Anatomy of the Pituitary gland (and strap muscles and adrenal gland) Flashcards

1
Q

name the endocrine glands in the cranial cavity

A

hypothalamus and pituritary (hypophysis)

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2
Q

name the endocrine glands in the neck

A

4 parathyroid glands and thyroid glands

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3
Q

name the endocrine glands in the abdomen

A

2 adrenal (suprarena)l glands and the pancreas

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4
Q

name the endocrine glands in the pelvis

A

female- ovaries

male- testes

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5
Q

what is the diencephalon

A

= thalamus + hypothalamus

forms the central core of the cerebellum with connections to the right and left cerebral hemispheres and the midbrain

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6
Q

what connects the hypothalamus to the pituitary gland

A

infundibulum (pituitary stalk)

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7
Q

what are the parts of the pituitary gland

A

anterior and posterior pituitary

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8
Q

what part of pituitary connects to the infundibulum

A

the posterior

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9
Q

what is the difference between the anterior and posterior pituitary

A

anterior is glandular
posterior is neural
(result of embryological development)

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10
Q

what is the adenohypophysis

A

the anterior pituitary

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11
Q

what is the anterior pituitary made up of

A

pars distalis, pars tuberalis and pars intermedia

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12
Q

what is the role of the anterior pituitary

A

synthesis and release of most pituitary hormones (GH, TSH, ACTH, FSH, LH, PRL)

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13
Q

where would you get an adenoma in your pituitary gland

A

in the anterior lobe as glandular

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14
Q

what is the nuerohypophysis

A

posterior lobe of pituitary gland

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15
Q

what makes up the posterior pituitary

A

pars nervosa

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16
Q

what is the posterior pituitary an extension of

A

the brain

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17
Q

what is the role of the posterior pituitary

A

releases ADH and OT (oxytocin)

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18
Q

where is the pituitary gland located in the skull

A

midline structure- in the pituitary fossa of the sphenoid bone

pituitary fossa lies within the sella tucica (turkish saddle)

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19
Q

where does the pituitary gland lie in relation to nerves

A

immediately inferior to the optic chiasm (where optic nerves come together)

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20
Q

what passes posteriorly from the optic chiasm

A

the left and right optic tracts

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21
Q

what happens to the axons of the optic nerve in the optic tracts

A

synapse with hypothalamus and then pass via the optic radiation to the visual cortex in the occipital lobe

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22
Q

what are the parts of the retina

A

nasal retina- peripheral vision

temporal retina- inner vision

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23
Q

what does the retina contain

A

photoreceptors: rods and cones

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24
Q

where is the optic canal and what goes through it

A

in sphenoid bone

optic nerve

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25
Q

where do the signals from the different sides of the retina separate into the correct optic tract

A

optic chiasm

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26
Q

what is the early clinical effect of a pituitary tumour on the visual pathway

A

initial midline compression of the optic chiasm

disrupts the transmission of action potentials from the nasal retina bilaterally

loses ability to see temporal visual field

=bitemporal hemianopia (loss of peripheral vision)

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27
Q

what are the approaches to the pituitary fossa

A

transcranial- subfrontal (under the frontal lobe)

transsphenoidal approach (via nasal cavities and sphenoidsinus- requires surgical fracture of nasal septum and the floor and roof of the sphenoid sinuses)

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28
Q

what is the roof of the nasal cavity

A

the cribiform plate of the ethmoid bone

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29
Q

what are the parts of the nasal septum

A

vomer and perpendicular plate of the ethmoid bone (superior part)

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30
Q

what are the paranasal sinuses

A

air filled spaces within the bones surrounding the nasal cavities

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31
Q

what are the four types of paranasal sinuses

A

frontal bone- frontal sinuses
maxillae- maxillary sinuses
ethmoid bone- ethmoidal aircells
sphenoid bone- sphenoid sinuses

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32
Q

what lines paranasal sinuses

A

mucous secreting respiratory mucosa

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33
Q

what is the purpose of the paranasal sinuses

A

make mucous, drain it into the nasal cavities through ostia (singular= ostium- bony drainage hole)
reduce the weight of the skull
add resonance to the voice

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34
Q

where are the right and left eithmoid air cells found (3 groups)

A

between the nasal cavity and the orbit

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35
Q

where are the sphenoid sinuses

A

within the body of the sphenoid bone- sometimes connect midline

36
Q

where are the maxillary sinuses

A

one in each maxilla

37
Q

what type of le fort fractures provides good surgical access to the pituitary gland

A

le fort 1

38
Q

what is the entire cranial cavity lined with

A

sura matter

39
Q

what is the tenrorium cerebelli

A

sheet of dura matter which tents over the cerebellum within the posterior cranial fossa with a central gap to permit the brainstem to pass through

40
Q

what is the diaphragm sellae

A

a tough sheet of dura matter forming a roof (diaphragm) over the pituitary fossa

41
Q

what are the dural venous sinuses

A

venous channels within the dura matter that drain most of the venous blood from the cranial cavity (and brain) into the the jugular veins

42
Q

what does the anterior intercavernous sinus do

A

connects the right and left cavernous sinuses anterior to the pituitary gland

43
Q

where do the dural venous sinuses drain into

A

the internal jugular veins at the jugular foraminae in the floor of the posterior cranial fossa

44
Q

what sinuses surround the pituitary gland

A

cavernous and intercavernous sinuses

45
Q

what passes through the cavernous sinuses

A

internal carotid arteries

46
Q

what is the ophthalmic artery and how does it enter the orbit

A

branch of the internal carotid artery

enters the orbit via the optic canal

47
Q

what makes the lateral wall of the cavernous sinuses

A

dura matter

48
Q

where is the diaphragm sellae in relation to the pituitary gland

A

pituitary gland is inferior to the diaphragm sellae

49
Q

why do you not attempt surgery in the lateral side of the head

A

due to tortuous path of internal carotid in the cavernous sinus

50
Q

what is the function of the optic chiasm

A

conducrs AP’s bilaterally from the nasal retinae

51
Q

what is the function of the oculomotor nerve

A

motor to muscles that move the eyeball (globe)

parasympathetic to the sphincter muscle of the iris

52
Q

what is the functional deficit of the oculomotor nerve

at risk in pituitary gland surgery

A

problems with eye movements

a dilated pupil

53
Q

what does the trochlear nerve do

A

motor to one muscle that moves the globe

54
Q

what is the function deficit of the trochlear nerve

at risk in pituitary gland surgery

A

problems looking inferiorly and laterally

55
Q

what is the function of the trigeminal nerve

A

sensory to most of the face

motor to the muscle of mastication

56
Q

what is the function deficit of the trigeminal nerve

at risk in pituitary gland surgery

A

sensory symptoms on the face

difficulty chewing

57
Q

what is the function of the abducent nerve

A

motor to one muscle that moves the globe

58
Q

what is the function deficit of the abducent nerve

at risk in pituitary gland surgery

A

problems abducting the eye

59
Q

what is the function of the cavernous sinus

A

drain venous blood

60
Q

what is the function deficit of the cavernous sinus

at risk in pituitary gland surgery

A

venous haemorrhage

61
Q

what is the function of the internal carotid artery

A

supplies arterial blood to brain and orbit (inc globe)

62
Q

what is the function deficit of the carotid artery

at risk in pituitary gland surgery

A

catastrophic haemorrhage

63
Q

what is the function of the dura matter

A

protects the structures of the cranial cavity

64
Q

what is the functional deficit of the dura matter

at risk in pituitary gland surgery

A

cerebrospinal fluid (CSF) leak

65
Q

what are the three branches of the trigeminal cranial nerve

A

opthalmic, maxillary, madibular

66
Q

which lobe of the brain lies in the middle cranial fossa

A

pituitary gland

67
Q

which cranial nerves lies close to the internal carotid artery in the cavernous sinus

A

abducent nerve

68
Q

what foramen do the branches of the trigeminal nerve go through

A

opthalmic- superior optic sinus
maxillary- foramen rotundum
mandibular- foramen ovale

69
Q

how do you remeber the names of the strap muscles

A

look at where they attach to and from (sternohyoid, thyrohyoid- except omohyoid)

70
Q

what innervates the strap muscles

A

all innervates by ansa cervicalis (anterior rami of C1-3) except thryohyoid which is hypoglossal

71
Q

what is the function of somatostatin and where else is it released in the body

A

In the hypothalamus, it regulates the secretion of hormones coming from the pituitary gland

In the pancreas, somatostatin inhibits the secretion of pancreatic hormones, including glucagon and insulin

72
Q

describe the blood supply to the pancreas

A

gastroduodenal- superior pancreatic- anastomosis- inferior pancreatic- superior mesenteric

splenic artery- dorsal pancreatic

73
Q

where are your adrenal glands

A

retroperitonium, superior to kidneys

74
Q

what separates your kidneys and adrenal glands

A

fascial septum

75
Q

what are the parts of the adrenal glands and their functions

A

adrenal cortex- glucocorticoids, mineralocorticoids, androgens

adrenal medulla- adrenaline, noradrenaline

76
Q

what is the difference between adrenaline and noradrenaline

A

adrenaline- acts on beta and alpha: increased blood sugar levels
increased heart rate
increased contractility
relaxation of smooth muscle in the airways

noradrenaline: only acts on alpha (found in arteries):
increased blood sugar levels
increased heart rate
increased contractility
vasoconstriction 
(increased blood pressure)
77
Q

describe the blood supply to the adrenal gland

A

inferior (branch of renal), middle and superior (branches of aorta) suprarenal arteries

78
Q

what is the venous drainage of the blood supply

A

suprarenal vein, renal vein, IVC

79
Q

what do the different parts of the pituitary glands secrete

A

anterior- ACTH, FSH, GH, LH, prolactin, TSH

intermediate- MSH

posterior- ADH, oxytoxcin

80
Q

what do hypothalmic hormones produce

A
releasing hormones (stimulate pituitary) 
release inhibitory hormones
81
Q

what transports hypothalmic hormones to the end capillary bed in the anterior pituitary gland

A

hypophyseal portal system

82
Q

what are the embryological origins of the parts of the pituitary gland

A

anterior- upgrowth of oral ectoderm (rathke’s pouch)

posterior - downgroth of diencephalon

83
Q

where is the carvernous sinus

A

bilaterally to the sella turcica and extends from the superior orbital fissure anteriorly to the petrous part of the temporal bone posteriorly

84
Q

what artery can cause haemorrhage in the middle fossa of the brain

A

internal carotid

85
Q

what nerves are in the carvernous sinus

A

3,4 and 6th cranial nerve