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Summer 2020 - Physiology 2 - Endocrine > Hypothalamus & Pituitary - Quiz 2 > Flashcards

Hypothalamus & Pituitary - Quiz 2 Flashcards

(44 cards)

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1
Q

What is the Hypothalamic Pituitary Axis?

A

Unit formed by hypothalamus & pituitary responsible for brain-endocrine interactions and control Gonads, Thyroid, and Adrenal glands

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2
Q

Which endocrine gland is considered the Master Gland?

A

Pituitary

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3
Q

How does the Hypothalamus work?

A

Coordinating Center

Gets signals from cortical inputs, autonomic function, environment, and endocrine feedback then delivers precise signals to the pituitary to release hormones influencing other endocrine systems

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4
Q

Where can the Pituitary Gland be found?

A

In the Sella tursica of the Sphenoid Bone

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5
Q

How is the Pituitary Gland divided?

A
  • Anterior Pituitary (Adenohypophysis)
  • Pars Intermedius
  • Pars tubularis
  • Neurohypophysis - Posterior Pituitary
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6
Q

Which part of the Pituitary Gland is highly vascular and does not secrete any hormones?

A

Pars Tuburalis

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7
Q

Which is the largest part of the Pituitary Gland?

A

Anterior Pituitary / Adenohypophysis

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8
Q

Which part of Pituitary Gland is present only up until Fetal Development?

A

Pars Intermedius

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9
Q

What makes the Anterior and Posterior Pituitary distinct?

A

Different connections to hypothalamus

Contain different cell types

Secrete different hormones

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10
Q

What are the main functions of the Hypothalmus?

A
  1. Produce Releasing and Inhibiting hormones that influence Anterior Pituitary
  2. Produces Oxytocin & ADH and stored in Posterior Pituitary
  3. Oversees ANS and helps stimulate Adrenal Medulla
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11
Q

How does the Anterior Pituitary connect to the Hypothalamus?

A

Portal Venous Network

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12
Q

Which hormones and glands does the Anterior Pituitary regulate?

A

FLATPIG

  • *F** ollicle Stimulating Hormone - gonads
  • *L** uteinizing Hormone - Ovaries
  • *A** Adrenocorticotropic Hormone (ACTH)
  • *T** hyroid Stimulating Hormone
  • *P** rolactin (PRL) - mammary
  • *I** gnored - Melanocyte Stimulating Hormone
  • *G** rowth Hormone - Somatotropic
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13
Q

What are the different cell types of the Anterior Pituitary

A

Somatotropes - most abundant (30-40%)

Corticoctropes (20%)

Thyrotropes (3-5%)

Gonadotropes (3-5%)

Lactotropes (3-5%)

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14
Q

What is the Posterior Pituitary made of?

A

Collection of Axonal Projections from the Hypothalamus

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15
Q

What are the functions of the Posterior Pituitary?

A

Receives Oyxtocin & ADH made in the Hypothalamus and secretes these hormones

Regulates Uterine Contraction & Water Balance

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16
Q

What supplies blood to the Hypothalamus?

A

Superior Hypophyseal Artery

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17
Q

What supplies blood to the Posterior Pituitary?

A

Inferior Hypophyseal Artery

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18
Q

How is ADH & Oxytocin transported from the Hypothalamus to the Posterior Pituitary?

Study These Flashcards
A

Via nerve fibers in the Supraoptic Nucleus & Paraventricular Nucleus

19
Q

What does Vasopressin do?

Study These Flashcards
A

↑Collecting Duct Permeability

↑Water Reabsorption

↑ECF Volume

↑Urine Osmolality

↓Plasma Osmolality

Vasoconstriction

20
Q

What does the V1 & V2 Vasopressin receptors do?

Study These Flashcards
A

V1: Pressor Effect

V2: ADH effect

21
Q

What stimulates Vasopressin/ADH release?

Study These Flashcards
A
  • Plasma Osmolality > 290
  • Decreased ECF Volume
  • Increased Sodium
  • Low BP
  • Angiotensin II
  • Nicotine
  • Stress & Pain
  • Positive Pressure Ventilation
22
Q

Alcohol, Increased ECF, and Decreased Plasma Osmolality causes what?

Study These Flashcards
A

Depressed release of Vasopressin/ADH

23
Q

What conditions are due to ADH disturbances?

Study These Flashcards
A

Diabetes Insipidus & SIADH

24
Q

How does Diabetes Insipidus happen?

Study These Flashcards
A

Inability to release ADH causing ADH Deficiency

Can be Neurogenic (most common) or Nephrogenic

25
What are the symptoms of Diabetes Insipidus?
Pee Alot Extreme Thirst Hyperosmotic Plasma HypoOsmotic Urine
26
How should patients w/ Diabetes Insipidus be managed?
Water Intake Limit Sodium Give DDAVP
27
What can cause Nephrogenic Diabetes Insipidus?
Chronic Renal Disease Lithium Toxicity Hypercalcemia Hypokalemia Tubulointerstitial Disease
28
What are some Anesthetic considerations for a pt w/ Hypernatremia r/t DI?
Increased MAC Decreased CO = decreased uptake Hypovolemia = decreased IV dose
29
What are symptoms of Hypernatremia?
Restlessness Lethargy Hyperreflexia Seizures Coma Death CORRECT SLOWLY
30
An **_overload_** of Vasopressin/ADH causes this type of ADH Disturbance?
Syndrome of Inappropriate ADH
31
What can cause SIADH?
CNS Disorders Head Trauma Lung Squamous Cell Carcinoma Pulmonary Infection Pituitary Surgery
32
What are the signs and symptoms of SIADH?
Water Intoxication Hyponatremia Concentrated Urine Dilute Plasma Brain Edema Lethargy, Seizure, Coma
33
How should a patient w/ SIADH be managed?
Treat underlying cause Fluid Restriction Demeclocycline 3% Hypertonic Saline Lasix CORRECT SLOWLY & Monitor Na q1-2 hrs
34
At what levels of sodium should postponing elective surgeries be considered?
Sodium \< 130 or \> 150
35
What can happen if Hyponatremia is treated too aggressively?
Central Pontine Myelinolysis Spastic Quadriplegia Pseudobulbar Palsy Encephalopathy Coma
36
Where is Oxytocin secreted from?
Paraventricular Nucleus
37
How does Oxytocin increase Lactation?
Positive Feedback Oxytocin --\> Lactation --\> Baby Eats --\> Activates Afferent Fibers --\> Signals Paraventricular Nuclei to release more Oxytocin
38
Beside lactation, what else is Oxytocin/Pitocin used for?
Organize Labor by increasing Uterine Contraction & Decreasing Blood loss after birth
39
What are some complications associated w/ Pitocin?
Fetal Distress d/t hyperstimulation Uterine Tetany Maternal Water Intoxication Hypertension Tachycardia N/V Seizures
40
What can happen if the Pituitary grows too big or if there are tumors on it?
Compression of Optic Chiasm causing vision problems
41
What should you expect for a patient having Pituitary surgery and has too much Growth Hormone?
Acromegaly making it difficult to mask & intubate (Use smaller ETT) Glucose Intolerance HTN Cardiomyopathy LVH
42
What is to be expected w/ a patient who has too much ACTH?
Cushing's Disease & Difficult Airway
43
What should be given to a patient w/ Panhypopituitarism?
Hormone replacement: DDAVP Cortisol Levothyroxine
44
During Pituitary surgery, when would you suspect IntraOp Diabetes Insipidus and how would you treat?
High uring output w/ \< 1.005 specific gravity DDAVP 0.5 - 1 mcg Fluids

Summer 2020 - Physiology 2 - Endocrine (5 decks)

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