4 are the active thyroid hormones.
They are fat soluble and mostly carried by plasma proteins – Thyronine Binding Globulin
and Albumin.
T3 and T4 are deactivated by removing iodine in the liver and kidney.
As T4 has a longer half-life, it is used in the treatment of hypothyroidism
• Exercise
• Stress
• Malnutrition
• Low Plasma Glucose Level
• Sleep
Iodine Deficiency
Thyroid hormones enter the cell nucleus and regulate gene expression, i.e. they increase or
decrease the synthesis of some proteins including enzymes. They enhance the effects of other
hormones, e.g. adrenaline (epinephrine) and noradrenaline (norepinephrine).
T3 and T4 affect most cells of the body by:
increasing the basal metabolic rate and heat production
regulating metabolism of carbohydrates, proteins and fats
T3 and T4 are essential for normal growth and development of skeleton and nervous system.
Physiological effects of T3 and T4 on the heart, skeletal muscles, skin, digestive and reproductive
systems are more evident when there is underactivity or over-activity of the thyroid gland.
Hyperthyroidism:
INCREASED Hypothyroidism: DECREASED
T3 and T4 secretion T3 and T4 secretion
Increased basal metabolic rate Decreased basal metabolic rate
Weight loss, good appetite Weight gain, anorexia
Anxiety, physical restlessness, mental Depression, psychosis, mental
excitability slowness, lethargy
Hair loss Dry skin, brittle hair
Tachycardia, palpitations, atrial Bradycardia
fibrillation
Dry cold skin, prone to hypothermia
Warm sweaty skin, heat intolerance
Constipation
Diarrhoea
Exophthalmos in Graves’ disease
Parathyroid glands
The parathyroid glands are small endocrine glands
located in the anterior neck.
They are responsible for the production
of Parathyroid hormone (PTH).
There are four small parathyroid glands, two
embedded in the posterior surface of each lobe of
the thyroid gland. They are surrounded by fine
connective tissue capsules.
The cells forming the glands are spherical in shape
and are arranged in columns with sinusoids
containing blood between them.
Function
The parathyroid glands secrete parathyroid hormone
(PTH, Parathormone).
Secretion is regulated by blood calcium levels. When
they fall, secretion of PTH is increased and vice versa.
The main function of PTH is to increase the blood
calcium level when it is low.
This is achieved by indirectly increasing the amount of
calcium absorbed from the small intestine and
reabsorbed from the renal tubules.
If these sources don’t supply adequate amount of
Calcium then PTH stimulates osteoclasts (bone
destroying cells) and calcium is released from bones
into the blood.
Parathormone and calcitonin
from the thyroid gland act in a
complementary manner to
maintain blood calcium levels
within the normal range.
This is needed for:
muscle contraction
nerve transmission
blood clotting
normal action of many
enzymes.
Adrenal glands
The two adrenal (suprarenal) glands are situated on the upper
pole of each kidney enclosed within the renal fascia.
They are about 4 cm long and 3 cm thick.
Arterial blood supply to the glands is by branches from the
abdominal aorta and renal arteries.
Venous return is by suprarenal veins. The right gland drains
into the inferior vena cava and the left into the left renal
vein.
Glands are composed of two parts which have different
structures and functions, outer part is cortex and inner part is
medulla.
The adrenal cortex is essential to life but the medulla is not.
Adrenal cortex
The adrenal cortex produces three groups of steroid hormones from cholesterol.
Collectively called adrenocorticoids (corticosteroids). They are:
Glucocorticoids
Mineralocorticoids
Sex hormones (androgens)
Sex hormones:
Sex hormones secreted by the adrenal cortex are mainly androgens (male sex
hormones) The amounts produced are insignificant compared with those secreted by
the testes and ovaries in late puberty and adulthood
In pathological and pharmacological
quantities glucocorticoids (commonly
referred to as ‘steroids’) also have
other effects including:
Anti-inflammatory actions
Suppression of immune
responses
Delayed wound healing
RENIN-
ANGIOTENSIN-
ALDOSTERONE
SYSTEM
When renal blood flow is reduced or
blood sodium levels fall, the enzyme
renin is secreted by kidney cells.
Renin converts the plasma protein
angiotensinogen, produced by the
liver, to angiotensin 1.
Angiotensin converting enzyme (ACE),
formed in small quantities in the lungs,
proximal kidney tubules and other
tissues, converts angiotensin 1 to
angiotensin 2, which stimulates
secretion of aldosterone.
It also causes vasoconstriction and
increases blood pressure.
The Pancreas
A pale grey gland weighing about 60 grams. About 12 to
15 cm long
Situated in the epigastric and left hypochondriac regions
of the abdominal cavity.
The pancreas is a dual-functional gland, with both
exocrine (digestive) and endocrine (hormonal) functions.
Consists of a broad head, a body and a narrow tail.
The head lies in the curve of the duodenum, the body
behind the stomach and the tail lies in front of the left
kidney and just reaches the spleen.
The abdominal aorta and the inferior vena cava lie behind
the gland.
Cells of pancreas
There are a variety of cell groups within the pancreas.
Firstly, there are clusters of cells known as Islets of
Langerhans. These islets contain the cell types that
produce the hormones relating to
the endocrine functions of the pancreas.
There are also acini and duct systems within the
pancreas, which are responsible for
producing enzymes relating to the exocrine functions of
the pancreas.
The endocrine pancreas
Throughout the gland, groups of
specialised cells called the pancreatic
islets (of Langerhans) are distributed.
The islets have no ducts, so the
hormones diffuse directly into the blood.
The endocrine pancreas secretes the
hormones insulin and glucagon, which
are principally concerned with control of
blood glucose levels
Blood supply of pancreas
ARTERIAL SUPPLY - Splenic and Mesenteric arteries
VENOUS DRAINAGE- Veins of the same names - that join other veins to form the portal vein.
Pancreatic islets
The pancreas is a
partially retroperitoneal, abdominal organ found
posterior and inferior to the stomach.
The cells that make up the pancreatic islets (islets of
Langerhans) are found in clusters irregularly
distributed throughout the substance of the pancreas.
Unlike the exocrine pancreas, there are no ducts
leading from the clusters of islet cells.
Pancreatic hormones are secreted directly into the
bloodstream and circulate throughout the body.
The lighter tissue in this section is the islet cells. The
darker staining tissue is pancreatic acini.
Islets are thought to make up 5% of the overall volume of the pancreas, although they receive
around 15% of its blood flow.
The Islets of Langerhans contain the following cell types:
Alpha cells – these make up roughly 15-20% of Islet cells and are responsible for
producing glucagon
Beta cells – these make up 65-80% of Islet cells and produce insulin and amylin
Delta cells – these make up 3-10% of Islet cells and produce somatostatin
Gamma cells – these make up 3-5% of Islet cells and are responsible for production
of pancreatic polypeptide
Epsilon cells – these make up less than 1% of Islet cells and produce ghrelin
Pancreatic Hormones
Pancreatic hormones are produced in the Islets of Langerhans. Scattered
throughout exocrine tissue in the tail of the pancreas, these are spherical
groups of different cell types producing different polypeptide hormones.
There are 6 key polypeptide hormones secreted by the endocrine pancreas.
These hormones can also regulate the action of other cell types within the Islets.
Insulin stimulates action of beta cells and inhibits alpha cells.
Glucagon stimulates action of alpha cells, which in turn then leads
to activation of beta and delta cells
Somatostatin leads to inhibition of both alpha and beta cells.
PANCREATIC
HORMONE PRODUCED BY FUNCTION
Insulin
Beta cells
Decrease blood glucose levels
Amylin
Beta cells
Slows gastric emptying to
prevent spikes in blood glucose
Glucagon levels
Alpha cells
Somatostatin Increase blood glucose levels
Delta cells
Pancreatic Regulates Islet cell secretion of
Polypeptide Gamma cells
other hormones
GI function
Ghrelin Epsilon cells
Increase in appetite
Pineal gland
The pineal gland is a small body
attached to the roof of the third
ventricle and is connected to it by a
short stalk containing nerves, many
of which terminate in the
hypothalamus.
The pineal gland is about 10 mm
long, is reddish brown in colour and
is surrounded by a capsule.
The gland tends to atrophy after
puberty and may become calcified
in later life.
Melatonin
This is the main hormone secreted by the pineal gland.
Secretion is controlled by daylight and levels fluctuate during each 24-hour
period, being highest at night and lowest around midday.
Secretion is also influenced by the number of daylight hours, i.e. seasonal
variations.
Although its functions are not fully understood, melatonin is believed to be
associated with:
coordination of the circadian and diurnal rhythms of many tissues, possibly
by influencing the hypothalamus
inhibition of growth and development of the sex organs before puberty,
possibly by preventing synthesis or release of gonadotrophins.
Thymus gland
The thymus gland lies in the upper part of the
mediastinum behind the sternum and extends
upwards into the root of the neck.
It weighs about 10 to 15 g at birth and grows until
puberty, when it begins to atrophy.
Its maximum weight, at puberty, is between 30
and 40 g and by middle age it has returned to
approximately its weight at birth.
Thymosin - the hormone secreted by the thymus
gland and is involved in the development of T-
lymphocytes for cell-mediated immunity
Local hormones
A number of body tissues not normally described as endocrine glands
secrete substances that act in tissues nearby (locally).
Some of these are :
Histamine
Serotonin
PG’s
Gastrointestinal hormones
Several local hormones, including gastrin, secretin and cholecystokinin
(CCK), influence the secretion of digestive juices.
Histamine
This is synthesised and stored by mast cells
in the tissues and basophils in blood.
It is released as part of the inflammatory
response, increasing capillary permeability
and causing vasodilation.
It also causes contraction of smooth muscle
of the bronchi and alimentary tract and
stimulates the secretion of gastric juice.
