Anatomy & Histology of Endocrine (3)

Our lecture covers two sides 1) Neurohypophysis 2) anatomy of thyroid gland Notes:* refer to slides as you are reading this sheet. *feel free to skip any box around since all boxes contain extra information. *some information written in Arabic because the doctor said it in Arabic. Warm up: In last lecture, we have described histological sections as basophilic or although all the slides were blue in color In fact most of Dr Darwish's slides are semi thin. Thick sections (ordinary):1) 5-7 microns in thickness 2) stained with H&E stain 3) histological sections described based on them. Thin sections: 1-1.5 microns in thickness. Ultrathin sections: 0.2-1 micron in thickness which is used in electron microscopy only Semi thin sections: 1) 1.5-3 microns in thickness 2)don't take H&E stain easily because different chemicals ,procedures ,and materials used in preparing them , but if you insist ,you can .however, they are not stained deeply ;needing more time to accept H&E stain; losing their color gradually as they exposed to light ;should be used immediately after applying antibodies because flouresenese fades with time )( 2 alanine toludine blue 5 () . So the slides appear blue in color.
|Page1

Flashback: Pars Distalis: the most anterior and largest part of anterior pituitary Pars Tuberalis: surrounds the infundibulum. ------------The neurohypophysis is divided into: Pars Nervosa: the most posterior and largest part of posterior pituitary Infundibulum: contains the hypothalamo-hypophysial tract. -----------Median Eminence: which is debatable ( ) in classification, some scientists consider it part of hypothalamus but others insist that it is a part of posterior pituitary and we prefer the 2nd. Starting off Slide 35 represents a section in a pituitary gland of an animal As you see, anterior pituitary is highly cellular Pars intermedia are less cellular; and filled with colloid-filled cysts. The cysts are the remainder of Rathkes pouch indicating low functionality if any. Posterior pituitary with the least cellularity

The posterior pituitary 1-does not contain secretary cells, so it belongs to nervous system rather than endocrine. 2-contains secretary neurons .the mother cells of these neurons present in hypothalamus either in the paraventricular or in supraoptic hypothalamic nuclei. The mother cells are the sites of activity from which the activity, impulses, and products start then propagate through axons .any damage occurs at the mother cell, affects the whole cell. In CNS the mother cells grouped together in nuclei such as paraventricular & supraoptic hypothalamic nuclei.
|Page2

3- The most numerous cells in the posterior pituitary are called pituicytes, these cells resemble astrocytes.

cells of CNS

neurons (function cells)

supporting cells (glial cells)

more in number

astrocytes
form BBB (support&protection)

oligodendrocytes
equivilent to schwan in periferal (PNS(

microgial phagocytosis
(defens & protection)

epidendimal
secrete CSF

4-the nerve fibers are so special because A) They don't terminate at target organ instead they terminate diffusely around the fenestrated capillaries which are openings in endothelium; thus, their secretions are Distributed to the general circulation. B) The secretary vesicles distributed all over the neuron unlike the usual neurons in which the secretary vesicles restricted to the bodies! C) Their secretions are regular in shape indicating a presence of membranes about them. Herring bodies: are eosinophilic dilatations in terminal of axon; and contain numerous membrane-enclosed vesicles, so they are regular in shape, but not in size. The neurons present in the posterior pituitary secrete two hormones produced in the hypothalamus; Anti-diuretic hormone (ADH) also called vasopressin, and oxytoxin. These hormones are transported axonally into the pars nervosa and are stored in axonal dilations called neurosecretory bodies or Herring Bodies.

|Page3

Nerve impulses along the axons trigger the release of peptides from Herring bodies for uptake by the fenestrated capillaries of the pars nervosa, and the hormones are distributed to the general circulation. ADH (Vasopressin) Most ADH is released from supra optic nuclei in the hypothalamus. ADH facilitates reabsorption of water From the distal tubules and collecting ducts of the kidney by altering the permeability of cells to water. It is released in response to decreased blood pressure and leads to increased water retention. ADH helps regulate the osmotic balance of body fluids. If there hadn't been ADH at all, one would have had to drink huge amount of water releasing a huge amount of urine spending his life in bathroom. Luckily, ADH nowadays prepared on commercial base; moreover, the incidence of diabetes insipidus () is relatively low. After major surgeries, in appropriate ADH response takes place in spite of the normal level of ADH, so those patients have to undergo dialysis. Oxytocin Most oxytocin is released from paraventricular nuclei in the hypothalamus. It promotes contraction of the smooth muscles; especially, the uterus and the myoepithelial cells of the breast aiding in the release of milk, and returning the uterus close to normal size (7.5 cm in length); by the way, nothing returns back 100% but to acceptable extent, preventing huge amount of blood lose; therefore, the probability of having Puerperal fever or childbed fever (.) The most powerful stimulus for oxytocin is suckling
The substance oxytocin, which is present in the date, is used in modern medicine to facilitate birth. In fact, oxytocin means "rapid birth." It is also known to increase levels of mother's milk after birth There is considerable wisdom in the way that Allah recommends Maryam to eat this fruit. The date is an excellent choice of food for the pregnant women and for those who have just given birth. This is a widely accepted scientific fact.

|Page4

Thyroid
thyroid = thyreo + eides Greek, like a door-shaped (shield) , thyra Greek, door The thyroid cartilage was named first. It shields the vocal cords of the larynx. This cartilage (cartilago Latin, gristle) sticks out in front of the neck and is called the Adam's apple. A thyreos was an ancient Greek army shield shaped like a door (thyra), with a notch at the top for the soldier's chin. Gently feel the top of your Adam's apple. It has a notch. Thyroid is a fitting name, isn't it?
Alertness: being mentally quick, active, and keenly aware
of the environment.

Thyroxin abuse *to lose some weight; unfortunately, increase apatite!!! *students take small dose to become alert; unfortunately, without focusing; moreover, increasing sweat, apatite, and nervousness. Thyroid hormone is important regulators of overall basal metabolic rate; it affects both turnover and growth. Its name is derived from the Hyoid bone situated superiorly The only bone without bony articulation Position and components 10 grams in weight Has basically 2 lobes The isthmus lies on tracheal rings 2, 3 and 4 connecting the two lobes. The apex of each lobe rests on the thyroid cartilage and reaches its oblique line which separates the anterior & the posterior parts of the lamina, so we consider it as a land mark. Small (but maybe variable in length) pyramidal lobe projects upward from
|Page5

Greek word hyoeides meaning "shaped like the letter upsilon" ()

the left lobe in 40% of cases (but may from the right lobe) reaching the oblique line in some cases. The pyramidal lobe is connected to the hyoid bone by a fibrous band that may contain a few smooth muscle fibers which make up the muscle named the Levator Glandulae Thyroidae. The base of thyroid reaches the 6th tracheal ring. The thyrohyoid membrane situated between hyoid bone and thyroid cartilage having a) superior horn which gives attachment to the lateral hyothyroid ligament (membrane). b) Inferior horn for articulation with the side of the cricoids cartilage Thus thyroid is widely extended Surgery room The patient is placed supine (face up) on the operating room table. A folded towel is placed under the neck to hyperextend the neck. The top part of the table is elevated so the patient is in a slightly reclining position. The head must be perfectly aligned with the body so a symmetrical incision is made by the surgeon. The incision is made transversely (side to side) about two fingers breadth above the sternal notch. It should be placed in a skin crease if possible for best cosmetic result. Most commonly, a slight indentation is made in the skin by using a heavy silk suture to compress the skin For thyroidectomy (removal of the thyroid gland), the most important are the relations. Surfaces and relations Superficial surface: Covered by skin, superficial fascia including the platysma muscle which is redundant in elderly, and described as the mystery of smile by Leonardo da Vinci. The anterior border of the sternocleido mastoid. The pretracheal fascia. Stern hyoid Omohyoidomo:shoulder The infrahyoid muscles, except the thyrohyoid. Medial surface: Thyroid and cricoid cartilages:
|Page6

Regardless of the differences among sexes, the cricoid cartilage is the only cartilage with the shape of a complete circle in the human body. It is very similar to the tracheal rings except that they are C shaped with a posterior opening, not complete circles. Trachea and esophagus which contain in between the tracheoesophageal tract. The external laryngeal and the recurrent laryngeal nerves. Cricothyroid cartilage inferior pharyngeal constrictor muscle : A) Cricopharyngeal muscle which continues as esophagus; this muscle is the only muscle in the human body that is in a contracted state at rest, in order to keep air from entering the esophagus. When swallowing, this muscle relaxes, allowing the morsel ( )to enter the esophagus, after which it returns to its contracted state. In order for this muscle to perform its function which requires speedy contraction, it is a skeletal muscle and not a smooth muscle. b) Thyropharyngeal muscles: attach the pharynx from one side then diverged into 1) Superior which attaches to the base of skull 2) Middle which attaches to hyoid bone 3) inferior which attaches to thyroid and cricothyroid cartilage Posterior surface: Common carotid artery in front of the Longus Colli muscle. The parathyroid glands. The inferior thyroid artery. Note: *take care of parathyroids because destruction of them= titanic . * this region is extremely vascular .

: Written by Ihmeidan's keyboard

|Page7