ANATOMY AND PHYSIOLOGY

OF THE ENDOCRINE SYSTEM

Presenté par :

Dr NZENGO YACTCHOUA FRANKY Y.

MD,FHS-BUEA
Directeur Medical Technique CM Ste Thérèse
President fondateur GREEN BLOOM ASSOCIATION
Vice- President CEFAT Foundation
Directeur Cellule santé WOCOTOMADI Inc. USA- CAMEROUN
Coordonateur Technique en charge des projets et partenariats RC3D
Secretaire Technique Projet (RSS-CSU)
 Some definitions
• The endocrine system (endo: inside and krinian: secreted) refers to the set of
organs and tissues that release hormones into the blood.
• It is one of the two major communication systems of the body, the other being the
nervous system.
• Its role is essential for the realization of certain major physiological functions and
homeostasis, i.e. the relatively constant maintenance of the internal environment.

• The endocrine system is composed of secreting organs, the endocrine glands,

which synthesize and release hormones into the body
• An endocrine gland is a structure specialized in the secretion of hormones, products that are
released into the bloodstream and that act on the functioning or development of other organs.

• A true endocrine gland is a structure that specializes solely in the secretion of hormones.

• Among the true endocrine glands, we can mention the thyroid, the adrenals, the pituitary.

• Other organs are capable of both endocrine secretion and another physiological role, for example
the hypothalamus, the gonads.

• The same endocrine gland can secrete several types of hormones.

• When we speak of an exocrine gland

• it is a gland whose secretion is no longer released into the internal environment (blood) but is
released into the external environment.

example:

- the pancreas which produces digestive enzymes, released into the duodenum

- the testicle with spermatozoids,

• These 2 glands are both endocrine and exocrine

• A hormone (from hormao, I excite I stimulate) is a chemical messenger secreted by an endocrine
gland.

• Informative molecules secreted into the bloodstream and acting at a distance from the place of
secretion via receptors (proteins) capable of selectively recognizing them.

• Only target cells that contain receptors are sensitive to hormones.

• Three major characteristics of the endocrine hormone:

• - secreted in small quantities

• - released into the bloodstream and transported, their action takes place at a distance

• - act on specific cells (target tissue) to produce specific effects

• The hormones released by the endocrine glands are of three different categories: peptide
hormones, mono-amino hormones, steroid-derived hormones.
 PEPTIDE HORMONES
• These are small proteins.

• Once secreted into the bloodstream, these hormones circulate freely

• They act on the target cells through protein receptors that cross the plasma membranes of the target cells.

• The receptors are specific for a given hormone, but a hormone can have several types of membrane receptors.

• Examples of peptide hormones: insulin, glucagon, parathormone, prolactin, erythropoietin, GH, TSH, LH,
FSH, ACTH, TRH....
 MONO-AMINO HORMONES
• They are all derived from an amino acid: tyrosine.

• They are small molecules and their mechanism of action on target cells is close to that of peptide
hormones. They circulate freely in the blood and act on target cells via trans-membrane receptors:

- the first subgroup contains essentially: adrenaline, noradrenaline, dopamine;

- the other subgroup consists of the thyroid hormones T3 and T4.

• They are bound to plasma proteins in their transport, which inactivates them

• They act on intra-cellular receptors.

• Only the target cells that contain receptors are sensitive to the hormones.
 STEROID HORMONES
• They are lipids synthesized from a cholesterol core.

• These steroids must bind to plasma proteins in order to be transported in the bloodstream.

- The steroid-protein complex is inactive; only the free steroid hormone has an endocrine action.

- The transport protein releases the steroid hormone only into the blood capillaries that supply the
target organs.

- These steroid hormones act on intra-cellular receptors.

- Steroid hormones: cortisol, androgens, progesterone estrogens....

 HORMONE METABOLISM

• Once released, they can either circulate freely (free fraction) or be associated with transport
proteins (reservoir)

• Only the free fraction is active

• The situations which modify the concentration of the transport protein, increase the total
concentration of the hormone without modifying its free fraction and thus its hormonal activity.

• The main endocrine glands are: pituitary, thyroid, parathyroid, adrenal and pineal glands.

• Other organs have endocrine cells: hypothalamus, thymus, pancreas, ovaries, testicles, kidneys,
stomach, liver, small intestine, skin, heart, fatty tissue
Location of the endocrine glands in the body

• Hypophyses
thyroïd

surrénale
• Pancréas

• testicles ovaries
 Hypothalamus
• Hypothalamic-pituitary axis
 ANATOMY

• Central nervous system organ located above the pituitary gland and in contact with the cerebellum

• In connection with the pituitary gland, it secretes neurohormones and intervenes in the endocrine
and autonomic nervous system regulation

• in the regulation of sexual, alimentary, defense, stress and thermoregulatory behavioral functions

• It is connected to the pituitary gland below by the pituitary stem

• The hypothalamus is the endocrine brain of the body since it controls the secretion of all the endocrine glands
of the body
• TRH (thyroid releasing hormone) which stimulates the secretion and release of pituitary TSH (which
stimulates the thyroid gland)
• GnRH (gonadotrophin releasing hormone) which causes the release of both FSH and LH (which regulate the
secretion of the sex glands)
• CRF (cortico releasing factor) which promotes the release of ACTH from the pituitary gland and its synthesis
(action on the adrenal gland which secretes cortisol)
OTHERS HYPOTHALAMIC HORMONES
• ADH or antidiuretic hormone or vasopressin
• Oxytocin
• These 2 hormones are secreted in the hypothalamus and then transported by the pituitary stalk to the posterior
pituitary gland or post pituitary gland where they are stored
 Noyau
périventriculaire
Neurone
Neurosécrétoire

Noyau
Supraoptique

Tractus Hypophyse
hypothalamo-
postérieure
hypophysaire

Hypophyse
antérieure
The pituitary gland
 ANATOMY
• The pituitary gland
• Small gland of 5 mm high and 15 mm wide, 10 mm thick. It weighs 0.60g. It is contained in a
bony compartment called the sella turcica dug in the sphenoid bone
• Organs related to the pituitary gland
• The optic chiasma above the pituitary gland (possibility of compression by pituitary tumors)
• The cavernous sinuses on each side of the gland
• The sphenoidal sinus, the wall is very thin and opens onto the nasal cavity
• The basilar trunk and the protuberances behind the posterior wall of the sella turcica
• Vascularization by 2 systems
• The pituitary arterial system and the hypothalamo-pituitary portal system
• Hypothalamus is connected to the pituitary gland by the infundibulum (connecting rod or pituitary stalk)

• The gland is divided into two parts:

-the adenohypophysis or anterohypophysis glandular part of the pituitary gland that secretes six
hormones: GH,TSH,FSH, LH, PRL ,ACTH.

-the neurohypophysis or post pituitary gland which contains two hormones ADH and OT oxytocin

Pituitary hormones

• somathormone (STH) or growth hormone (GH)

• PROLACTIN

Pituitary stimulins which act on the peripheral glands: thyroid, gonads, adrenals

• corticotropin ACTH (adrenals) gonadotropic hormones FSH, LH (gonads) thyroid stimulating

hormone TSH (thyroid)
 SST : somatostatine

SST GH-RH
GH : Growth Hormone

GH-RH : Growth Hormone Releasing Hormone

IGF-1 : Insulin like Growth Factor 1

GH
IGF1
GH regulation
 PROLACTIN
• The number of prolactin cells is variable and they multiply during pregnancy
• Prolactin secretion increases during pregnancy
• Dopamine from the hypothalamus inhibits prolactin
• TRH stimulates prolactin
• Prolactin causes the mammary gland to produce milk
Pituitary stimulins

ACTH secreted continuously by the pituitary gland but at a variable rate depending on the time of day,
maximum in the morning and minimum at 8 o'clock in the evening 24 hours.

The secretion is regulated by cortisol which acts on the hypothalamic CRH which controls the secretion of
ACTH. ACTH stimulates the adrenal gland and stimulates the production of all adrenal hormones
• FSH secretion regulated by the menstrual cycle

- on the ovary intervenes in the recruitment of oocytes

- on the testis promotes spermatogenesis

• LH : - in women is secreted from puberty every 90 minutes and triggers ovulation

- in men it is secreted cyclically and leads to the production of testosterone

• TSH is permanently secreted but its level is variable during the day.

• It causes the secretion of T3 and T4 secretion under the dependence of the hypothalamic TRH
 FUNCTIONAL ORGANIZATION
• The pituitary is like a conductor

The pituitary gland regulates the peripheral endocrine glands:

• thyroid
• adrenals
• gonads
• mammary gland...
THYROID
 Anatomical description
Thyroid gland

The parathyroids are at the posterior part of the thyroid lobes

• The thyroid gland has 2 lateral lobes, right and left, connected by an isthmus.

• It weighs about 30 g in adults

• The lateral lobes: they have the shape of a rounded pyramid 6 cm high from the thyroid cartilage at the top to
the 6th tracheal ring at the bottom

• the isthmus is pressed against the 2nd and 3rd tracheal ring below
 Thyroid reports

• the trachea: the thyroid goes up and down with the movements of swallowing. A nodule can lead to
breathing problems

• the esophagus: behind the trachea a thyroid tumor can compress the esophagus

• The recurrent nerves: motor nerves of the vocal cords run along the angle between the trachea and
the esophagus

• Larynx: compression of the recurrent nerves can lead to vocal cord paralysis

• Parathyroids: attached to the posterior part of the thyroid lobes

 Outside the thyroid box, the neck
Forward: the skin

• subcutaneous cellular tissue

• the superficial cervical aponeurosis which engages 4 muscles this diamond serves as a reference point for the tracheotomy

On each side: the vascular-nervous bundle of the neck

• carotid artery

• internal jugular vein

• great hypoglossus nerve cervical plexus

Vessels and nerves: two superior and inferior thyroid arteries and a middle one associated with the superior veins lymphatics
and numerous sympathetic plexuses that innervate the thyroid
 Physiology
Iodine

• Thyroid hormones are made from the mineral iodine found in food and drinking water. Daily
needs of 250 to 300 microg/day

There are 2 types of thyroid hormone

• -tetra iodothyronine or T4 or thyroxine which contains 4 atoms of iodine secreted by the thyroid
follicles in large quantities but is not immediately active

• -triiodothyronine or T3 which contains 3 iodine atoms secreted by the follicles and formed in the
target tissues from thyroxine is the active hormone on the tissues.
 Action of thyroid hormones T3 and T4
• Thyroid hormones are secreted into the bloodstream as needed

• They target almost all the cells of the body but particularly

• On the metabolisms :

- glucidic, increases the catabolism of glucose (tendency to hyperglycemia)

- lipidic increases lipolysis,

- protidic, increases the catabolism of nitrogen,

- hydric ,
• Basic metabolism, heat production, calorigenic effect.

• Muscle tissue: control of conduction velocity (controls normal myocardial function) and contraction (peripheral muscles)

• Controls the growth and development of bone and nerve tissue.

• Nervous tissue: control of nerve conduction velocity.

• Digestive tract: control of transit time

• Control of the normal functioning of the genital organs.

 Transport
• Thyroid hormones after release bind to the plasma protein TBG thyroxine binding hormone which
transports them in the blood to the target cells

• T3 is 10 times more active than T4, the tissues are able to convert T4 into T3 thanks to enzymes
(separation of an iodine atom)
 Modulation of thyroid function
• TRH = - released by the hypothalamus
- stimulates secretion and synthesis of TSH
• TSH = - Secreted by the anterior pituitary gland
- Increases intestinal resorption of iodine
- Increases the synthesis of thyroid hormones
- Increases mobilization of T3 and T4 reserves
- If produced continuously => thyroid hypertrophy
• The level of free circulating hormone will regulate the activity of the thyroid = self-regulation

CALCITONIN
• TC is produced by the parafollicular cells of the thyroid gland.
• TC is most effective in childhood.
• In adults, TC is only a weak hypocalcemic agent.
The parathyroids
 ANATOMY
• There are 4 parathyroid glands, 2 superior and 2 inferior, located behind the thyroid lobes. Ectopic
parathyroids may exist, especially in the mediastinum, behind the larynx or the esophagus.

• They measure from 2 to 9 mm in length, from 2 to 5 mm in width and from 0.5 to 4 mm in height. Total
weight 120 to 145 mg.

Relationships:

• essential relationship to the thyroid, but the parathyroids have their own capsule that allows them to be
separated from the thyroid

• vessels and nerves close to the inferior thyroid artery and vein and the recurrent nerve that controls the
vocal cords
• Synthesis: secreted by the main cells of the parathyroid.

• Action of PTH

- Increases the level of calcium in the blood: hypercalcemic and hypophosphatemic hormone.

- at the kidney level: increases the reabsorption of Ca2+ and decreases the reabsorption of
phosphate.

- in the bone: increases bone resorption by activating osteoclasts

- Small intestine (= indirect effect): PTH  activation of calcitriol formation from vitamin D3 by
the kidneys of Ca2+ ion absorption by the small intestine.
OVARIES
 Frontal section of female genitalia

• The ovaries are 2

• Dimensions 5 x 4 x 2 cm
• White pearly color
• Located on each side of the uterus
• Connected to the uterus by utero ovarian ligaments and to the fallopian tubes by the tubo
ovarian ligaments
• Surface marked by grooves ovulation scars and projections of ovarian follicles
Three main hormones:
• Hypothalamic  GnRH: gonadotropin releasing hormone or
gonadoliberin

• Pituitary: glycoproteins with two subunits:

- FSH: follicle stimulating hormon
- LH: luteinizing hormon
 The gonadotropic axis in women
• Role of pituitary hormones:

-FSH Allows follicle growth = stimulates egg production



Stimulates the production of gonadal hormones

-
(estrogenes, progesterone) Allows the ovulation and
 LH
the transformation of the follicle into corpus
luteum
 ROLE OF THE DIFFERENT HORMONES
• FSH acts in synergy with LH to mature the ovarian follicle.
• LH alone triggers ovulation.
• Before puberty, gonadotropins are absent.
• During puberty, the gonadotropins FSH and LH are produced by the gonadotropic cells of the
blood concentration of FSH and LH Estrogens and Progesterone.
• Roles of Estrogens :
- Maturation of the genitalia at puberty;
- appearance of female secondary sexual characteristics at puberty
• Roles of Progesterone: in association with estrogens favors the development of the breasts in
association with estrogens favors the cyclic modifications of the uterine mucous membrane (=
menstrual cycle).
 THE TESTES: ANATOMY
• There are two of them
• Located outside the body, inside the bursa called scrotum the left one is higher than the right one
• Measure 3.5 to 5 cm long, 2.5 to 3.5 wide and 1.5 to 2.5 thick. Weight around 20 g
Main relations
- With the envelopes of the surface to the depth one finds 7 elements: the skin, the dartos, cellular
tissues under cutaneous, superficial fibrous tunic, the cremaster, the deep fibrous tunic, the vaginal tunic.
- With the organs: the epididymis organ formed by the efferent ducts located on the upper edge and
the external part of the testicle
- the vas deferens, which carries sperm from the testicle to the seminal vesicles
Vessels and nerves
• nerves come from the solar plexus and the hypogastric plexus
• the arteries come from the terminal branches of the spermatic artery
 PHYSIOLOGY
• The testis has 2 functions, a reproductive function and an endocrine function

Reproductive function ensured by the spermatozoids contained in the semen, the regulation is done
by the pituitary FSH direct action of the androgens on the seminiferous tubes

Endocrine function carried out by the action of male hormones

• metabolism of male hormones: testosterone, delta4 androstene dione,

dehydroepiandrostenedione (dha)

• regulation of secretion by pituitary gonadostimulines LH which stimulates endocrine secretion of

testosterone
 PHYSIOLOGY
physiological action of male hormones,

- on the genital tract in the fetus responsible for the masculinization of the external genitalia,

- after puberty they allow the development of genitalia, secondary sexual characteristics:
appearance of hair, voice, muscular and skeletal development of male type

- at tissue level anabolic action

 ROLE OF THE TESTOSTERONE
• Testosterone is multifunctional

• It acts on Sertoli cells to promote spermatogenesis

• It allows the differentiation and growth of the reproductive organs

• It is responsible for secondary sexual characteristics

• It exerts a negative feedback on the hypothalamus and pituitary gland

 The gonadotropic axis in men
• Role of pituitary hormones:

FSH and LH Receptors on the Sertoli cell stimulate

-FSH
spermatogenesis


- LH
Receptors on the Leydig cell

Stimulates the synthesis of testosterone
Adrenal gland
 Anatomy
• The adrenal glands are two in number and are located above the kidneys, deep in the abdomen
near the lumbar wall on either side of the spine.

• Triangular in shape, they cover the upper pole of the kidney

• Measure 4.5 cm long, 3 cm wide and 1 cm thick

• They weigh about 8 g

• They are composed of 2 parts : the adrenal cortex and the adrenal medulla (in the middle)
 ANATOMY
They are different on the right and on the left
THE RIGHT ADRENAL GLAND
• Posterior: close to the D12 spine
• Anterior: the inferior vena cava
• outside: the external border of the right kidney
• Superior: above the liver

THE LEFT ADRENAL GLAND

• Posterior: the lumbar wall
• Anterior: in front the body of the pancreas
• outside the left kidney
• Superior: the top of the kidney and the spleen

Vessels and nerves richly vascularized nerves form an adrenal plexus

•A- Adrenal cortex
• The adrenal cortex synthesizes about 30 steroid hormones called
•corticosteroids (= from cholesterol).

The cortical cells are arranged in 3 concentric zones:

Glomerular zone: the outermost zone;

•its cells produce mainly mineralocorticoids
•hormones involved in the hydro-electrolytic balance of the blood.

Fascicular zone: median ;

•its cells produce mainly glucocorticoids, hormones involved in organic metabolism.
•Glucocorticoids are essential hormones for life.

Reticular zone: more internal (= contiguous to the adrenal medulla); its cells produce mainly androgens,
adrenal sex hormones
B- Adrenal medulla

• Responsible for the secretion of adrenaline

• Adrenalin and noradrenalin have actions on the heart, bronchi, digestive tract
PANCREAS
 ANATOMY
• Retroperitoneal abdominal organ, a gland annexed to the digestive tract

• In front of the aorta, the vena cava and the renal veins

• Behind the stomach and the transverse colon in front of and above the kidneys

• The head, isthmus, body and tail can be distinguished along its length

• The duodenal frame surrounds the head of the pancreas

• The choledochus enters the head of the pancreas before ending in the duodenum through a
common structure with the duct of Wirsung: the duodenal papilla

• The pancreas is an exocrine gland excreting pancreatic enzymes into the duodenum through the
duct of Wirsung
• The pancreas synthesizes secretory products, the hormones, which are released into the
bloodstream or act at a distance towards the target cells

• The endocrine part represents only 1% of the mass of the pancreas

• The products synthesized by the endocrine pancreas at the level of the islets of Langherans are the
following hormones

1 - Insulin, the only hypoglycemic hormone

2 - Glucagon hyperglycemic hormone

3 - Somatostatin
 the islets of Langherans
• Glucagon and insulin are two hormones necessary for the regulation of blood sugar levels

• They are produced in the cells of the islets of Langherans

- A alpha island cells for glucagon 15 to 20 % of B beta island cells for insulin

- B beta island cells for insulin 80 % of the island cells

• D or delta cells produce the hormone somatostatin which has an inhibitory effect on insulin and
glucagon. Represent 2 to 5% of the islet

• Also the PP cells secreting pancreatic polypeptides

• the endocrine cells are separated from the exocrine tissue by a collagen capsule that surrounds the islet
HORMONAL REGULATION OF
BLOOD SUGAR
• Insulin and glucagon are involved in the regulation and maintenance of blood sugar levels (blood
sugar levels must be constant throughout the day). (There must be a permanent balance between
the intake of glucose and its use by the cells.

• Only one hormone allows to lower the blood sugar level (hypoglycemic hormones): insulin

• Insulin is secreted by the B cells of the islets of Langerhans. On the other hand, many hormones
can increase the sugar level (hyperglycemic hormones): glucagon, adrenalin
• Insulin: mode of actionInsulin acts on the three insulin-dependent tissues:

- LiverFavors the storage of glucose in the liver in the form of glycogen. If glucose is stored, it
no longer circulates, so it has a hypoglycemic effect

- MuscleInsulin promotes the storage of glucose in the muscle in the form of glycogen

- Adipose tissueInsulin promotes the storage of glucose in adipose tissue in the form of
glycogen
Glucagon: mode of action

- It has the opposite effect of insulin

- Its action is mainly at the level of the liver.

- It stimulates the release and degradation of glycogen in the form of glucose (glycogenolysis) ->

- It increases blood glucose levels

- It allows the production of glucose from amino acids: neoglucogenesis

THANKS FOR YOUR KIND ATTENTION

END