組織學(xué)與胚胎學(xué) 內(nèi)分泌系統(tǒng)

內(nèi)分泌系統(tǒng)EndocrineSystemEndocrineorgans:Thyroidgland甲狀腺Parathyroidgland甲狀旁腺Adrenalgland腎上腺Hypophysis垂體Dispersedendocrinecells23Characteristicsofendocrineglands:Cellsarearrangedincord,follicle,aggregationornet-likeDuctless.richincapillaries.secretion

passintoblood.Secretehormone,actontargetorgan,tissueorcells.paracrine旁分泌：直接作用于周圍的器官4Hormonestravelviathebloodstreamtotargetcells5Peptide-secretingcells含氮類激素分泌細(xì)胞rERGolgicomplexMembranedsecretinggranulesTwotypesofendocrinecells:678Steroid-secretorycell類固醇分泌細(xì)胞sERLipiddropletsMitochondriacontainingtubular-likecristae.91011Largestendocrineglandinthebody.Generalstructure:Fibrouscapsuleprotrudesanddividestheparenchymaintolobulescontainingfolliclesandrichincapillaries.一、甲狀腺Thyroidgland12（一）Follicle:LM：Follicularepithelialcell:Simplecuboidalorcolumnardependinguponthefunctionalstatus.Colloid:Containsiodinatedthyroglobulin.EM：RER,Golgi,secretingG,microvilli,phagosomes,lysosome。

Function：Formationoftriiodothyronine(T3)&tetraiodothyronine(T4):13甲狀腺濾泡上皮細(xì)胞電鏡像14Synthesisiodinationstoragere-absorptionCleavagerelease

Synthesisofthyroxine15FunctionofT3、T4a.elevatesthebasalmetabolicrate.b.influencethebodygrowthandnervoussystemdevelopmentduringfetallife.Correlateddiseases：

Cretinism呆小癥:童年時期甲狀腺功能低下引起的身體矮小和智力低下。

Hyperthyroidism甲狀腺功能亢進(jìn)癥：甲狀腺素合成和分泌過多。

Hypothyroidism甲狀腺機(jī)能機(jī)能減退：粘液性水腫16地方性甲狀腺腫

地方性甲狀腺腫的主要原因是碘缺乏，所以又稱為碘缺乏性甲狀腺腫，多見于山區(qū)和遠(yuǎn)離海洋的地區(qū)。碘是甲狀腺合成甲狀腺激素的重要原料之一，碘缺乏時合成甲狀腺激素不足，反饋引起垂體分泌過量的TSH，刺激甲狀腺增生肥大。

17甲狀腺機(jī)能亢進(jìn)：甲狀腺素合成和分泌過多18克汀病19

濾泡上皮細(xì)胞膠質(zhì)濾泡上皮之間的濾泡旁細(xì)胞濾泡之間的濾泡旁細(xì)胞HE染色20（二）濾泡旁細(xì)胞parafollicularcell:Situatedofteningroupsamongfollicles,oramongfollicularepitheliumcellsbutarenotadjacenttocolloidLM：

Lightlystained

Argyrophilic212223EM：

ContainrichRERandsecretorygranules.

功能:Calcitonin降鈣素

activityofosteoblasts.

腸和腎小管吸收鈣

bloodCa2+level

Calcitoningenerelatedpeptide(CGRP)降鈣素基因相關(guān)肽2425二、甲狀旁腺parathyroidgland262728Chiefcell主細(xì)胞:

ParothyroidH甲狀旁腺激素2.Oxyphilcell嗜酸性細(xì)胞破骨細(xì)胞,骨細(xì)胞

腸和腎小管吸收鈣

血鈣

29三、腎上腺AdrenalGland30Cortex：

Zonaglomerulosa球狀帶

Zonefasciculate束狀帶

Zonereticularis網(wǎng)狀帶

Medulla:313233（一）cortex：1.Zonaglomerulosa15%LM：薄，團(tuán)狀排列，小，多邊形，胞核小，色深。EM：線粒體，滑面內(nèi)質(zhì)網(wǎng)，少量脂滴Function：

Mineralocorticoid(aldosterone)distalconvolutedtubulecollectingductsNa+absorptionK+excretion

34352.Zonefasciculata78%LM：厚，細(xì)胞大，界限清楚，多邊形，核圓形或卵圓形，色淡EM：typicalsteroid-secretingcells

Function:

Glucocorticoid糖皮質(zhì)激素

(cortisol皮質(zhì)醇)(corticosterone皮質(zhì)酮)Influences

metablismofproteincarbohydrates,fatSupressimmuneresponseAntiinflammation36腎上腺皮質(zhì)束狀帶細(xì)胞電鏡像Ly:lysosomeL:lipiddropletsP:lipofuscinG373.Zonereticularis7%Arrangedinnet-likestructureandcontainmorelipofuscinGFunctions:

Androgen雄激素

Smallamountsofglucocorticoid&estrogen38腎上腺糖皮質(zhì)激素↑面圓而紅軀干肥胖高血壓高血糖閉經(jīng)多毛等腎上腺皮質(zhì)機(jī)能亢進(jìn)：皮質(zhì)醇增多癥(cushing綜合癥)為各種病因造成腎上腺分泌過多糖皮質(zhì)激素（主要是皮質(zhì)醇）所致病癥的總稱。39（二）MedullaChromaffincellepinephrinecell:80%norepinephrinecellSympatheticganglioncell4041Sympatheticganglioncell4243腎上腺髓質(zhì)光鏡像(示交感神經(jīng)節(jié)細(xì)胞)44腎上腺髓質(zhì)腎上腺素細(xì)胞電鏡像4546四、垂體Hypophysis47

被膜

遠(yuǎn)側(cè)部（前葉）垂體腺垂體結(jié)節(jié)部中間部神經(jīng)垂體神經(jīng)部漏斗正中隆起漏斗柄（后葉）48

腺垂體遠(yuǎn)側(cè)部腺垂體中間部神經(jīng)垂體神經(jīng)部4950(一)腺垂體Adenohypophsis

1.遠(yuǎn)側(cè)部(Parsdistalis):

細(xì)胞排列成團(tuán)索狀，其間有豐富的竇狀毛細(xì)血管（垂體門脈系統(tǒng)的次級毛細(xì)血管網(wǎng)）。(1)Acidophiliccell:40%.大，粗大嗜酸性顆粒生長激素細(xì)胞(Somatotroph):分泌生長激素(Growthhormone)，促進(jìn)骨組織等生長。若少兒時期缺乏則造成侏儒癥，分泌過多引起巨人癥，成人分泌過多發(fā)生肢端肥大癥。催乳素細(xì)胞(Mammotroph):分泌催乳素(Prolaction/PRL)，促進(jìn)乳腺發(fā)育和乳汁分泌。515253生長激素細(xì)胞-----催乳激素細(xì)胞-----促性腺激素細(xì)胞-----垂體遠(yuǎn)側(cè)部電鏡像54

巨人癥559歲16歲23歲52歲肢端肥大癥5657(2)Basophiliccell:10%，胞體大小不等，含嗜堿性G促甲狀腺素細(xì)胞(Thyrotroph):分泌促甲狀腺激素(thyroidstimulatinghormone,TSH)。促進(jìn)甲狀腺素的分泌。促性腺激素細(xì)胞(Gonadotroph):

分泌促性腺激素，包括卵泡刺激素(folliclestimulatinghormone,FSH)和黃體生成素(luteinizinghormone,LH)。前者促進(jìn)生殖細(xì)胞的發(fā)育，后者促進(jìn)性激素的分泌。促腎上腺皮質(zhì)激素細(xì)胞(Corticotroph):

分泌促腎上腺皮質(zhì)激素(adrenocorticotrophichormone,ACTH)促進(jìn)腎上腺皮質(zhì)束、網(wǎng)狀帶細(xì)胞的分泌。(3)Chromophobecell:50%58席漢氏綜合征

產(chǎn)后大出血垂體前葉血液循環(huán)障礙前葉組織壞死多種前葉激素分泌不足腎上腺皮質(zhì)功能低下持續(xù)閉經(jīng)，性欲減退精神淡漠，畏寒血壓低，面色蒼白，體重降低性腺功能低下

甲狀腺功能低下59腺垂體功能減退癥（sheehan綜合癥）乳房萎縮長期閉經(jīng)毛發(fā)脫落60中間部濾泡嫌色細(xì)胞嗜堿性細(xì)胞

黑素細(xì)胞刺激素3.結(jié)節(jié)部

毛細(xì)血管嫌色細(xì)胞61

腺垂體遠(yuǎn)側(cè)部腺垂體中間部神經(jīng)垂體神經(jīng)部6263Primarycapillarynetwork（神經(jīng)垂體漏斗部）HypophysealportalVeinSecondarycapillarynetwork（腺垂體遠(yuǎn)側(cè)部）4.bloodsupplyofadenohypophysis

&Hypophysealportalsystem垂體門脈系統(tǒng)Superiorhypophysealartery645.腺垂體與下丘腦的關(guān)系

弓狀核:

神經(jīng)內(nèi)分泌細(xì)胞

釋放激素釋放抑制激素調(diào)節(jié)腺垂體遠(yuǎn)側(cè)部內(nèi)各種細(xì)胞的分泌

垂體門脈系統(tǒng)反饋65(二）神經(jīng)垂體Neurohypophsisunmyelinatednervefibers:aretheaxonsofneurons,whosecellbodieslocateinparaventricularandsupraopticnucleiinhypothalamus.theHerringBodiesaretheaxondilationscontainingmanysecretorygranules.pituicytes(glialcell)：sustain、nutritionSinusoidalcapillariesReticularfiber.666768垂體神經(jīng)部光鏡像↖

赫令體↖

垂體細(xì)胞69內(nèi)皮軸突內(nèi)的分泌顆粒赫令體電鏡像70Theoxytocin催產(chǎn)素,whichisproducedbyparaventricularnuclei,canshrinksmoothmusclesinuteruswhenparturition.Theantidiuretichormone抗利尿激素

(ADH,vasopressin),whichisproducedbysupraopticnuclei,canfac