HUMAN ANATOMY

AND PHYSIOLOGY I
LECTURE 4:

- THYROID GL AND
- ADRENAL GL ANDS
- PANCREAS AND GLUCOSE
METABOLISM
Dr. George Chow
gchow@cihe.edu.hk
 Lecture outline
Thyroid gland Adrenal glands Pancreas
• Anatomy of thyroid • Anatomy of adrenal glands • Histology of pancreatic
gland • Hormones produced in islets
• Regulation of thyroid adrenal cortex and their • Control of insulin and
hormone secretion functions glucagon secretion by
• Functions of thyroid • Hormones produced in plasma glucose
hormones adrenal medulla and their • Effects of insulin and
• Diseases of the thyroid functions glucagon
• Regulation of aldosterone • Diseases of the pancreas
secretion
Parathyroid glands • Regulation of cortisol
• Anatomy of parathyroid secretion
glands • Short-term and long-term
• Functions of parathyroid stress responses
hormones • Disorders of the adrenal
• Diseases of the glands
parathyroid
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Intended Learning Outcomes (ILOs)

Upon the completion of this lecture, you should be able to:

1) Describe the anatomical and the functional aspects of the thyroid gland, the
parathyroid gland, the adrenal glands, and the pancreas.

2) Describe the functions of the hormones released by these endocrine glands.

3) Explain the interrelationships between the brain and the thyroid gland; and
between the brain and the adrenal glands.

4) Explain how the hormones play their roles in maintaining homeostasis of the
human body.

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Thyroid gland (甲狀腺)

● Butter-shaped organ located at

the base of the neck.
● Responsible for producing and
secreting two hormones: thyroxine
(T4) and triiodothyronine (T3)
● These hormones are important for
regulating the metabolism of our
body cells.
● The activity of thyroid gland is
controlled by thyroid-stimulating
hormone (TSH) secreted by the
anterior pituitary.

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Thyroid hormones

● The spherical sacs (thyroid follicles) are

filled with colloid and surrounded by the
follicular cells.
● Parafollicular cells are located between
the thyroid follicles.
● The follicular cells are responsible for
secreting the thyroid hormones
● Thyroxine (Tetraiodothyronine) (T4):
Major form in blood
Triiodothyronine (T3): Converted from T4
mainly in liver cells; more active than T4

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Hypothalamus control of thyroid hormone secretion

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 Mechanism of thyroid hormone action

• Thyroid hormones can diffuse

across the plasma membrane,
thereby further entering the
nucleus and bind to nuclear
receptors to activate gene
transcription.

• For example, increase in

expression of beta-adrenergic
receptors leads to permissive
effects on catecholamines,
enhancing heart rate and
contractility.

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Thyroid hormones - functions

1. Increasing metabolic rate

a. Basal metabolic rate is increased.
b. Enhanced carbohydrate and fat metabolism

2. Growth
a. Important in central nervous system (CNS) development
b. Growth of muscles and bone

3. Enhancing the effects by catecholamines (epinephrine and norepinephrine)

a. Increase in cardiac output
b. Increase in expression of beta-adrenergic receptors in heart and nervous system

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Calcitonin

• Secreted by parafollicular cells (C-

cells) of thyroid gland
• Blocks osteoclast activity (inhibits
bone resorption, reduces
phosphates and Ca2+ in blood);
accelerate the uptake of calcium and
phosphates into bone extracellular
matrix
• Decreases formation of 1,25-
dihydroxyvitamin D3 (in kidney)
• Acts as an antagonist to parathyroid
hormone (PTH)

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Calcitonin

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http://www.vivo.colostate.edu/hbooks/pathphys/endocrine/thyroid/calcium.html
Diseases of the Thyroid
• Hypothyroidism – Lack of iodine → too little thyroid hormones secreted
– Low negative feedback leads to hyperactivity of
thyroid gland under excessive TSH stimulation

(甲狀腺腫) 11
Diseases of the Thyroid - Goiter

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Diseases of the Thyroid
Hyperthyroid – too much hormone secreted
• Graves’ disease (格雷夫斯氏病)(10 times
more often in female than male)
o Autoantibodies (that mimic TSH)
over- stimulate thyroid.
o Produces exophthalmos, fast heart rate
o Surgical removal of thyroid gland,
anti-thyroid drug, radioactive iodine

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 Parathyroid glands
● Parathyroid glands are located on
the posterior side of the thyroid
gland.
● Important in secreting parathyroid
hormones (PTH)
● PTH effects include:
I. Promoting bone resorption
II. Promoting absorption of Ca2+
from the intestine via Vitamin D
III. Stimulating kidneys to produce
more active form of Vitamin D
IV. Promoting kidneys to reabsorb
more Ca2+

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PTH vs Calcitonin

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PTH vs Calcitonin

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Diseases of the parathyroid

• Hypoparathyroidism – too little parathyroid hormone secreted

o Leads to deficiency of blood Ca2+
o Results in tetany of skeletal muscle

• Hyperparathyroidism – excessive parathyroid hormone secreted

o Excessive resorption of bone matrix, raises the blood levels of calcium and
phosphate
o Results in bone softness → bones easily fracture
o Promotes kidney stone (due to high blood Ca2+)
o Fatigue, personality change, lethargy

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Adrenal glands
The body has two adrenal glands, each
located superior to each kidney. Each
adrenal gland is anatomically
differentiated and developed into two
regions:
● Adrenal cortex:
The outer region of the adrenal gland,
making up the bulk of the gland
● Adrenal medulla:
The inner region of the adrenal gland

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Adrenal glands - Histology

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Adrenal glands – Hormones in the adrenal cortex
The adrenal cortex is further divided into three zones and each zone is
responsible for secretion of different groups of hormones.
1. Zona glomerulosa
⚫ Outermost zone of the adrenal cortex, responsible for secreting mineralocorticoids.

2. Zona fasciculata
⚫ Middle zone of the adrenal cortex, responsible for secreting glucocorticoids.

3. Zona reticularis
⚫ Innermost zone of the adrenal cortex, responsible for secreting sex hormones
(androgens) and a smaller amount of glucocorticoids.

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Adrenal glands – Hormones in the adrenal cortex

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Adrenal glands – Functions of hormones in the adrenal
cortex

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Regulation of aldosterone secretion in adrenal cortex

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Other factors regulating
aldosterone release
• The stress signals hypothalamus to
release CRH → stimulating the anterior
pituitary to release ACTH → increase in
aldosterone release → increase sodium
ion reabsorption and water reabsorption
→ increase in blood volume and pressure

• High blood pressure / blood volume

stimulates the heart to release atrial
natriuretic peptide (ANP) → inhibition on
the release of aldosterone → decrease in
sodium ion reabsorption and water
reabsorption → decrease in blood volume
and pressure
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Regulation of cortisol secretion in adrenal cortex

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Adrenal glands – Hormones in the adrenal medulla
● The adrenal medulla is a modified sympathetic ganglion, having the
innervation of the sympathetic nervous system.
● The major hormone produced by the adrenal medulla is epinephrine
(adrenaline), and the adrenal medulla a smaller amount of norepinephrine
(noradrenaline). These two hormones belong to catecholamines.
● These hormones are released under the stimulation of the sympathetic
nervous system, which is activated in stressful conditions and being
physically active. Low blood glucose can also increase the sympathetic
output to the adrenal medulla.

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Adrenal glands – Hormones in the adrenal medulla
● Norepinephrine and epinephrine are
structurally similar.
● The conversion from norepinephrine to
epinephrine is catalyzed by
phenylethanolamine N-
methyltransferase (PNMT) which is
primarily expressed in medullary cells
(Chromaffin cells).
● Due to structural similarity, both
norepinephrine and epinephrine bind to
alpha and beta adrenergic receptors, at
different affinity and specificity.
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Adrenal glands – Hormones in the adrenal medulla

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Adrenal glands – Effects of catecholamines
1. Increase heart rate and contractility → increase cardiac output.
2. Vasoconstriction → increase blood pressure
3. Stimulate glycogenolysis in liver and skeletal muscle → increase the
availability of glucose in blood
4. Mobilization of fatty acids
5. Increase metabolic rate

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Adrenal glands – Effects of catecholamines

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Selectivity of epinephrine and norepinephrine to
adrenergic receptors

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Short-term and long-term stress responses

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Adrenal glands disorders
Cushing’s Syndrome (庫欣氏症候群)
• Excessive secretion of cortisol → hypercortisolism
• Can be due to tumor in the adrenal gland, or tumor the
pituitary gland, lungs or other tissues, which secrete
adrenocorticotropic hormone (ACTH)
• Can also be due to hyperplasia of adrenal glands
• Characterized by breakdown of muscle proteins and
redistribution of body fat → spindly arms and legs and
round moon-like face
• Bruise easily
• Hyperglycemia, osteoporosis, weakness, hypertension,
increased susceptibility to infection, decreased resistance
to stress, mood swing
• Long term glucocorticoid therapy (risk factors)
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Adrenal glands disorders
Addison’s Disease (愛迪生氏病) (Primary adrenal insufficiency)
• Hyposecretion of glucocorticoids and aldosterone
• Antibodies cause adrenal cortex destruction or block the binding of ACTH
to its receptor in adrenal cortex
• Symptoms appears when 90% of adrenal cortex has been destroyed
• Mental lethargy, anorexia, nausea, vomiting, weight loss, hypoglycemia,
muscular weakness
• Loss of aldosterone → increases K+ and reduces Na+ in the blood → low
blood pressure, dehydration, decreased cardiac output, arrhythmias, even
cardiac arrest

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Pancreas
● Pancreas is located close to stomach
and spleen in the abdominal cavity.
● Both exocrine (acinar cells) for
secreting digestive enzymes (being part
of the digestive system) and endocrine
(islet cluster cells) for releasing
hormones into the bloodstream.
● Head of the pancreas - situated in the
loop of the duodenum
● Body of the pancreas - posterior to the
distal part of the stomach
● Tail of the pancreas - situated near the https://www.pancreapedia.org/reviews/anatomy-and-histology-of-pancreas

hilum of the spleen (脾)

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Pancreas - Histology
Important hormones in glucose metabolism and homeostasis
- Alpha-cells (producing glucagon)
- Beta-cells (producing insulin)
https://www.researchgate.net/figure/Overview-of-pancreas-
localization-and-anatomy-The-pancreas-is-composed-of-an-
endoand_fig3_328475917
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Pancreas - Histology

● Pancreatic islets are sized in the

range from 50 - 250 μm.
● Most of these islets are spherical in
shape but they can also be irregular.
● Alpha cells in pancreatic islets are
responsible for producing glucagon.
● Beta cells in pancreatic islets are
responsible for producing insulin.

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Insulin and glucagon secretion in pancreatic islets

➢ Insulin - secreted in response to a rise in blood glucose level. It stimulates

the uptake of glucose into muscle cells and adipose cells, and the conversion
to glycogen from glucose in liver cells.

➢ Glucagon - secreted in response to a drop in blood glucose level. It

stimulates liver cells to break down glycogen to form glucose and
gluconeogenesis.

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Regulation of carbohydrate
metabolism by insulin and glucagon
Insulin increases the rate of glycolysis by enhancing
the activities of
● Glucokinase
● Phosphofructokinase
● Pyruvate kinase
→ More breakdown of glucose

Glucagon decreases the rate of glycolysis by reducing

the activities of
● Glucokinase
● Phosphofructokinase
● Pyruvate kinase
→ Breakdown of glucose is inhibited 42
Metabolic effects of insulin
● Enhance:
○ Lipogenesis
○ Protein synthesis
○ Uptake of glucose in muscle cells and adipocytes
○ Glycogen synthesis
○ Glycolysis

● Inhibit:
○ Lipolysis
○ Breakdown of protein
○ Breakdown of glycogen
○ Gluconeogenesis
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Metabolic effects of glucagon
● Enhance:
○ Fatty acid oxidation in liver
○ Ketone bodies formation
○ Glycogenolysis
○ Gluconeogenesis
○ Breakdown of glycogen in liver

● Inhibit:
○ Lipogenesis
○ Glycogenesis
○ Glycolysis
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Summary of the metabolic effects by insulin and glucagon

https://www.researchgate.net/figure/The-interplay-of-the-small-intestine-
pancreatic-islets-and-the-liver-Schematic_fig6_328475917

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Diseases of the Pancreas
Diabetes mellitus (DM)
• Two types:
o Type I, previously known as Insulin dependent DM (IDDM)
o Type II, previously known as Non-insulin dependent DM (NIDDM)
• Due to lack of insulin secretion (Type I) or response to insulin (Type II)
• Leading to hyperglycemia (increase in blood glucose level)

Note:
Diabetes means siphon, to pass through. Mellitus means sweet or honeyed. Excess sugar is found in blood and urine.

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Diseases of the Pancreas
Hyperglycemia – high plasma [glucose]
• IDDM (Type I) – (usually <20 yr old)
o Beta cells do not secrete insulin
▪ Immune system destroys the pancreatic beta cells (autoimmune disease)
o Ketoacidosis (breakdown of fatty acids into ketones which are converted into ketoacids)
o Requires insulin injections, regular diet, exercise

• NIDDM (Type II) – (>35 yr old)

o Often associated with hyperinsulinemia; and/or
o Cells become resistant to insulin (e.g. downregulate receptors)
o Treated with oral pancreatic stimulators and/or drugs that decrease insulin resistance (e.g.
metformin, glyburide)

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Diseases of the Pancreas
Hypoglycemia - low plasma [glucose]
• If plasma [glucose] drops to too low level, coma develops.

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References

• Tortora, G.J., & Derrickson, B.H. (2020). Principles of anatomy and

physiology (16th ed.). John Wiley & Sons

• Marieb, E.N., & Keller, S.M. (2021). Essentials of human anatomy &
physiology (13th ed.). Pearson.

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