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Physiology 2 test 1 > Chapter 75 > Flashcards

Chapter 75 Flashcards

1
Q

What is the HPA?

A

hypothalamus pituitary axis.

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2
Q

What is the most dominant portion of the entire endocrine system?

A

HPA

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3
Q

What does the output of the HPA regulate?

A
  • Thyroid gland
  • Adrenal gland
  • Reproduction
  • Somatic growth
  • lactation/milk secretion
  • water metabolism
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4
Q

What does pituitary function depend on?

A

hypothalamic releasing hormones.

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5
Q

What does the hypothalamus link together?

A

nervous system to endocrine system via the pituitary gland

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6
Q

What is the hypothalamus the collecting center for?

A

homeostatic information: Body temp, hunger, thirst, circadian cycle

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7
Q

What is the hypothalamus responsive to?

A
  • light
  • olfactory stimuli
  • steroids
  • neurally transmitted info
  • autonomic inputs
  • blood-borne stimuli
  • stress
  • temp
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8
Q

What does the hypothalamus secrete and synthesize?

A

neurohormones and HRIH (hypothalamus releasing/inhibiting hormones)

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9
Q

Where are neurohormones transported to?

A

posterior pituitary along axons from neural bodies

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10
Q

Where are neurohrmones stored?

A

in terminal axons.

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11
Q

Where are HRIH released?

A

into median eminence and tuber cinereum of hypothalamus into the hypohysial portal

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12
Q

What does the HRIH control?

A

secretions of hormones by the anterior pituitary (adenohypophysis)

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13
Q

What is the vascular connection to the pituitary?

A

HRIH via blood control anterior pituitary

hypothalamic-hypophysial portal vessels.

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14
Q

What are the neural connections to pituitary?

A

nerve signals control posterior pituitary secretion of neurohormones made in hypothalamus

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15
Q

What are the two categories of hypothalamic output?

A
  • neural projections

- endocrine hormones.

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16
Q

What are the neural projections of hypothalamic output?

A

multiple fiber system

  • connects Hypothalamus to different areas of CNS
  • neurohormones created in the hypothalamus secreted to the neurohypophysis then into circulation
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17
Q

Where are most hormones generated by the hypothalamus distributed to?

A

pituitary via the hypophyseal portal system

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18
Q

Where are posterior pituitary hormones synthesized?

A

magnocellular neurons of the supraoptic nuclei (ADH) & paraventricular nuclei (oxytocin) of the hypothalamus

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19
Q

What are the posterior pituitary hormones synthesized from?

A

from prohormones:
peptide + binding peptide (neurophysin)
Neurophysin travels in secretory granules along axon to posterior pituitary for secretion

Vasopressin/Antidiuretic Hormone (ADH)

Oxytocin

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20
Q

Does the posterior pituitary produce hormones?

A

No it only secretes hormones produced in hypothalamus.

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21
Q

What does the neurohypophysis consist of?

A

primarily of hypothalamic axons supported by glial-like cells called pituicytes.

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22
Q

What is anatomically and embryologically continuous with the hypothalamus

A

neurohypophysis

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23
Q

Are there neural bodies in the posterior lobe?

A

no!

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24
Q

What is the outgrowth of the hypothalamus?

A

neural tissue

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25
Q

Where are hormones that are secreted from the neurohypophysis synthesized?

A

in supraoptic and paraventricular nuclei of hypothalamus

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26
Q

If the stock is cut above the pituitary will the posterior pituitary hormones continue to be secreted?

A

yes, because the hormones are synthesized in neural bodies in the hypothalamus.

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27
Q

What are the posterior pituitary hormones and where are they produced?

A 
Antidiuretic hormone (ADH)/Vasopressin 
primarily produced in supraoptic nuclei
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28
Q

How is ADH regulated?

A
  • Osmotic concentration of fluid

- Decreased blood volume

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29
Q

How is osmotic concentration of fluids detected?

A

by osmoreceptors in hypothalamus and major arteries

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30
Q

Does ADH increase or decrease with concentration?

A

increase with concentration (low blood volume)

decreases with dilution

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31
Q

What does ADH influence in the kidney?

A

collecting ducts

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32
Q

What does underfilling of atria, aorta, carotid, and pulmonary vessels lead to?

A

unexcited stretch/baroreceptors and very high concentrations of ADH are produced to cause constriction of arterioles and increase arterial pressure

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33
Q

What does ADH bind to?

A

G protein coupled receptor on tubular cell

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34
Q

What activated adenyl cyclase to make cAMP?

A

alpha subunit

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35
Q

After alpha subunity activate adenyl cyclase and makes cAMP what is activated?

A

protein kinase cascade

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36
Q

What is inserted in the cell membrane after the protein kinase cascade starts?

A

vesicles containing aquaporins

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37
Q

What is the final step in the cellular mechanism of ADH?

A

absorption of water from collecting tubules.

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38
Q

What does an insufficient secretion of ADH lead to?

A

diabetes insipidus

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39
Q

what is diabetes insipidus?

A

body loses capacity to concentrate urine

affected individuals excrete as much as 20 L of dilute urine/day

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40
Q

What does and oversecretion of ADH lead to?

A

SIADH - syndrome of inappropriate ADH secretion

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41
Q

What is associated with SIADH?

A

a variety of ADH secreting tumors
various CNS disorders
pulmonary disorders
drugs

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42
Q

What is the cause of diabetes insipidus?

A
  • deficiency of ADH

- insensitivity of kidneys to ADH

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43
Q

What are the symptoms of diabetes Insipidus?

A
  • increased frequency of urination
  • nocturia
  • enuresis
  • increased thirst
  • increased fluid consumption
  • dehydration - too much water being excreted
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44
Q

What are the causes of SIADH?

A
  • excess ADH secreted from autonomous site
  • head injury
  • drugs (SSRIs, MDMA)
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45
Q

what is hyponatremia? and what is it associated with?

A

not a deficiency of sodium, rather a water excess.

SIADH

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46
Q

what does dilution hyponatremia cause?

A 
headaches
nausea
vomiting
confusion
convulsions
coma
(same side effects from attending neurophys lectures)
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47
Q

Where is oxytocin produced?

A

paraventricular nuclei

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48
Q

What does oxytocin help with?

A

partuition and expressing milk from breast glands during lactation

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49
Q

What is the only hormone to produce positive feedback? and during what event does this occur?

A

Oxytocin

-labor! gross

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50
Q

What are the 5 steps in breast feeding that are associated with oxytocin?

A

1) suckling
2) signals via sensory nerves to oxytocin neurons via hypothalamus
3) increased oxytocin carried by blood to breast
4) contraction of myoepithelial cells
5) milk ejection

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51
Q

When is oxytocin secreted in men?

A

during ejaculation

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52
Q

How does oxytocin function as a neurotransmitter?

A

decreases fear response by amygdala and influences pair bonding

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53
Q

How is the anterior pituitary connected to the hypothalamus?

A

by the hypothalamic-hypophysial portal system

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54
Q

How does the hypothalamus control secretions of anterior pituitary hormones?

A

via HRIH which are secreted and synthesized by neurons in median eminence of hypothalamus

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55
Q

What are the 6 HRIH’s?

A
  • Thyrotropin-releasing hormone (TRH u TSH)
  • corticotropin -releasing hormone (CRH u ACTH)
  • growth hormone-releasing hormone (GHRU u ^hGH; GHIH (somatostatin) u, hGH
  • gonadotropin-releasing hormone (GnRH u LH/FSH)
  • prolactin inhibitory hormone (dopamine) (PIH)
  • Prolactin releasing hormone (PRH u PRL)
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56
Q

What is the effect of CRH?

A

stimulate ACTH

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57
Q

What is the effect of TRH?

A

stimulate TSH and prolactin secretion

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58
Q

What is the effect of GHRH?

A

stimulate GH secretion

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59
Q

what is the effect of somatostatin?

A

INHIBITS: GH (& TSH, insulin, gastrin, glucagon, secretin, VIP)

60
Q

what is the effect of GnRH?

A

stimulates secretion of LH and FSH

61
Q

What is the effect of PRF/H, TRH, VIP?

A

stimulates PRL secretion

62
Q

What is the effect of prolactin inhibiting hormone (dopamine)?

A

inhibits PRL secretion

63
Q

When are HRIHs secreted?

A

in pulses

64
Q

What do HRIHs act on?

A

specific membrane receptors

65
Q

How do HRIHs transduce signals?

A

via second messengers

66
Q

What do HRIHs stimulate?

A
  • release of stored pituitary hormones

- hyperplasia, and hypertrophy of target cells.

67
Q

What do HRIHs stimulate and inhibit?

A

synthesis and release of pituitary hormones

68
Q

Are HRIHs monospecific?

A

not always!

69
Q

What is the path of HRIHs from Hyopthalamus to anterior pituitary gland? and what do they regulate?

A

HRIH –> capillaries of pituitary portal system at median eminence –> anterior pituitary gland.
regulate secretion of pituitary hormones.

70
Q

What does the pituitary help regulate?

A
  • Growth
  • pregnancy and childbirth
  • breast milk production
  • sex organ function
  • thyroid function
  • metabolism
  • water and osmolarity
  • blood pressure
71
Q

Which artery (specifically) connects hypothalamus to adenohypophysis?

A

superior hypophyseal artery

72
Q

What does the adenohypophysis produce and secrete?

A

peptide hormones that regulate: stress, growth, reproduction

73
Q

What does the adenohypophysis contain (in regards to cells)

A

endocrine cells originating from ectodermal cells (rathkes pouch)

74
Q

What kind of tissue is the adenohypophysis?

A

cellular and vascular

75
Q

What is the adenohypophysis composed of?

A

5 types of glandular cells (-tropes)

76
Q

What do the 5 types of glandular cells of the adenohypophysis produce?

A

6 peptide (trophic or tropic) hormones

77
Q

What 5 glandular cells are produced in the adenohypophysis?

A

1) somatropes (30-40%)
2) corticotropes(20%)
3) thyrotropes ((3-5%)
4) gonadotropes (3-5%)
5) lactotropes (3-5%)

78
Q

What hormone does somatotropes produce and what do they target?

A

Human growth hormone (GH)

targets liver, all tissues

79
Q

What hormone does corticotropes produce and what is their target?

A 
adrenocorticotropic hormone (ACTH)
targets adrenal glands, melanocytes, adipocytes
80
Q

What hormone does thyrotropes produce and what is their target?

A

thyroid-stimulating hormone

targets thyroid gland

81
Q

What hormone do gonadotropes produce and what is their target?

A 
luteinizing hormone (LH), follicle stimulating hormone (FSH)
targets ovaries, testes
82
Q

What hormone do lactotropes produce and what is their target?

A

prolactin (PRL)

Target breast, ovary, testes.

83
Q

What does prolactin stimulate?

A

development of mammary glands and secretion of milk

84
Q

What does cortisol do?

A

raises glucose levels in the blood and its comes from the adrenal cortex and ACTH

85
Q

How does prolactin stimulate lactation in postpartum?

A

estrogen and dopamine production by the placenta inhibit milk production in pregnancy - when placenta is expelled and estrogen decreases, milk production ensues in 1-7 days.

86
Q

Describe prolactin vs oxytocins function is regards to milk.

A

prolactin is involved in milk production while oxytocin is for milk ejection

87
Q

When do serum levels of prolactin begin to rise?

A

5 weeks gestation to 10-20x at birth.

88
Q

What inhibits prolactin?

A
  • PIH, aka dopamine

- GABA, dopaminergic meds

89
Q

What stimulates prolactin?

A
  • TRH
  • Sleep
  • Stress
  • nipple stimulation (oh la la)
  • VIP via hypothalamus
  • serotonergic pathways
  • estrogen therapy
  • Drugs (dopamin antags, MAO-I)
90
Q

What is a prolactinoma?

A

pituitary adenoma

91
Q

What causes a hyperprolactinemia?

A

pituitary tumor - women, menstrual dysfunction: short luteal phase, anovulation, oligomenirrhea, infertility.
men: decreased testosterone, decreased spermatogenesis, infertility, impotence, decreased libido, gynecomastia

92
Q

What are the most common causes of moderately raised prolactin levels?

A

prescription drugs.

93
Q

What do 40% of prolactinomas produce, and is it significant?

A

prolactin. and NO

94
Q

What is a cause of prolactinomas?

A

hyperprolactinemia

95
Q

Why would hypothyroidism cause hyperprolactinemia?

A

because TRH stimulates prolactin

96
Q

What tissues does Growth hormone effect? and how?

A

all of them! by increasing cell size, increased mitosis, and specific differentiation of bone/muscle cells.

97
Q

What does synthesis of GH stimulate?

A

GHRH from hypothalamus

98
Q

What does inhibitory somatostatin block?

A

action of GHRH on somatrophs

99
Q

When is the largest “burst” of GH?

A

within 1 hour after falling asleep. sleep stages 3 and 4.

100
Q

When does secretion rate of GH increase?

A

from birth to childhood - enormous burst at puberty. then levels off.

101
Q

Where does GHRH attach?

A

to receptor on surface of GH cell (somatotropes) in adenohypophysis

102
Q

What does the GHRH receptor activate?

A

JAK/STAT (enzyme linked signaling)

103
Q

What is the short-term effect of JAK/STAT?

A

increase Ca2+ transport into cell and cause fusion of GH vesicles on cell membrane for secretion into blood

104
Q

What is the long term effect of JAK/STAT?

A

increase transcription in somatotrope nucleus to stimulate synthesis of new GH

105
Q

What is the “theory” of GHRH?

A

GH controlled mainly by negative feedback mechanisms and diurnal pulses.

106
Q

What is the process of GH negative feedback?

A

1) GHRH stimulates GH –> short feedback inhibition to hypothalamus to inhibit GHRH
2) GH stimulates somatostatin (GHIH) in hypothalamus, which inhibits GHRH in an ultra-short feedback inhibition
3) GH stimulates production of somatomedins

107
Q

What two ways do somatomedins participate in GH negative feedback?

A

1) indirect: stimulating somatostatins production by hypothalamus
2) direct: inhibiting GH production in somatotropes of adenohypophysis

108
Q

What factors inhibit GH?

A
  • obesity
  • hyperglycemia
  • elevate [FA] in blood
  • aging
  • GHIH
  • somatomedins
109
Q

What factors stimulate GH?

A
  • starvation, fasting, malnutrition, protein deficiency
  • hypoglycemia
  • low [FA] in blood
  • exercise
  • excitement, trauma, stress
  • testosterone, and estrogen
  • deep sleep
  • serotonin, dopamine, catecholamines
  • GHRH
110
Q

What are the metabolic effects of GH?

A

1) increased protein synthesis
2) increased mobilization of FA in blood
3) decreased rate of glucose utilization
4) stimulates cartilage and bone growth

111
Q

How does GH increase protein synthesis?

A
  • increase AA transport
  • increase DNA transcription, increased RNA
  • Decreased catabolism of AA and proteins
  • increases synthesis, decreases catabolism*
112
Q

Why are Kwashiorkor patients GH levels high?

A

they have severe protein deficiency

113
Q

What can help maintain GH levels?

A

supplementing with carbohydrates

114
Q

What does low protein production stimulate?

A

GH. - supplemeting patients with complete protein lowers serum GH

115
Q

How does GH increase FA utilization?

A
  • increase release of FA from adipose
  • increases conversion of FA to acetyl CoA (fat used for energy instead of CHO & protein)
  • increase in overall lean body mass
  • ketogenic effects
116
Q

How does GH decrease CHO use?

A

GH conserves CHO (increase gluconeogenesis, increased blood glucose, increased insulin secretion, decreased glucose uptake and use by mm and adipose)

117
Q

What is diabetogenic?

A

GH = “diabetogenic” or “hyperglycemic” - GH-induced insulin resistance and diabetes.

118
Q

What is the theory of Gh decreasing CHO use?

A

GH causes an increase in FFA that makes the liver and mm resistant to insulin’s actions (increase insulin secretion, with decrease effectiveness)

119
Q

How does GH stimulate cartilage and bone growth?

A
  • increased deposition of protein by chondrocytes and osteocytes
  • increased rate of reproduction of both cell types
  • converts chondrocytes into osteocytes
120
Q

What do somatomedians mediate?

A

bone growth

121
Q

What are IGFs?

A

insulin-like growth factors - small proteins produced by liver and other tissues in response to GH

122
Q

If GH is applied directly to chondrocytes does it promote growth?

A

NO

123
Q

What happens when somatomedin C and IGF-1 amounts are decreased?

A

dwarfism

124
Q

What is panhypopituitarism?

A

decreased secretion of all anterior pituitary hormones

  • congenital
  • can be a tumor, or thrombosis etiology
125
Q

What are symptoms of panhypopituitarism?

A

LOW GH

hypothyroidism, decreased glucocortocoids, decreased gonadotropins

126
Q

What are characteristics of dwarfism?

A

-mostly panhypopituitarism in childhood
-development proportional, but rate is decreased
-lack of puberty, sexual/repro functions
LOW GH

127
Q

What percent of dwarfism is GH only deficiency?

A

1/3. sex/repro function intact

128
Q

What are the characteristic of gigantism?

A

HIGH GH
GH cell tumor or excessively active GH cells
-rapid growth of all tissues
-overproduction of GH causes glandular burnout, preadolescent GH excess can cause height up to 8 feet.

129
Q

What will panhypopituitarism due to burnout lead to if untreated?

A

DEATH

130
Q

What is acromegaly?

A

extremities enlargement

131
Q

what is acromegaly caused by?

A

GH cell tumor after adolescence. (benign)

  • bones become thicker, soft tissues grow
  • middle aged adults most common affected
132
Q

What is GH as a treatment for?

A

dwarfism (GH only deficient)

other metabolic disorders

133
Q

How is hGH synthesized?

A

from e coli via recombinant DNA

134
Q

What is the pineal gland AKA?

A

epiphysis

135
Q

What does the pineal gland do?

A

synthesizes and secretes melatonin (ability to coordinate biological rhythms)

136
Q

Why do some call the pineal gland the “third eye”?

A

because of its light-transducing ability

137
Q

What is the pineal gland regulated by?

A

Sympathetic nervous system - transduces signals from sympathetic into a hormonal signal

138
Q

What does the pineal gland regulate?

A

gonadal function and development in season breeders and chronobiologic rhythms

139
Q

What is secretion f melatonin from the pineal gland stimulated by?

A

hypoglycemia and darkness.

140
Q

What is length of melatonin secretion proportional to?

A

length of darkness/night

141
Q

What is the path of transmitting light from retina to pineal gland?

A

1) light exposure to retina
2) superchiasmatic nucleus of hypothalamus
3) hypothalamic fibers
4) spinal cord
5) superior cervical ganglia
6) post-ganglionic neurons ascend back to pineal
7) pineal transduces signals from SNS to hormonal signal

142
Q

What are the effects of melatonin on reproduction?

A

Melatonin is anti-gonadotropic.

  • melatonin inhibits secretion of gonadotropic hormones LH/FSH via inhibiting GnRH
  • elevated in non-breeding season = inhibition of reproduction
143
Q

What is the normal function of melatonin on sleep?

A

helps decrease skeletal muscle activity and body temp to induce sleep.

144
Q

What effect does melatonin have on RA patients?

A

melatonin increases pro-inflammatory cytokines like TNF-a.

145
Q

What kind of levels of melatonin do breast cancer patients have?

A

low serum melatonin. Melatonin inhibits growth of breast tissue.

Physiology 2 test 1 (3 decks)

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