Dilranjan Kaur, Nursing Tutor 1

THE ENDOCRINE SYSTEM, Bsc Nursing 1st year

By- Dilranjan Kaur, Nusing Tutor

THYROID GLAND
The thyroid gland is a hormone-producing gland that is familiar to most people primarily
because many obese individuals blame their overweight condition on their “glands”
(thyroid).

 Location. The thyroid gland is located at the base of the throat, just inferior to the Adam’s
apple, where it is easily palpated during a physical examination. The butterfly-shaped
thyroid gland is located just inferior to the larynx (voice box); the right and left lateral lobes
lie on either side of the trachea. The gland usually weighs about 30 g (1 oz) and has a rich
blood supply, receiving 80–120 mL of blood per minute.

 Lobes. It is a fairly large gland consisting of two lobes joined by a central mass, or isthmus.
 Composition. Microscopic spherical sacs called thyroid follicles make up most of the
thyroid gland. The wall of each follicle consists primarily of cells called follicular cells.
Internally, the thyroid gland is composed of hollow structures called follicles, which store a
sticky colloidal material. The gland is composed of cuboidal epithelium that forms spherical
follicles. These secrete and store colloid, a thick sticky protein material. Between the
follicles there are other cells found singly or in small groups: parafollicular cells, also called
C-cells, which secrete the hormone calcitonin.
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BLOOD SUPPLY TO THYROID GLAND-

 The main blood supply of the thyroid gland is from the superior thyroid artery (a branch
of the external carotid artery) and the inferior thyroid artery (a branch of the thyrocervical
trunk from the subclavian artery).
 The thyroid gland is drained by the superior and middle thyroid veins, which pass into the
internal jugular veins, and the inferior thyroid veins, which join either the brachiocephalic
veins or the internal jugular veins. (for more detail please refer page no. 6 of pdf)

THYROID HORMONES
The follicular cells of thyroid gland produce two hormones: THYROXINE, which is also
called tetraiodothyronine, or T4, because it contains four atoms of iodine, and
TRIIODOTHYRONINE, or T3, which contains three atoms of iodine. T3 and T4 are also
collectively referred to as thyroid hormones.
A few cells called parafollicularcells, or C cells, may be embedded within a follicle or lie
between follicles. They produce the hormone calcitonin, which helps regulate calcium
homeostasis.
 Thyroxine. Thyroxine is the major hormone secreted by the thyroid follicles.
 Triiodothyronine. Most triiodothyronine is formed at the target tissues by
conversion of the thyroxine to triiodothyronine.
 Calcitonin. Calcitonin decreases blood calcium levels by causing calcium to be
deposited in the bones; calcitonin is made by the so-called parafollicular
cells found in the connective tissues between the follicles.
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FUNCTION OF THYROID HORMONES T3 & T4

 Thyroid hormone controls the rate at which glucose is “burned” oxidized, and
converted to body heat and chemical energy; it is also important for normal tissue
growth and development.
 The thyroid hormones regulate cellular metabolism.
 The thyroid hormones regulate oxygen use and basal metabolic rate.
 The thyroid hormones regulate growth and development.
 Thyroid hormones enter the target cells and regulate the expression of genes in the
nucleus, i.e. they increase or decrease the synthesis of some proteins including
enzymes.
 They combine with specific receptor sites and enhance the effects of other hormones,
e.g. adrenaline and noradrenaline.
 T3 and T4 affect most cells of the body by: increasing the basal metabolic rate and heat
production, regulating metabolism of carbohydrates, proteins and fats.
 T3 and T4 are essential for normal growth and development, especially of the skeleton
and nervous system.
 Most other organs and systems are also influenced by thyroid hormones —
physiological effects of T3 and T4 on the heart, skeletal muscles, skin, digestive and
reproductive systems are more evident when there is underactivity or overactivity of
the thyroid gland.

How Thyroxine and triiodothyronine secreations are regulated in our body?

Iodine is essential for the formation of the thyroid gland hormones, thyroxine (T4) and
triiodothyronine (T3). The body's main sources of iodine are seafood, vegetables grown in
iodine-rich soil and iodinated table salt in the diet. The thyroid gland selectively takes up
iodine from the blood, a process called iodine trapping.
 The thyroid hormones are synthesised as large precursor molecules called
thyroglobulin, the major constituent of colloid. The release of T3 and T4 into the blood
is regulated by thyroid stimulating hormone (TSH) from the anterior pituitary.
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 Secretion of TSH is stimulated by the thyroid releasing hormone (TRH) from the
hypothalamus and secretion of TRH is stimulated by exercise, stress, malnutrition, low
plasma glucose and sleep.
 The level of secretion of TSH depends on the plasma levels of T3 and T4 because
these hormones affect the sensitivity of the anterior pituitary to TRH. Increased levels
of T3 and T4 decrease TSH secretion and vice versa (Fig. 9.8).

 When the supply of iodine is deficient, excess TSH is secreted and there is
proliferation of thyroid gland cells and enlargement of the gland (Goitre). (Secretion of
T3 and T4 begins about the third month of fetal life and is increased at puberty and in
women during the reproductive years, especially during pregnancy. Otherwise, it
remains fairly constant throughout life).
 Thyroid hormones enter the target cells and regulate the expression of genes in the
nucleus, i.e. they increase or decrease the synthesis of some proteins including
enzymes.
 They combine with specific receptor sites and enhance the effects of other hormones,
e.g. adrenaline and noradrenaline. T3 and T4 affect most cells of the body by:
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increasing the basal metabolic rate and heat production, regulating metabolism of
carbohydrates, proteins and fats.
 T3 and T4 are essential for normal growth and development, especially of the skeleton
and nervous system. Most other organs and systems are also influenced by thyroid
hormones — physiological effects of T3 and T4 on the heart, skeletal muscles, skin,
digestive and reproductive systems are more evident when there is underactivity or
overactivity of the thyroid gland. These changes are listed in Table 9.3.

CALCITONIN
 A few cells called parafollicularcells, or C cells, may be embedded within a follicle or lie

between follicles. They produce the hormone calcitonin, which helps regulate calcium
homeostasis.
 This hormone is secreted by the parafollicular or C-cells in the thyroid gland. It acts on
bone and the kidneys to reduce the blood calcium (Ca2+) level when it is raised.
 It reduces the reabsorption of calcium from bones and inhibits reabsorption of calcium
by the renal tubules. Its effect is opposite to that of parathyroid hormone (PTH,
parathormone), the hormone secreted by the parathyroid glands. Release of calcitonin
is stimulated by an increase in the blood calcium level. This hormone is important
during childhood when bones undergo considerable changes in size and shape.
 Calcitonin. Calcitonin decreases blood calcium levels by causing calcium to be
deposited in the bones; calcitonin is made by the so-called parafollicular cells found in
the connective tissues between the follicles.
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PARATHYROID GLANDS

The parathyroid glands are mostly tiny masses of glandular tissue.

 Location. The parathyroid glands are located on the posterior surface of the thyroid gland.
They are Partially embedded in the posterior surface of the lateral lobes of the thyroid
gland are several small, round masses of tissue called the parathyroid glands (para-beside).
Each parathyroid gland has a mass of about 40 mg (0.04 g). Usually, one superior and one
inferior parathyroid gland are attached to each lateral thyroid lobe

 Parathormone. The parathyroids secrete parathyroid hormone (PTH) or parathormone,

which is the most important regulator of calcium ion homeostasis of the blood; PTH is
a hypercalcemic hormone (that is, it acts to increase blood levels of calcium), whereas
calcitonin is a hypocalcemic hormone.; PTH also stimulates the kidneys and intestines to
absorb more calcium.

Microscopically, THE PARATHYROID GLANDS CONTAIN TWO KINDS OF EPITHELIAL CELLS.

1. Chief (principal) cells- They more numerous cells and produce parathyroid
hormone (PTH), or parathormone.
2. Oxyphil cell- The function of the other type of parathyroid epithelial cell, called an
oxyphil cell, is unknown in a normal parathyroid gland.
However, its presence clearly helps to identify the parathyroid gland histologically
due to its unique staining characteristics.
Furthermore, in a cancer of the parathyroid glands, oxyphil cells secrete excess
PTH.
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PTH function
 PTH decreases blood HPO4 level and increases blood Ca2 and Mg2 levels. With
respect to blood Ca2 level.
 PTH and calcitonin are antagonists; that is, they have opposite actions.
 A third effect of PTH on the kidneys is to promote formation of the hormone
calcitriol, the active form of vitamin D.

BLOOD SUPPY TO PARATHYROID GLANDS

The parathyroid glands are abundantly supplied with blood from branches of the superior
and inferior thyroid arteries.
Blood is drained by the superior, middle, and inferior thyroid veins. The nerve supply of the
parathyroid glands is derived from the thyroid branches of cervical sympathetic ganglia.

Students revise the functions of hormones from the following table