The Endocrine System

Overview of the Endocrine System

System of ductless glands that
secrete hormones
Hormones are messenger
molecules
Circulate in the blood
Act on distant target cells
Target cells respond to the
hormones for which they
have receptors
The effects are dependent on
the programmed response of
the target cells
Hormones are just molecular Mechanisms of hormone release
triggers (a) Humoral: in response to changing levels
Endocrine Organs of ions or nutrients in the blood

Purely endocrine organs (b) Neural: stimulation by nerves

Pineal gland (c) Hormonal: stimulation received from

other hormones
Pituitary gland
Thyroid gland
Parathyroid glands
Adrenal: 2 glands
Cortex
Medulla
Endocrine cells in other organs
Hypothalamus HYPOTHALAMUS

Thymus gland Link the nervous system to the

endocrine system via the pituitary
Pancreas gland
Gonads (ovary & testis) Synthesizes and secretes releasing
hormones or hypothalamic hormones,
 these in turn stimulate/inhibit the
secretion of pituitary hormones.
Located below the thalamus
Just about the brainstem
Part of the limbic system
Forms the ventral part of the
diencephalon
Contains a number of small nuclei
with a variety of functions.
Hypothalamus controls anterior pituitary
hormone release
Releasing hormones (releasing
factors)
Secreted like neurotransmitters from
neuronal axons into capillaries and veins
to anterior pituitary (adenohypophysis)
TRH-----turns on TSH
CRH-----turns on ACTH
GnRH (=LHRH) ---turns on FSH and LH
PRF-----turns on PRL
GHRH----turns on GH
Inhibiting hormones
PIF-----turns off PRL
GH inhibiting hormone ---turns off GH
Releasing hormones (releasing
factors) of hypothalamus
Secreted like neurotransmitters from
neuronal axons into capillaries and veins
to anterior pituitary (adenohypophysis)
TRH (thyroid releasing hormone)
-----turns on* TSH
CRH (corticotrophin releasing hormone)
-----turns on ACTH
GnRH (gonadotropin releasing hormone)
---turns on FSH and LH
PRF (prolactin releasing hormone)
-----turns on PRL
GHRH (growth hormone releasing
hormone) ----turns on GH
Inhibiting hormones of
hypothalamus
PIF (prolactin inhibiting factor) -----turns
off PRL
GH (growth hormone) inhibiting
hormone ---turns off GH
The hypothalamus controls secretion of
hormones which in their turn control the
secretion of hormones by the thyroid
gland, the adrenal cortex and gonads: in
this way the brain controls these
endocrine glands
*Note: turns on means causes to be
released
TRH - TSH stimulates the thyroid to
produce thyroid hormone
CRH - ACTH stimulates the adrenal cortex
to produce corticosteroids: aldosterone and
cortisol
GnRH- FSH stimulates follicle growth and
ovarian estrogen production; stimulates
sperm production and androgen-binding
protein
GnRH - LH has a role in ovulation and the
growth of the corpus luteum; stimulates
androgen secretion by interstitial cells in
testes
GHRH - GH (aka somatotropin hormone)
stimulates growth of skeletal epiphyseal
plates and body to synthesize protein
PRF - PRL stimulates mammary glands in
breast to make milk
MSH stimulates melanocytes; may increase
mental alertness
ADH (antidiuretic hormone AKA
vasopressin) stimulates the kidneys to
reclaim more water from the urine, raises
blood pressure
Oxytocin prompts contraction of smooth
muscle in reproductive tracts, in females
initiating labor and ejection of milk from
breasts
Blue is from hypothalamus
Black is from pituitary
TRH (thyroid releasing hormone)
turns on TSH
CRH (corticotropin releasing hormone)
turns on ACTH
GnRH (gonadotropin releasing hormone)
turns on FSH and LH
PRF (prolactin releasing hormone)
turns on PRL
GHRH (growth hormone releasing hm)
turns on GH
ACTH stimulates the adrenal cortex to
produce corticosteroids: aldosterone and
cortisol
FSH stimulates follicle growth and ovarian
estrogen production; stimulates sperm
production and androgen-binding protein
LH has a role in ovulation and the growth of
the corpus luteum; stimulates androgen
secretion by interstitial cells in testes
GH (aka somatrotropic hormone) stimulates
growth of skeletal epiphyseal plates and
body to synthesize protein
PRL stimulates mammary glands in breast to
make milk
MSH stimulates melanocytes; may increase
mental alertness
ADH (antidiuretic hormone or vasopressin)
stimulates the kidneys to reclaim more water
from the urine, raises blood pressure
Oxytocin prompts contraction of smooth
muscle in reproductive tracts, in females
initiating labor and ejection of milk from
breasts

TSH: thyroid-stimulating hormone

ACTH: adrenocorticotropic hormone
FSH: follicle-stimulating hormone
LH: luteinizing hormone
GH: growth hormone
PRL: prolactin
MSH: melanocyte-stimulating hormone
ADH: antidiuretic hormone
Oxytocin

TSH stimulates the thyroid to produce

thyroid hormone
PITUITARY GLAND with the function of the nerve fibers
crossing in the chiasma (from the inner
Located in the bony sella turcica quadrants of the retina), and the patient
Enlargement causes it to expand
presents with bitemporal hemianopsia
superiorly Further expansion of the pituitary tumor
A pituitary tumor classically pushes the
causes erosion of the body of the
diaphragm sellae (roof of the sella
sphenoid bone.
turcica) upward and causes pressure on
the optic chiasma causing interference
 What the letters stand for
TSH: thyroid-stimulating hormone
ACTH: adrenocorticotropic hormone
FSH: follicle-stimulating hormone
LH: luteinizing hormone
GH: growth hormone
PRL: prolactin
MSH: melanocyte-stimulating
hormone
Bitemporal hemianopia is usually an
ADH: antidiuretic hormone
incomplete loss of vision in the temporal
fields of both eyes. It is caused by pressure Oxytocin
on the optic chiasm.

GIGANTISM
Occurs in the young the epiphyses in long
bones fuse with the diaphysis
Excessive production of the growth
hormone
Abnormal growth of the skeleton
The Pituitary
Growth hormone stimulates the cartilage
Sits in hypophyseal fossa: depression in cells of the epiphyseal cartilage to
sella turcica of sphenoid bone continue laying down new matrix, so that
fusion of the epiphyses with the shaft of
Pituitary secretes 9 hormones
long bones is delayed and the bone
lengthen enormously.
ACROMEGALY
Occurs after adolescence, following the
fusion of the epiphyses in long bones with
the diaphysis individual cannot grow taller
Overgrowth occurs in the bones and soft
tissues of the forehead, nose, lower jaw,
hands, and feet
In the fully developed syndrome, the
prominent supraorbital ridges and mandible,
the very large nose, and the very large, thick
hands and feet make the diagnosis relatively
easy.
PITUITARY DWARFISM
The achondroplastic dwarf has an
orthopedic reason for having short
limbs and a short spinal colum.
The pituitary dwarf lacks growth
hormone (an endocrine reason).
SYMPTOMS:
GH Deficiency
Low blood sugar
Growth does not stop entirely, and the
different parts of the body are in relatively
normal proportions.
Person is of normal intelligence, but the
facial skin is often wrinkled and sexual
maturation is delayed.
The Thyroid Gland
Anterior neck on trachea just inferior
to larynx
Two lateral lobes and an isthmus
The thyroid gland is invested in a
sheath derived from the pretracheal
fascia
Explains why the thyroid gland
follows the movements of the larynx
in swallowing
Important because any pathologic
neck swelling that is part of the
thyroid gland will move upward
when the patient is asked to swallow.
The close relationship between the
trachea and the lobes of the thyroid
gland commonly results in pressure
on the trachea in patients with
pathologic enlargement of the
thyroid
Produces two hormones
Thyroid hormone: tyrosine
based with 3 or 4 iodine
molecules
T4 (thyroxine) and T3
Calcitonin involved with
calcium and phosphorus
metabolism
 laryngeal nerve, which supplies the
cricothyroid muscle.
The terminal branches of the inferior
thyroid artery on each side are
relayed to the recurrent laryngeal
nerve. Damage to the external
laryngeal nerve results in an inability
to tense the vocal folds and in
hoarseness

Thyroid is composed of spherical

follicles
Follicle cells: produce
thyroglobulin, the precursor
of thyroid hormone
(thyroxin)
Colloid lumen is of
thyroglobulin
Two main arteries supplying the
thyroid gland are closely related to Parafollicular C cells:
important nerves that can be produce calcitonin
damaged during thyroidectomy
Some Effects of Thyroid Hormone
operations
(Thyroxine)
The superior thyroid artery on each
side is relayed to the external Increases the basal metabolic rate
 The rate at which the body
uses oxygen to transform
nutrients (carbohydrates, fats
and proteins) into energy
Affects many target cells throughout
the body; some effects are
Protein synthesis
Bone growth
Neuronal maturation
Cell differentiation
The Effects of Calcitonin
Secreted from thyroid Parafollicular
(C) cells when blood calcium levels
are high
Calcitonin lowers Ca++ by slowing
the calcium-releasing activity of
osteoclasts in bone and increasing
calcium secretion by the kidney
Acts mostly during childhood
HYPERTHYROIDISM
Common in middle-aged women
Thyroid gland is diffusely enlarged
Serum thyroid-stimulating hormone
level is normal or below normal
In most patients, there is a thyroid-
stimulating immunoglobulin in the
blood that is capable of stimulating
increased thyroid activity
The symptoms of hyperthyroidism
are caused by the excessive
stimulation of the tissue by the
thyroid hormones.
Treatment
o (1) surgical excision of
thyroid tissue,
o (2) antithyroid drugs, and
o (3) radioactive iodine.
The condition can be successfully treated by
the daily oral administration of the thyroid
hormones.
Thyroid Tumors
Benign thyroid tumors occur in the form of
adenomas. Carcinoma of the thyroid gland is
relatively rare.
Congenital Anomalies of the Thyroid
Gland
Agenesis of the Thyroid
Failure of development of the thyroid gland
may occur and is the commonest cause of
cretinism.
Incomplete Descent of the Thyroid
The descent of the thyroid may be arrested A small protein hormone
at any point between the base of the tongue
and the trachea.

The Parathyroid Glands

Usually four in number
Closely related to the posterior
surface of the thyroid gland

Function of PTH
(parathyroid hormone or parathormone)
Increases blood Ca++ (calcium)
concentration when it gets too low
Mechanism of raising blood calcium
1. Stimulates osteoclasts to
Parathyroids release more Ca++ from bone
(two types of cells) 2. Decreases secretion of Ca++
Rare chief cells by kidney

Abundant oxyphil cells (unknown 3. Activates Vitamin D, which

function) stimulates the uptake of Ca++
from the intestine
Chief cells produce PTH
Unwitting removal during
Parathyroid hormone, or thyroidectomy was lethal
parathormone
 Has opposite effect on calcium as
calcitonin (which lowers Ca++
levels)

Hypoparathyroidism
Most commonly caused by injury to
or removal of the glands during
surgical procedures on the thyroid
gland
The main symptoms and signs of low
serum calcium.
Numbness and tingling in the
fingers and toes
Carpopedal spasm (cramps in
the hands and feet)
Spasm, or muscle tetany, may
also involve the facial or
laryngeal muscles.
The central nervous system may
also be involved (confusion and
loss of memory)
The condition is treated by
giving the patient calcium
gluconate and large quantities of
vitamin D by mouth
Congenital Anomalies of the Parathyroid
Glands
Absence and Hypoplasia of the Parathyroid
Glands
Agenesis or incomplete development
of the parathyroid glands
Ectopic Parathyroid Glands
Close relationship between the
parathyroids and the developing
thymus
If the parathyroid glands remain
attached to the thymus, they may be
pulled inferiorly into the lower part
of the neck or thoracic cavity.
Pineal Gland
Location and Development
Outgrowth of the roof of the diencephalon.
Found near the posterior margin of the
corpus callosum, slightly cranial and
superior to cerebellum.
Arterial Supply: circulosus arteriosus cerebri
Venous Drainage: cavernous venous sinus
Function: MELATONIN amino acid
derivative thought to have connection with
regulating sleep cycle
Pineal Calcification
With age, the pineal gland
accumulates magnesium phosphate
and carbonate within the glial cells
and connective tissue.
These deposits are useful to
radiologists, because they serve as a
landmark and assist in determining
whether the pineal gland has been
displaced laterally by a space-
occupying lesion within the skull.
Pineal Tumors and Reproductive Function
Pineal tumors may have an
antigonadtropic effect.
As they increase in size, they may
obstruct the cerebral aqueduct of the
midbrain, producing hydrocephalus.
Occasionally, the tumor destroys the
pineal gland and causes precocious
puberty.
 1. The superior suprarenal
arteries are multiple small branches from
the inferior phrenic artery, whereas the
2. Middle suprarenal artery is a
direct branch from the abdominal aorta.
ENDOCRINE GLANDS IN ABDOMEN
AND PELVIS

3.
A

Adrenal (suprarenal) glands n inferior suprarenal artery, sometimes

multiple, arises from the renal artery on
(suprarenal means on top of the kidney) each side
Small, yellowish organs that rest on Venous Drainage
the upper poles of the kidneys
Right adrenal gland is pyramidal, 1. Suprarenal vein to the left renal vein or
Left one is more crescentic, 2. Directly to the inferior vena cava on the
extending toward the hilum of the right side.
kidney.
Innervation: adjacent Lymphatic Drainage
Sympathetic fibers Lymphatics drain medially to the aortic
No parasympathetic nodes.
innervation.

Vascular Anatomy Arterial Supply

Three sources of arteries maintain blood
supply to suprarenal glands.
 At age 1 year, each adrenal gland
weighs approximately 1 g, and this
increases with age to a final weight
of 4-5 g.
Each suprarenal gland is composed
of 2 distinct tissues
The suprarenal cortex (outer
layer) and the
Suprarenal medulla (inner
layer)
These 2 major regions are
encapsulated by connective
tissue known as the capsule
SUPRARENAL CORTEX
largest part of the gland
composed of 3 zones:
1. the zona glomerulosa (outer
zone),
2. the zona fasciculate (middle
zone), and
3. the zona reticularis (inner zone).
1. Zona glomerulosa
Production of mineralocorticoids,
mainly aldosterone, which
regulates blood pressure and
electrolyte balance.
Aldosterone main hormone
Secreted in response to a
decline in either blood
volume or blood pressure
(e.g. severe hemorrhage)
The terminal hormone in
renin-angiotensin mechanism
It prompts the distal and
collecting tubules in kidney to
reabsorb more sodium
Water passively follows
Blood volume thus increases
2. Zona fasciculata
Production of glucocorticoids,
predominantly cortisol, which
increases blood sugar levels via
gluconeogenesis, suppresses the
 immune system, and aids in
metabolism.
Secretes cortisol both at a basal
level and as a response to the
release of adrenocorticotropic
hormone (ACTH) from the
pituitary gland
CORTISOL
Keeps blood glucose levels high
enough to support brains
activity
Forces other body cells to switch
to fats and amino acids as energy
sources
Catabolic: break down protein
Redirects circulating
lymphocytes to lymphoid and
peripheral tissues where
pathogens usually are
In large quantities, depresses
immune and inflammatory
response
3. Zona reticularis
Produces gonadocorticoids and is
responsible for administering
these hormones to the
reproductive regions of the body
Most of the hormones released by
this layer are androgens
dehydroepiandrosterone (DHEA),
which is the most abundant
hormone in the body and serves as
the starting material for many
other important hormones
produced by the suprarenal gland,
such as estrogen, progesterone,
testosterone, and cortisol.
Composed of chromaffin cells, which are
organized in clusters around blood
vessels.
Chromaffin cells produce epinephrine
(also known as adrenaline) and
norepinephrine.
These 2 hormones prepare the body for
the fight-or-flight response by:
Increase the heart rate,
Vasoconstriction
Increasing the metabolic rate,
Heightening cognitive
awareness, and
Increasing the respiratory rate
PANCREAS
elongated, tapered organ
located across the back of the
abdomen behind the stomach
right side of the organ, called the
head, is the widest part of the organ
and lies in the curve of the
duodenum
Innervation: foregut:
Sympathetic greater
splanchnic nerve
Parasympathetic vagus
nerve (X)
Arterial supply:
pancreaticoduodenal (branch of
celiac) artery
 Venous Drainage:
pancreaticoduodenal vein is tributary
of splenic vein
Pancreatic islet endocrine cells
Alpha cells:
o Secrete glucagon
o Raises blood sugar
o Mostly in periphery
Beta cells:
o Secrete insulin
o Lowers blood sugar
o Central part (are more
abundant)
Also rare Delta cells
o Secrete somatostatin
o Inhibits glucagon
The Gonads (testes and ovaries)
main source of the steroid sex hormones
Testes
Interstitial cells secrete androgens
Primary androgen is testosterone
Maintains secondary
sex characteristics
Helps promote sperm
formation
Ovaries
Androgens secreted by thecal
folliculi
Directly converted to estrogens
by follicular granulosa cells
Granulosa cells also produce
progesterone
Corpus luteum also secretes
estrogen and progesterone
OVARY
Produce ova in regular cycle determined
by hormonal secretions
Hormonal secretion is stimulated by FSH
and LH from the anterior pituitary
Secretes:
o ESTROGENS stimulate
development of female sex organs
and sexual characteristics.
o PROGESTERONE + ESTROGENS
regulate menstrual cycle; maintain
pregnancy in presence of developing
embryo or fetus.
TESTES
Innervation: sympathetic similar to
hindgut level T12 follows least splanchnic
nerve. Parasympathetic sacral outflow.
Arterial Supply: testicular artery. Branches
off of abdominal aorta sometimes branch off
of renal artery.
Venous Drainage: testicular vein, drainage
into inferior vena cava.
Function: responsible for sperm production
and synthesis of male sex hormones.
TESTOSTERONE stimulate development Modified cholesterol
of male sex organs, secondary sexual with uv exposure becomes Vitamin D
characteristics, and behavioral features. precursor
Functions of testosterone and its secretion is
Vitamin D necessary
tied to secretion of LH from anterior
for calcium metabolism: signals
pituitary gland.
intestine to absorb CA++
Pathology
Endocrine cells in various organs
Pituitary
continued
Gigantism too much GH in
The heart: atrial natriuretic peptide
childhood
(ANP)
Acromegaly too much GH
Stimulates kidney to
in adulthood
secrete more salt
Pituitary dwarfs too little
Thereby decreases
GH in childhood
excess blood volume, high BP and
high blood sodium concentration Diabetes insipidus - too much
ADH
GI tract & derivatives: Diffuse
neuroendocrine system (DNES) Pancreas
The placenta secretes steroid and Diabetes mellitus one type
protein hormones of insulin (not enough)
Estrogens, Thyroid
progesterone
Hyperthyroidism, commonest
CRH is Graves disease
(autoimmune)
HCG
Hypothyroidism
The kidneys
In childhood leads to
Juxtaglomerular cells
cretinism
secrete renin
Endemic goiter from
Renin
insufficient iodine in
indirectly signals adrenal cortex to
diet
secrete aldosterone
Adult hypothyroidism
Erythropoietin:
(myxedema):
signals bone marrow to increase RBC
autoimmune
production
The skin
ADRENAL GLAND
Addisons Disease
Hyposecretion (under secretion) of adrenal Cushings syndrome
cortex
Suprarenal glands produce too much cortisol
Known as primary suprarenal (adrenal)
Disorder can be caused by Cushing disease,
insufficiency
in which the pituitary gland makes too much
Suprarenal glands do not produce enough of adrenocorticotropic hormone (ACTH),
the hormone cortisol and often the hormone which signals the suprarenal glands to
aldosterone produce cortisol
Results from damage to the suprarenal
cortex, usually as a result of an autoimmune
disease
Although less likely, damage to the
suprarenal cortex can also occur from a
tumor or through certain infections, such as
HIV infection or tuberculosis.