ANATOMY AND PHYSIOLOGY

The endocrine system is made up of glands that produce and secrete hormones.
These hormones regulate the body's growth, metabolism (the physical and chemical
processes of the body), and sexual development and function. The hormones are released
into the bloodstream and may affect one or several organs throughout the body.

Hormones are
chemical messengers
created by the body. They
transfer information from
one set of cells to another
to coordinate the
functions of different
parts of the body.

The major glands

of the endocrine system
are the hypothalamus,
pituitary, thyroid, para-
thyroids, adrenals, pineal
body, and the re-
productive organs
(ovaries and testes). The
pancreas is also a part of
this system; it has a role in
hormone production as
well as in digestion.

The endocrine
system is regulated by
feedback in much the
same way that a
thermostat regulates the
temperature in a room.
For the hormones that are
regulated by the pituitary
gland, a signal is sent from the hypothalamus to the pituitary gland in the form of a "releasing
hormone," which stimulates the pituitary to secrete a "stimulating hormone" into the
circulation. The stimulating hormone then signals the target gland to secrete its hormone. As
the level of this hormone rises in the circulation, the hypothalamus and the pituitary gland
shut down secretion of the releasing hormone and the stimulating hormone, which in turn
slows the secretion by the target gland. This system results in stable blood concentrations of
the hormones that are regulated by the pituitary gland.
 Pituitary Stimulating Hypothalamic Releasing
Hormone
Hormone Hormone
 Thyroid Thyroid-stimulating Thyrotropin-releasing
hormones T4, T3 hormone (TSH) hormone (TRH)
Adrenocorticotropin Corticotropin-releasing factor
 Cortisol
hormone (ACTH) (CRF)
Luteinizing hormone-releasing
Follicle-stimulating
 Estrogen or hormone (LHRH) or
hormone (FSH), luteinizing
testosterone gonadotropin-releasing
hormone (LH)
hormone (GnRH)
 Insulin like
Growth hormone-releasing
growth factor-I Growth hormone
hormone (GHRH)
(IGF-I)

THE PANCREAS

The pancreas is a
pinkish white glandular organ
found in vertebrates near the
stomach and small intestine.
The pancreas is the second
largest gland that is connected
to the digestive tract, after the
liver.
The pancreas is one of
the few organs that have both an
exocrine and an endocrine
function. Exocrine glands are
glands that secrete their
products into ducts (duct
glands). Endocrine glands are
glands that secrete their product
directly into the blood rather
than through a duct. The
pancreas' exocrine function
involves the secretion of
bicarbonate and digestive enzymes into the small intestine. Its endocrine function involves
the regulation of blood sugar levels by secreting the hormones insulin, glucagon, and
somatostatin directly into the blood. The endocrine portion of this organ consists of about
1 million islets of Langerhans, amounting to only 1-3 percent of the organ weight. The
majorities of cells are exocrine and secrete one to three liters of digestive fluid per day.
 The pancreas is an important organ for digestion and the control of circulating
levels of glucose. This organ is an excellent example of an intricate, well-tuned organ that
functions in harmony with other parts of the body, providing a service to the body while
receiving the nutrients and removal of wastes necessary for its survival. For example, in
terms of its function in the digestive system, it is one of several parts of the body that work
together, involving cooperative giving and
receiving, including the stomach, intestines, liver,
pancreas, heart, brain, and so forth.

ANATOMY
In human beings, the pancreas is a 6-10
inch elongated organ weighing 65 to 160 grams
and lying in the abdominal cavity. It lies posterior
to the stomach, anterior to the kidneys, and
empties into the duodenum portion of the small
intestine.
The human pancreas can be divided into
five regions: (1) the head, which touches the
duodenum, (2) the body, which lies at the level of
second lumbar vertebrae of the spine, (3) the tail, 1: Head of pancreas
which extends towards the spleen, (4) the uncinate process, and (5) 2: Uncinate process of pancreas
the pancreatic notch, which is formed at the bend of the head and 3: Pancreatic notch
body. 4: Body of pancreas
5: Anterior surface of pancreas
6: Inferior surface of pancreas
BLOOD SUPPLY 7: Superior margin of pancreas
The pancreas is supplied arterially by the pancreaticoduodenal 8: Anterior margin of pancreas
arteries: 9: Inferior margin of pancreas
10: Omental tuber
 the superior mesenteric artery feeds the inferior 11: Tail of pancreas
12: Duodenum
pancreaticoduodenal arteries
• the gastroduodenal artery feeds the superior
pancreaticoduodenal artery

NERVE SUPPLY
The pancreas receives neural innervation from the vagus (cranial X). This is part of
the autonomic parasympathetic supply. The role of the vagus is to stimulate secretion of
the pancreatic digestive juices.
Autonomic sympathetic nerves to the pancreas derive from the celiac ganglionic
plexus, the superior mesenteric plexus, and the hepatic plexus. These plexuses lie outside
the pancreas and send postganglionic fibers into the pancreatic cells. These sympathetic
nerves inhibit the production of digestive enzymes (Berne et al. 1996).

The innervation of the pancreas is comprised of both an intrinsic component that

consists of many intrapancreatic ganglia and an extrinsic component made of neurons lying
outside the digestive tract and belonging to the sympathetic and parasympathetic systems
 Many different neurotransmitters have been found within the pancreas including
acetylcholine, epinephrine, norepinephrine, serotonin, nitric oxide, and others (Salvioli et
al. 2002).

MICROSCOPIC ANATOMY
When the pancreas is sliced, stained, and then viewed with a microscope, it is easy
to distinguish many different types of cells that correspond to different pancreatic
functions. The microscopic appearance of the pancreas shows a series of islands (the Islets
of Langerhans) consisting of small cells packed closely together, surrounded by much
larger and less dense acinar cells. The islands have an endocrine function and the
surrounding cells have an exocrine function.

Appearance Region Function

secretes hormones that
 centralized islands
endocrine pancreas regulate blood glucose
(islets of Langerhans)
levels
 surrounding acinar produces enzymes and
exocrine pancreas
cells bicarbonate

ENDOCRINE FUNCTION
There are four main types of cells in the islets of Langerhans. They all look similar
when using standard staining techniques, but when special stains are used they can be
classified into four different types:

Name of cells Product % of islet cells Representative function

beta cells Insulin and Amylin 50-80% lower blood sugar
alpha cells Glucagon 15-20% raise blood sugar
delta cells Somatostatin 3-10% inhibit endocrine pancreas
Pancreatic
gamma cells 1% inhibit exocrine pancreas
polypeptide

The islets are a compact collection of endocrine cells arranged in clusters and cords
that are crisscrossed by a dense network of capillaries. The capillaries are lined by layers
of endocrine cells in direct contact with them by either cytoplasmic processes or by direct
apposition. The cells release their hormones, without ducts, directly into the capillaries.

HORMONES PRODUCED BY THE PANCREAS

Insulin is a polypeptide containing two chains of amino acids joined together by
two disulfide bridges, and contains a total of 51 amino acids.
* helps to transport glucose into skeletal muscle and liver.
* is produced when blood sugar exceeds 50 mg/deciliter.
* has an average production of 1.0 to 2.5 mg/day.
* stimulates skeletal muscle and liver to convert glucose to a storage form called
glycogen.
* stimulates fat cells to synthesize fat.
* acts on the hypothalamus to reduce appetite.
 Amylin is another polypeptide secreted by the beta cells. It is slightly smaller than
insulin with 37 amino acids. It works to supplement the actions of insulin.
* inhibits the secretion of glucagon.
* lowers the level of glucose in the blood.
* slows the emptying of the stomach into the intestine.
* sends a signal of satiety to the brain.

Glucagon is a polypeptide containing 29 amino acids.

* is released into the blood in response to a blood glucose level falling below 80
mg/deciliter
* acts primarily on the liver to stimulate glucose production by breaking down
glycogen and converting protein and fat into glucose
* secretion is inhibited by amylin (Bowen 2002).

Somatostatin
Purpose: Regulate the production and excretion of other endocrine tumors
Action : Slows down production of insulin, glucagon, gastrin, and other
endocrine tumors
Secreted in response to: High levels of other endocrine hormones
Secretion inhibited by: Low levels of other endocrine hormones
Disease due to deficient action: Poorly defined
Disease due to excess action: Diabetes, gallstones, and dietary fat intolerance
Tumor called: Somatostatinoma

The endocrine function of the pancreas is to produce important hormones including

insulin, glucagon, and somatostatin and export them to the blood supply on demand.

Pancreatic polypeptide is secreted by the gamma cells and consists of 36 amino

acids. It is produced in response to chewing and swallowing food. It probably acts to reduce
appetite (Taylor et al. 1982).

INSULIN
Insulin is a hormone that has profound effects on metabolism. Insulin causes cells in
the liver, muscle, and fat tissue to take up glucose from the blood, storing it as glycogen in
the liver and muscle, and stopping use of fat as an energy source. When insulin is absent
(or low), glucose is not taken up by body cells, and the body begins to use fat as an energy
source, for example, by transfer of lipids from adipose tissue to the liver for mobilization
as an energy source. As its level is a central metabolic control mechanism, its status is also
used as a control signal to other body systems (such as amino acid uptake by body cells).
In addition, it has several other anabolic effects throughout the body.

When control of insulin levels fails, diabetes mellitus will result. Consequently, insulin
is used medically to treat some forms of diabetes mellitus. Patients with Type 1 diabetes
mellitus depend on external insulin (most commonly injected subcutaneously) for their
survival because the hormone is no longer produced internally. Patients with Type 2
diabetes mellitus are insulin resistant, and because of such resistance, may suffer from a
relative insulin deficiency. Some patients with Type 2 diabetes may eventually require
insulin if other medications fail to control blood glucose levels adequately, though this is
somewhat uncommon.

Insulin also influences other body functions, such as vascular compliance and
cognition. Once insulin enters the human brain, it enhances learning and memory and in
particular benefits verbal memory.

Insulin is a peptide hormone composed of 51 amino acids and has a molecular weight
of 5808 Da. It is produced in the islets of Langerhans in the pancreas. The name comes
from the Latin insula for "island". Insulin's structure varies slightly between species of
animal. Insulin from animal sources differs somewhat in 'strength' (in carbohydrate
metabolism control effects) in humans because of those variations. Porcine (pig) insulin is
especially close to the human version.