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endocrine exam 1 > pituitary hormones and hypothalamic control > Flashcards

pituitary hormones and hypothalamic control Flashcards

1
Q

____ secretes small protein “releasing factors”, except for prolactin

A

hypothalamus

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2
Q

releasing factors

A

target anterior pituitary via portal system

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3
Q

anterior pituitary releases which 6 hormones in response to RFs

A
  • somatotrophin (GH)
  • Thyrotopin (TSH)
  • Follicle stimulating H (FSH)
  • Corticotropin (ACTH)
  • Prolactin
  • Luteinizing hormone (LH)/gonadotropic hormones
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4
Q

posterior pituitary releases —

A

oxytocin and vasopressin (antidiuretic hormone, ADH)

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5
Q

pituitary gland is known as —

A

hypophysis

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6
Q

pituitary gland is connect to the hypothalamus by the ____

A

pituitary/hypophyseal stalk

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7
Q

anterior pituitary contains how many types of secretory cells?

A

5

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8
Q

somatotropes

A
  • –> growth hormone
  • single chain of 191 amino acids
  • stimulates body growth; stimulates secretion of IGF-1; stimulates lipolysis
  • inhibits actions of insulin on carb and lipid metabolism
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9
Q

thyrotropes

A
  • -> thyroid stimulating hormone (TSH; thyrotropin)
  • stimulates production of thyroid hormones by thyroid follicular cells
  • maintains size of follicular cells
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10
Q

what are conduced to the anterior pituitary via hypophysial portal vessels?

A

hypothalamic-releasing and inhibitory hormones

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11
Q

all hormones increase secretions, except the secretion of ____, which is inhibited by ______

A

all hormones increase secretions, except the secretion of prolactin, which is inhibited by dopamine

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12
Q

______ receives nervous signals from almost all possible sources in NS—collecting center of information for control of secretion by pit gland

A

hypothalamus

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13
Q

thyrotropin-releasing hormone

A

causes release of thyroid-stimulating hormone (TSH, thyrotropin) from anterior pit

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14
Q

corticotropin-releasing hormone (CRH)

A

causes release of adrenocorticotropin from anterior pit

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15
Q

growth hormone-releasing hormone (GHRH)

A

causes release of growth hormone from anterior pit

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16
Q

growth hormone inhibitory hormone (GHIH)

A

somatostatin

-inhibits release of GH (somatotropin)

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17
Q

gonadotropin-releasing H (GnRH)

A

causes release of LH and FSH

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18
Q

prolactin-inhibitory hormone (PIH/dopamine)

A

causes inhibition of prolactin secretion–elevated dopamine release from HT inhibits prolactin from the anterior pituitary

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19
Q

growth hormone

A
  • somatotropin
  • released from anterior pit by GHRH
  • small, single chain protein that binds to cell membrane receptors that have “catalytic” property
  • affects all/almost all tissues of body
  • promotes growth of tissues capable of growing: increased cell size and mitosis – stimulate cartilage and bone growth
  • metabolic effects
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20
Q

growth hormone’s effect is manifested through

A

weight gain

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21
Q

growth hormone’s protein deposition effect in tissues:

A
  • enhancing amino acid transport through membrane
  • enhancing mRNA translation for protein synthesis by ribosomes
  • increased nuclear transcription of DNA to form mRNA
  • decreased catabolism of protein and amino acids
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22
Q

GH increases almost all facets of ______ and ______, while decreasing ______ of proteins

A

increases amino acid uptake and protein synthesis while decreasing breakdown of proteins

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23
Q

effect of GH on fat utilization

A
  • increases fat utilization for energy

- causes increased release of fatty acids from adipose tissues and their utilization with ketogenic effect

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24
Q

GH decreased cab utilization by

A
  • decreasing glucose uptake/utilizatioon in tissues such as skeletal muscle (increases blood glucose)
  • increases glucose production by liver (stimulation of gluconeogenesis, thus increases blood glucose)
  • increases insulin secretion (resistance occurs)
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25
Q

how does GH stimulate cartilage and bone growth?

A
  • stimulates epiphyseal cart or growth of plates of long bones
  • stimulation of chondrocytes in growth plate leads to cell proliferation and increase in secretion of collagen and deposition of cartilage, followed by conversion of cartilage to bone
  • increased osteoblast number and activity
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26
Q

somatomedins

A
  • intermediate substances GH uses to exert most of its effect indirectly
  • insulin-like growth factors (IGFs) and somatomedin C
  • from the liver
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27
Q

GH induces a more rapid effect directly, but a delayed/prolonged effect indirectly with _____

A

somatomedins

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28
Q

what factors stimulate growth hormone secretion?

A
  • decreased blood glucose (hypoglycemia)
  • decreased blood free fatty acids
  • starvation or fasting, protein deficiency
  • trauma, stress, excitement
  • exercise
  • testosterone, estrogen
  • deep sleep
  • growth hormone-releasing hormone
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29
Q

what factors inhibit growth hormone secretion?

A
  • increased blood glucose
  • increased blood free fatty acids
  • aging
  • obesity
  • growth hormone inhibitory hormone (somatostatin)
  • growth hormone (exogenous)
  • somatomedins (insulin-like growth factors)
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30
Q

incomplete or partial proteins diet

A

a diet lacking one or more of the essential amino acids required for protein synthesis

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31
Q

kwashiorkor

A
  • failure to grow
  • lethargy
  • depression
  • low plasma protein
  • hypoprotein edema
  • on only a corn meal diet, lacking tryptophan
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32
Q

patients with kwashiorkor have increased plasma ____ and protein supplementation brings down the plasma hormone level towards normal, while relieving symptoms

A

GH

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33
Q

panhypopituitarism

A

decreased secretion of all the anterior pituitary hormones

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34
Q

dwarfism

A
  • ateliotic dwarfs–deficiency of GH during childhood
  • laron or levi-loraine dwarfs and African pygmy–rate of growth hormone secretion is normal or high, but there is a hereditary inability to form somatomedin C (GH insensitivity)
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35
Q

giantism/gigantism

A

GH hypersecretion (usually due to tumors)

  • before adolescence (before epiphysis fuse)
  • overall growth increases
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36
Q

acromegaly

A
  • GH hypersecretion after adolescence (after epiphyseal closure)
  • certain body parts particularly become large (hands, feet, lower jaw, facial bones)
  • hyperglycemia
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37
Q

aging associated with:

A
  • low level of GH
  • decreased protein deposition in body esp in muscles
  • increased fat deposits
  • feeling of decreased energy
  • wrinkling of skin
  • administering GH improves some of the conditions in some pts
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38
Q

posterior pit contains 2 types of cells (pituicytes) with what in between?

A

nerve fibers and blood capillaries

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39
Q

nerve fibers for posterior pituitary originate where?

A

in 2 hypothalamic nuclei

-terminals store and secrete hormones on capillary surfaces in PP, which then join the circulation

40
Q

antidiuretic hormone (ADH, vasopressin)

A

-primarily formed in supraoptic nucleus of the HT

41
Q

oxytocin

A

formed primarily in the paraventricular nucleus of HT

42
Q

In the posterior pit, each nucleus synthesizes about ____ as much of the second hormone as its primary hormone

A

one sixth

43
Q

ADH and oxytocin are each a _____ polypeptide

A

9 amino acid polypeptide (nano-peptide)

44
Q

similarities between oxytocin and antidiuretic hormone

A
  • both initially formed in HT as prohormones and then transported to PP via nerve tracts to be stored
  • both are nanopeptides, differing only in 2 amino acid residues
  • produce effects by binding to CM/surface receptors
  • each is secreted into general circulation and transported to target tissues
45
Q

ADH deficiency results in —-

A

diabetes insipidus, a condition associated with excessive urination and thirst

46
Q

functions of ADH (vasopressin)

A

antidiuresis

vasoconstriction/pressor effect

47
Q

antiduiresis

A
  • ADH decreases excretion of water by the kidneys
  • increases permeability of collecting ducts and tubules to water (by increasing aquaporin insertion via V2 receptor activation and increasing cAMP)
  • conserves water–> concentrated urine
  • ADH controls rate of water secretion into urine, helping regulate concentration of water/electrolyte in body fluids
48
Q

vasoconstriction

A

vasopressin (ADH) causes vasoconstriction and blood pressure increase
-mech related to constriction of arterioles via V1 receptor activation, which increases IP3 and Ca (usually occurs with high ADH release)

49
Q

osmotic regulation

A
  • antidiuretic effect of ADH
  • concentrated electrolyte solution in plasma increases ADH secretion to retain water and maintain normal osmolality
  • dilute solution/plasma decreases ADH secretion
50
Q

blood volume regulation (vasopressin)

A
  • decreased blood volume increases ADH secretion

- increased blood volume decreases ADH secretion

51
Q

two major functions of oxytocin

A
  • causes contraction of uterus towards end of gestation, helping delivery of baby
  • aids milk ejection by breast by inducing myoepithelial cells around breast ducts to contract
52
Q

release of oxytocin

A
  • suckling stimuli on nipple of breast causes release of oxytocin by PP, which contracts myoep cells to eject milk (milk letdown reflex)
  • distention of cervix during partition generates neurohormonal reflex to cause increased secretion of oxytocin (positive feedback mech)
53
Q

where are T3 and T4 synthesized?

A

follicular cells in thyroid

54
Q

two major hormones made in thyroid gland

A
  1. thyroxine (T4)–93% initially

2. triiodothyronine (T3)–7%

55
Q

how are hormones secreted into circulation from the thyroid?

A

thyroid stimulating hormone (TSH, thyrotropin) which is released from the anterior pituitary

56
Q

T4 is eventually converted into —-

A

T3 in target tissues

57
Q

what is needed for the synthesis and release of T3 and T4?

A

iodine, thyroglobulin and enzymes

58
Q

path of synthesis and release of T3 and T4

A
  1. follicular cell synthesizes enzymes and thyroglobulin for colloid
  2. Iodine is cotransported into cell with Na and transported into colloid
  3. enzymes add iodine to thyroglobulin to make T3 and T4
  4. thyroglobulin is taken back into cell
  5. intracellular enzymes separate T3 and T4 from protein
  6. free T3 and T4 enter circulation
59
Q

thyroglobulin

A

precursor protein for iodine-containing thyroid hormones, T4 and T3

60
Q

iodide originally consumed with food is taken up from circulation and changed to ?

A

molecular iodine I2

61
Q

organification of iodine

A

binding of iodine with thyroglobulin

62
Q

substances made from organification and coupling

A

monoiodotyrosine, diiodotyrosine, 3,5,3-triiodothyronine, thyroxine

63
Q

what breaks the bond between T3 and T4?

A

proteases

64
Q

MIT, DIT, t3 and t4 all undergo what?

A

pinocytosis

65
Q

T3 and T4 are released into circulation by ?

A

protease enzymes

66
Q

T3 and T4 are transported in combination with?

A

plasma proteins–thyroxine-binding globulin (major), thyroxine-binding pre-albumin, albumin

67
Q

TH are released relatively _____ compared to other hormones

A

slowly

68
Q

1/2 of T4 in blood released into tissues every — days and 1/2 of T3 every —- days

A

6 days and every day

69
Q

effects of TH are produced by _____ binding and- _____ of nuclear receptors

A

effects of TH are produced by direct binding and activation of nuclear receptors which then interacts with specific DNA structures to ultimately generate new proteins (but steroids produce effects by first binding to cytosolic receptors)

70
Q

effects of T3 and T4 on metabolism

A

increase

  • mitochondira
  • NA K ATPase
  • O2 consumption
  • glucose absorption
  • gluconeogenesis
  • glycogenolysis
  • lipolysis
  • protein synthesis
  • Body Basal Metabolic rate**
71
Q

how do you measure basal metabolic rate

A

oxygen consumption

72
Q

pharmacokinetics on basal metabolic rate based on a single injection of T4

A
  • slow onset (2-3 days)
  • long duration (6-8 weeks)
  • if you increase the dose of T4 –> increases BMR
73
Q

the effect of TH on growth is manifested in ___

A

children

74
Q

hypothyroidism in children

A

retarded growth in general, including growth and development of brain during fetal life and first few years of postnatal life

75
Q

hyperthyroidism in children

A

excessive skeletal muscle growth (but mature more rapidly, and duration of growth and eventual height shortened)

76
Q

effect of TH on specific bodily metabolism

A
  • stim of carb metabolism
  • stim of fat metabolism
  • increased requirement for vitamins
  • increased BMR
  • **decreased body weight
77
Q

effect of TH on cardiovascular system

A
  • increased blood flow and cardiac output
  • increased heart rate
  • increased heart strength
  • normal arterial pressure (BP)
78
Q

other systemic effects of TH

A
  • increased respiration
  • increased GI motility (diarrhea)
  • excitatory effect on CNS causing muscle tremors
  • effect on sleep-insomnia
79
Q

lack of TH in women causes–(hypo)

A

menorrhagia (excessive menstrual bleeding)
polymenorrhea (freq menstrual bleeding)
greatly decreased libido

80
Q

hyperthyroid women–

A

oligomenorrhea (greatly reduced bleeding)

amenorrhea (absence)

81
Q

lack of TH in men–

A

loss of libido

excess TH causes impotence (can’t perform)

82
Q

effect of TSH on thyroid gland

A
  • increased proteolysis of thyroglobulin (increased release of hormones)
  • increased activity of iodine pump
  • increased iodination of tyrosine
  • increased size and secretory activity of thyroid cells
  • increased number of thyroid cells
83
Q

what mediates the stimulatory effect of TSH on thyroid gland?

A

cAMP

84
Q

how is amount of T3 and T4 regulated

A

negative feedback loop on TRH (thyroid releasing hormone)

85
Q

hyperthyroidism

A

toxic goiter, thyrotoxicosis or Graves disease

  • caused by autoimmune/inflamm problem, adenoma, drugs/chemicals
  • manifested by symps of hyperthyroidism, exophthalmos and goiter
  • -sometimes inflamm (Hashimotos) and drug impair can cause HYPOthyroidism
86
Q

**general symptoms of hyperthyroidism

A
  • increased BMR, HR but decrease in PVR
  • increased pulse pressure but not mean arterial pressure
  • high state of excitability
  • intolerance to heat
  • increased sweating
  • mild to extreme weight loss
  • diarrhea
  • nervousness, confusion, irritability
  • insomnia, extreme fatigue
  • tremor
  • osteoporosis
87
Q

symptoms of exophtalmos

A
  • protrusion of eyeball due to retro-ocular deposition of mucopolysaccharides
  • thyroid stimulating antibodies which cause hyperactivity of gland are also believed to cause this
88
Q

symptoms of goiter

A
  • enlargement of thyroid

- hyperthyroidism caused by action of thyroid stimulating antibodies on gland

89
Q

hypothyroidism

A
  • cretinism (children) and myxdema (adults)

- opposite symptoms of hyperthyroidism

90
Q

myxedema symptoms

A
  • deficiency of TH in adults
  • swollen face with eye bags
  • constipation
  • increase BMI and arteriosclerosis
  • increase body weight
  • anemia, decreased blood volume
  • slow HR/bradycardia
  • mental dullness, sluggish response, somnolence
  • depressed hair growth and scaliness
  • froglike voice
  • sexual atrophy and amenorrhea
  • increased sensitivity to cold
91
Q

cretinism symptoms

A
  • hypothyroidism in children
  • congenital–lack of thyroid gland or no TH
  • endemic–iodine lack in diet
  • failure to grow normally
  • mental retardation
  • obese and short
  • growth inhibited
92
Q

endemic goiter

A

caused by dietary iodine deficiency

underdeveloped countries

93
Q

idiopathic non-toxic colloid goiter

A
  • problem with iodine use

- caused by thyroiditis, which induces mild hypothyroidism, leading to increased TSH and thyroid enlargement

94
Q

dental implications of hyperthyroidism

A
  • nervousness, increasaed sensitivity to pain
  • tremor and muscle weakness
  • increased bone loss, cardiac activity, palpitation, arrhythmia, highly sensitive to epinephrine
  • osteoporosis of bone, dental caries, Perio disease
  • rapid teeth and jaw development, early loss of teeth
95
Q

dental implications of hypothyroidism

A
  • hyperlipidemia, cardiac dysfunction, osteoporosis
  • delayed eruption of teeth, malocclusion, skeletal growth retardation
  • tongue enlargement
  • increased capillary fragility, exaggerated resp to CNS depressants

endocrine exam 1 (5 decks)

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