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hypothalamic and pituitary part 1 Flashcards

1
Q

what is the pituitary gland composed of?

A

anterior pituitary

posterior pituitary

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2
Q

what is the neural portion of the pituitary?

A

neurohypophysis (posterior)

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3
Q

what is the epithelial portion of the pituitary?

A

adenohypophysis (Anterior)

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4
Q

what connects hypothalamus and pituitary gland?

A

hypophyseal stalk

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5
Q

where do tumors of the pituitary put their pressure, what symptoms do these cause?

A

on optic nerves

visual issues, dizziness

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6
Q

where is posterior pituitary derived from?

A

neural tissue

cell bodies of axons and nerves whose cell bodies
are in hypothalamus

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7
Q

what are the nuclei of posterior pituitary? what do they secrete?

A

Supraoptic nucleus (ADH)

paraventricular nucleus (Oxytocin)

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8
Q

what are the connections between the hypothalamus and anterior pituitary?

A

neural and hormonal

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9
Q

what is the anterior pituitary derived of?

A

endocrine cells from primitive foregut

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10
Q

what does anterior pituitary secrete?

A 
ACTH
TSH
LH
FSH
GH
Prolactin
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11
Q

How is anterior pituitary connected to hypothalmus?

A

Hypothalamic-hypophysial portal blood vessels

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12
Q

How does the hypothalamic-hypophysial portal system work? what occur?

A

releasing or release inhibiting hormones delivered directly

from hypothalamus to anterior pituitary in high

concentrations

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13
Q

do hormones from hypothalamic-hypophysial portal system appear in systemic circulation?

A

not in high concentrations

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14
Q

what are the hormone families of the anterior pituitary?

A

ACTH Fam

TSH, FSH, LH Fam

GH, Prolactin fam

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15
Q

what secretes ACTH

A

Corticotrophs

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16
Q

what secretes TSH

A

thyotrophs

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17
Q

what secretes FSH and LH

A

gonadotrophs

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18
Q

what secretes GH

A

somatotrophs

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19
Q

what secretes Prolactin

A

lactotrophs

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20
Q

describe how TSH is secreted?

what are the steps from the hypothalamus to anterior pituitary?

A

TRH from hypothalamus

target thyrotrophs in anterior pituitary

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21
Q

describe how ACTH is secreted?

what are the steps from the hypothalamus to anterior pituitary?

A

CRF from hypothalamus

target corticotrophs in anterior pituitary

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22
Q

describe how LH, FSH is secreted?

what are the steps from the hypothalamus to anterior pituitary?

A

GnRH from hypothalamus

target gonadotrophs in anterior pituitary

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23
Q

describe how Prolactin is secreted?

what are the steps from the hypothalamus to anterior pituitary?

A

Increase in TRH and decrease in PIF from hypothalamus

target lactotrophs in anterior pituitary

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24
Q

How are endocrine axes maintained?

A

around a set point via negative feedback inhibition

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25
what is one of the most common ways that hypothalamic hormones are secretes?
in a pulsatile manner through circadian rhythms
26
what is a primary endocrine disorder?
defect in peripheral endocrine gland causes hormone imbalance
27
what is a secondary endocrine disorder?
defect in pituitary gland causes hormone imbalance
28
what is a tertiary endocrine disorder?
defect in hypothalamus causes hormone imbalance
29
name the major anterior pituitary gland axes
hypothalamus- pituitary- gonad hypothalamus- pituitary- liver hypothalamus- pituitary- prolactin hypothalamus- pituitary- thyroid hypothalamus- pituitary- adrenal
30
where are FSH and LH released from? how are they regulated
from anterior pituitary gonadotropes they are regulated by hypothalamic GnRH (pulsatile release)
31
why is FSH and LH important?
estrogen and progesterone in females (normal menstrual cycle depends on it especially!) testosterone in males
32
what can inhibit GnRh production?
extreme energy deficits, extreme exercise, depression
33
What is acromegaly caused by? symptoms?
excessive secretion of growth hormone in adulthood too much growth of soft tissue, cartilage, bone in face hands and feet shows gradually
34
What is growth hormone produced by and what does it target? what inhibits it?
somatotropes in anterior pituitary targets liver and bone Somatostatin and IGF1 as part of negative feedback
35
what type of signalling is GH receptor linked to?
JAK-STAT signalling
36
what stimulated GH?
FASTING/HUNGER/STARVATION HYPOGLYCEMIA GHRELIN CAN STIMULATE IT! puberty exercise sleep stress
37
what are the three direct actions of GH?
1. Growth - hypertrophy 2. cell reproduction - hyperplasia 3. metabolism - increase protein synthesis - increase glycogen and fat breakdown
38
what are the indirect actions of GH and how is it relevant?
most growth is indirect tells liver cells to make IGF1, targetting almost every cell in body stimulates hypertrophy and hyperplasia
39
What two cells are produced by the hypothalamus that affect anterior pituitary GH? how do they do it?
GhRh stimulates GH production in anterior pituitary GHIH(somatostatin) inhibits GH
40
greater production of GH has what feedback effect?
decreases GHRH from hypothalamus increases IGF1 from liver
41
greater production of IGF1 from liver has what feedback effect?
decreases GH increases GHIH
42
what two hormones affect GH production? from where and how
ghrelin from stomach GHRH from hypothalamus two different receptors
43
what is a secondary deficiency in production of GH?
not enough GH from anterior pituitary
44
what is a tertiary deficiency in production of GH?
not enough ghrelin and GHRH
45
what can be used to treat defective release of GHRH?
semorelin
46
what can be used as replacement of GHRH?
somatropin | somatrem
47
what can be used due to failure of IGF1 release from GH, GH deficiency or patients with GH antibody?
mecasermin
48
what causes gigantism?
in youth, before closure of bone epiphyses due to IGF1 stimulation!!
49
what factors cause liver to produce IGF1? what will this cause the liver to do? what is this called?
increased carb uptake which allows for insulin availability increased protein uptake, amino acids are available causes mitogenesis, lypolysis, differentiation FAVORABLE GROWTH PROMOTING FACTORS
50
describe unfavorable conditions that will stop GH and the liver will not make IGF1 what will happen?
enough carbs to have insulin not enough protein to have amino acids lipogenesis and carb storage will occur WEIGHT GAIN!
51
what will cause a fasted state? what will happen to GH levels and IGF1? what will this cause?
decreased carbs and little insulin increased protein for amino acids gh levels will go up, so will IGF1 lipolysis, ketogenic metabolism and diabetogenic
52
how is GH related to insulin insensitivity?
raises blood glucose by decreasing peropheral glucose intake, stimulate hepatic gluconeogenesis
53
what is a sensitive test for acromegaly
patient has : high GH and IGF1 doesnt suppress GH production in response to oral glucose ALSO PITUITARY ENLARGEMENT ON MRI!
54
what are the main metabolic functions of GH?
diabetogenic effect increased protein synthesis and growth factor increased linear growth
55
how does GH cause a diabetogenic effect?
decreases glucose uptake by target tissues increase lipolysi in fat incraes blood insulin levels
56
how does GH cause an increase in protein synthesis? what is the main mediator
increases uptake of amino acids stimulates DNA, RNA and protein is mediated by IGF1
57
how does GH cause an increase in linear growth? what is the main mediator
stimulates DNA, RNA and protein synthesis increase in metabolism in cartilage forming cells and chondrocytes mediated by IGF1
58
when is GH level highest during the day? during life?
sleep, exercise puberty, lowest during adulthood
59
what can disturb GH secretion?
sleep disturbances, fluctuates throughout day
60
what causes GH deficiency, why is it bad?
decreases GHRH causes it (hypothalamus issue) can't make IGF1 (somatomedins)
61
What causes GH excess? why is it bad?
pituitary adenoma Gigantism and acromegaly!
62
what does prolactin do?
primarily makes lactation happen also suppresses GnRH, stopping LH and FSH decreases sexual drive and reproduction
63
what makes prolactin and when what stops it?
lactotropes, 5th week of pregnancy, pulsatile inhibited by hypothalamic dopamine, feedback by prolactin causes dopamine to be made
64
what stimulates prolactin secretion?
``` pregnancy breast feeding sleep stress TRH ```
65
what inhibits prolactin secretion?
dopamine/ agonists somatostatin prolactin itself
66
what are pituitary adenomas, what do they cause?
adenomas release active hormone into blood excessively usually prolactinoma!
67
what causes hypopituitarism?
brain damage such as a stroke or injury tumors non pituitary tumors such as craniopharyngioma (most common tumor affecting HP axis in kids) infections infarction such as sheehan syndrome autoimmune pituitary hypoplasia genetic disorders
68
describe steps in oxytosin secretion?
preprooxyphysin to prooxyphysin in hypothalamus to hypothalamic-hypophyseal tract( neurophysins cleaved) to posterior lobe of pituitary as oxytocin to breast
69
what does oxytocin do?
milk letdown - contraction of cells lining milk ducts - caused by sucking, sight of infant uterine contraction - caused by dilation of cervix - causes uterine contractions - induces labor

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