Endocrine Glands

Endocrine Glands

1. ENDOCRINE GLANDS

3. Introduction
•Hypophysiscerebri
•Master of endocrine
orchestra
•But under control of
the hypothalamus
•Suspended from
3rd ventricle

4. Measurements
•Small size
•Reddish -Grey, ovoid body
•Transverse -12 mm
•Antero-posterior -8 mm
•Weight-500 mg

5. Situation
•Hypophysealfossa
roofed by diaphragma
sellae–meningeal
layer of Dura matter
•Capsule adherent to
dura.
•No CSF around Gland

6. Relations
•Anterior –Anterior intercavernoussinus
•Posterior-Posterior intercavernoussinus
•Superior
a.Diapragmasellae
b.Optic chiasma
c.Tubercinerium
d.Infundibularrecess of 3rd ventricle
•Inferior
a.Irregular venous channels Between two Layers Of Dura Mater
b.Hypophysealfossa
c.SphenoidalAir sinuses
•On Each Side-Cavernous sinus & Structures passing
through it.

7. Presenting parts
The pituitary has two major parts
a.Anterior Lobe / Adenohypophysis
b.Posterior Lobe / Neurohypophysis
Differ in their Origin, Structure &
Function

8. Anterior Lobe
It is an ectodermal
derivative of the
stomatodeum.
a.Highly cellular.
b.Pars Anterior
(Pars DistalisOr
Glandularis).
c.Pars Intermedia.
d.Pars Tuberalis.

10. Histology
•Clusters of epithelial cells surrounded by
reticular fibers
•Sinusoids & Fenestrated capillaries
•Glandular cells are arranged in irregular
clumps or cords between a network of
capillaries
•Types of cells:-
–Chromophobecells
–Chromophil(acidophil and basophil) cells.

11. Chromophobecells
•50% of population
•Inactive precursor or
degranulatedafter
release of their most of
hormonal content
•Electron Microscope
shows few granules
inside.
•Melanotropescells

12. •Epithelialcellsfoundintheanteriorand
intermediatelobesofthepituitary.
•Theseepithelialcellsareresponsiblefor
producingthehormonesoftheanterior
pituitaryandreleasingthemintothe
bloodstream.
•Melanotrophsareanothertypeof
chromophobewhichsecretemelanocyte
stimulatinghormone(MSH)

13. Chromophilcells
•50 % population
•Contains cytoplasmicgranules
•The contents of the secretoryvesicles
are responsible for the staining
characteristics of the chromophilcells.
i.Acidophil cells (or acidophils)
ii.Basophilcells (or basophils)

14. Acidophil cells
•40 % of parenchyma, subtype of acidophilsare the
–Somatotrophs
–Mammotrophs
•Somatotrophsproducegrowthhormone(GHor
somatotropin),whichstimulateslivercellstoproduce
polypeptidegrowthfactorswhichstimulategrowth(e.g.
somatomedinwhichstimulatesepiphysealcartilage)
–overproductionofthishormonemayresultingigantism
oracromegaly
•Mammotrophsorlactotrophssecreteprolactin.Their
numberincreasessignificantlyinlatepregnancyandthe
earlymonthsoflactation

15. Basophilcells
•10 % of Parenchyma
•Secrete Trophichormones
•Thyrotrophsproduce thyroid stimulating hormone (TSH or
thyrotropin).
•Gonadotrophsproduce follicle stimulating hormone (FSH),
which stimulates the seminiferousepithelium in males in
addition to early follicular growth in females.
Gonadotrophsalso produce luteinizing hormone (LH),
which stimulates production of testosterone by Leydigcells
in males in addition to late follicular maturation, oestrogen
secretion and formation of corpus luteumin females.

16. •Corticotrophs(oradrenocorticolipotrophs)
secrete
–Adrenocorticotropichormone(ACTHor
corticotropin)
–Lipotropin(LPH,noknownfunctionin
humans).
•Corticotropesarethemostfrequentcelltypein
theparsintermedia.

17. Posterior Lobe / Neurohypophysis
•Neurohypophysisis a diencephalicdown
growth connected with the hypothalamus
–Neural Lobe Or Pars Posterior
–Median Eminence
–InfundibularStem

19. Histology
•Consistsofunmyelinatednervefibersderivedfrom
neurosecretorycellsofthesupraoptic&
paraventricularhypothalamicnucleiandpituicytes.
•Ovalorroundnucleiofthepituicytesarevisible
•Hypothalamicnervefiberstypicallyterminateclose
tocapillaries
•Herringbodies-Scattered,large,andbluish-violet
(inPAS/OrangeGstainedsections)masses
representdilationsofthesenervefibers.
•Containneurosecretoryproductsofthe
hypothalamiccells.

20. •Theneurohormonesstoredinthemainpartoftheneurohypophysis
are
–Vasopressin(antidiuretichormone;ADH),whichcontrolsreabsorptionof
waterbyrenaltubules.
–Oxytocin:-paraventricularnucleusofhypothalamus which
promotesthecontractionofuterinesmoothmuscleinchildbirthandthe
ejectionofmilkfromthebreastduringlactation.
•Storagegranulescontainingactivehormonepolypeptidesboundtoa
transportglycoprotein,neurophysin,passdownaxonsfromtheirsite
ofsynthesisintheneuronalsomata.Thegranulesareseenasswellings
alongtheaxonsandattheirterminals,whichcanreachthesizeof
erythrocytes

21. Hypothalamic control
•Hypophysiotropicareaofhypothalamus
•Hypothalamicparaventricularnucliiand
hypothalamicneuronsarehelpstoregulate
thefunctionsofpituitarygland.

23. Anterior pituitary
•Adrenocorticotrophichormone (ACTH)
•Thyroid-stimulating hormone (TSH)
•Luteinisinghormone (LH)
•Follicle-stimulating hormone (FSH)
•Prolactin(PRL)
•Growth hormone (GH)
•Melanocyte-stimulating hormone (MSH)
Posterior pituitary
•Anti-diuretic hormone (ADH)
•Oxytocin

24. •TRH-secreatedby dorsomedialnucleus
•LHRH-Preopticarea & anterior hypothalamus
•CRH-Corticotropin-releasing hormone -Supra-
optic & paraventricularnucli
•GHRH–Growthhormone releasinghormone -
Ventero-medial nucleus
•GIH-(Growth Inhibiting Hormone)-periventricular
nucleus
•PRH–Location is not yet known
•PIH-Arcuatenucleus, dopaminargic. Dopamine
inhibits Prolactinrelease

25. •Dwarfismisaconditioninwhichthegrowthof
theindividualisveryslowordelayed,resultingin
lessthannormaladultstature.
Clinicalfeatures:
•Pubertydelayed,Anaverage-sizetrunk
•Shortarmsandlegs,withparticularlyshortupper
armsandupperlegs
•Shortfingers,oftenwithawideseparation
betweenthemiddleandringfingers
•Limitedmobilityattheelbows
•Adisproportionatelylargehead,withaprominent
foreheadandaflattenedbridgeofthenose
•Progressivedevelopmentofbowedlegs
•Progressivedevelopmentofswayedlowerback
•Anadultheightaround4feet
•Sexuallyactive.
Applied anatomy/Applied physiology
Dwarfism

26. Gigantism
Gigantismisaconditioncharacterizedby
excessivegrowthandheightsignificantly
aboveaverage.Inhumans,thisconditionis
caused by over-production
ofgrowthhormoneinchildhoodresultingin
peoplebetween7feet(2.13m)and9feet
(2.75m)inheight.
•Itoccursbeforetheepiphysealclosure.
CLINICALFEATURES:
Very large hands and feet
Thick toes and fingers
A prominent jaw and forehead
Coarse facial features
Children with gigantism may also have flat
noses and large heads, lips, or tongues.

27. Acromegaly
•Acromegalyisaconditionthat
resultsfromexcessgrowth
hormone(GH)afterthegrowth
plateshaveclosed.
•Theinitialsymptomistypically
enlargementofthehandsandfeet.
Theremayalsobeenlargementofthe
forehead,jaw,andnose.Other
symptomsmayincludejointpain,
thickerskin,deepeningofthe
voice,headaches,andproblemswith
vision.Complicationsofthedisease
mayinclude
•Type2diabetes,sleepapnea,
andhighbloodpressure

29. •Thepinealgland,alsoknownasthepineal
body,conariumorepiphysiscerebri,isa
smallendocrineglandinthevertebratebrain.
•Theshapeoftheglandresemblesapinecone,
henceitsname.
•Thepinealglandislocatedintheepithalamus,
nearthecenterofthebrain,betweenthe
twohemispheres,tuckedinagroovewherethe
twohalvesofthethalamusjoin.

30. •Theepiphysiscerebriisareddish-grey,
approximately5–8mmlong,pinecone-like
structurethatislocatedinthediencephalic
partoftheprosencephalon(forebrain).The
glandwasformedasanoutwardgrowthof
theroofofthethirdventricle.

31. Position
•It’sattachmenttoeitherhalfofthe
brainisbytheHabenular
commissureandtrigonesuperiorly,
andtheposteriorcommissure
inferiorly.
•TheHabenularandposterior
commissuresareapartofthepineal
stalk.
•TheHabenularcommissureisapart
ofthesuperiorlaminaofthestalk,
whiletheposteriorcommissureisa
partoftheinferiorlamina.
•Thespacebetweenthelaminaeis
knownasthepinealrecess.
•Itcommunicatesanteriorlywiththe
hypothalamicsulcusandthethird
ventricle.

32. Relations
Coronal section of the brain
•Superiorly,thespleniumofthe
corpuscallosum
•Superolaterally,thechoroid
plexusofthethirdventricle
•Inferiorly,thesuperiorand
inferiorcolliculi
Thesagittalsection
•Inferiorlythequadrigeminal
plate.
•AnterosuperiortheHabenular
commissureandthethalamus.
•Theposteriorcommissure,the
cerebralpeduncle

33. •Thepinealglandproducesmelatonin,
aserotoninderivedhormonewhich
modulates sleep patterns in
bothcircadianandseasonalcycles.

34. Histology
•Pinealocytes:-They produceand
secretemelatonin.
•Interstitialcells:-theyarelocatedbetween
thepinealocytes.Theyhaveelongated
nucleiandacytoplasm.
•Perivascularphagocytes:-Theperivascular
phagocytesareantigenpresentingcells.

35. Blood Supply
•Supplied from the choroidalbranches of
theposterior cerebral artery

36. Nerve supply
•The pineal gland receives
asympatheticinnervationfromthesuperior
cervicalganglion.
•Aparasympatheticinnervationfrom
thepterygopalatineandoticganglia.
•Neurons in the trigeminal
ganglioninnervatetheglandwithnerve
fiberscontainingthepituitaryadenylate
cyclase-activatingpolypeptide(PACAP.)

38. •Thethyroidglandisanendocrineglandin
theneck,consistingoftwolobesconnectedby
anisthmus.Itisfoundatthefrontoftheneck,
belowtheAdam'sapple.
•Thethyroidglandsecretesthyroidhormones,
whichprimarilyinfluencethemetabolic
rateandproteinsynthesis.
•Thethyroidhormones
–Triiodothyronine(T
3)
–Thyroxine(T
4)
–Calcitonin,

39. •Effects of thyroid
hormonesT
3andT
4
–Metabolic,
–Cardiovascular
–Developmental
•Hormonaloutputfromthe
thyroidis regulated
by thyroid-stimulating
hormone(TSH)secreted
from the anterior
pituitarygland,whichitself
isregulatedbythyrotropin-
releasinghormone(TRH)
produced by
thehypothalamus

40. •There are three primary features of the
thyroid
–Follicles
–Follicular cells
–Parafollicularcells

41. Follicles
•Thyroidfolliclesaresmallspherical
groupingsofcells0.02–0.9mmindiameter.
Itsurroundsacoreofcolloidthatconsists
mostlyofthyroidhormoneprecursor
proteins called thyroglobulin,
aniodinatedglycoprotein.

42. Follicularcells
•Thecoreofafollicleissurroundedbyasingle
layeroffollicularcells.Whenstimulatedby
thyroidstimulatinghormone(TSH),these
secretethethyroidhormonesT3andT4.They
dothisbytransportingandmetabolisingthe
thyroglobulincontained in the
colloid.Follicularcellsvaryinshapefromflat
tocuboidtocolumnar,dependingonhow
activetheyare.

43. Parafollicularcells
•Scatteredamongfollicularcellsandin
spacesbetweenthesphericalfolliclesare
anothertypeofthyroidcell,parafollicular
cells.Thesecellssecretecalcitoninandso
arealsocalledCcells.

44. Thethyroidglandweighs10to
20gramsinnormaladults.
Thyroidvolumemeasuredby
ultrasonographyisslightly
greaterinmenthanwomen
itincreaseswithageandbody
weight.
itdecreaseswithincreasing
iodineintake.
Thethyroidisoneofthemost
vascularorgansinthebody.
Thus,USmeasurementsof
thyroidvolumeandevennodule
sizecandiffermarkedlyfrom
thesizeafterdevascularization
andresection.

45. Its location & relations
•Thenormalthyroidglandis
immediatelycaudaltothe
larynxandencirclesthe
anterolateralportionofthe
trachea.
•Thethyroidisborderedbythe
tracheaandesophagusmedially
andthecarotidsheathlaterally.
•The sternocleidomastoid
muscleandthethreestrap
muscles (sternohyoid,
sternothyroid,andthesuperior
bellyoftheomohyoid)border
thethyroidglandanteriorlyand
laterally

46. Shape
•Itconsistsoftwolobesconnected
byanarrowisthmus.
•Eachlobeispyramidalinshape,
withitsapexdirectedupwardand
itsbasedirecteddownward.
•Theisthmusisthenarrowpartof
theglandconnectingthetwolobes.
•Asmallpyramidallobeprojecting
upwardfromtheisthmusisoften
presenttotheleftofthemidline.

47. BLOOD SUPPLY
Thearterialbloodsupplyto
thethyroidglandisprimarily
fromtherightandleft
superiorandinferiorthyroid
arteries,derivedfromthe
externalcarotidarteriesand
thyrocervical trunk,
respectively.
Thevenousdrainageconsists
ofthesuperior,middle,and
inferiorthyroidveinsthat
drainintotheinternal
jugularveinandinnominate
vein

48. Superiorthyroidartery:-isthefirstbranchoff
theexternalcarotidartery.Itextendsinferiorlyto
thesuperiorpoleofthethyroidlobe.
Inadditiontosupplyingthethyroid,thesuperior
thyroidarteryistheprimarybloodsupplyto
approximately15percentofsuperiorparathyroid
glands.
Thesuperiorthyroidarteryisalandmarkfor
identificationofthesuperiorlaryngealnerve,which
courseswiththearteryuntilapproximately1cm
fromthesuperiorthyroidpole

49. Inferior thyroid artery:-is a branch of
the thyrocervicaltrunk which arises from the
subclavianartery.
The inferior thyroid artery courses posterior to
the carotid artery to enter the lateral thyroid.
The point of entry can extend from superior to
inferior thyroid poles.
The inferior thyroid artery also supplies the
inferior parathyroid glands and approximately
85 percent of superior parathyroid glands.

50. Thyroideaimaartery:-isfoundin
approximately3percentofindividualsand
arisesfromtheaorticarchorinnominate
arteryandcoursestotheinferiorportionofthe
isthmusorinferiorthyroidpoles.
Surgicalcontrolofthethyroidimaarteryis
essentialduringthyroidectomy.
Thethyroideaimaarterycanbequiteenlarged
inpatientswiththyroiddiseasesuchasgoiter
orhyperthyroidism

51. Venous drainage
Superior thyroid
vein:
Itarisesfromtheupperpartof
thelobe.
Itendsintotheinternaljugular
vein.
Middlethyroidvein:
Itarisesfromthemiddleofthe
lobe.
Itendsintotheinternaljugular
vein.
Inferior thyroid
veins:
Arisefromtheisthmusand
lowerpartsofthelobes.
Descendinfrontofthetrachea.
Endintotheleftbrachiocephalic
vein.

52. Lymphatic drainage
The lymphatic vessels of
the thyroid gland drain
into:-
–Pretracheallymph
nodes.
–Paratracheallymph
nodes.
The efferent of these
nodes drain into:-
–The deep cervical
lymph nodes.

53. Thyroid Physiology
Synthesis of the thyroid hormone
•Trappingofinorganiciodidefromtheblood
•Oxidationofiodidetoiodine.
•Bindingofiodinewithtyrosinetoform
iodotyrosines.
•Couplingofmono-iodotyrosinesanddi-
iodotyrosinetoformT3,T4

54. •Themetaboliceffectsofthethyroid
hormonesareduetounboundT4andT3.
•T3isthemoreimportantandisalso
producedintheperipherybyconversion
fromT4.
•T3isquickacting(withinafewhours)
whereasT4actsmoreslowly(4-14days)

55. Regulation of thyroid
hormone production

56. •Thyrotropin-releasinghormone(TRH)increasesthe
secretionofthyrotropin(TSH),whichstimulatesthe
synthesisandsecretionoftrioiodothyronine(T3)and
thyroxine(T4)bythethyroidgland.
•T3andT4inhibitthesecretionofTSH,bothdirectlyand
indirectlybysuppressingthereleaseofTRH.
•T4isconvertedtoT3intheliverandmanyothertissues
bytheactionofT4monodeiodinases.
•SomeT4andT3isconjugatedwithglucuronideandsulfate
intheliver,excretedinthebile,andpartiallyhydrolyzedin
theintestine.
•SomeT4andT3formedintheintestinemaybe
reabsorbed.
•Druginteractionsmayoccuratanyofthesesites.

57. Effects of Thyroid Hormone
Fetal brain and skeletal maturation
Increase in basal metabolic rate
Increases sensitivity to catecholamines
Stimulates gut motility
Increase bone turnover
Increase in serum glucose, decrease in serum
cholesterol

58. Applied anatomy/Applied physiology
•Hypothyroidism:-A condition in which the
thyroid gland doesn't produce enough thyroid
hormone.
•Hyperthyroidism:-The overproduction of a
hormone by the butterfly-shaped gland in the
neck (thyroid).
•Thyroiditis:-Inflammation of the thyroid, the
butterfly-shaped gland in the neck.
•Thyroid cancer:-A cancer of the thyroid, the
butterfly-shaped gland at the base of the neck.

59. •Goiter:- Abnormal
enlargementofthe
butterfly-shaped gland
belowtheAdam'sapple
(thyroid).
•Cretinismisaconditionof
severelystuntedphysical
andmentalgrowthowing
tountreatedcongenital
deficiencyofthyroid
hormone (congenital
hypothyroidism)usually
owing tomaternal
hypothyroidism.

61. •The parathyroid
glandsarefourtinyglands,
locatedintheneck,that
controlthebody'scalcium
levels.
•Eachglandisaboutthe
sizeofagrainofriceand
weighsapproximately30
milligramsandis3-4
millimetersindiameter.
•Theparathyroidsproduce
a hormone
calledparathyroidhormon
e(PTH).

62. Size and location
Normal parathyroidglandsare
approximatelythesizeofagrainofriceora
lentil.
Normalglandsareusuallyabout5by4by2
millimetersinsizeandweigh35to50
milligrams.
Enlargedparathyroidglandscanbe50
milligramsto20gramsinweight,most
typicallyweighingabout1gramand1
centimeterinsize

63. •Twouniquetypesofcellsarepresentinthe
parathyroidgland:-
•Chiefcells,whichsynthesizeandrelease
parathyroidhormone.Thesecellsaresmall,
andappeardarkwhenloadedwithparathyroid
hormone,andclearwhenthehormonehas
beensecreted,orintheirrestingstate.
•Oxyphilcells,whicharelighterinappearance
andincreaseinnumberwithage,havean
unknownfunction.

64. Functions of Parathormone
•Parathyroidhormone regulatesserum
calciumthroughitseffectsonbone,kidney,andthe
intestine
•PTHreducesthereabsorptionofphosphatefrom
theproximaltubuleofthekidney
•PTH increasestheactivityof1-α-
hydroxylaseenzyme,whichconverts25-
hydroxycholecalciferol,themajorcirculatingformof
inactive vitamin D, into 1,25-
dihydroxycholecalciferol,theactiveformofvitamin
D,inthekidney.

65. Superior parathyroid glands
Normalsuperiorparathyroidglandsare
usuallylocatedontheposterior-lateral
surfaceofthemiddletosuperiorthyroid
lobe.
Theylieunderthethyroidsuperficialfascia,
posteriortotherecurrentlaryngealnerve
andcanbevisualizedbycarefullydissecting
thethyroidcapsuleinthisregion.

66. Stimulators
•Decreased serum [Ca
2+
].
•Mild decreases in serum [Mg
2+
].
•An increase in serum phosphate
Inhibitors
•Increased serum [Ca
2+
].
•Severe decreases in serum [Mg
2+
]
•Calcitriol

67. Blood Supply
•Thesuperiorparathyroidglandsreceive
mostoftheirbloodsupplyfromtheinferior
thyroidarteryandalsoaresuppliedby
branchesofthesuperiorthyroidarteryin
15to20percentofpatients.

68. Inferiorparathyroidglands
Thetwoinferiorparathyroidglandsreside
intheanteriormediastinalcompartment,
anteriortotherecurrentlaryngealnerve.
Theyaremostoftenfoundinthe
thyrothymictract,orjustinsidethethyroid
capsuleontheinferiorportionofthe
thyroidlobes

69. Blood Supply
•Theinferiorparathyroidglandsreceive
theirend-arterialbloodsupplyfromthe
inferiorthyroidartery.

71. Introduction…
•Soft, lobulated
elongated gland with
both exocrineand
endocrinefunctions
•Exocrine –pancreatic
juice
•Endocrine-insulin

72. Location…
•epigastric& left
hypochondriac
regions
•behind the stomach
and lesser sac
•Transversely across
the posterior
abdominal wall at
the level of the L2
&L3

73. Size and shape…
•J shaped or
retort shaped.
•Length-15-20
cm
•Thickness-
1.2-1.8 cm
•Breadth-2.5 -
3.8 cm
•Wt-90 gm

74. Parts …

75. Head …
Enlarged part C
shaped, lying within
the concavity of
duodenum, consist of
•3 borders-superior
,inferior & right
lateral
•2 surfaces-anterior
& posterior
•uncinateprocess

76. Head …
•Superior border-
-1
st
part of duodenum
-Sup. pancreaticodudenalA.
•Inferior border-
-3
rd
part of duodenum
-Inf. pancreaticodudenalA.
•Rt. lateral border-
-2
nd
part of duodenum
-Terminal part of bile duct
-Anastomosisbetween 2
arteries.

77. Head…
Anterior surface
•1st part of
duodenum.
•Transverse
colon
•Jejunum
separated by
peritotneum.

78. •Stomach
•Lesser
omentum
•Lesser sac

80. Head…
Posterior
surface:
•IVC
•Right Renal
veins
•Right crusof
diaphragm
•Bile duct

81. Uncinateprocess
Triangular projection
which arises from
lower and left part off
the body.
Relations:
•Anterior:
-Superior mesenteric
vessels.
•Posterior
-Aorta
•Above
-Left renal vein

82. Neck
Relations:
Anterior surface
•Peritoneum
covering lesser sac
•Pylorus

83. Posterior surface
is related to
•superior
mesenteric vein
•portal vein

84. Body
•Elongated part.
•Extends from neck
to the tail.
•Passes toward the
left with slight
upward and
backward inclination

85. Triangularin cross
section
•3 borders
–Anterior
–Superior
–Inferior
•Tuber omentale-
small projection on
superior border little
to the left of the neck

86. Body-Relations
Borders:
•Anteriorattach to
root of the tranverse
mesocolon.
•Superior related to
coeliactrunk, hepatic
artery & splenic
artery
•Inferior is related to
superior mesenteric
artery.

87. Surfaces:
•Anterioris convex
covered by the
peritoneum related to
the lesser sac &
stomach.
•Inferior surface
covered by the
peritoneum related the
DJ flexure coils of
jejunum & Lt. colic
flexure.

88. Posterior surface
•Aorta
•Left crusof the
diaphragm
•Left kidney
•Left Suprarenal gland
•Left renal vessels
•Splenicvein

89. Tail
•Left end of the
pancreas
•Lies in the lienorenal
ligament ,together
with the splenic
vessels
•Related to the lower
part of the spleen
(gastric surface.

90. Ducts system…
Exocrine
part of
pancreas is
drained by
the 2 ducts
•Main
•Accessory.

91. Main pancreatic duct of wirsung…
•Lies near posterior
surface ,3 mm in
diam.whitein colour
•Begins at the tail, runs
throughout the body
,bends at the neck to
run downwards
backwards in the head.
•Herring bone pattern

92. Herring bone pattern…

93. Main pancreatic duct of wirsung…
•Lies near the posterior
surface of the pancreas
•White in color
•Begins at the tail, runs to
the right through the
body, bends at the neck
runs downwards
backwards and to the
right in the head.

94. Main pancreatic duct of wirsung…
•In the head of the
pancreas, it is related
to the bile duct(on rt.
side)
•Two ducts open in the
wall of the 2
nd
part of
the duodenum and
join to form
hepatopancreatic
ampullaof vater
which open as major
duodenal papilla,8-10
cm distal to pylorus.

95. Accessory duct of Santorini…
•Begins in the lower
part of head, crosses
the main duct with
which it
communicates
•Opens as minor
duodenal papilla in
the 2
nd
part of
duodenum (6-8 cm
distal to pylorus)

96. Arterial supply…
-SplenicA.
-Superior pancreatico-
duodenal artery
(from coeliactrunk)
-Inferior pancreatico-
duodenal A.(from
superior mesenteric
A)

97. Venous drainage…
•Splenicvein
•Superior mesenteric
vein
•Portal vein

98. Nerve supply…
•Parasympatheticby
the vagusnerve
controlling secretion .
•Sympathetic from
coeliac& superior
mesenteric plx.
•Secretion is also
controlled by
harmonesecretin-
pancreozymine.

99. Lymphatic drainage…
•Head & neck –ventral & dorsal
pancreaticodudenalgroup LN.
•Body &tail by pancreatico-splenicLN.
•Efferentsto Coeliac& sup. mesenteric LN

100. Applied anatomy…
•Congenital
•Truama
•Infection /inflammation
•Tumour
•Procedures

101. Congenital
•Annularpancreas:
Developmentalanomalywherering
ofpancreatictissuesurroundsand
obstructduodenum

102. Truama
•Results from sudden
forceful compression
of abdomen such as
steering wheel leading
to rupture.
•Digestion of pancreas
and surrounding tissue
by free pancreatic
juice is very painful
clinical condition.

103. Inflammation…
Pancreatitis
•May be primary or
secondary due to gall
stone.
•Results in collection of
fluid in the lesser sac
•Pain is poorly localised
,referred to epigastrium.
•Acute pancreatitis is
serious clinical condition
may be due to mumps

104. Carcinoma
•Common in head
•Causes obstructive
jaundice due to BD
compression
•Causes ascitesdue
to portal vein
compression.
•Causes pyloric
obstruction.

105. Procedures
•Endoscopic retrograde cholangiopancreatico
graphy:-Standard procedure for Dxof pancreatic &
biliarydiseases

106. Diabetes mallitus
•Conditioninwhichthepancreasnolonger
producesenoughinsulinorcellsstop
respondingtotheinsulinthatisproduced,
sothatglucoseinthebloodcannotbe
absorbedintothecellsofthebody.
•Symptoms:frequenturination,lethargy,
excessivethirst,andhunger.
•Treatmentincludeschangesindiet,oral
medications,andinsomecases,daily
injectionsofinsulin.