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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
Q

what causes progressive opthalmoplegia?

A

compression of cranial nerves 3, 4 and/or 6

26
Q

where are the adrenal glands found?

A

on top of the kidneys

27
Q

what are the shapes of the right and left adrenal glands? what structures are they closely associated with?

A
  • R = pyramidal shaped - closely associated with the liver and IVC
  • L = crescent shaped – associated with spleen, stomach and pancreas
28
Q

where do the kidneys develop?

A

pelvis

29
Q

where do the adrenal glands develop?

A

stay within the abdomen

30
Q

what are the 2 main parts of the adrenal glands and what do they secrete?

A

o Adrenal cortex secretes aldosterone, cortisol, androgens

o Adrenal medulla secretes adrenaline and noradrenaline

31
Q

how does the adrenal medulla act as a specialised sympathetic ganglion?

A

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
Q

what are the 3 layers of the adrenal cortex (innermost to outermost)?

A

zona reticularis
zona fasciculata
zona glomerulosa

33
Q

what does the zona reticularis secrete and what is its function?

A

secretes androgens (testosterone precursor)

34
Q

what does the zona fasciculata secrete and what is its function?

A

glucocorticoids (cortisol in response to stress)

35
Q

what does the zona glomerulosa secrete and what is its function?

A

mineralocorticoids –aldosterone (regulation of Na+)

36
Q

what arteries supply the pituitary gland and where do they originate from?

A
  • Inferior phrenic artery  superior suprarenal arteries (6-8)
  • Abdominal aorta near SMA  middle suprarenal artery (1+)
  • L + R renal arteries  inferior suprarenal (1+)
37
Q

what levels is the thyroid found at?

A

C5-T1

38
Q

what is the isthmus?

A

connects the left and right lobe

39
Q

what is the pyrimidal lobe?

A

• 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
Q

what nerve travels down each side of the thyroid?

A

recurrent laryngeal nerve

41
Q

what are the 4 infrahyoid muscles and what do they connect from?

A

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
Q

where does the thyroid gland lie?

A

lies inferior to the thyroid cartilage (covers the hyoid cartilage)

43
Q

describe the thyroid arterial blood supply

A
  • External carotid artery  superior thyroid artery
  • Thyrocervical trunk  inferior thyroid artery
  • 10% of people have the thyroid ima artery
44
Q

how many people have the thyroid ima artery?

A

10% of people

45
Q

where does the thyroid ima artery originate?

A

can vary - can come off the carotid, aorta and brachiocephalic

46
Q

describe the thyroid venous drainage

A
  • Superior thyroid vein and middle thyroid vein –> internal jugular vein
  • Inferior thyroid vein –> brachiocephalic veins
47
Q

what are the parathyroid glands and what do they do?

A
  • 4 glands on the posterior surface of the thyroid gland

* Secrete parathyroid hormone  increases blood calcium

48
Q

which structures must a surgeon avoid during a thyroidectomy? what will damage to these structures cause?

A
  • 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
Q

what do the endocrine and exocrine part of the pancreas do?

A

o Exocrine – secretion of powerful digestive enzymes in the small intestine
o Endocrine – releases insulin and glucagon into the bloodstream

50
Q

where is the pancreas found?

A
  • Head sits in the curvature of the duodenum
  • Anterior to the abdominal aorta and IVC
  • Tail extends to the spleen
51
Q

where does the blood supply to the pancreas come from?

A

coeliac trunk and superior mesenteric artery

52
Q

which arteries supply the head of the pancreas?

A

Inferior and superior pancreaticoduodenal artery

53
Q

what are the 2 major ducts of the pancreas? where do they drain?

A

main pancreatic duct + accessory pancreatic duct (drain into the duodenum)

54
Q

what are the minor and major duodenal papillae?

A

opening of the pancreatic duct drain into the duodenum

55
Q

how is the common hepatic duct formed?

A

left and right hepatic ducts converge to form the common hepatic duct

56
Q

how is the common bile duct formed?

A

common hepatic duct joins with the cystic duct

57
Q

what drains into the major duodenal papilla?

A

common bile duct

58
Q

what is the sphincter of Oddi?

A

major duodenal papilla

59
Q

when are gallstones asymptomatic?

A

if they’re not blocking anything

60
Q

what happens if there’s a blockage of the cystic duct?

A 
biliary colic (pain following meals)
o	Worsens when a patient eats fatty foods
61
Q

what happens if there’s a blockage of the common bile duct?

A

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
Q

what happens if there’s a blockage in the duodenal papilla?

A

blockage of bile and pancreatic ducts –> biliary colic, jaundice and pancreatitis

m2 (24 decks)

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