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Endocrine Glands
What are endocrine glands?
Glands that produce hormones and
secrete them directly in the blood
stream
They do not have ducts
– Pituitary
– Thyroid
– Parathyroid
– Adrenals
– Pancreas
Pituitary Gland
Pituitary Gland
Master gland of the endocrine system
Lies in the hypophyseal fossa (sella
turcica)
Fossa is roofed by diaphragma sellae
Stalk of the hypophysis cerebri pierces
the diaphragma sellae and is attached
above to the floor of the third ventricle
Pituitary Gland
Glandis oval in shape
Measures 8 mm (AP diameter) and
12 mm (transversely)
Weighs 500 mg
Relations
Superiorly
– Diaphragma sellae
– Optic chiasma
– Tuber cinerium
– Infundibular recess of 3rd ventricle
Inferiorly
– Hypophyseal fossa and irregular venous
channels between the two layers of dura
covering it
– Sphenoidal air sinuses
On each side
– Cavernous sinus with its contents
Subdivisions
Adenohypophysis
– Anterior lobe
– Intermediate lobe
– Tuberal lobe
Neurohypophysis
– Posterior lobe
– Infundibular stem
– Median eminence of the tuber cinerium
Blood Supply
Arterial
– Branches of internal carotid artery
Veins
– Short veins emerge on the surface of
the gland and drain into the
neighbouring venous sinuses
Radio-Imaging of Pituitary
Gland
Not visualized on Plain X-Ray of the
skull, except for the sella turcica and
clinoid processes – housing the
pituitary gland
Visualized on
– CT Scan of brain
– MRI of brain
– PET Scan of brain
Radiograph of Skull
Lateral view shows
the sella turcica
Pituitary gland
resides on top of the
sella turcica
The anterior and
posterior clinoid
processes define the
anterior and posterior
boundaries
Radiograph of Skull
Towne’s View
shows dorsum
sellae on top of
which lies the
pituitary gland
A. Frontal Lobe
B. Frontal Bone (Superior
Surface of Orbital Part)
C. Dorsum Sellae
D. Basilar Artery
E. Temporal Lobe
F. Mastoid Air Cells
G. Cerebellar Hemisphere CT Scan of
Head
MRI of Brain
MRI
of
Brai
n
MRI of Brain
MRI of Brain
Pituitary
Gland
Pituitary Gland
Sella
turcica
Normal
Optic
Chiasm
Pituitary
Adenoma
Optic
nerves
Pituitary
Adenom
a
Thyroid Gland
Endocrine Gland
• regulates basal
metabolic rate
• stimulates
somatic and psychic
growth
• plays important
role in calcium
metabolism
Ultrasound of Thyroid Gland
Thyroid Gland
Two lobes joined by the
isthmus
Lies against the C5,C6, C7
and T1 vertebrae clasping
the upper part of trachea
Each lobe extends from
the middle of the thyroid
cartilage to the 4th or 5th
tracheal ring
Isthmus extends from 2nd
to 3rd tracheal rings
Thyroid Gland
Lobes measure about 5 cm x 2.5 cm
x 2.5 cm
Isthmus measures about 1.2 cm x
1.2 cm
Larger in females than in males
Increases in size during menstruation
and pregnancy
Capsules
True – peripheral condensation of
connective tissue of the gland
False – derived from pretracheal
layers of deep cervical fascia
False capsule forms the suspensory
ligament of Berry which connects the
lobe to the cricoid cartilage
A dense capillary plexus is present
deep to the true capsule
Relations
Lobes are conical in shape and have
– Apex
– Base
– Three surfaces – lateral, medial and
posterolateral
– Two borders – anterior and posterior
Relations
Lateral surfaces
– Convex
– Covered by – sternothyhyoid,
sternohyoid, superior belly of omohyoid
and anterior border of sternomastoid
muscles
Relations
Medial surface
– Two tubes – trachea and esophagus
– Two muscles – inferior constrictor and
cricothyroid
– Two nerves – extrenal laryngeal and
recurrent laryngeal
Relations
Posterolateral surface
– Carotid sheath
– Overlaps common carotid artery
Relations
Anterior border
– Thin
– Anterior branch of superior thyroid artery
Posterior border
– Thick
– Inferior thyroid artery
– Anastomosis between superior and inferior
thyroid artery
– Parathyroid gland
– Thoracic duct (left side)
Relations
Apex
– Directed upwards
Base
At the level of 4th or 5th tracheal ring
Relations
Isthmus
– Connects the lower parts of the lobes
– Two surfaces –
Anterior and posterior surfaces
– Two borders
Superior and inferior borders
Isthmus
Upper border
– Anastomosis between Right and Left
Superior Thyroid Arteries
Lower border
– Inferior thyroid veins leave the gland at
this border
Blood Supply
Arterial
– Superior thyroid artery – branch of
external carotid artery
– Inferior thyroid artery – branch of
thyrocervical trunk
Veinous
– Superior thyroid vein
– Inferior thyroid vein
Radio-Imaging of Thyroid
Gland
Not visualized on Plain X-Ray unless
calcified
Visualized on
– Ultrasound
– CT scan
– MRI
– Nuclear Medicine study
Coned apical radiograph of the upper
thorax shows curvilinear calcification
in a thyroid adenoma, at the root of
the neck, on the right side
Stenohyoid and Isthmus
sternothyroid
muscles
Trachea
Carotid
Artery
Thyroid Gland
Transverse Section of the Right Lobe of Thyroid
Gland
Sagittal Section Transverse
of the Thyroid section of Thyroid
Gland Gland
Isthmus
Transver
se
Section Trachea
of the
Thyroid
Gland
Left Lobe
Right Lobe
CT Scan of Thyroid Gland
Thyroid Scanning – Nuclear
Medicine
Thyroid Scanning – Nuclear Medicine
Parathyroid Gland
Parathyroid Gland
Two pairs
– Superior
– Inferior
Lieon the posterior border of the thyroid
gland within the thyroid capsule
Oval or lentiform in shape
Measure about 6 x 4 x 2 mm
Weighs 50 mg
Parathyroid Gland
Anastomotic artery between superior
and inferior thyroid artery is a good
marker because they lie close to it
Superior parathyroid glands are more
consistent in location near the
middle of the posterior border of the
thyroid lobe
Blood Supply
Arterial
– Inferior thyroid artery
– Anastomosis between superior and
inferior thyroid arteries
Veinous
– Thyroid veins
Radio-Imaging
Not visualized on normal studies
Seen mostly when there is adenoma
Sometimes may be ectopic in
location
Transverse and longitudinal views
of the left parathyroid gland
Immediate
scan Delayed scans
Nonspecific accumulation of
radioactivity in the region of the
parathyroids
A 1.3 x 1.0 cm. nodule, relatively
hyperintense is seen posterior to the left lobe
of the thyroid gland and lateral to the
esophagus.
Injection of radioactive
material shows rapid
uptake by the thyroid
gland
Delayed image
shows a retention of
the radioactive
material at the
inferior pole of the
left thyroid –
parathyroid
Adrenal Glands
Adrenal Glands
A pair of glands
Lie in the epigastium at the upper
pole of the kidneys
In front of the crus of diaphragm
Opposite the vertebral end of the 11th
intercostal space and 12th rib
Adrenal Glands
Right adrenal gland is triangular or
pyramidal in shape
Left adrenal gland is semilunar
Measures about 50 mm in height, 30 mm
in breadth and 10 mm in thickness
1/3rd the size of kidneys in children and
1/30th the size in adults
Weighs 5 g
Right Adrenal Gland
An apex
A base
Two surfaces – anterior and posterior
Three borders – anterior, medial and
lateral
Relations
Anterior surface – devoid of peritoneum
except a small part below
– Inferior vena cava medially
– Liver laterally and
– Occasionally duodenum inferiorly
Posterior surface
– Crus of diaphragm
Anterior border
– Hilum where veins emerge below the apex
Medial border
– Right celiac ganglion
– Right inferior phrenic artery
Left Adrenal Gland
Two ends –
– Upper narrow end
– Lower rounded end
Two borders
– Medial – convex
– Lateral – concave
Two surfaces
– Anterior
– Posterior
Relations
Anterior surface –
– cardiac end of stomach
– Splenic artery
– Pancreas
Posterior surface
– Kidney laterally
– Left crus of diaphragm medially
Medial border
– Left celiac ganglion
– Left inferior phrenic artery
– Left gastric artery
Blood Supply
Arterial
– Superior adrenal artery – branch of
inferior phrenic artery
– Middle adrenal artery – branch of
abdominal aorta
– Inferior adrenal artery – branch of renal
artery
Blood Supply
Veinous
– Each gland drained by one vein
– Right adrenal vein drains into inferior
vena cava
– Left adrenal vein drains into left renal
vein
Radio-Imaging
Not seen on plain X-Ray unless
calcifications are present
Visualized by
– CT Scan
– MRI
– Ultrasonography – seen better in
children than in adults
Imaging of Adrenal Glands
IVC
Spleen
and
Splenic
Vessels
Crus of diaphragm
Ultrasound of adrenal
mass
Oblique sagittal image
of the abdomen
demonstrates an
isoechoic mass of the
left adrenal gland that
is anterolateral to the
aorta and medial to
the left kidney
Right
Adrenal
Adenoma
Pancreas
Pancreas
Exocrine gland
– Secretes digestive enzymes
Endocrine gland
– Secretes hormones like insulin
The pancreas is 12-15 cm long and is
located in the epigastrium
Parts of the pancreas:
– Head
– Uncinate process
– Neck
– Body
– Tail
The head and body lie outside the
peritoneum
The head of the pancreas is surrounded by
the duodenum as it makes a C-loop
around the pancreas
The common bile duct traverses
through the head of the pancreas and
joins with the pancreatic duct at the
ampulla of Vater to empty bile into the
second or descending part of the
duodenum
Both the pancreatic ducts of Santorini
and Wirsung drain the exocrine
pancreas
Relationship to Surrounding
Structures
– Head
Posterior
– Superior Mesenteric Vein
– Splenic vein
– Inferior Vena Cava
– Terminal portion of renal vein
– Right crus of diaphragm
Anterior
– Transverse colon
Lateral
– Bile duct
Relationship to Surrounding
Structures
– Neck
Anterior
– Pylorus
– Omental bursa
Posterior
– SMV
– Beginning of portal vein
Relationship to Surrounding
Structures
– Body
Anterior
– Stomach separated by omental bursa
Posterior
– Aorta and SMA
– Left crus of diaphragm
– Left kidney and adrenal gland
– Left renal vein and splenic vein
Inferior
– Transverse mesocolon and splenic
flexure
– Duodeno-jejunal junction
Relationship to Surrounding
Structures
– Tail
The tail of the pancreas lies in the
splenorenal ligament and enters the
hilum of the spleen with splenic
vessels
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