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M2 Endocrine > 15. Pituitary Structure/Function > Flashcards

15. Pituitary Structure/Function Flashcards

1
Q

two things that hormones do at their target organs?

A
  • stimulate secretion of the effector hormone

- maintain the weight of the target organ. if a gland is deprived of hormone, it will atrophy

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2
Q

inhibiting and releasing factors from the hypothalamus reach the anterior pituitary how?

A

via capillaries. (portal bed, traverses the capillary stalk). serves to concentrate these factors sufficiently to affect their targets in the pituitary.

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3
Q

what are the 6 hormones from the hypothalamus that affect the anterior pituitary?

A

CRH, GnRH, GRH, somatostatin, TRH, dopamine

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4
Q

what hormones released from the anterior pituitary are glycoprotein hormones? what do they all have in common?

A

FSH, LH, TSH (CG)

ALPHA subunit is identical for all

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5
Q

what is HCG? what part of it do we assay for when doing a lab test?

A

human chorionic gonadotropin (released by placental tissue, indicates preg). probe for the BETA unit because the ALPHA unit of glycoprotein hormones are all identical.

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6
Q

can we detect the hypothalamic releasing/inhibiting hormones in the periphery?

A

no, too dilute

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7
Q

what are the effector hormones released from the posterior pituitary?

A

ADH, oxytocin

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8
Q

where are ADH and oxytocin synthesized?

A

hypothalamic nuclei

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9
Q

if the pituitary were removed, would we have trouble with anterior pit hormones? post pit hormones?

A

only with anterior pit hormones. the pituitary is only a storage depot for post pit hormones, can do fine without it.

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10
Q

how are hormones transported from the hypothal to the posterior pituitary?

A

via axonal transport. not capillaries, no portal circulation

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11
Q

what are the two general categories of problems that can result from the pituitary?

A
  • neuro issues due to mass effect

- endocrine issues due to over/under hormone aounts

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12
Q

if the pituitary expands superiorly, what structures are likely to be damaged? what symptoms?

A
  • tentorium sella, through which the pit stalk passes, is highly innervated. stretching will –> headache
  • big superior extension -> optic chiasm, bitemporal hemianopsia
  • will yield hormonal issues, esp loss of satiety due to the presence of leptin receptors here. -> hypothalamic obesity and temp dysregulation
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13
Q

if the pituitary expands laterally, what structures are likely to be damaged? what symptoms?

A
  • cavernous sinus structures (both loops of carotid artery. no risk of stroke but makes pituitary surgery risky
  • CN 3, 4, 6 –> conjugate gaze problems, diplopia
  • CN V (maxillary): not affected bc too far inferior
  • medial temporal lobes: characteristic seizures w olfactory aura
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14
Q

if the pituitary expands inferiorly, what structures are likely to be damaged? what symptoms?

A

-floor of sella, sphenoid sinus. consequence: if erosion through this struct, open connection between brain/CSF and the nasopharynx. risk for meningitis.

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15
Q

what is a sx that a pituitary tumor has caused erosion of the floor of the sella?

A

CSF rhinorrhea

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16
Q

how does the post pit appear w MRI?

A

bright white spot: for some reason lights up due to presence of ADH.

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17
Q

what ventricle is just superior to the optic chiasm?

A

third ventricle

18
Q

hormones involved in the HPA axis?

A

CRH ->POMC/ACTH->adrenal glands.

19
Q

3 parts of the adrenal glands, and hormones each produces?

A

z. glomerulosa -> mineralocorticoids
z. fasiculata -> glucocorticoids
z. reticulata -> sex steroids

20
Q

what is an example of a mineralocorticoid?

A

aldosterone

21
Q

what part of the adrenal gland is not reliant on ACTH?

A

z. glomerulosa (mineralocorticoids)

22
Q

what is an example of a glucocorticoid?

A

cortisol

23
Q

what adrenal hormone provides feedback to the hypothalamus?

A

only cortisol/glucocorticoid

24
Q

a patient with hypoadrenalism from lack of ACTH will be deficient in what hormones?

A

sex hromones, glucocorticoids. mineralocorticoid (aldo) will be ok

25
Q

in what situation could a pt be deficient in all 3 adrenal hormones?

A

Addison’s disease, destroys entire adrenal

26
Q

what axes of the anterior pit have oscillators?

A
  • HPA (24h)
  • gonadotropin (1 mo)
  • growth hormone (24h)
27
Q

thyroid axis: hormones involved?

A

somatostatin (-) and TRH (+) ->TSH -> T4 and T3 from thyroid

28
Q

where is most T3 produced?

A

not in thyroid

29
Q

feedback from thyroid to pituitary and hypothal?

A

both T3 and T4

30
Q

Gonadotropin axis: hormones involved?

A

GnRH -> LH and FSH ->ovulation and spermatogenesis

31
Q

of LH and FSH, which stimulates sex steroids and which stimulates germ cells?

A

LH -> sex steroids

FSH -> germ cells (ovaries, testes)

32
Q

Growth Hormone axis: hormones involved?

A

GHRH and somatostatin -> GH -> liver -> IGF1

33
Q

Prolactin axis: hormones involved?

A

Dopamine (purely inhibitory) -> prolactin -> breast tissue -> breast milk

34
Q

what hormone will stimulate prolactin, in a pathogenic state?

A

TRH if at high enough levels will stimulate prolactin. occurs w hypothyroid -> galactorrhea

35
Q

what is the difference between gigantism and acromegaly?

A

the overproduction of growth hormone has occurred either before the closing of the epiphyseal plates (gigantism) or after the closing (acromegaly)

36
Q

what is pituitary apoplexy? what are the symptoms?

A

acute bleed from a pituitary tumor. causes bad headache, sudden vision issues (bitemp, diplopia), stiff neck w/o fever

37
Q

if the pituitary axes are all suddenly cut, which hormone do we need to replace emergently?

A

cortisol. TSH, LH, FSH, GH, prolactin are not necessary on an emergent basis.

38
Q

which stimulating hormones are reliant on the Pit1 transcription factor?

A

GH, TSH, PRL

39
Q

Which stimulating hormones are reliant on the Prop1 transcription factor?

A

FSH/LH, TSH, GH, PRL

40
Q

What stimulating hormone is reliant on neither Prop1 nor Pit1?

A

ACTH

M2 Endocrine (8 decks)

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