•      The endocrine system consists of glands widely separated from each other with no physical connections.

•      Endocrine glands are groups of secretory cells surrounded by an extensive network of capillaries that facilitates diffusion of hormones (chemical messengers) from the secretory cells into the bloodstream. They are commonly referred to as ductless glands because hormones diffuse directly into the bloodstream. Hormones are then carried in the bloodstream to target tissues and organs that may be quite distant, where they influence cellular growth and metabolism.

•      Homeostasis of the internal environment is maintained partly by the autonomic nervous system and partly by the endocrine system.

Anterior pituitary

Some of the hormones secreted by the anterior lobe stimulate or inhibit secretion by other endocrine glands (target glands) while others have a direct effect on target tissues. Table 9.1 summarises the main relationships between the hormones of the hypothalamus, the anterior pituitary and target glands or tissues.

Growth hormone (GH)

•      This is the most abundant hormone synthesised by the anterior pituitary.

•      It stimulates growth and division of most body cells but especially those in the bones and skeletal muscles. Body growth in response to the secretion of GH is evident during childhood and adolescence, and thereafter secretion of GH maintains the mass of bones and skeletal muscles.

•    It also regulates aspects of metabolism in many organs, e.g. liver, intestines and pancreas; stimulates protein synthesis, especially tissue growth and repair; promotes breakdown of fats; and increases blood glucose levels

 

Thyroid stimulating hormone (TSH)

•      This hormone is synthesised by the anterior pituitary and its release is stimulated by thyrotrophin releasing hormone (TRH) from the hypothalamus. It stimulates growth and activity of the thyroid gland, which secretes the hormones thyroxine (T4) and tri-iodothyronine (T3).

Anterior Pituitary Hormones

Adrenocorticotrophic hormone (ACTH, corticotrophin)

•      Corticotrophin releasing hormone (CRH) from the hypothalamus promotes the synthesis and release of ACTH by the anterior pituitary. This increases the concentration of cholesterol and steroids within the adrenal cortex and the output of steroid hormones, especially cortisol.

Prolactin

•      This hormone is secreted during pregnancy to prepare the breasts for lactation (milk production) after childbirth.

Gonadotrophins

Just before puberty two gonadotrophins (sex hormones) are secreted in gradually increasing amounts by the anterior pituitary in response to luteinising hormone releasing hormone (LHRH), also known as gonadotrophin releasing hormone (GnRH). At puberty secretion increases, further enabling normal adult functioning of the reproductive organs; in both males and females the hormones responsible are:

• follicle stimulating hormone (FSH)

• luteinising hormone (LH).

Antidiuretic hormone (ADH, vasopressin)

The main effect of antidiuretic hormone is to reduce urine output (diuresis is the production of a large volume of urine). ADH acts on the distal convoluted and collecting ducts of the nephrons of the kidneys, increasing their permeability to water. As a result, the reabsorption of water from the glomerular filtrate is increased. The amount of ADH secreted is determined by the osmotic pressure of the blood circulating to the osmoreceptors in the hypothalamus.

 

 

 

Thyroid Gland – Thyroxine and tri-iodothyronine

•      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.

Calcitonin

•      This hormone is secreted by the parafollicular or C-cells in the thyroid gland.

•       It acts on bone cells and the kidneys to reduce blood calcium (Ca2+) levels when they are raised.

Parathyroid Glands

•      There are four small parathyroid glands, two embedded in the posterior surface of each lobe of the thyroid gland. They are surrounded by fine connective tissue capsules. The cells forming the glands are spherical in shape and are arranged in columns with sinusoids containing blood between them.

Function

•      The parathyroid glands secrete parathyroid hormone (PTH, parathormone). Secretion is regulated by blood calcium levels. When they fall, secretion of PTH is increased and vice versa.

•      The main function of PTH is to increase the blood calcium level when it is low.)

Adrenal cortex

The adrenal cortex produces three groups of steroid hormones from cholesterol. They are collectively called adrenocorticocoids (corticosteroids). They are:

•      glucocorticoids

•      mineralocorticoids

•      sex hormones (androgens).

The hormones in each group have different characteristic actions but due to their structural similarity their actions may overlap.

 

 

Glucocorticoids

•      Cortisol (hydrocortisone) is the main glucocorticoid but small amounts of corticosterone and cortisone are also produced. They are essential for life, regulating metabolism and responses to stress. Secretion is controlled through a negative feedback system involving the hypothalamus and anterior pituitary.

Mineralocorticoids (aldosterone)

•      Aldosterone is the main mineralocorticoid. Its functions are associated with the maintenance of water and electrolyte balance in the body. Through a negative feedback system it stimulates the reabsorption of sodium (Na+) by the renal tubules and excretion of potassium (K+) in the urine.

Pancreatic Islets – Insulin

Insulin is a polypeptide consisting of about 50 amino acids. Its main function is to lower raised blood nutrient levels, not only glucose but also amino acids and fatty acids. These effects are described as anabolic, i.e. they promote storage of nutrients. When these nutrients, especially glucose, are in excess of immediate needs insulin promotes their storage by:

•      acting on cell membranes and stimulating uptake and use of glucose by muscle and connective tissue cells

•      increasing conversion of glucose to glycogen (glycogenesis), especially in the liver and skeletal muscles

•      accelerating uptake of amino acids by cells, and the synthesis of protein

•      promoting synthesis of fatty acids and storage of fat in adipose tissue (lipogenesis)

•      decreasing glycogenolysis (breakdown of glycogen into glucose)

•      preventing the breakdown of protein and fat, and gluconeogenesis (formation of new sugar from, e.g., protein).

 

 

 

 

Glucagon and Somatostatin (GHRIH)

The effects of glucagon increase blood glucose levels by stimulating:

•      conversion of glycogen to glucose in the liver and skeletal muscles (glycogenolysis)

•      gluconeogenesis.

Secretion of glucagon is stimulated by a low blood glucose level and exercise, and decreased by somatostatin and insulin.

Somatostatin (GHRIH)

The effect of this hormone, also produced by the hypothalamus, is to inhibit the secretion of both insulin and glucagon in addition to inhibiting the secretion of GH from the anterior pituitary

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 Organ of the alimentary canal

•      Mouth

•      Pharynx

•      Oesophagus

•      Stomach

•      Small intestine

•      Large intestine

•      Rectum and anal canal

Accessory Organs

•      Three pairs of salivary glands

•      The pancreas

•      The liver and biliary tract.

The walls of the alimentary tract

•      Adventitia or serosa – outer covering

•      Muscle layer

•      Submucosa

•      Mucosa – lining

Nerve Supply

The parasympathetic supply

One pair of cranial nerves, the vagus nerves, supplies most of the alimentary canal and the accessory organs. Sacral nerves supply the most distal part of the tract. The effects of parasympathetic stimulation are:

•      increased muscular activity, especially peristalsis, through increased activity of the myenteric plexus

•      increased glandular secretion, through increased activity of the submucosal plexus.

 

 

 

Salivary Glands

Parotid glands

•      These are situated one on each side of the face just below the external acoustic. Each gland has a parotid duct opening into the mouth at the level of the second upper molar tooth.

Submandibular glands

•      These lie one on each side of the face under the angle of the jaw. The two submandibular ducts open on the floor of the mouth, one on each side of the frenulum of the tongue.

Sublingual glands

•      These glands lie under the mucous membrane of the floor of the mouth in front of the submandibular glands. They have numerous small ducts that open into the floor of the mouth.

Functions of Saliva

•      Chemical digestion of Polysaccharides

•      Lubrication of food

•      Cleaning and lubricating the mouth

•      Non-specific defence

•      Taste

Stomach

The stomach is continuous with the oesophagus at the cardiac sphincter and with the duodenum at the pyloric sphincter.

Muscle Layer - This consists of three layers of smooth muscle fibres:

•      an outer layer of longitudinal fibres

•      a middle layer of circular fibres

•      an inner layer of oblique fibres.

 

 

 

 

Functions of Gastric Juices

•      Water further liquefies the food swallowed.

•      Hydrochloric acid:

•      acidifies the food and stops the action of salivary amylase

•      kills ingested microbes

•      provides the acid environment needed for effective digestion by pepsins.

•      Pepsinogens are activated to pepsins by hydrochloric acid and by pepsins already present in the stomach. These enzymes begin the digestion of proteins, breaking them into smaller molecules. Pepsins act most effectively at a very low pH, between 1.5 and 3.5.  

•      Intrinsic factor (a protein) is necessary for the absorption of vitamin B12 from the ileum.

•      Mucus prevents mechanical injury to the stomach wall by lubricating the contents.

Functions of Small Intestine

•      Onward movement of its contents by peristalsis, which is increased by parasympathetic stimulation

•      Secretion of intestinal juice, also increased by parasympathetic stimulation

•      Completion of chemical digestion of carbohydrates, protein and fats in the enterocytes of the villi

•      Protection against infection by microbes that have survived the antimicrobial action of the hydrochloric acid in the stomach, by the solitary lymph follicles and aggregated lymph follicles

•      Secretion of the hormones cholecystokinin (CCK) and secretin

•      Absorption of nutrients.

 

 

 

 

 

Chemical Digestion in the Small Intestine

Pancreatic Juice

Pancreatic juice is secreted by the exocrine pancreas and enters the duodenum at the duodenal papilla. It consists of:

•      water

•      mineral salts

•      enzymes:

•      amylase

•      lipase

•      nucleases that digest DNA and RNA

•      inactive enzyme precursors including:

•      trypsinogen

•      chymotrypsinogen.

Bile

Bile has a pH of around 8 and between 500 and 1000 ml are secreted daily. It consists of:

•      water

•      mineral salts

•      mucus

•      bile salts

•      bile pigments, mainly bilirubin

•      cholesterol.

Functions of the Bile

•      The bile salts emulsify fats in the Small Intestine

•      Fatty acids are insoluble in water and bile salts make cholesterol and fatty acids soluble so enable both these and fat-soluble vitamins (A, D, E and K) to be readily absorbed

•      The bile pigment bilirubin is the waste product of the breakdown of red blood cells

•      Stercobilin colours and deodorises the faeces

Intestinal Secretions

The principal constituents of intestinal secretions are water, mucus and mineral salts.

Most of the digestive enzymes in the small intestine are contained in the enterocytes of the walls of the villi. Digestion of carbohydrate, protein and fat is completed by direct contact between these nutrients and the microvilli and within the enterocytes. The enzymes that complete chemical digestion of food at the surface of the enterocytes are:

•      peptidases

•      lipase

•      sucrase, maltase and lactase.

Functions of the Large Intestine

•      Absorption of water, mineral salts, vitamins and some drugs

•      Microbial activity – bacterial growth help in the synthesis of vitamin K and folic acid

•      Mass movement

•      Defecation

Functions of the Liver

•      Carbohydrate, fat and protein metabolism

•      Synthesis of plasma proteins and clotting factors

•       Detoxification of drugs and toxic substances

•      Inactivation of hormones (e.g. insulin)

•      Storage (e.g. glycogen)

•      Secretion of bile