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Glands of the body list: You and Your Hormones from the Society for Endocrinology


Sweat glands – Mayo Clinic

Your skin has two types of sweat glands: eccrine and apocrine. Eccrine glands occur over most of your body and open directly onto the surface of your skin. Apocrine glands open into the hair follicle, leading to the surface of the skin. Apocrine glands develop in areas abundant in hair follicles, such as on your scalp, armpits and groin.


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Parathyroid Disorders | Michigan Medicine

Parathyroid disorders lead to abnormal levels of calcium in the blood that can cause brittle bones, kidney stones, fatigue, weakness, and other problems.

At the University of Michigan, our experts are focused on making an accurate diagnosis through comprehensive testing and providing the best therapy options for each patient.

What are the Parathyroid Glands?

There are typically four parathyroid glands located near the thyroid gland. Each parathyroid gland is normally about the size of a grain of rice (about 3-5 millimeters in diameter and 30 – 60 milligrams in weight). Although the thyroid and parathyroid glands are physically near each other and are both part of your body’s endocrine system, their functions are unrelated. Parathyroid glands release parathyroid hormone (PTH) which controls the calcium levels in the blood stream. Other areas of the body, especially the bones, kidneys and small intestine, respond to PTH by increasing calcium levels in the blood. Calcium is very important for our bodies, especially for muscle and nerve function.

About Parathyroid Disorders

As a rule, if the calcium level in the blood is low, the parathyroid glands sense this and release PTH. PTH then causes release of calcium from the bones into the bloodstream, increases vitamin D production from the kidney which ultimately increases absorption of calcium from the intestines. If the calcium level is too high, then PTH secretion should decrease to a very low level. 

Hyperparathyroidism exists when the parathyroid glands produce too much parathyroid hormone (PTH). This may be due to multiple reasons, and the reason helps determine the appropriate type of treatment. Sometimes treatment is as simple as replacing vitamin D when the parathyroid gland is responding appropriately to a problem elsewhere in the body. In other cases, there is an issue with the gland itself and surgery is required. Excess parathyroid hormone can lead to negative effects on the body such as osteoporosis which can lead to fractures, kidney stones, decreased kidney function, heart disease, pancreatitis, increased acid secretion in the stomach and ulcers. Many patients experience symptoms of fatigue, depression, anxiety, difficulty concentrating, difficulty with their memory, insomnia, generalized muscle aches and pains, frequent urination (especially at night), and constipation. Because these symptoms may be related to many other disorders, it is never known until after treatment whether or not these will improve.

The opposite problem, hypoparathyroidism, occurs when the parathyroid glands do not produce enough PTH. This leads to a low blood calcium level and can adversely affect muscle, nerve and other functions.

Diagnosis of Parathyroid Disorders

We diagnose parathyroid disorders through comprehensive testing that starts with a complete history and physical exam. Diagnosis of the type of hyperparathyroidism is based on blood work and other types of laboratory testing. Imaging tests are not used to diagnose parathyroid disorders, but may be ordered once the presence of a parathyroid disorder has been confirmed by lab tests.

Disorders of the Hypothalamus and Pituitary Gland

Of the endocrine glands, the hypothalamus and pituitary glands are of major importance since they act as the coordinating centers of the endocrine system.

The hypothalamus is responsible for maintaining the body’s internal balance (homeostasis) by stimulating or inhibiting major bodily functions such as the heart rate and blood pressure, body temperature, fluid and electrolyte balance, appetite and body weight, sleep cycle and function of the gastrointestinal track. The hypothalamus is also considered the master regulator of the endocrine system; Regulatory hormones secreted by the hypothalamus are transported by the hypophyseal-portal system to the anterior and posterior pituitary (Figure 2), prompting the release of secondary hormones that can affect various organ functions. 

Figure 2. The hypophyseal-portal system

Hormones typically bind to membrane or nuclear receptors of specific target glands/organs, which in turn release hormones that exert negative feedback control on the releasing sites. (Figure 3). 

Figure 3. Example of negative (in red) feedback inhibition:

The hypothalamus secretes releasing factors that act on the pituitary gland to stimulate the release of trophic hormones.

Trophic hormones act then on target organs (e.g., adrenal, thyroid or gonads), which in response produce other

hormones/signals, shutting down the production of releasing or/and trophic hormones.

The hypothalamus secretes various hormones that are then transported to the anterior pituitary (Figure 4):

  • Corticotropin releasing hormone (CRH)
  • Growth hormone releasing hormone (GHRH)
  • Thyrotropin releasing hormone (TRH)
  • Gonadotropin releasing hormone (GnRH)
  • Somatostatin (inhibits growth hormone secretion)
  • Prolactin releasing and prolactin inhibitor hormones



Figure 4. Overview of hypothalamic and pituitary hormones and their actions

 The pituitary gland also secretes hormones in response to hypothalamic release hormones:

  • Thyroid stimulating hormone (TSH)
  • Adrenocortical stimulating hormone (ACTH)
  • Follicle stimulating hormone (FSH)
  • Luteinizing hormone (LH)
  • Prolactin
  • Melanocyte-stimulating hormone
  • Endorphins

Supraoptic and paraventricular nuclei of the hypothalamus also secrete hormones that are transported to the posterior pituitary to be released into the circulation. These are:

  • Anti-diuretic hormone (ADH): regulates plasma osmolality
  • Oxytocin: regulates ejection of milk and uterine contractions.

Disorders of the hypothalamus can result in appetite, temperature and sleep disorders. As an example, hypothalamic obesity occasionally develops in response to major hypothalamic injury/damage affecting the centers of appetite regulation and energy balance. Hypothalamic obesity is characterized by an uninhibited eating disorder that often results in morbid obesity and can be associated with other obesity complications like diabetes, dyslipidemia, obstructive sleep apnea, mood disorder etc.

Disorders of the hypothalamus and/or anterior pituitary can also result in hypopituitarism, including adrenal insufficiency (see adrenal disorders section), hypothyroidism (see thyroid disorders section), hypogonadism (see puberty and its disorders section), growth hormone deficiency (see growth disorders section) and prolactin deficiency (inability to lactate).

Disorders of the posterior pituitary can result in diabetes insipidus and disorders pertaining to oxytocin deficiency (like inability to lactate, vaginal dryness, decreased libido etc.).

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List of Three’s

List of Three’s

List of Three’s in Anatomy

The structure of the human body is organized into groups of three with remarkable frequency. I have listed several examples of this tendency by region. This list does not include structures contributing to form the many “triangles” in the body. If you know of any more, please let me know John A. McNulty, Ph.D.


3 body planes - frontal sagittal transverse 3 layers of skin- epidermis dermis hypodermis 3 general venous circulations- systemic pulmonary portal


3 germ layers- endoderm mesoderm ectoderm 3 divisions of somites- sclerotome dermatome myotome 3 definitive kidneys- pronephros mesonephros metanephros 3 derivatives of skull- desmo/dermatocranium splanchno/viscerocranium chondrocranium 3 initial embryonic divisions of the brain- prosencephalon mesencephalon rhombencephalon


3 parts of the erector spinae m. - iliocostalis longissimus spinalis each are divided again into 3 parts 3 parts of the transversospinalis m. - semispinalis m. multifidus m. rotator m. 3 coverings of the spinal cord- dura mater arachnoid pia 3 spaces surrounding spinal cord- epidural subdural subarachnoid 3 borders of the scapula- medial (vertebral) lateral superior 3 angles of the scapula


3 parts of the axillary artery 3rd part has 3 branches- subscapular anterior humeral circumflex posterior humeral circumflex Brachial plexus 3 trunks- upper middle lower 3 posterior divisions 3 anterior divisions 3 cords- lateral medial 3 branches off medial cord- medial brachial medial antebrachial medial pectoral posterior 3 branches off posterior cord- upper subscapular lower subscapular thoracodorsal 3 branches off the thyrocervical trunk- transverse cervical suprascapular inferior thyroid 3 veins drain the thyroid gland - superior (into internal jugular) middle (into internal jugular) inferior (into left brachiocephalic) 3 scalene muscles- anterior middle posterior 3 muscles attach to spine of C2- semispinalis cervicis obliquus capitis inferior rectus capitis posterior major 3 constrictor muscles- superior middle inferior 3 parts of the pharynx- nasopharynx oropharynx laryngeopharynx 3 parts to the hyoid bone- body greater horn lesser horn 3 structures inside carotid sheath- common carotid artery internal jugular vein vagus nerve 3 ganglia in sympathetic cervical chain- superior (magnum) middle inferior (stellate)


3 parts of the maxillary artery- mandibular pterygoid pterygopalatine 3 divisions of the trigeminal n. - V1 - ophthalmic - has 3 branches frontal nasociliary lacrimal V2 - maxillary V3 - mandibular- has 3 parts undivided trunk anterior division posterior division- has 3 branches auriculotemporal lingual inferior alveolar 3 cranial fossae- anterior middle posterior 3 nuchal lines- inferior superior highest 3 layers to calvarium- outer table diploe inner table 3 clinoid processes of the sphenoid bone- anterior middle posterior 3 cranial nerves pass through jugular foramen- C.N. IX C.N. X C.N. XI 3 cranial nerves travel in the wall of the cavernous sinus- C.N. III C.N. IV C.N. V 3 cranial nerves carry parasympathetics to the head- C. N. III C.N. VII C.N. IX 3 nasal conchae- superior middle inferior 3 principal components of the temporal bone- squama petro/mastoid tympanic ring 3 bones of the upper jaw/palate- premaxilla maxilla palatine 3 salivary glands- parotid submaxillary sublingual 3 muscles innervated by 3 cranial nerves attach to the styloid process- stylohyoid - C.N. VII stylopharyngeus - C.N. IX styloglossus - C.N. XII 3 layers in tympanic membrane (derived from 3 germ layers) 3 cranial nerves innervate the external tympanum- C.N. V C.N. VII C.N. X 3 middle ear bones- incus malleus stapes 3 parts of the ear- outer middle inner 3 semicircular canals 3 membranes of the cochlea- Reissner Tectorial Basilar 3 intrinsic muscles of the tongue- longitudinal vertical transverse 3 muscles elevate the mandible- masseter m. temporalis m. medial pterygoid m. 3 branches of the posterior auricular artery- stylomastoid branch auricular branch occipital branch 3 branches of the ophthalmic nerve (VI)- nasociliary n. frontal n. lacrimal n. 3 superior alveolar nerves- anterior superior alveolar n. middle superior alveolar n. posterior superior alveolar n. 3 types of deciduous teeth- incisors canine molars 3 layers of dentition- enamal dentin pulp 3 general layers of the eye - retinal choroidal/ciliary body scleral/corneal 3 color receptors in cone cells - red blue yellow 3 nerves to the larynx - external laryngeal n. internal laryngeal n. recurrent laryngeal n. 3 cerebral arteries - anterior middle posterior 3 arteries supply the cerebellum - superior cerebellar anterior inferior cerebellar posterior inferior cerebellar


3 muscles attach to coracoid process - coracobrachialis pectoralis minor short head of biceps 3 parts of the axillary a. ; 3rd part has 3 branches- subscapular a. anterior circumflex humeral a. posterior circumflex humeral a 3 muscles of the rotator cuff are rotators 3 glenohumeral ligaments - superior middle inferior


3 muscles in anterior comparment- biceps brachii coracobrachialis brachialis 3 heads of triceps brachii m.- long lateral medial 3 muscles attach to greater tubercle of the humerus- supraspinatus infraspinatus teres minor 3 parts of the ulnar collateral ligament of the elbow - anterior posterior oblique


3 muscles in deep anterior compartment - flexor digitorum profundus flexor pollicis longs pronator quadratus


3 muscles in thenar eminence- opponens pollicis flexor pollicis brevis abductor pollicis brevis 3 muscles in hypothenar compartment- flexor digiti minimi abductor digiti minimi opponens digiti minimi 3 phalanges in fingers- proximal middle distal 3 palmer interossei


3 compartments- mediastinum left pleural cavity right pleural cavity 3 branches off the aortic arch- brachiocephalic a. left common carotid a. left subclavian a. 3 parts of the aorta- ascending arch descending 3 principal surfaces of the pleura- costal diaphragmatic mediastinal *the cupola is the superior extension 3 lobes of the right lung- superior middle inferior 3 bronchopulmonary segments of the upper right lobe- apical posterior anterior 3 muscles of interthoracic wall- external intercostal internal intercostal intercostalis intimus 3 false ribs on each side 3 cusps of the semilunar aortic and pulmonary valves of the heart 3 cusps of the tricuspid valve 3 main arteries of the heart- circumflex anterior interventricular right coronary 3 splanchnic nerves- greater lesser least


3 folds in anterior abdominal wall- median (obliterated urachus) medial (obliterated umbilical a. ) lateral (inferior epigastric a.) 3 muscles contribute to linea semilunaris/rectus abdominus aponeurosis - internal oblique external oblique transversus abdominus 3 openings in diaphragm- aortic esophageal inferior vena cava 3 arcuate ligaments of diaphragm- median over aorta medial over psoas major m. lateral over quadratus lumborum m. 3 parts of the stomach- fundus body pylorus 3 smooth muscle layers of the stomach- oblique longitudinal circular 3 unpaired branches of the abdominal aorta- celiac a. superior mesenteric a. inferior mesenteric a. 3 branches of celiac a.- left gastric a. splenic a. common hepatic a. 3 branches of common hepatic a.- right gastric a. proper hepatic a. gastroduodenal a. 3 arterial branches supply adrenal glands- inferior phrenic aorta renal 3 structures lie within porta hepatis- proper hepatic a. portal vein common bile duct 3 principal veins contribute to the portal vein- splenic v. superior mesenteric v. inferior mesenteric v. 3 parts of the small intestine- duodenum jejunum ileum 3 parts of large intestine- ascending transverse descending 3 tenia of large intestine 3 coverings of the spermatic cord- external spermatic fascia cremasteric fascia internal spermatic fascia 3 vessels in the umbilical cord umbilical vein 2 umbilical arteries

Pelvis and Perineum

3 bones in os coxae- pubis ilium ischium 3 parts of the pubis- body superior ramus inferior ramus 3 foramina in the pelvis- obturator foramen greater ischiadic foramen lesser ischiadic foramen 3 gluteus muscles- gluteus maximus gluteus medius gluteus minimus 3 rectal arteries- superior rectal from inferior mesenteric a. middle rectal from internal iliac a. inferior rectal from internal pudendal a. 3 branches of the posterior division of internal iliac a.- iliolumbar lateral sacral superior gluteal 3 openings in the urinary bladder- left ureter right ureter urethra 3 parts of the urethra- prostatic membranous spongy 3 parts of the uterus- fundus body cervix 3 erectile compartments of the penis- corpus spongiosum left corpus cavernosum right corpus cavernosum 3 muscles in superficial perineal pouch- bulbospongiosus ischiocavernosus superficial transverse perineus 3 arteries supply the rectum- superior rectal (from inferior mesenteric) middle rectal (from internal iliac) inferior rectal (from internal pudendal) 3 valves in the rectum- superior middle inferior


3 gluteal muscles- gluteus maximus gluteus medius gluteus minimus 3 muscles innervated by superior gluteal n. - gluteus medius gluteus minimus tensor fascia lata


3 hamstring muscles- biceps femoris semitendinosus semimembranosus 3 compartments in the femoral sheath 3 muscular compartments of the thigh- anterior medial posterior 3 branches of the lateral femoral circumflex a.- descending branch transverse branch ascending branch 3 muscles contribute to the pes anserinus- sartorius semitendinosus gracilis


3 compartments in the leg 3 muscles in anterior compartment - tibialis anterior extensor digitorum extensor hallucis 3 branches of the peroneal artery in the leg - anterior tibial a. posterior tibial a. peroneal a. 3 peroneal muscles in the leg - peroneus longus m. peroneus brevis m. peroneus tertius m. 3 muscles that comprise the triceps surae - grastrocnemius m. soleus m. plantaris m. 3 muscles in the deep posterior compartment - tibialis posterioris m. flexor hallucis longus m. flexor digitorum longus m.


3 cuneiform bones- medial intermediate lateral 3 phalanges in toes- proximal middle distal 3 plantar interossei 3 described arches - medial lateral transverse


3 exams in the course

If you like this kind of stuff, you may want to visit Michael Eck’s Book of Threes

Other contributors include:

    Lora Leuzinger

  1. Diego Villa Restrepo
  2. Cindy Kuiper
  3. Erika Goodwin
  4. Rob Grieve

Brain anatomy, Anatomy of the human brain


The brain is an amazing three-pound organ that controls all functions of the body, interprets information from the outside world, and embodies the essence of the mind and soul. Intelligence, creativity, emotion, and memory are a few of the many things governed by the brain. Protected within the skull, the brain is composed of the cerebrum, cerebellum, and brainstem.

The brain receives information through our five senses: sight, smell, touch, taste, and hearing – often many at one time. It assembles the messages in a way that has meaning for us, and can store that information in our memory. The brain controls our thoughts, memory and speech, movement of the arms and legs, and the function of many organs within our body.

The central nervous system (CNS) is composed of the brain and spinal cord. The peripheral nervous system (PNS) is composed of spinal nerves that branch from the spinal cord and cranial nerves that branch from the brain.


The brain is composed of the cerebrum, cerebellum, and brainstem (Fig. 1).

Figure 1. The brain has three main parts: the cerebrum, cerebellum and brainstem.

Cerebrum: is the largest part of the brain and is composed of right and left hemispheres. It performs higher functions like interpreting touch, vision and hearing, as well as speech, reasoning, emotions, learning, and fine control of movement.

Cerebellum: is located under the cerebrum. Its function is to coordinate muscle movements, maintain posture, and balance.

Brainstem: acts as a relay center connecting the cerebrum and cerebellum to the spinal cord. It performs many automatic functions such as breathing, heart rate, body temperature, wake and sleep cycles, digestion, sneezing, coughing, vomiting, and swallowing.

Right brain – left brain

The cerebrum is divided into two halves: the right and left hemispheres (Fig. 2) They are joined by a bundle of fibers called the corpus callosum that transmits messages from one side to the other. Each hemisphere controls the opposite side of the body. If a stroke occurs on the right side of the brain, your left arm or leg may be weak or paralyzed.

Not all functions of the hemispheres are shared. In general, the left hemisphere controls speech, comprehension, arithmetic, and writing. The right hemisphere controls creativity, spatial ability, artistic, and musical skills. The left hemisphere is dominant in hand use and language in about 92% of people.

Figure 2. The cerebrum is divided into left and right hemispheres. The two sides are connected by the nerve fibers corpus callosum.

Lobes of the brain

The cerebral hemispheres have distinct fissures, which divide the brain into lobes. Each hemisphere has 4 lobes: frontal, temporal, parietal, and occipital (Fig. 3). Each lobe may be divided, once again, into areas that serve very specific functions. It’s important to understand that each lobe of the brain does not function alone. There are very complex relationships between the lobes of the brain and between the right and left hemispheres.

Figure 3. The cerebrum is divided into four lobes: frontal, parietal, occipital and temporal.

Frontal lobe

  • Personality, behavior, emotions
  • Judgment, planning, problem solving
  • Speech: speaking and writing (Broca’s area)
  • Body movement (motor strip)
  • Intelligence, concentration, self awareness

Parietal lobe

  • Interprets language, words
  • Sense of touch, pain, temperature (sensory strip)
  • Interprets signals from vision, hearing, motor, sensory and memory
  • Spatial and visual perception

Occipital lobe

  • Interprets vision (color, light, movement)

Temporal lobe

  • Understanding language (Wernicke’s area)
  • Memory
  • Hearing
  • Sequencing and organization


In general, the left hemisphere of the brain is responsible for language and speech and is called the “dominant” hemisphere. The right hemisphere plays a large part in interpreting visual information and spatial processing. In about one third of people who are left-handed, speech function may be located on the right side of the brain. Left-handed people may need special testing to determine if their speech center is on the left or right side prior to any surgery in that area.

Aphasia is a disturbance of language affecting speech production, comprehension, reading or writing, due to brain injury – most commonly from stroke or trauma. The type of aphasia depends on the brain area damaged.

Broca’s area: lies in the left frontal lobe (Fig 3). If this area is damaged, one may have difficulty moving the tongue or facial muscles to produce the sounds of speech. The person can still read and understand spoken language but has difficulty in speaking and writing (i.e. forming letters and words, doesn’t write within lines) – called Broca’s aphasia.

Wernicke’s area: lies in the left temporal lobe (Fig 3). Damage to this area causes Wernicke’s aphasia. The individual may speak in long sentences that have no meaning, add unnecessary words, and even create new words. They can make speech sounds, however they have difficulty understanding speech and are therefore unaware of their mistakes.


The surface of the cerebrum is called the cortex. It has a folded appearance with hills and valleys. The cortex contains 16 billion neurons (the cerebellum has 70 billion = 86 billion total) that are arranged in specific layers. The nerve cell bodies color the cortex grey-brown giving it its name – gray matter (Fig. 4). Beneath the cortex are long nerve fibers (axons) that connect brain areas to each other — called white matter.

Figure 4. The cortex contains neurons (grey matter), which are interconnected to other brain areas by axons (white matter). The cortex has a folded appearance. A fold is called a gyrus and the valley between is a sulcus.

The folding of the cortex increases the brain’s surface area allowing more neurons to fit inside the skull and enabling higher functions. Each fold is called a gyrus, and each groove between folds is called a sulcus. There are names for the folds and grooves that help define specific brain regions.

Deep structures

Pathways called white matter tracts connect areas of the cortex to each other. Messages can travel from one gyrus to another, from one lobe to another, from one side of the brain to the other, and to structures deep in the brain (Fig. 5).

Figure 5. Coronal cross-section showing the basal ganglia.

Hypothalamus: is located in the floor of the third ventricle and is the master control of the autonomic system. It plays a role in controlling behaviors such as hunger, thirst, sleep, and sexual response. It also regulates body temperature, blood pressure, emotions, and secretion of hormones.

Pituitary gland: lies in a small pocket of bone at the skull base called the sella turcica. The pituitary gland is connected to the hypothalamus of the brain by the pituitary stalk. Known as the “master gland,” it controls other endocrine glands in the body. It secretes hormones that control sexual development, promote bone and muscle growth, and respond to stress.

Pineal gland:
is located behind the third ventricle. It helps regulate the body’s internal clock and circadian rhythms by secreting melatonin. It has some role in sexual development.

Thalamus: serves as a relay station for almost all information that comes and goes to the cortex. It plays a role in pain sensation, attention, alertness and memory.

Basal ganglia: includes the caudate, putamen and globus pallidus. These nuclei work with the cerebellum to coordinate fine motions, such as fingertip movements.

Limbic system: is the center of our emotions, learning, and memory. Included in this system are the cingulate gyri, hypothalamus, amygdala (emotional reactions) and hippocampus (memory).


Memory is a complex process that includes three phases: encoding (deciding what information is important), storing, and recalling. Different areas of the brain are involved in different types of memory (Fig. 6). Your brain has to pay attention and rehearse in order for an event to move from short-term to long-term memory – called encoding.

Figure 6. Structures of the limbic system involved in memory formation. The prefrontal cortex holds recent events briefly in short-term memory. The hippocampus is responsible for encoding long-term memory.


  • Short-term memory, also called working memory, occurs in the prefrontal cortex. It stores information for about one minute and its capacity is limited to about 7 items. For example, it enables you to dial a phone number someone just told you. It also intervenes during reading, to memorize the sentence you have just read, so that the next one makes sense.
  • Long-term memory is processed in the hippocampus of the temporal lobe and is activated when you want to memorize something for a longer time. This memory has unlimited content and duration capacity. It contains personal memories as well as facts and figures.
  • Skill memory is processed in the cerebellum, which relays information to the basal ganglia. It stores automatic learned memories like tying a shoe, playing an instrument, or riding a bike.

Ventricles and cerebrospinal fluid

The brain has hollow fluid-filled cavities called ventricles (Fig. 7). Inside the ventricles is a ribbon-like structure called the choroid plexus that makes clear colorless cerebrospinal fluid (CSF). CSF flows within and around the brain and spinal cord to help cushion it from injury. This circulating fluid is constantly being absorbed and replenished.

Figure 7. CSF is produced inside the ventricles deep within the brain. CSF fluid circulates inside the brain and spinal cord and then outside to the subarachnoid space. Common sites of obstruction: 1) foramen of Monro, 2) aqueduct of Sylvius, and 3) obex.

There are two ventricles deep within the cerebral hemispheres called the lateral ventricles. They both connect with the third ventricle through a separate opening called the foramen of Monro. The third ventricle connects with the fourth ventricle through a long narrow tube called the aqueduct of Sylvius. From the fourth ventricle, CSF flows into the subarachnoid space where it bathes and cushions the brain. CSF is recycled (or absorbed) by special structures in the superior sagittal sinus called arachnoid villi.

A balance is maintained between the amount of CSF that is absorbed and the amount that is produced. A disruption or blockage in the system can cause a build up of CSF, which can cause enlargement of the ventricles (hydrocephalus) or cause a collection of fluid in the spinal cord (syringomyelia).


The purpose of the bony skull is to protect the brain from injury. The skull is formed from 8 bones that fuse together along suture lines. These bones include the frontal, parietal (2), temporal (2), sphenoid, occipital and ethmoid (Fig. 8). The face is formed from 14 paired bones including the maxilla, zygoma, nasal, palatine, lacrimal, inferior nasal conchae, mandible, and vomer.  

Figure 8. The brain is protected inside the skull. The skull is formed from eight bones.

Inside the skull are three distinct areas: anterior fossa, middle fossa, and posterior fossa (Fig. 9). Doctors sometimes refer to a tumor’s location by these terms, e.g., middle fossa meningioma.

Figure 9. A view of the cranial nerves at the base of the skull with the brain removed. Cranial nerves originate from the brainstem, exit the skull through holes called foramina, and travel to the parts of the body they innervate. The brainstem exits the skull through the foramen magnum. The base of the skull is divided into 3 regions: anterior, middle and posterior fossae.

Similar to cables coming out the back of a computer, all the arteries, veins and nerves exit the base of the skull through holes, called foramina. The big hole in the middle (foramen magnum) is where the spinal cord exits.

Cranial nerves

The brain communicates with the body through the spinal cord and twelve pairs of cranial nerves (Fig. 9). Ten of the twelve pairs of cranial nerves that control hearing, eye movement, facial sensations, taste, swallowing and movement of the face, neck, shoulder and tongue muscles originate in the brainstem. The cranial nerves for smell and vision originate in the cerebrum.

The Roman numeral, name, and main function of the twelve cranial nerves:











moves eye, pupil



moves eye



face sensation



moves eye



moves face, salivate



hearing, balance



taste, swallow



heart rate, digestion



moves head



moves tongue


The brain and spinal cord are covered and protected by three layers of tissue called meninges. From the outermost layer inward they are: the dura mater, arachnoid mater, and pia mater.

Dura mater: is a strong, thick membrane that closely lines the inside of the skull; its two layers, the periosteal and meningeal dura, are fused and separate only to form venous sinuses. The dura creates little folds or compartments. There are two special dural folds, the falx and the tentorium. The falx separates the right and left hemispheres of the brain and the tentorium separates the cerebrum from the cerebellum.

Arachnoid mater: is a thin, web-like membrane that covers the entire brain. The arachnoid is made of elastic tissue. The space between the dura and arachnoid membranes is called the subdural space.

Pia mater: hugs the surface of the brain following its folds and grooves. The pia mater has many blood vessels that reach deep into the brain. The space between the arachnoid and pia is called the subarachnoid space. It is here where the cerebrospinal fluid bathes and cushions the brain.

Blood supply

Blood is carried to the brain by two paired arteries, the internal carotid arteries and the vertebral arteries (Fig. 10). The internal carotid arteries supply most of the cerebrum.

Figure 10. The common carotid artery courses up the neck and divides into the internal and external carotid arteries. The brain’s anterior circulation is fed by the internal carotid arteries (ICA) and the posterior circulation is fed by the vertebral arteries (VA). The two systems connect at the Circle of Willis (green circle).

The vertebral arteries supply the cerebellum, brainstem, and the underside of the cerebrum. After passing through the skull, the right and left vertebral arteries join together to form the basilar artery. The basilar artery and the internal carotid arteries “communicate” with each other at the base of the brain called the Circle of Willis (Fig. 11). The communication between the internal carotid and vertebral-basilar systems is an important safety feature of the brain. If one of the major vessels becomes blocked, it is possible for collateral blood flow to come across the Circle of Willis and prevent brain damage.

Figure 11. Top view of the Circle of Willis. The internal carotid and vertebral-basilar systems are joined by the anterior communicating (Acom) and posterior communicating (Pcom) arteries.

The venous circulation of the brain is very different from that of the rest of the body. Usually arteries and veins run together as they supply and drain specific areas of the body. So one would think there would be a pair of vertebral veins and internal carotid veins. However, this is not the case in the brain. The major vein collectors are integrated into the dura to form venous sinuses — not to be confused with the air sinuses in the face and nasal region. The venous sinuses collect the blood from the brain and pass it to the internal jugular veins. The superior and inferior sagittal sinuses drain the cerebrum, the cavernous sinuses drains the anterior skull base. All sinuses eventually drain to the sigmoid sinuses, which exit the skull and form the jugular veins. These two jugular veins are essentially the only drainage of the brain.

Cells of the brain

The brain is made up of two types of cells: nerve cells (neurons) and glia cells.

Nerve cells

There are many sizes and shapes of neurons, but all consist of a cell body, dendrites and an axon. The neuron conveys information through electrical and chemical signals. Try to picture electrical wiring in your home. An electrical circuit is made up of numerous wires connected in such a way that when a light switch is turned on, a light bulb will beam. A neuron that is excited will transmit its energy to neurons within its vicinity.

Neurons transmit their energy, or “talk”, to each other across a tiny gap called a synapse (Fig. 12). A neuron has many arms called dendrites, which act like antennae picking up messages from other nerve cells. These messages are passed to the cell body, which determines if the message should be passed along. Important messages are passed to the end of the axon where sacs containing neurotransmitters open into the synapse. The neurotransmitter molecules cross the synapse and fit into special receptors on the receiving nerve cell, which stimulates that cell to pass on the message.

Figure 12. Nerve cells consist of a cell body, dendrites and axon. Neurons communicate with each other by exchanging neurotransmitters across a tiny gap called a synapse.


Glia cells

Glia (Greek word meaning glue) are the cells of the brain that provide neurons with nourishment, protection, and structural support. There are about 10 to 50 times more glia than nerve cells and are the most common type of cells involved in brain tumors.

  • Astroglia or astrocytes are the caretakers — they regulate the blood brain barrier, allowing nutrients and molecules to interact with neurons. They control homeostasis, neuronal defense and repair, scar formation, and also affect electrical impulses.
  • Oligodendroglia cells create a fatty substance called myelin that insulates axons – allowing electrical messages to travel faster.
  • Ependymal cells line the ventricles and secrete cerebrospinal fluid (CSF).
  • Microglia are the brain’s immune cells, protecting it from invaders and cleaning up debris. They also prune synapses.

Sources & links

If you have more questions, please contact Mayfield Brain & Spine at 800-325-7787 or 513-221-1100.




updated > 4.2018
reviewed by > Tonya Hines, CMI, Mayfield Clinic, Cincinnati, Ohio

Mayfield Certified Health Info materials are written and developed by the Mayfield Clinic. We comply with the HONcode standard for trustworthy health information. This information is not intended to replace the medical advice of your health care provider.

Glands of the Abdomen – Advanced Anatomy 2nd. Ed.


The adrenal gland is a yellow, pyramid-shaped gland that sits on top of each kidney. Since they sit on top of the kidney’s superior border, the adrenals can be referred to as the suprarenal gland. The adrenal glands are connected to the kidneys via the dense fibrous capsule that firmly holds the two organs together. The adrenals are also located near the 12th rib and the diaphragm with major arteries and veins in close proximity as they run along the posterior wall of the abdominopelvic cavity. Since it is an endocrine organ it is important that is highly vascularized, this will allow for the secreted hormones to affect the body. The adrenal gland had two key layers, the adrenal medulla and adrenal cortex.

The adrenal medulla is the deep layer of the adrenal gland. The medulla is often a grey-pink colour due to the abundance of blood vessels and connective tissues. The medulla is responsible for the secretion of two hormones. From specialized cells epinephrine, also known as adrenaline, and norepinephrine, also known as noradrenaline, are produced. Each hormone is produced by one cell with evidence showing that the two types of cells are found in different areas of the adrenal medulla and that they are independently controlled.

The adrenal cortex is the more superficial layer. It has a yellowish colour due to the stored lipids, which include cholesterol and various fatty acids. From the cortex, dozens of hormones are released that are collectively called corticosteroids. Corticosteroids are vital to survival. These corticosteroids are produced in three distinct zones on the adrenal cortex, these include the zona glomerulosa, zona fasciculata, and zona reticularis. Each zone produces specific steroid hormones that make up the corticosteroids. Transport proteins are needed to move adrenal hormones around the body.  Transcortin, found in the blood bound with the corticosteroid hormones and carry them to their target organs.


The adrenals medulla is responsible for the release of epinephrine and norepinephrine. These hormones are released by packing the hormones into vesicles that then cluster just inside the plasma membrane. From here these hormones are slowly released at low levels through exocytosis, however, if there is a sympathetic stimulus epinephrine and norepinephrine are released at a dramatically accelerated rate of exocytosis. The sympathetic nervous system involves the fight or flight mechanism, so it makes sense that the role of epinephrine and norepinephrine help the body response to a stressful situation. Epinephrine and norepinephrine have four key functions, the acceleration of ATP production, breakdown of stored fat, liberating glucose stores in the liver, and increase the rate and force of cardiac muscle contraction. This in terms of short-term stress this response means that your heart rate and pressure will increase and that you will have better muscular strength and endurance. So, if your stressful situation is running into a hungry lion or mugger you will have the surge of strength and endurance to fight your attacker or run away. The metabolic changes that epinephrine and norepinephrine cause reach their peak 30 seconds after the stimulus and persist for several minutes.

The adrenal cortex has a more complex role when it comes to the endocrine functions. It is responsible to produce corticosteroids which can be broken down into three groups that are associated with the zone that produces them. These zones are the Zona Glomerulosa, Zona Fasciculata and the Zona Reticularis.

The Zona Glomerulosa is responsible for the production of a group of hormones called Mineralocorticoids. The mineralocorticoids affect the concentration and composition of electrolytes in body fluids. The main hormone from mineralocorticoid group is Aldosterone. Aldosterone is responsible for the conservation of sodium ion and the elimination of potassium ion. The target of aldosterone is the kidneys, sweat gland, salivary gland and the pancreas. Aldosterone is also responsible for increasing a person interest in salty food by increasing the sensitivity of the salt receptor taste bud on the tongue. Aldosterone is stimulated when the sodium concentration falls, a drop in blood volume, a drop in blood pressure, or a rise in potassium concentration in the blood.

The Zona Fasciculata is responsible for the production of the group of hormones called Glucocorticoids. Glucocorticoids are a group of steroid hormones that affect glucose metabolism. When the zona fasciculata is stimulated by ACTH, a pituitary hormone, the secretion of cortisol also known as hydrocortisone. Cortisol is the primary hormone in the glucocorticoid, with corticosterone and cortisone also released in smaller amounts. Cortisol is often referred to as the stress hormone, but unlike epinephrine and norepinephrine, the stressor is not a single short-term event. In times of long-term stress, cortisol helps control blood sugar levels, regulate metabolism, reduce inflammation and assist in memory formulation.

The final zone is Zona Reticularis, this zone produces small amounts androgens. Androgens are usually associated with the reproductive organs, but small amounts are produced by the adrenal cortex. In early stages of puberty adrenal androgen stimulate the growth of pubic hair in both girls and boys. In adulthood, adrenal androgens are not important to men. However, for adult women, adrenal androgens are important to build muscle mass, blood cell formation and to support their sex drive.

Clinical application

In today’s world chronic stress is commonplace, with people stressing about finances, school, work, family and ironically health. Although cortisol can be helpful in short bouts of chronic stress, it can be damaging when high levels are maintained over a long period of time. In this short video by DNews explains the effect of long-term stress.



Bartholomew E.F., Hutching R.T. Martini F.H., Nath J.L, Ober C.E.,Ober W.O, O’Keefe R.A,& Welch K.. (2015) Fundamentals Of Anatomy and physiology (10th ed.) Pearson


D News  https://www.youtube.com/watch?v=8IUZjCSkbrc


The pancreas is both an exocrine digestive organ and endocrine, playing a major role in internal metabolism and external digestion. The pancreas is part of the retoparitanemum as it sits deep to the stomach and proximal portion of the small intestine called the duodenum. The pancreas is long, slender, lumpy and pale organ ranging from 20-25 cm long with an average weight (in adults) of 80g. There are three sections to the pancreas, the head, the body and the tail. The head fits into the loop formed by the duodenum. The body it the middle section that extends toward the spleen, this section forms the long slender shaper of the pancreas. Lastly, the tail is the most lateral section of the pancreas and forms a short, blunt, rounded end of the pancreas.

The endocrine functions of the pancreas are based on a cluster of cells called the pancreatic islets or the islets of Langerhans.  Although only about 1% of the pancreas is made up of the islet of Langerhans, a typical pancreas can contain 2 million islets of Langerhans. They are four different types of cells in the islet of Langerhans, these cells are called Alpha cells, Beta cells, Delta cells and F cells. Alpha cells and beta cells are responsible for regulating the blood sugar levels. Delta cells produce peptide hormone identical to growth hormone- inhibiting hormone (GH-IH) which suppresses the release of glucagon and insulin.  A peptide hormone released from the delta cells also slow the rated of food adsorption and enzyme secretion along the digestive tract. The second cell type found in the Pancreatic acini is the F cells. The F cells produce the hormone pancreatic polypeptide (PP) which inhibits gallbladder release of bile and regulates the production of some of the pancreatic enzymes. This is thought to help to control the rate of nutrient absorption.

The pancreas also has a role in exocrine digestion through the pancreatic acini clusters can be found around the ends of the pancreatic ducts. The pancreas plays an important in digestion as it produces digestive enzymes and buffers. For more information about the exocrine function of the pancreas go to the visceral organ section under the Abdominal tab.

As the pancreas is an endocrine gland a good blood supply is necessary to move the hormones produced by the pancreatic islets to the rest of the body. The arteries that feed the pancreas are the splenic, superior mesenteric, and common hepatic arteries. These arteries branch off to form the major branches called the pancreatic arteries and the pancreaticoduodenal arteries. The venous system removes wastes and moves hormones around the body. The splenic view and its branches move waste and hormones away from the pancreas to be excreted or used.

Image of an islet of Langerhans that is died to show where the hormones are found.


The pancreas is responsible for hormones that are responsible for the metabolism of the glucose in the blood. The two main hormones are insulin and glucagon. They work together to regulate blood sugar levels. These hormones are produced in the islets of Langerhans by specialized cells. The beta and alpha cells.  Together these two hormones work to maintain a normal blood sugar level ranging between 70-110 mg/dL of blood. This is done through be each hormone’s effect on lean tissues, adipose tissue, and liver.

Insulin is a peptide hormone that is responsible for the reduction of high blood sugar, secreted by the beta cells. To drop the blood sugar level in the blood, insulin is released to increase the utilization of glucose by the lean tissues and through the storage of excess glucose. Insulin can be thought of as a key that unlocks the cells allowing glucose into the cells. Glucose is necessary for energy production so lean tissues like muscles, especially the heart muscles, use a lot of glucose. In the muscle and liver excess glucose is stored as glycogen. This storage is an important immediate source of energy in times of stress on the muscles, like physical activity.  If there is excess glucose left in the blood that hasn’t been used by the lean tissues or stored in the muscle or liver, insulin is also responsible for the storing the excess glucose as fat. The adipose tissues are very sensitive to insulin. Insulin has 6 effects the target cells that are dependent on the cell type of the target. These include acceleration of glucose uptake, accelerating glucose utilization, enhanced ATP production, stimulating glycogen formation, stimulating amino acid absorption and protein synthesis, and stimulating triglyceride formation in adipose tissue. Problems arise when insulin is unable to get sugar out of the bloodstream. See the clinical application for an explanation on how the body responses to high blood sugar.

Although high blood sugar can to problematic, low blood sugar can also impact our health. To prevent low blood sugar and to maintain homeostasis within the normal blood sugar range, glucagon is released by the alpha cells. A way to remember the stimulus for the release of glucagon is to break the word do into to an acronym. Glucagon is released when Glucose is All Gone. The primary function of glucagon is to increase blood sugar and to do that is has 3 key effects: to stimulate the breakdown of glycogen, stimulating the breakdown of triglycerides in adipose tissue, and stimulate the production and release of glucose by the liver. The process that glucagon stimulates to increase blood sugar levels is called gluconeogenesis. Gluconeogenesis is the process that happens in the liver to reform glucose from its storage form, especially when it is stored with amino acids.

Clinical application

Diabetes Mellitus commonly referred to as diabetes, sometimes referred to as the eye, nerve and kidney disease, is caused by the inability to lower the blood sugar levels. There are two types of Diabetes mellitus, type I and type 2.

Type 1, which used to be referred to as adolescent onset diabetes, is when beta cells don’t produce adequate amounts of insulin. Often this shows up in childhood or as a young adult and requires lifelong blood sugar management through insulin injections and dietary changes. Type 1 diabetes accounts for approximately 5% of cases.

Type 2 diabetes, or adult-onset diabetes, is considered a lifestyle caused disease as type 2 diabetes is associated with obesity. Type 2 Diabetes is caused by the insulin targets cells becoming insensitive to the stimulus, this, in turn, means that glucose remains in the blood causing elevated blood sugar. The elevated blood sugar can cause damage to nerves in the eyes, peripheral nerves, heart, peripheral tissue damage and kidney damage. The damage to the peripheral nerves and tissues often are associated (incomplete sentence). In people with type 2 diabetes injury to the feet can go unnoticed due to the loss of nerve function. Injuries even if treated can take a long time to heal as the elevated blood sugar slows the healing process. However, unlike type 1 diabetes, type 2 is often curable. Through weight loss associated with healthy lifestyle changes type 2 diabetes can be reversed.

Type 2 diabetes, or adult-onset diabetes, is considered a lifestyle caused disease as type 2 diabetes is associated with obesity. Type 2 Diabetes is caused by the insulin targets cells becoming insensitive to the stimulus, this, in turn, means that glucose remains in the blood causing elevated blood sugar. The elevated blood sugar can cause damage to nerves in the eyes, peripheral nerves, heart, peripheral tissue damage and kidney damage. The damage to the peripheral nerves and tissues often are associated (incomplete sentence). In people with type 2 diabetes injury to the feet can go unnoticed due to the loss of nerve function. Injuries even if treated can take a long time to heal as the elevated blood sugar slows the healing process. However, unlike type 1 diabetes, type 2 is often curable. Through weight loss associated with healthy lifestyle changes type 2 diabetes can be reversed.


Bartholomew E.F., Hutching R.T. Martini F.H., Nath J.L, Ober C.E.,Ober W.O, O’Keefe R.A,& Welch K.. (2015) Fundamentals Of Anatomy and physiology (10th ed.) Pearson

Bartholomew E.F., Hutching R.T. Martini F.H., Nath J.L, Ober C.E.,Ober W.O, O’Keefe R.A,& Welch K.. (2015) Fundamentals Of Anatomy and physiology (10th ed.) Pearson


needs citation https://nyaspubs.onlinelibrary.wiley.com/doi/abs/10.1111/j.1749-6632.1959.tb44921.x


khan academy https://www.youtube.com/watch?v=xNf–q0YMq8


Picture of the islet of Langerhans https://upload.wikimedia.org/wikipedia/commons/0/05/Human_pancreatic_islet.jpg


Cushing’s Syndrome/Disease – Causes, Symptoms, Diagnosis and Treatments

Cushing’s Syndrome/Disease | American Association of Neurological Surgeons

Cushing’s syndrome is a disorder caused by the body’s exposure to an excess of the hormone cortisol. Cortisol affects all tissues and organs in the body. These effects together are known as Cushing’s syndrome.

Cushing’s syndrome can be caused by overuse of cortisol medication, as seen in the treatment of chronic asthma or rheumatoid arthritis (iatrogenic Cushing’s syndrome), excess production of cortisol from a tumor in the adrenal gland or elsewhere in the body (ectopic Cushing’s syndrome) or a tumor of the pituitary gland secreting adrenocorticotropic hormone (ACTH) which stimulates the over-production of cortisol from the adrenal gland (Cushing’s disease).

Cortisol is a normal hormone produced in the outer portion of the adrenal glands. When functioning correctly, cortisol helps the body respond to stress and change. It mobilizes nutrients, modifies the body’s response to inflammation, stimulates the liver to raise blood sugar and helps control the amount of water in the body. Cortisol production is regulated by the ACTH produced in the pituitary gland.

Prevalence of Cushing’s Syndrome

  • An estimated 10-15 per million people are affected every year.
  • Pituitary adenomas (Cushing’s disease) account for more than 70 percent of cases in adults and about 60-70 percent of cases in children and adolescents.
  • Cushing’s syndrome most commonly affects adults ages 20-50 and is more prevalent in females, accounting for about 70 percent of all cases.


Underlying Causes

Pituitary Adenomas — Cushing’s Disease

Pituitary adenomas are benign tumors of the pituitary gland that secrete increased amounts of ACTH causing excessive cortisol production. Most patients have a single adenoma. First described in 1912 by neurosurgeon Harvey Cushing, MD, in his book The Pituitary Body and Its Disorders, Cushing’s disease is the most common cause of spontaneous Cushing’s syndrome, accounting for 60-70 percent of all cases.


Ectopic ACTH Syndrome

Some benign or malignant (cancerous) tumors that arise outside the pituitary gland can produce ACTH. This condition is known as ectopic ACTH syndrome. Lung tumors (malignant adenomas or carcinoids) cause more than 50 percent of these cases. Other less common types of tumors that can produce ACTH are thymomas, pancreatic islet cell tumors and medullary carcinomas of the thyroid.

Adrenal Tumors

An abnormality of the adrenal glands, such as an adrenal tumor, may cause Cushing’s syndrome. Most of these cases involve non-cancerous tumors called adrenal adenomas, which release excess cortisol into the blood.

Adrenocortical carcinomas, or adrenal cancers, are the least common cause of Cushing’s syndrome. Cancer cells secrete excess levels of several adrenal cortical hormones including cortisol and adrenal androgens. Adrenocortical carcinomas often cause very high hormone levels and a rapid onset of symptoms.

Familial Cushing’s Syndrome

Most cases of Cushing’s syndrome are not genetic. However, some individuals may develop Cushing’s syndrome due to an inherited tendency to develop tumors of one or more endocrine glands. In primary pigmented micronodular adrenal disease, children or young adults develop small cortisol-producing tumors of the adrenal glands. In multiple endocrine neoplasia type I (MEN I), hormone-secreting tumors of the parathyroid glands, pancreas and pituitary gland can occur. Cushing’s syndrome in MEN I may be due to a pituitary, ectopic or adrenal tumor.


Signs and Symptoms Associated with Cushing’s Syndrome/Disease:

  • Weight gain in face (moon face)
  • Weight gain above the collar bone (supraclavicular fat pad)
  • Weight gain on the back of neck (buffalo hump)
  • Skin changes with easy bruising in the extremities and development of purplish stretch marks (striae) particularly over the abdomen or axillary region
  • Red, round face (plethora)
  • Central obesity with weight gain centered over the chest and abdomen with thin arms and legs
  • Excessive hair growth (hirsutism) on face, neck, chest, abdomen and thighs
  • Female balding
  • Generalized weakness and fatigue
  • Blurry vision
  • Vertigo
  • Muscle weakness
  • Menstrual disorders in women (amenorrhea)
  • Decreased fertility and/or sex drive (libido)
  • Hypertension
  • Poor wound healing
  • Diabetes mellitus
  • Severe depression
  • Extreme mood swings



The diagnosis of Cushing’s syndrome is based on clinical suspicion combined with a review of the patient’s medical history, physical examination and laboratory tests to help determine the existence of excessive levels of cortisol. A patient suspected of having Cushing’s syndrome must initially have an appearance suggestive of excess cortisol production combined with an elevated 24-hour urinary excretion of cortisol. In assessing the physical features of Cushing’s syndrome, it can often be beneficial to compare old and recent photographs to reveal the classic changes in facial and body appearance associated with this disorder.

The following tests can help determine if there are excessive levels of cortisol being produced:

  • The 24-hour urinary cortisol test measures the amount of cortisol being produced within the urine over the course of an entire day. Levels higher than 50-100 micrograms per day in an adult suggest the presence of Cushing’s syndrome. Although the majority of patients with Cushing’s syndrome have elevated levels of cortisol, it is becoming increasingly evident that many patients with a mild case of Cushing’s syndrome may also have normal levels of cortisol resulting in several 24-hour urine collections to confirm a diagnosis.
  • The low-dose dexamethasone suppression test measures the response of the adrenal glands to ACTH and has been widely utilized for four decades. It involves taking a small dose of a cortisol-like drug, dexamethasone (1 mg), at 11 p.m., then having blood drawn to screen for cortisol the following morning. In patients without Cushing’s syndrome, the morning level of cortisol is typically very low, indicating that ACTH secretion was suppressed by the evening dose of dexamethasone. In patients with Cushing’s syndrome, the morning cortisol level will be high. It is evident that normal patients will suppress their cortisol to a very low level (1.8 mg/dl), whereas those suffering from Cushing’s syndrome will not. Using this strict criterion, this test should provide an estimated 95-97 percent diagnostic accuracy rate. However, some patients with a mild case of Cushing’s syndrome can suppress their cortisol to low levels making it difficult to fully diagnose utilizing this test.
  • The late-night salivary cortisol test is a relatively new test that checks for elevated levels of cortisol in the saliva between 11 p.m. and midnight. Cortisol secretion is usually very low late at night, but in patients with Cushing’s syndrome, the level will always be elevated during this time. Collection of saliva requires special sampling tubes; however, this is an easy test for patients to perform and can be done multiple times. Normal levels of late-night salivary cortisol virtually exclude the diagnosis of Cushing’s syndrome. When administered correctly, this test should provide an estimated 93-100 percent diagnostic accuracy rate.

After a definitive diagnosis has been made, the source must then be determined. The first step in distinguishing the underlying cause is the measurement of ACTH. Patients with ACTH-secreting tumors will either have a normal or elevated level of ACTH. In contrast, patients with an excess of adrenal cortisol will have a subnormal level. Performing a high-dose dexamethasone suppression test may be helpful in this situation. This test, similar to the low-dose dexamethasone suppression test, involves taking a high dose of dexamethasone (8 mg) at 11 p.m. then having blood drawn to screen for the presence of cortisol the following morning. In normal patients, the morning level of cortisol will again be very low. Patients with pituitary tumors will also suppress their serum cortisol level, but those with adrenal tumors will maintain a high level of cortisol production. A high level of cortisol points to a non-pituitary source.

Despite the tests described above, distinguishing a pituitary from a non-pituitary ACTH-secreting tumor can be diagnostically challenging. The majority of patients with ACTH-secreting tumors have a pituitary lesion that is often very small.

The following tests are recommended:

  • Magnetic Resonance Imaging (MRI) of the pituitary gland with gadolinium enhancement is a recommended approach. When an obvious pituitary tumor (>5 mm) is identified with an MRI, further diagnostic evaluation may not be needed depending on the clinical presentation. However, about 50 percent of patients will have a “normal” MRI of the pituitary, with 10 percent having incidental tumors unrelated to ACTH production. In such cases, the MRI will not provide a definitive diagnosis and additional tests will be required.
  • Petrosal sinus sampling is a test used to distinguish the source of ACTH secretion and should only be performed after the diagnosis of Cushing’s syndrome has been confirmed. ACTH and other pituitary hormones produced in the pituitary gland enter the blood stream by drainage through veins called the inferior petrosal sinuses. To perform this procedure, a catheter is placed in both veins at the same time and blood is sampled for ACTH before and after the administration of the corticotropin-releasing hormone (CRH) and at two, five and 10 minute intervals. This invasive technique should be performed at a medical center by a medical professional with extensive experience in this procedure. When administered correctly, this test should provide an estimated 95-98 percent diagnostic accuracy rate.


Treatment of Cushing’s Syndrome

Treatment of Cushing’s syndrome depends on the underlying cause of excess cortisol but may perhaps include surgery, radiation, chemotherapy or the use of cortisol-inhibiting drugs. If the cause is iatrogenic, from long-term use of glucocorticoid hormones to treat another disorder, the physician will gradually reduce the dose of the externally administered steroid to the lowest dose adequate for control of that disorder. Once control is established, the dose of glucocorticoid hormones may be given on alternate days to lessen side effects for the patient.


Treatment of Cushing’s Disease

Microsurgical resection of an ACTH-secreting pituitary adenoma is the optimum treatment for Cushing’s disease with cure rates of 80-90 percent if a tumor is found. Surgery is most often done through a transnasal transsphenoidal approach, which will not leave a visible scar. This type of surgery may be performed, per the surgeon’s preference, using either a minimally invasive operating microscope or with the use of an endoscope. Partial removal of the pituitary gland (subtotal hypophysectomy) may be used in patients without clearly identifiable adenomas.


In patients to whom a remission is not obtained after surgery, the use of various medications that can inhibit cortisol production may be used, such as:

These agents are not as effective as surgery and are considered a second–line course of treatment. In some patients who are particularly resistant to all forms of therapy, removal of the adrenal glands bilaterally (bilateral adrenalectomy) may be considered.

Post-surgery, with successful tumor removal, the production of ACTH drops below normal. This decrease is natural and temporary, and patients are prescribed a synthetic form of cortisol such as hydrocortisone or prednisone to compensate this change. Most patients can discontinue replacement therapy within six to 12 months, but others may require the use of oral steroids for several years to, possibly, their lifetime. Patients who need adrenal surgery may also require steroid replacement therapy.

One additional treatment option in patients who have failed surgical procedures or are too high risk medically to bring to surgery is radiation therapy. Radiation therapy, which is administered over a six-week period to the pituitary gland, has yielded improvement in 40-50 percent of adults and up to 85 percent of children.

Stereotactic radiosurgery has also been found to be an effective treatment for patients with ACTH-secreting pituitary adenomas. A recent study demonstrated endocrine remission in 54 percent of patients and tumor-growth control in 96 percent. However, ongoing observation is required to monitor for tumor growth, disease recurrence, the development of new hormone deficiencies and damage to the optic pathways and brain.


Cushing’s Syndrome/Disease Resources

The AANS does not endorse any treatments, procedures, products or physicians referenced in these patient fact sheets. This information is provided as an educational service and is not intended to serve as medical advice. Anyone seeking specific neurosurgical advice or assistance should consult his or her neurosurgeon, or locate one in your area through the AANS’ Find a Board-certified Neurosurgeon” online tool.

90,000 Iron deficiency: a list of foods without which the body will suffer


Iron deficiency: a list of foods without which the body will suffer

Iron deficiency: a list foods without which the body will suffer – RIA Novosti Sport, 20.10.2021

Iron deficiency: a list of foods without which the body will suffer

Iron is a vital trace element for the body. It is part of hemoglobin, which helps deliver oxygen to the organs.Also iron … RIA Novosti Sport, 20.10.2021

2021-09-29T03: 15

2021-09-29T03: 15

2021-10-20T13: 51

healthy food




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MOSCOW, 29 Sep – RIA Novosti, Daria Darvina.Iron is a vital trace element for the body. It is part of hemoglobin, which helps deliver oxygen to the organs. Also, iron is involved in cholesterol metabolism, gastrointestinal processes, regulates body temperature and supports the immune system. Having enough iron affects the condition of your skin, hair and nails. The human body cannot produce iron on its own, so the only source is food. The daily intake of iron depends on the age and gender of the person.Children need 8 to 10 milligrams a day. Men between the ages of 19 and 50 need eight milligrams daily. But women require much more – up to 18 milligrams. This is due to the fact that during the period of menstruation, the level of a trace element in the female body drops, and it must be increased.With iron deficiency, the muscles and tissues of the body cease to function normally, which can lead to anemia. Among the possible reasons are also distinguished: large blood loss, poor and irregular nutrition, impaired absorption of iron.Symptoms of anemia: Increased fatigue and severe fatigue, headaches, flickering in the eyes, dizziness, rapid heartbeat, pale coloration of the inner surface of the lower eyelids, brittle nails and hair, shortness of breath on exertion, cold hands and feet, weak immunity and frequent infections. the functions of the cardiovascular system, the immune, digestive, and motor systems are disrupted. How to avoid the consequences of anemia? It’s simple: you need to eat foods that contain iron every day.There are two types of foods, animal protein and plant-based foods. Animal protein foods include liver, kidney, brain and heart, beef and lean beef, mussels, oysters, shellfish, turkey, canned tuna, and eggs. Most iron is found in dark meats (beef is number one). In addition, her liver contains many nutrients with minimal calories. Poultry meat contains protein, selenium and zinc, which help maintain muscle mass.What other foods are high in iron? For example, seafood, which is better absorbed. In the absence of fresh fish, it can be consumed in canned form, however, in this case, the iron will be much less. You will have to add something else to the diet. Eggs contain a fairly large amount of iron, which is found in the yolks. Both chicken and quail are useful. But you should not abuse them: the norm is 100-200 grams. Plant foods with iron: seeds, nuts, dark chocolate, broccoli, spinach, pomegranate, quinoa, beans.An excellent choice is sesame and pumpkin seeds. They are not very high in calories, but can replenish most of the daily value of iron. In terms of saturation and usefulness, nuts are very similar to meat, since they contain a lot of iron and high in calories. You should definitely pay attention to peanuts, almonds and pistachios. Cocoa beans, as in legumes, are also rich in iron. If the chocolate contains 70% or more cocoa, it can be consumed to restore iron levels. It also contains magnesium, which is essential for the smooth functioning of the heart.Low-calorie spinach and broccoli are full of minerals and vitamins, including – C. The proportion of iron in them is not as high as in other foods, so they can be used as an additive to meat dishes.



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food, nutrition, health

MOSCOW, September 29 – RIA Novosti, Daria Darvina. Iron is a vital trace element for the body. It is part of hemoglobin, which helps deliver oxygen to the organs. Also, iron is involved in cholesterol metabolism, gastrointestinal processes, regulates body temperature and supports the immune system.Having enough iron affects the condition of your skin, hair and nails.

The human body cannot produce iron on its own, therefore the only source is food.

October 20, 10:42 am

The doctor revealed what should be the rate of hemoglobin during pregnancy

The daily rate of iron depends on the age and sex of the person. Children need 8 to 10 milligrams a day. Men between the ages of 19 and 50 need eight milligrams daily.But women require much more – up to 18 milligrams. This is due to the fact that during the period of menstruation, the level of a trace element in the female body falls, and it must be increased.

With iron deficiency, the muscles and tissues of the body cease to function normally, which can lead to anemia. Among the possible reasons are also distinguished: large blood loss, poor and irregular nutrition, impaired absorption of iron.

September 28, 04:20 AM For cancer and heart disease: the benefits of an underestimated product in Russia have been disclosed

Symptoms of anemia

Increased fatigue and severe fatigue, headaches, flickering in the eyes, dizziness, rapid heartbeat, pale coloration of the inner surface of the lower eyelids brittle nails and hair, shortness of breath on exertion, cold hands and feet, weak immunity and frequent incidence of infections.

With anemia, the functions of the cardiovascular system, the immune, digestive, and motor systems are impaired.

How to avoid the consequences of anemia?

It’s simple: you need to eat foods that contain iron every day. There are two types of foods: animal protein and plant-based foods.

Animal protein products include: liver, kidneys, brains and heart, beef and lean beef, mussels, oysters, shellfish, turkey meat, canned tuna, eggs.September 28, 06:30 hOZhHow to determine iodine deficiency without tests: signs and advice from a doctor

Most iron is found in dark meat (beef is number one). In addition, her liver contains many nutrients with minimal calories. Poultry meat contains protein, selenium and zinc, which help maintain muscle mass.

What other foods are high in iron?

For example, in seafood, which is better absorbed. In the absence of fresh fish, it can be consumed in canned form, however, in this case, the iron will be much less.You will have to add something else to the diet.

Eggs contain a fairly large amount of iron, which is found in the yolks. Both chicken and quail are useful. But you should not abuse them: the norm is 100-200 grams.

Plant-based foods with iron: seeds, nuts, dark chocolate, broccoli, spinach, pomegranate, quinoa, beans.

September 28, 03:35 AM The doctor told who should not drink green tea

An excellent choice – sesame and pumpkin seeds. They are not very high in calories, but can make up most of the daily iron requirement.

In terms of saturation and usefulness, nuts are very similar to meat, since they contain a lot of iron and are high in calories. You should definitely pay attention to peanuts, almonds and pistachios.

Cocoa beans, as in legumes, are also rich in iron. If the chocolate contains 70% or more cocoa, it can be consumed to restore iron levels. It also contains magnesium, which is essential for the smooth functioning of the heart.

Low-calorie spinach and broccoli are full of minerals and vitamins, including C.The proportion of iron in them is not as high as in other foods, so they can be used as an additive to meat dishes.

September 16, 20: 14ZOZH Protein diet: its effect on the body, how to lose weight and what not to eat : fl. 2 ml 1 or 5 pcs., 10 ml 1, 2 or 5 pcs. (29503)

The adverse reactions listed below are listed according to the damage to organs and organ systems and the frequency of occurrence.The frequency of occurrence is defined as follows: very often (≥1 / 10), often (≥1 / 100 and <1/10), infrequently (≥1 / 1000 and <1/100), rarely (≥1 / 10000 and <1 / 1000), very rare (<1/10000, including isolated cases), the frequency is unknown.

The following adverse reactions were reported, identified in clinical trials in which the drug Ferinject ® was taken by more than 8000 patients, as well as reactions reported in the post-marketing period.

From the immune system: infrequently – hypersensitivity; rarely – anaphylactic / anaphylactoid reactions.

From the side of metabolism: often – hypophosphatemia.

From the nervous system: often – headache, dizziness; infrequently – paresthesia, taste distortion; frequency unknown – loss of consciousness 1 .

Mental disorders: rarely – anxiety 2 .

From the side of the cardiovascular system: often – “rush” of blood to the face, arterial hypertension; infrequently – tachycardia, arterial hypotension; rarely – phlebitis, fainting 2 , light-headedness 2 ; frequency unknown – Coonis syndrome 1 .

Respiratory system: infrequently – shortness of breath; rarely – bronchospasm 2 .

From the digestive system: often – nausea; infrequently – vomiting, indigestion, abdominal pain, constipation, diarrhea; rarely – bloating.

Skin and subcutaneous tissue disorders: infrequently – pruritus, urticaria, erythema, skin rash 3 ; rarely – angioedema 2 , pallor 2 ; frequency unknown – facial edema 1 .

From the musculoskeletal system: infrequently – myalgia, back pain, joint pain, pain in the limbs, muscle cramps.

General disorders and disorders at the injection site: often – reactions in the area of ​​injection / infusion 4 ; infrequently – fever, weakness, chest pain, peripheral edema, chills; rarely – malaise, flu-like condition (may occur over a period of time ranging from several hours to several days) 2 .

Laboratory and instrumental data: infrequently – an increase in the ALT activity in the blood, an increase in the AST activity in the blood, an increase in the GGT activity in the blood, an increase in the LDH activity in the blood, an increase in the ALP activity in the blood.

The most common adverse reaction is nausea, occurring in 2.9% of patients, followed by injection / infusion site reactions, hypophosphatemia, headache, flushing, dizziness and hypertension. Injection / infusion site reactions include several adverse reactions that are individually infrequent or rare.

For clinical trial participants who showed a decrease in serum phosphorus levels, troughs were obtained after about 2 weeks, and in most cases returned to baseline values ​​12 weeks after treatment with Ferinject ® . The most serious adverse reactions are anaphylactoid / anaphylactic reactions, the frequency of which is estimated to be rare (see section “Special instructions”).

1 Adverse reactions that were noted exclusively in the post-marketing period: the frequency of occurrence is assessed as rare.
2 Adverse reactions that were noted both in the post-marketing period and in clinical studies.
3 Including adverse reactions denoted by the following preferred terms: skin rash (the individual frequency of this adverse reaction is estimated as infrequent) and erythematous rash, generalized, macular, maculopapular, itching (the individual frequency of all adverse reactions is estimated as rare).
4 Including, but not limited to, adverse reactions denoted by the following preferred terms: pain at the injection site, hematoma, discoloration of the skin, extravasation, irritation, reaction at the injection site (individual frequency of all adverse reactions is assessed as infrequent) and paresthesia (individual the frequency of an adverse reaction is assessed as rare).

Radionucleide diagnostics (radioisotope laboratory) – Amur Regional Oncological Dispensary

The department employs:

– Lukyanov Igor Nikolaevich – head of the laboratory of radionucleide diagnostics, doctor-radiologist of the highest qualification category, certificate dated 30.09.2014 No. 0128240310180, specializing in radiology;

– Tkacheva Lyudmila Nikolaevna radiologist of the laboratory of radionucleide diagnostics of the highest qualification category, certificate of 18.04.2015 No. 0377060161398 “Radiology”;

– Andrienko Natalya Aleksandrovna, radiologist of the laboratory of radionucleide diagnostics, certificate dated May 27, 2015 No. 0178140032143;

The Laboratory of Radionucleide Diagnostics is the only subdivision of this profile in the Amur Region.

Single-photon emission

computer tomograph Mediso 101043

Radionuclide diagnostics is one of the modern and rapidly developing methods of radiation diagnostics for assessing the functional state of various organs and body systems using diagnostic radiopharmaceuticals labeled with radionuclides.

At present, of the methods of radionuclide diagnostics, scintigraphy is the most widespread method of functional imaging, which consists in introducing radioactive isotopes into the body and obtaining an image by determining the radiation emitted by them.

Features of radionuclide diagnostics (scintigraphy).

Imaging methods of radionuclide diagnostics are based on obtaining an image reflecting the distribution of radiopharmaceuticals introduced into the patient’s body, which specifically accumulate in various organs and tissues.Radiopharmaceuticals are certain chemical or biochemical compounds labeled with gamma-emitting radionuclides that have a short half-life. Gamma radiation emanating from the patient’s body is recorded by a gamma camera detector and, after computer processing, the resulting information is converted into a functional image of the organ under study. The spatio-temporal picture of the distribution of the radiopharmaceutical gives an idea of ​​the shape, size and position of the organ, as well as the presence of pathological foci in it.

Methods of radionuclide diagnostics refer to methods of molecular imaging, as they reflect pathological processes occurring at the molecular and cellular level, and do not duplicate information obtained by other methods of radiation diagnostics (ultrasound, CT, MRI). Functional changes, far ahead of anatomical ones, make nuclear medicine methods unique both in the early diagnosis of diseases and in dynamic observation. Radionuclide diagnostics is widely used in oncology, endocrinology, cardiology, uronephrology, and neurology.

Methods of radionuclide diagnostics:

1) Scintigraphy of various organs and systems is a method of radionuclide examination of internal organs based on visualization of the distribution of a radiopharmaceutical drug introduced into the body using a gamma scintillation camera.

With static scintigraphy, a two-dimensional image is obtained when performing one or several scintigrams to study the anatomical and topographic state of internal organs and to detect foci of pathological distribution of the radiopharmaceutical in them.This method is most often used for diseases of the thyroid and parathyroid glands, kidneys, liver, and lungs.

With dynamic scintigraphy, a series of two-dimensional images is obtained by registering individual frames with a specified time interval, which makes it possible to determine the nature of the movement of the radiopharmaceutical in the examined organ and evaluate its function. The methods of dynamic scintigraphy include studies of urinary function of the kidneys (dynamic renoscintigraphy), biliary function of the liver and gallbladder (dynamic hepatocholecystography).

2) Whole body scintigraphy – taking an image of the whole body using a specialized gamma camera with a large field of view. The advantage of this method is obtaining a full body scintigram in one study after a single injection of a radiopharmaceutical. It is most often used in oncology to identify the primary tumor focus and search for distant metastases, planning and evaluating treatment results.

3) Single-photon emission computed tomography (SPECT) – makes it possible to obtain a layer-by-layer picture of the distribution of a radiopharmaceutical in an organ with subsequent reconstruction of its three-dimensional image.One of the most interesting aspects of quantitative SPECT is associated with the new imaging technology – the ability to calculate the volume of functioning organ tissue by summing volumetric elements that form images of organ slices. This modern method is best used in oncology and cardiology.

4) Single-photon emission computed tomography combined with X-ray computed tomography (SPECT / CT) is the latest method of complex radiation and radiological research, which allows you to see at once not only the inclusion of a radiopharmaceutical in some pathological process, organ, especially in cancer, but and accurately determine the spatial localization from the picture of the tomographic section, which significantly improves the quality of scintigraphic images and increases the diagnostic accuracy.Such studies are carried out on a modern combined apparatus that combines a single-photon emission tomograph and an X-ray computed tomograph. This state-of-the-art technology is ideal for tumor imaging and treatment planning, as well as for examining cardiac patients.

Safety of radionuclide diagnostics.

In radionuclide diagnostics for scintigraphy, gamma-emitting radionuclides with a short half-life from several hours to several days (technetium-99m, iodine-131) are used.Due to the short half-life of radionuclides, low energy of gamma radiation and the rapid elimination of radiopharmaceuticals from the body, the patient receives a low radiation dose, which is not higher, and in most cases even lower than the radiation dose obtained in conventional X-ray examinations.

After scintigraphy, the patient does not pose a danger to others and can lead a normal life. After some research on the first day, contact with children under 3 years of age and pregnant women should be limited.

Absolute contraindications: pregnancy, breastfeeding.

Indications for referral to scintigraphy are determined by the attending physician (oncologist, endocrinologist, cardiologist, therapist), depending on the nature of the disease and the expected result of the radionuclide study.

Types of research:

1) Thyroid examination:

Thyroid scintigraphy

Provides information about its location, shape, size.This is the only method that evaluates the functional activity of its individual parts or nodules detected by ultrasound examinations, which makes it possible to decide on the need for and the amount of surgery.

Indications for scintigraphy are the presence of nodes in the thyroid gland, suspicion of improper positioning of the organ, retrosternal goiter, postoperative recurrence of the nodular goiter.

Preparation: 2 weeks before the study, preparations containing iodine, thyreostatic drugs, thyroid hormones should be discontinued, and the patient should be advised not to use an alcohol solution of iodine for 2 months.Beta-blockers are discontinued 5-6 days before the study.

Scintigraphy of the parathyroid glands

Allows you to identify the location, adenoma, increase in size and assess the functional state of the parathyroid glands.

The study is carried out in two stages.

No preparation for the study is required.

2) Liver examination:

Dynamic scintigraphy of the liver and gallbladder (scintigraphy of the hepatobiliary system)

This study allows long-term continuous monitoring of the passage of the drug in the liver under physiological conditions and allows you to assess the functional state of the hepatobiliary system, gallbladder, bile ducts, sphincters and indirectly judge the anatomical and pathophysiological changes in the system.

The study is carried out on an empty stomach, during the study the patient is given a choleretic breakfast.

Scintigraphy of the liver and spleen

Performed to determine the shape, size, violation of their anatomical structure. No preparation for the study is required.

Scintigraphic angiography of the liver. It is used to diagnose cavernous hemangiomas of the liver. No preparation for the study is required.

3) Kidney examination:

4) Examination of the skeleton:

Skeleton bone scintigraphy

Obtaining an image of the entire skeleton during scintigraphy enables early detection of metastatic bone lesions in patients with oncological diseases of various organs.

It is important that pathological remodeling of bone tissue is recognized in the early phases of the development of the process, even before the appearance of radiological signs of the disease.

No preparation for the study is required.

5) Lung perfusion scintigraphy. The main indication for the study is pulmonary embolism. No preparation for the study is required.

6) Perfusion brain scintigraphy. It allows you to identify a violation of the blood supply to the structures of the brain at the level of microcirculation and makes it possible to assess the blood flow of various parts of the brain in acute and chronic disorders of cerebral blood flow, neuropsychiatric disorders, and brain trauma.No preparation for the study is required.

Thyroid scintigraphy in Moscow

Thyroid scintigraphy is a functional study of thyroid metabolism (metabolism) using radiopharmaceuticals (RFP). The radiopharmaceutical is administered intravenously, accumulates in the gland and its distribution is recorded by the detectors of the gamma camera. As a result, after computer processing, an image is obtained.

There are two options for research.The main (standard) is thyroid scintigraphy, with RP, which is absorbed by the thyroid tissue in proportion to its function. Depending on the result of the main study, in some cases, the radiologist may recommend an additional study – neck scintigraphy with a tumorotropic drug, which is selectively absorbed by actively dividing cells.


  • Evaluation of the uptake of RP by the thyroid gland in relation to the administered dose and salivary glands
  • Leading method for determining the functional activity of thyroid nodules
  • The possibility of carrying out a tomographic study to determine the localization of the altered (ectopic) location of the gland

Preparation for the study: for standard thyroid scintigraphy it is necessary to cancel preparations containing iodine (incl.including X-ray contrast agents, Lugol’s solution), bromine (sedative mixtures, etc.), hormonal drugs (thyroid, pituitary, sex hormones, corticosteroids), antithyroid drugs (mercazolil, potassium perchlorate), antiarrhythmics of the amiodarone series (cordarone , amiodarone, etc.). You should also limit the intake of foods rich in iodine (seaweed, seafood, iodized salt, etc.).

Indication for examination:

  • Determination of the location, shape, size of the thyroid gland, identification of structural changes in the thyroid gland
  • Thyroid nodes detected by ultrasound
  • Determination of additional proportion of thyroid gland
  • Quality control of treatment, detection of relapses

Contraindications: pregnancy, restriction during breastfeeding.

Features of the study: A standard study is carried out 30 minutes after intravenous administration of the RFP. Scanning takes 10 to 15 minutes. The conclusion is issued on the day of the study.

Radiopharmaceuticals used (RFP): the study is carried out with 99mTc-Pertechnetat, which is captured by the thyroid tissue like iodine, but unlike it does not participate in the organic phase. Gamma quanta leave the body and are registered by the detectors of the device.

The analysis of the image is carried out taking into account the current condition of the patient, therefore, patients are recommended to come to the study with (if any) a blood test for the content of thyroid hormones (TSH, T3, T4), an ultrasound of the thyroid gland, an extract from the medical history or an outpatient card.

How is the procedure performed?

The patient can receive a radiofram drug intravenously or in the form of a capsule. If the oral route is chosen, then it is necessary to swallow a capsule containing radioactive isotopes of iodine or technetium 99 in a minimum and safe amount for the body – this is the whole preparation for the examination.A day after that, you can scan the gland. During the study of the parathyroid areas, the presence of pathologies, in particular, neoplasms in the form of nodes, is determined. The use of expensive radiopharmaceuticals determines the cost of the procedure, but it is this that will accurately determine the nature of the nodes, the “prospects” of their development and methods of treating the disease.


In the resulting image, the results are displayed by the features of the accumulation of iodine by the cells of the thyroid gland.”Cold” areas indicate a low accumulation of isotopes, and, therefore, the absence of cells that are able to capture iodine. Often, the presence of “cold” zones indicates a colloid nodular goiter or the presence of tumors. “Hot” areas indicate an excessive accumulation of iodine in certain areas – these are signs of toxic adenoma and toxic nodular goiter. After the thyroid scintigraphy is done, the patients of the Central Clinical Hospital of the Russian Academy of Sciences receive the examination results with interpretation, as well as a substantive consultation of the endocrinologist on the examination materials.

Contacts, phone number of the registry and other departments of N.N. N.N. Petrov. Details


Director: Aleksey Mikhailovich Belyaev, Doctor of Medical Sciences, Professor
Reception Director – Assistant Director Grishina Svetlana Olegovna, tel. +7 (812) 439-95-66
e-mail: [email protected]
Reception of visitors every Thursday from 16.00 to 17.00 by appointment.

Deputy Director: Alexander Mikhailovich Shcherbakov, Ph.MD, professor
Reception of the deputy director and chief physician – assistant Anna Dmitrievna Mrachko, tel. +7 (812) 439-95-31
e-mail: [email protected]
Reception of visitors every Wednesday from 16.00 to 17.00 by appointment.

Deputy Director for General Issues : Kirichuk Sergey Vasilievich
Tel .: +7 (812) 439-95-66
e-mail: [email protected]

Head of the Office : Lyulina Vera Nikolaevna
Tel.: +7 (812) 439-95-41
e-mail: [email protected]
8.30-13.00; 13.30-17.00
Documents can be certified with the official seal of the institution from 10.00 to 12.00 and from 14.00 to 16.00

Scientific Secretary : Ivantsov Alexander Olegovich, MD
Tel .: +7 (812) 439-95-54
e-mail: [email protected]

Chief Physician: Karitsky Andrey Petrovich, Ph.D.
Reception of visitors every Thursday, from 14.00 to 15.00 by appointment.
Tel .: +7 (812) 439-95-31
e-mail: [email protected]

Head of the department of educational and methodological work: Rogachev Mikhail Vasilievich
Tel .: +7 (812) 439-95-29
e-mail: [email protected]

Deputy Chief Physician for Medical: Donskikh Roman Vladimirovich, Ph.D.
Tel .: +7 (812) 439-95-60
e-mail: [email protected]

Deputy chief physician for clinical expert work: Litvin Anna Yurievna, oncologist of the highest category
Tel.: +7 (812) 439-95-72
e-mail: [email protected]

Head of HR Department: Olga Vladimirovna Kazakova
Tel .: +7 (812) 439-95-48
e-mail: [email protected]

Chief Accountant: Klabukova Olga Aleksandrovna
Tel .: +7 (812) 439-95-55
e-mail: [email protected]

Press service: Stolyarova Irina Mikhailovna
Tel .: +7 (812) 439-95-55
e-mail: [email protected]

Clinical units

Surgical department of breast tumors tel.439-95-01

Surgical thoracic department tel. 439-95-02

Surgical department of bone, soft tissue and skin tumors. 439-95-03

Surgical Department of Abdominal Oncology tel. 439-95-04

Department of Chemotherapy and Innovative Technologies tel. 439-95-05

Department of Hematology and Chemotherapy, tel. 439-95-06

Surgical gynecological oncology department tel.439-95-07

Radiotherapy department tel. 439-95-74

Children’s Oncology Department tel. 439-95-10

Surgical department of head and neck tumors tel. 439-95-11

Department of short-term chemotherapy tel. 439-95-13

Surgical Department of Oncourology Tel. 439-95-12

Requisites of FSBI NMITs of Oncology named afterN.N. Petrov “Ministry of Health of Russia:

Legal address:
197758, St. Petersburg, pos. Sandy, st. Leningradskaya, house 68.

INN 7821006887 KPP 784301001

Beneficiary: UFK for St. Petersburg (Department No. 10, Federal State Budgetary Institution “N.N. Petrov National Medical Research Center of Oncology” of the Ministry of Health of Russia)
Beneficiary bank: GRKTs GU Bank of Russia for St. Petersburg
R / s 40501810300002000001, BIK 044030001 Personal account No. 20726X13530

OGRN 1027812406687; OKVED 86.10, 72.19, 85.23; OKATO 40281554000; OKPO 01897995

Founder: Russian Federation.

Person acting as a founder: Ministry of Health of the Russian Federation

Bank details valid from 01.01.2021:

Recipient: UFK in St. Petersburg (Department No. 10, Federal State Budgetary Institution “N.N. Petrov National Medical Research Center of Oncology” of the Ministry of Health of Russia, medical unit 20726X13530)

Beneficiary’s treasury account (settlement): 03214643000000017200

Beneficiary’s bank: NORTH-WEST GU BANK OF RUSSIA // UFK PO G.SAINT-PETERSBURG St. Petersburg, BIK 014030106

Cor. account (EKS): 40102810945370000005

Date of state registration: 25.12.2002

License to carry out medical activities

Information about managers

Structure and governing bodies

GALASTOP / List of drugs / Company products / Ceva Russia

Active ingredient: cabergoline.


Cabergoline is a derivative of ergoline (ergot alkaloid), selectively acts on dopamine receptors, inhibits the release of prolactin – a hormone responsible for the development of mammary glands and milk production. Cabergoline has no effect on other endocrine processes. It is not a hormonal agent.


The drug is prescribed for the treatment of false pregnancy and suppression of lactation according to clinical indications (for example, early weaning of puppies) in bitches.The use of the drug prevents lactation, breast enlargement and the development of lactational mastitis. A decrease in prolactin levels contributes to the rapid disappearance of the signs of false pregnancy, as well as changes in the behavior of the animal.


The drug is administered orally with food or by force on the tongue at a dose of 0.1 ml (0.1 ml contains 3 drops) per 1 kg of animal body weight for 4-6 days.

If there is no effect or the appearance of symptoms of false pregnancy after stopping the administration of the drug, the course can be repeated.


Rarely, some animals in the first days of treatment have a single vomiting, lack of appetite or drowsiness, which does not require discontinuation of the drug. Treatment is stopped only in case of indomitable vomiting.


The drug is contraindicated in pregnancy due to the increased likelihood of abortion. Do not use in animals with hypotension, or simultaneously with antihypertensive drugs, as well as animals under the influence of anesthetic drugs because of the possible increase in the hypotensive effect of Galastop.