Page 1 of 4 Kid, youll move mountains! Dr. Seuss Alyssa WillisL. Ng, 1A, A.Y. 2014-2015Far Eastern UniversityNicanor Reyes Medical Foundation Gross HSB B Adrenal Gland, Pancreas, Testis, Ovary Dr. Banez (Nov. 6, 2014) Endocrine System second messenger system of the body uses chemical messages (hormones)hormones control several major processes oreproduction ogrowth and development omobilization of body defences omaintenance of much of homeostasis oregulation of metabolism other organs onot included due to its other more important functions kidney produce rennin heart produce atrial natriuretic polypeptide (ANP) stomach produce gastrin small intestine largest endocrine organ produce hormones that control itself, stomach, and biliary tree thymus produce hormones controlling the red bone marrow to produce cellular elements of the blood Adrenal Gland two yellowish retro-peritoneal glands (primary) lie on the upper poles of the kidneys surrounded by renal fascia or Gerotas fascia separated from the kidney by perirenal fat each gland has a yellow cortex and a dark brown medulla parts ocortex zona glomerulosa most superficial just beneath the fascia mineral corticoids ocontrol of fluid and electrolyte otarget organ: kidney (PCT) zona fasciculata glucocorticoids (cortisol) control of metabolism of carbohydrates, fats, and proteins zona reticularis small amounts of sex hormones (androgens) oplay a role in prepubertal development of sex organs controlled by ACTH and rennin omedulla catecholamines epinephrine norepinephrine right suprarenal gland opyramid shaped ocaps the upper pole of the right kidney olies behind the right lobe of the liver and extends medially behind the IVC orests posteriorly on the diaphragm left suprarenal gland ocresentic in shape oextends along medial border of left kidney from the upper pole of the hilus olies behind the: pancreas lesser sac stomach orests posteriorly on the diaphragm blood supply: oarteries superior suprarenal artery from inferior phrenic artery middle suprarenal artery from abdominal aorta inferior suprarenal artery from renal artery oveins single vein from hilum of each gland right adrenal vein IVC left adrenal vein left renal vein lymph drainage odrains into lateral aortic nodes nerve supply opreganglionic sympathetic fibers from splanchnic nerves omost nerves in medulla of the gland Pancreas exocrine glandopancreatic acinar cells osecretes enzymes that hydrolyze: CHOs (amylase) CHONs (carboxypeptidase A and B, trypsinogen) fats (lipase) endocrine gland opancreatic islets (islets of Langerhans) oproduces: glucagon (alpha cells) insulin (beta cells) somatostatin (delta cells) pancreatic polypeptide (PP cells) elongated soft and lobulated location: olies in epigastrium and LUQ osituated on the posterior abdominal wall behind peritoneum ocrosses the transpyloric plane relations: oanteriorly (right to left): transverse colon attachment of transverse mesocolon lesser sac stomach Page 2 of 4 Kid, youll move mountains! Dr. Seuss Alyssa WillisL. Ng, 1A, A.Y. 2014-2015oposteriorly (right to left): bile duct portal and splenic veins IVC aorta origin of SMA left psoas muscle left suprarenal gland left kidney spleens hilum parts: ohead disc shaped expanded part lies within concavity of the duodenum to the right of superior mesenteric vessels posterior surface: common bile ductoin a groove on the posterosuperior surface of the head or is embedded in it IVC right renal vessels left renal vein uncinate process projection from inferior part of the pancreatic head extends to the left, behind the superior mesenteric vessel oneck constricted portion of the pancreas connects head to the body anterior surface: covered with peritoneum, adjacent to pylorus posterior surface: beginning of the portal vein (SMV + splenic vein) origin of SMA obody runs upward and to the left across the midline lies to the left of SMV somewhat triangular in cross section passes over the aorta and L2 vertebra anterior surface: covered with peritoneum forms part of stomach bed posterior surface: devoid of peritoneum in contact with: oaorta oSMA oleft suprarenal gland oleft kidney and renal vessels otail passes forward in splenicorenal ligament (Snell, p. 202) relatively mobile passes between the splenorenal ligament with splenic vessels (Moore, p. 267) comes in contact with hilum of the spleen blunted and turned superiorly lies anterior to left kidney closely related to left colic flexure ducts omain pancreatic duct (of Wirsung) begins in the tail runs the length of the gland receives numerous tributaries on the way turns inferiorly and unite with common bile duct to form the short, dilated hepatopancreatic ampulla (of Vater) opens into the second part of the duodenum on the major duodenal papilla sphincters control flow of bile and pancreatic juice into the duodenum three sphincters: osphincter of pancreatic duct around terminal part of pancreatic duct osphincter of the bile duct around the termination of the bile duct osphincter of Oddi hepatopancreatic sphincter sometimes, main duct drains separately into the duodenum (25% of the time) oaccessory pancreatic duct (of Santorini) drains the upper part of the head opens into the duodenum a short distance above the main duct opens on the minor duodenal papilla frequently communicates with the main duct (60%) in some cases, main pancreatic duct is smaller than accessory pancreatic duct and they may not be connected accessory duct carries most of the pancreatic juice blood supply oarteries anterior and posterior superior pancreaticoduodenal arteryanterior and posterior inferior pancreaticoduodenal arteryoveins corresponding veins drain the pancreas (Snell, p. 203) anterior and posterior arcades drain the head splenic vein drains the body and tail pancreatic veins (Moore, p. 267) tributaries of splenic and superior mesenteric parts of the hepatic portal vein most drains to the splenic vein lymph drainage olymph nodes situated along the arteries that supply the gland omost end in pancreaticosplenic lymph node (along splenic artery) osome into pyloric lymph node oefferent vessels from these nodes ultimately drain into celiac and superior mesenteric lymph nodes via the hepatic lymph nodes Page 3 of 4 Kid, youll move mountains! Dr. Seuss Alyssa WillisL. Ng, 1A, A.Y. 2014-2015nerve supply osympathetic and parasympathetic fibers reach it by passing along the arteries from the celiac and SM plexus osympathetic nerves from abdominopelvic splanchnic nerves predominantly inhibitory effect oparasympathetic nerves from vagal nerves secretomotor stimulate both endocrine and exocrine secretion ohowever pancreatic secretion is mainly thru: duodenal hormones under stimulus of gastric acid cholecystokinin and secretin Testis firm, mobile organ paired ovoid approx. 5 X 2.5 cm lie within the scrotum left testis is usually a little lower than the right produces osperms (spermatozoa) omale hormones, primarily testosterone epididymis osolid, very coild tube owhere sperm will pass through and mature oat posterior side of the testes tunica vaginalis oclosed peritoneal sac partially surrounding the testis orepresents the closed-off distal part of the embryonic processus vaginalis ovisceral layer covers surface of each testis, except where the testis attaches to the epididymis and spermatic cord oparietal layer adjacent to the internal spermatic fascia more extensive than the visceral layer osinus of the epididymis slit-like recess of the tunica vaginalis bet. body of the epididymis and posterolateral surface of the testis tunica albuginea otough, fibrous capsule surrounding each testis othickens into a ridge on its internal, posterior aspect as the mediastinum of the testis septuli testis ofibrous septa extending from the inner surface of the capsule, specifically from the internal ridge, which divide the organ into lobules seminiferous tubules o1 3 coiled tubules lying within each lobule owhere sperms are produced oopen into a network of channels called rete testisa network of canals in the testis mediastinumefferent ductules oconnect rete testis to upper end of the epididymis normal spermatogenesis ocan occur only if testes are at a temp. lower than that of the abdominal cavity owhen located in scrotum, theyre at a temp. of about 1.5-2.5 C (lec) or 3 C (Snell, p. 131) lower than the abdominal temperature blood supply: oarteries abdominal aorta testicular artery ovein pampiniform venous plexus testicular veins converge superiorly to form the right and left testicular veins right testicular vein IVC left testicular vein left renal vein lymph drainage: olymph vessels ascend in the spermatic cord oend in the lumbar or para-aortic LNs at the level of L1 nerve supply: otesticular plexus of nerves vagal parasympathetic visceral afferent fibers sympathetic fibers from T10 (-T11) of the spinal cord Page 4 of 4 Kid, youll move mountains! Dr. Seuss Alyssa WillisL. Ng, 1A, A.Y. 2014-2015Ovary oval-shaped 1.5 x 0.75 in. (4 x 2 cm) mesovarium oattaches it to the back of the broad ligament ligaments: osuspensory ligament part of the broad ligament extends bet. attachment of mesovarium and lateral wall of pelvis oround ligament remains of the upper part of the gubernaculum connects lateral margin of uterus to ovary obroad ligament double layer of peritoneum (mesentery) extends from sides of the uterus to the lateral walls and floor of the pelvis most important ligament supports the internal genitalia of the female mesometrium olargest part of the broad ligament oinferior to the mesosalpinx and mesovarium omesentery for the uterus itself mesosalpinx oanterosuperior free border of the broad ligament outerine tube lies here mesovarium oposterior aspect of the broad ligament oovary lies here location: oovarian fossa depression in the lateral wall of the pelvis wherein it usually lies bounded by external iliac vessels above bounded by internal iliac vessels behind position: oextremely variable ooften found hanging down in rectouterine pouch (pouch of Douglas) oduring pregnancy, enlarging uterus pulls ovary up into abdominal cavity oafter childbirth, broad ligament is lax, ovary takes up a variable position in the pelvis tunica albuginea othin fibrous capsule germinal epithelium omodified peritoneum covering the capsule omisnomer because layer does not give rise to ova ooogonia develop before birth appearance: obefore puberty, ovary is smooth oafter puberty, ovary becomes progressively scarred as successive corpora lutea degenerate oafter menopause, ovary becomes shrunken and its surface is pitted with scars function: oproduction of female germ cells ova oproduction of female sex hormones estrogen progesterone blood supply: oarteries abdominal aorta ovarian arteryat the level of L1 oveins ovarian veins right IVC left renal vein lymph drainage: ofollow ovarian artery odrain into para-aortic nodes at the level of L1 nerve supply: oaortic plexus, which accompanies ovarian artery blood supply, lymph drainage, and nerve supply o over the pelvic inlet and cross the external iliac vessels oreach the ovary through the suspensory ligament, lateral end of the broad ligament ovessels and nerves enter the hilum of the ovary via the mesovarium