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endocrine glands Flashcards

1
Q

what are endocrine glands?

A

• Ductless, secrete hormones directly into the bloodstream

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2
Q

what is the infundibulum?

A

attaches the pituitar gland to the hypothalamus

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3
Q

where is the pituitary gland?

A

sits in the sella turcica of the sphenoid bone

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4
Q

what holds the pituitary gland in place?

A

diaphragm sella (dural fold)

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5
Q

what are the lobes of the pituitary gland? (give both names)

A 
anterior = adenohypophysis
posterior = neurohypophysis
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6
Q

what does the anterior lobe secrete?

A 
o	Adrenocorticotrophic hormone (ACTH)
o	Thyroid-stimulating hormone (TSH)
o	Luteinising hormone (LH)
o	Follicle-stimulating hormone (FSH)
o	Prolactin (PRL) 
o	Growth hormone (GH)
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7
Q

what does the posterior lobe secrete?

A

o Anti-diuretic hormone (ADH)

o Oxytocin

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8
Q

where does the posterior lobe of the pituitary originate from?

A

downgrowth from hypothalamus

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9
Q

explain the 2 main posterior pituitary neural connections

A
  • Cell bodies in the supraoptic nuclei secrete ADH  axons transport ADH  ADH secreted directly into capillary bed  acts on the kidneys
  • Cell bodies in the paraventricular nuclei secrete oxytocin  axons transport oxytocin  secreted directly into capillary bed  acts on reproductive organs
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10
Q

explain the vascular connection of the anterior pituitary

A

Internal carotid artery  superior hypophyseal artery  primary plexus (in the hypothalamus)  anterior lobe via hypophyseal portal vein  secondary plexus  leaves pituitary via efferent hypophyseal veins  cavernous sinus

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11
Q

what does ACTH act on? what does excessive production lead to?

A
  • acts on adrenal glands

- EP: excessive cortisol –> Cushings

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12
Q

what does TSH act on? what does excessive production lead to?

A

thyroid gland

EP: hyperthyroidism; weight loss, rapid HR, tremors

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13
Q

what do LH and FSH act on? what does excessive production lead to?

A

reproductive organs

o EP: rare; irregular menstrual periods or decreased interest in sex

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14
Q

what does PRL act on? what does excessive production lead to?

A

lactation

o EP: irregular menstrual periods. Abnormal milk production

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15
Q

what does GH act on? what does excessive production lead to?

A

acts on metabolism and growth

o EP: Gigantism in children and acromegaly in adults

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16
Q

how does a pituitary adenoma cause bitemporal hemianopia?

A

compresses optic chiasm –> bitemporal hemianopia

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17
Q

what vein lies close to the pituitary gland?

A

cavernous sinus

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18
Q

why does it seem as though there are 2 arteries running though the cavernous sinus?

A

ICA runs through it and then bends acutely – makes it look as though there are 2 arteries running through it

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19
Q

what cranial nerves pass by the pituitary gland? where do they exit the cranium?

A

3, 4, V1, V2 and 6

exit via the superior orbital fissure

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20
Q

what % of all intracranial tumours do pituitary tumours make up? how many are benign adenomas?

A

10-15%

90% are benign

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21
Q

what is the most common treatment for pituitary adenomas and what is the aim of this?

A

Surgery - Aim is to remove the tumour and leave at least some of the normal pituitary gland behind

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22
Q

what can cause cushing-like symptoms in a patient?

A

ACTH secreted from anterior lobe via anterior connection. Acts on adrenal glands to make excessive cortisol  symptoms

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23
Q

give examples of cushing like symptoms?

A

o Thinning of the skin
o Weight gain
o Reddish-purple stretch marks on the thighs, stomach, buttocks, arms, legs or breasts

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24
Q

what can cause loss of peripheral vision?

A

compression of optic chiasm

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25
what causes progressive opthalmoplegia?
compression of cranial nerves 3, 4 and/or 6
26
where are the adrenal glands found?
on top of the kidneys
27
what are the shapes of the right and left adrenal glands? what structures are they closely associated with?
* R = pyramidal shaped - closely associated with the liver and IVC * L = crescent shaped – associated with spleen, stomach and pancreas
28
where do the kidneys develop?
pelvis
29
where do the adrenal glands develop?
stay within the abdomen
30
what are the 2 main parts of the adrenal glands and what do they secrete?
o Adrenal cortex secretes aldosterone, cortisol, androgens | o Adrenal medulla secretes adrenaline and noradrenaline
31
how does the adrenal medulla act as a specialised sympathetic ganglion?
o Preganglionic sympathetic neurones travel out of the spinal cord o Travel through the sympathetic chain (don’t synapse here) o Carry on into the abdomen and into the adrenal gland o No postsynaptic ganglion
32
what are the 3 layers of the adrenal cortex (innermost to outermost)?
zona reticularis zona fasciculata zona glomerulosa
33
what does the zona reticularis secrete and what is its function?
secretes androgens (testosterone precursor)
34
what does the zona fasciculata secrete and what is its function?
glucocorticoids (cortisol in response to stress)
35
what does the zona glomerulosa secrete and what is its function?
mineralocorticoids –aldosterone (regulation of Na+)
36
what arteries supply the pituitary gland and where do they originate from?
* Inferior phrenic artery  superior suprarenal arteries (6-8) * Abdominal aorta near SMA  middle suprarenal artery (1+) * L + R renal arteries  inferior suprarenal (1+)
37
what levels is the thyroid found at?
C5-T1
38
what is the isthmus?
connects the left and right lobe
39
what is the pyrimidal lobe?
• Extra glandular tissue called the pyramidal lobe – during development, bc thyroid initially develops posterior to the tongue then descends down, we can get different sites of extra-glandular tissue
40
what nerve travels down each side of the thyroid?
recurrent laryngeal nerve
41
what are the 4 infrahyoid muscles and what do they connect from?
o Thyrohyoid– thyroid to hyoid bone o Sternothyroid– sternum to thyroid o Sternohyoid – sternum to hyoid o Omohyoid – attaches to the scapula (omo means shoulder)
42
where does the thyroid gland lie?
lies inferior to the thyroid cartilage (covers the hyoid cartilage)
43
describe the thyroid arterial blood supply
* External carotid artery  superior thyroid artery * Thyrocervical trunk  inferior thyroid artery * 10% of people have the thyroid ima artery
44
how many people have the thyroid ima artery?
10% of people
45
where does the thyroid ima artery originate?
can vary - can come off the carotid, aorta and brachiocephalic
46
describe the thyroid venous drainage
* Superior thyroid vein and middle thyroid vein --> internal jugular vein * Inferior thyroid vein --> brachiocephalic veins
47
what are the parathyroid glands and what do they do?
* 4 glands on the posterior surface of the thyroid gland | * Secrete parathyroid hormone  increases blood calcium
48
which structures must a surgeon avoid during a thyroidectomy? what will damage to these structures cause?
* Recurrent laryngeal nerve  dysphonia * Thyroid ima artery  post-operative haemorrhage which can lead to compressing the trachea). Within our neck we have pre-tracheal fascia with compartments so haemorrhage can compress structures. * Major vessels * Parathyroid glands  tetany
49
what do the endocrine and exocrine part of the pancreas do?
o Exocrine – secretion of powerful digestive enzymes in the small intestine o Endocrine – releases insulin and glucagon into the bloodstream
50
where is the pancreas found?
* Head sits in the curvature of the duodenum * Anterior to the abdominal aorta and IVC * Tail extends to the spleen
51
where does the blood supply to the pancreas come from?
coeliac trunk and superior mesenteric artery
52
which arteries supply the head of the pancreas?
Inferior and superior pancreaticoduodenal artery
53
what are the 2 major ducts of the pancreas? where do they drain?
main pancreatic duct + accessory pancreatic duct (drain into the duodenum)
54
what are the minor and major duodenal papillae?
opening of the pancreatic duct drain into the duodenum
55
how is the common hepatic duct formed?
left and right hepatic ducts converge to form the common hepatic duct
56
how is the common bile duct formed?
common hepatic duct joins with the cystic duct
57
what drains into the major duodenal papilla?
common bile duct
58
what is the sphincter of Oddi?
major duodenal papilla
59
when are gallstones asymptomatic?
if they're not blocking anything
60
what happens if there's a blockage of the cystic duct?
``` biliary colic (pain following meals) o Worsens when a patient eats fatty foods ```
61
what happens if there's a blockage of the common bile duct?
blocking cystic duct from gallbladder and the common hepatic duct from the liver --> bilirubin in bile cannot be broken down and accumulates --> biliary colic and jaundice
62
what happens if there's a blockage in the duodenal papilla?
blockage of bile and pancreatic ducts --> biliary colic, jaundice and pancreatitis

m2 (24 decks)

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