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Summary Hormones- medical school study guide

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This is a medical school level comprehensive overview of principles of hormones, related diseases, and pharmacological concepts.

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Week 1

Mar 24: Endocrine Overview
Pituitary Gland
Overview
-​ Master organ of the endocrine system
-​ Composed of two distinct parts:
1.​ Anterior Pituitary (Adenohypophysis)
-​ Histo: Glandular epithelium
-​ Derived from ectoderm
2.​ Posterior Pituitary (Neurohypophysis)
-​ Histo: Neural secretory tissue
-​ Derived from neuroectoderm
Anterior Lobe (Adenohypophysis)
-​ Structural Components
-​ Derived from Rathke's pouch: outpouching of the roof of pharynx
-​ Consists of: glandular epithelium
-​ Pars anterior: Largest part, responsible for hormone secretion
-​ Pars intermedia: Thin epithelial layer between anterior and posterior lobes
-​ Pars tuberalis: Upward extension surrounding infundibulum
-​ Hormone Regulation
-​ Release controlled by hypothalamus
-​ Communication via neurotransmitters in hypophyseal portal vessels
Posterior Lobe (Neurohypophysis)
-​ Originates from embryonic forebrain, essentially an extension of the hypothalamus
-​ Consists of Nervous tissue
-​ Infundibulum stalk: hypothalamus connection
-​ Pars Nervosa: hormone storage
Embryological Development
Dual Origin
-​ Epithelial Portion: pharyngeal roof and Rathke's pouch detaches→ anterior pituitary
-​ Neural: extension of forebrain/hypothalamus via infundibulum → posterior pituitary
Developmental Process
-​ Week 3:
-​ Proximal infundibulum develops in 3rd ventricle floor→ ventral growth
-​ Ectodermal placode→ forms Rathke's pouch→ loses stomodeum connection
-​ Differentiates into adenohypophysis
Anatomical Characteristics
-​ Small, ovoid body (500mg), located in sphenoid bone's pituitary fossa
-​ Covered by diaphragm sellae, near optic chiasm
-​ Vasculature

, -​ Superior Hypophyseal A→ Anterior Pituitary
-​ Unique portal system allows hypothalamic communication
-​ Posterior Pituitary: multiple arteries
-​ Superior Hypophyseal A, Infundibular A, Inferior Hypophyseal A
-​ Anterior Pituitary
-​ Pars Distalis: makes up bulk of anterior pituitary
-​ Contains acidophiles, basophils, chromophobes
-​ Pars Intermedia: between pars distalis and pars nervosa
-​ Contains Rathke Cysts and secretory cells → Melanocyte-Stimulating H(MSH)
-​ Pars Tuberalis: surrounds the infundibulum
-​ Contains parenchymal cells and squamous/cuboidal cells
-​ Shows immunoreactivity to ACTH, FSH, LH
Cellular Composition
Anterior Pituitary
1.​ Acidophils (40%): stain red
-​ Somatotrophs: Somatotropin(GH)
-​ Stimulated by GHRH, Inhibited by Somatostatin
-​ Increase metabolic rate via Insulin-GF(IGF-1) → bone and muscle growth
-​ Lactotropes: Prolactin
-​ Stimulated by PRH and Oxytocin, Inhibited by Dopamine/PIF
-​ Increase mammary gland development and lactation
2.​ Basophils (10%): stain blue
-​ Corticotrophs: ACTH precursor
-​ Stimulated by CRH, Inhibited by high plasma cortisol
-​ Increases release of hormones from adrenal cortex
-​ Thyrotrophs: Thyrotropin (TSH)
-​ Stimulated by TRH, Inhibited by blood T4/T3
-​ Increases synthesis and release of thyroid hormones
-​ Gonadotrophs: FSH and LH
-​ Stimulated by GnRH, Inhibited by ovarian/testes hormones
-​ Increases ovarian follicle growth, estrogen/testosterone secretion
3.​ Chromophobes (50%): stain weakly
-​ Stem cells and undifferentiated progenitors
Posterior Pituitary
-​ Characteristics
-​ Not a true endocrine gland, storage and release site for hypothalamic neurosecretions
-​ Cell bodies in hypothalamus, unmyelinated axons terminating in posterior lobe
-​ Pars Nervosa: Neurosecretory axon endings
-​ Features Herring bodies: accumulation of axons with granules(oxytocin/ADH)
-​ Supported by Pituicytes (glial-like cells)
-​ Infundibulum: Neurosecretory tract

Adrenal Glands
Overview

, -​ Location: Paired organs on superior poles of each kidney
-​ Structure:
-​ Covered by dense connective tissue capsule
-​ Stroma consists of reticular fibers and microvasculature
-​ Composed of two regions: adrenal cortex and adrenal medulla
Neurovasculature
Arterial Supply
-​ 50-60 branches penetrate the gland's capsule
-​ Sources:
-​ Inferior Phrenic AA→ Superior Suprarenal AA→ superior portion
-​ Abdominal Aorta → Middle Suprarenal AA → middle portion
-​ Renal A → Inferior Suprarenal AA → inferior portion
Venous Drainage
-​ Right Suprarenal V→ drains into IVC
-​ Left suprarenal V→ drains into L Renal V
-​ Often joined by Inferior Phrenic V
Innervation
-​ Adrenal Cortex: mainly responds to hormonal input (ACTH)
-​ Secrete mineralocorticoids, glucocorticoids, sex hormones
-​ Adrenal Medulla: direct sympathetic innervation, produces steroids
-​ Preganglionic Symp. fibers → pass thru paravertebral ganglia→ Greater Splanchnic N
-​ Can synapse directly on adrenal medulla or pass thru celiac ganglion→ Chromaffin cells
-​ Produces catecholamines (norepinephrine/epinephrine)
Adrenal Cortex
-​ Mesenchyme origin
-​ Functional Zones (outer→inner)
1.​ Zona Glomerulosa (15% of cortex)
-​ Histo:: Small columnar/pyramidal shaped cells
-​ Hormone: Mineralocorticoids(Aldosterone)
-​ Regulates Na+ and K+ homeostasis→ fluid and electrolyte balance
-​ Feedback from renin-angiotensin system
2.​ Zona Fasciculata (80% of cortex)
-​ Histo: Long cords of large, polyhedral cells
-​ Hormones: Glucocorticoids (Cortisol, Corticosterone)
-​ Regulates gluconeogenesis and glycogenesis
3.​ Zona Reticularis (5-7% of cortex)
-​ Histo: Smaller cells with dark nuclei
-​ Hormones: Dehydroepiandrosterone (DHEA)
-​ Secretes weak androgens(masculinizing)
Adrenal Medulla
-​ Neural crest origin
-​ Functions as modified sympathetic ganglion
1.​ Chromaffin Cells:
-​ Large epithelioid cells arranged in clusters or cords surrounded by capillaries

, -​ Two populations of cells called pheochromocytes
-​ Secrete either epinephrine/norepinephrine depending on cortisol levels (high→epi)
-​ Stimulated by ACh from preganglionic sympathetic terminals
Adrenal Gland Development
-​ Cortex: Develops from mesenchyme
-​ Medulla: Develops from neural crest cells
Developmental Stages:
-​ Neural crest cells form mass on medial side of embryonic cortex
-​ Zona glomerulosa and fasciculata present at birth
-​ Zona reticularis recognizable by end of third year
-​ Fetal glands 10-20x larger relative to body weight compared to adult glands
Thyroid Gland
Overview
-​ Largest endocrine gland, 2 lobes connected by an isthmus
-​ Located anteriorly to the 2nd tracheal ring, surrounded by a thin fibrous capsule
-​ Hormones Produced
1.​ Thyroid hormones(T3/T4): Control metabolism rate
2.​ Calcitonin: decreases blood calcium
Neurovasculature
-​ Arterial Supply
-​ L side: Common Carotid A→ superior part, L Subclavian A → inferior part
-​ R: Brachiocephalic trunk→ External Carotid → Superior Thyroid A and Thyroid ima A
-​ Superior part and isthmus
-​ Venous Drainage
-​ Similarly named veins → L and R brachiocephalic V→ SVC
-​ Innervation
-​ Sympathetic: superior, middle & inferior sympathetic cervical ganglia
-​ Parasympathetic: Vagus N (CN X)
Thyroid Gland Development
-​ Origin: endoderm
-​ Forms at the apex of foramen cecum on developing tongue
-​ Key Developmental Stages:
-​ Forms late in week 4
-​ Descends through neck via thyroglossal duct
-​ Duct breaks down by end of fifth week
-​ Reaches final position below cricoid cartilage by seventh week
-​ Begins hormone secretion as early as week 10
-​ Cell Composition:
-​ Invested with neural crest cells and ultimobranchial bodies → form parafollicular cells
-​ Pharyngeal Pouches
-​ 1st: tympanic cavity and mastoid(ear part)
-​ 2nd: palatine/tonsillar fossa
-​ 3rd: inferior parathyroid and thymus
-​ 4th: superior parathyroid and parafollicular cells of thyroid

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