Endocrine Lecture 2 Flashcards

1
Q

Hypothalamus regions receive unique inputs from all areas in the body and then the hypothalamus has to integrate those signals into a singular output:

either to the anterior or posterior pituitary

What hormones are released from anterior vs posterior pituitary?

A

Anterior Pituitary: ACTH, GH. TSH, LH, FSH, Prl (metabolism, growth and development, reproduction, lactation and response to stress)

Posterior Pituitary: OT and AVP (water balance, parturition and lactation)

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2
Q

The hypothalamus is an example of a _____ endocrine gland.

It is ______ and dumps its hormones _____

A

Hypothalamus is a classic endocrine gland

It is ductless, dumps its hormones into the blood stream at the medial geniculate

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3
Q

Explain the functions of these hypothalamuc nuclei:

PVN

POA

SO

AR

A

Hypothalamic Nuclei Functions:

PVN (avp neurons, regulates thirst, blood pressure, also mood/emotion/stress)

POA: reproductive function and body temp

SO (lots of avp neurons regulating osmolarity)

ARC (regulates stress and feeding behavior)

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4
Q

What is the median eminence?

A

The median eminence is the floor of the hypothalamus, convergence point for axons

“Important to point out that cell bodies of neurons are located in the hypothalamic nuclei, BUT their axons are extended down to the median eminence, where hormones are dumped directly into the blood”

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5
Q

Explain the following hypothalamic releasing factor hormones (which brain nucleui do they originate from, what is their pituitary target, function)

  1. GnRH and GnIH
  2. CRH
  3. TRH
A
  1. GnRH (IH is inhibitor) comes from neurons scattered all over brain, but majority in POA, targets gonadotrope cells in the pituitary to release FSH and LH for reproductive function
  2. CRH comes from the PVN to target corticotropes in the pituitary to release ACTH for many functions (glucocorticoids)
  3. TRH comes from the PVN, and targets thyrotropes in the pituitary to release TSH for function of thyroid hormone (also has many functions)
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6
Q

Explain the following hypothalamic releasing factors (which nuclei they originate from, what their pituitary targets are and what their function is)

  1. GHRH
  2. Somatostatin
  3. Dopamine
A
  1. GHRH comes from the Arcuate nucleus to target somatotropes in the pituitary to release GH, function of growth and development
  2. Somatostatin (GHRH inhibitor) comes from the PeVN to target somatotropes in the pituitary to inhibit GH as its function
  3. Dopamine: comes from arcuate nucleus, targets lactotropes in the pituitary to release prolactin for milk production
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7
Q

GnRH:

Cell bodies are _________

Very long axons extend toward the _______

If you do not have these neurons you will be _____

GnRH is a _______ hormone, meaning that it binds to a ____-

A

GnRH:

Cell bodies are scattered throughout forebrain, with the largest concentration in the POA (Pre-optic area)

Very long axons extend toward the median eminance

If you don’t have these neurons you will be sterile

GnRH is a decapeptide, meaning its a peptide hormone and therefore binds to a cell surface receptor

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8
Q

Kallman Syndrome:

What is kallman syndrome?

A

Kallman Syndrome:

Rare genetic disease where the GnRH neurons fail to enter the CNS during embryonic development (these neurons originate in the nose and travel to the brain during early development)

Kallman disease is characterized by reproductive failure and anosmia

It is heritable: X linked (Kal 1) and Autosomal (Kal 2)

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9
Q

GnRH:
GnRH is released via the ___________ system and binds to cell surface receptors on ________ (pituitary cells).

It then through different secondary messenger systems causes the pituitary to release two hormones: ____, ___

Explain how one hormone can regulate the synthesis of two different hormones

A

GnRH:

GnRH is released via the hypophysial portal system and binds to cell surface receptors on gonadotroph cells in the pituitary. It then causes through different pathways those gonadotroph cells to release LH or FSH

It regulates two totally different hormones from the same cell type by regulating the frequency by which GnRH itself is released / “pulsitility” (LH is fast pulsitility, FSH is slow pulses), and also by two different signaling pathways.

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10
Q

Explain the hypophysial portal system

Can you measure hypothalamuc releasing hormones via a blood test?

A

The hypophysial portal system is a vascular connection between the hypothalamus and the pituitary gland.

The cell bodies of the hypothalamic releasing and inhibiting hormones are within the hypothalamus, and the axons of them end right at the median eminence, where the hormones travel through portal vein to get to anterior pituitary.

NOTE: you CANNOT measure these hypothalamic releasing portal veins in systemic blood, only in portal vein so they are never looked at

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11
Q

GnRH Pulsitility:
Explain the relationship between GnRH pulsing and the pituitary hormone pulses of LH and FSH

Also explain the significance of GnRH pulsing and why it is important that it is pulsitle

A

GnRH Pulsitility:

  • GnRH pulse is right before the pituitary hormone pulse
  • Pulse frequency determines which pituitary hormone is released:
    • Slow: FSH
    • Fast: LH

For GnRH pulsitility is important to recycle receptors back to the surface AND important for distinguishing which pituitary hormone gets released

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12
Q

Explain the difference for pituitary hormones between the Beta subunit and the alpha subunit in all the hormones

A

All pituitary hormones contain ghe same alpha subunit (a-GSU)

But they all differ in which Beta subunit they have

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13
Q

Explain the tuberoinfundibular system vs the neurohypophysial tract

A

Two Major Pathways for Hypothalamic-Pituitary Connection:

  1. Tuberoinfundibular system: comprises all neurons that send axonal projections to the median eminence. Hormones target the anterior pituitary through the portal vein
  2. Neurohypophysial Tract: comprises neurons whose axons terminate in the posterior pituitary
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14
Q

Pituitary Gross Anatomy:

The Anterior Pituitary main part is called the _____

The posterior pituitary consists of ______ and ____

A

Pituitary Gross Anatomy:

Anterior Pituitary: pars distalis

Posterior Pituitary: pars nervosa and infundibulum (stalk)

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15
Q

Explain the different tissue types that make up the anterior and posterior pituitary:

Anterior pituitary: _______ tissue

Posterior pituitary: ______ tissue

A

Anterior pituitary: glandular tissue: cords of epithelial cells

anterior pituitary: adenohypophysis

Posterior Pituitary: neurohypophysis, neural tissue

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16
Q

Label these stains: which part is anterior pituitary which part is posterior pituitary

A

Darker stain: anterior pituitary (pars distalis)

Lighter stain on the bottom: posterior pituitary (pars nervosa)

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17
Q

Posterior Pituitary - Neurohypophysis:

Axons from ______ neurons terminate in the neurohyphophysis

Blood supply is seperate, and is from the ____ artery

Major hormones released from posterior pituitary:

  • *
A

Posterior Pituitary: Neurohypophysis:

Axons from magnocellular neurons terminate in neurhypophysis (neurohypophysial tract)

Blood supply from inferior hypophysial artery- has its own capillary bed

Major Hormones: Argininge Vasopressin (AVP) and oxytocin (OXY)

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18
Q

Posterior Pituitary:

Pars Nervosa Histology:

Axons terminate near the _________

A

Posterior Pituitary:

Axons terminate near fenestrated capillaries that way they can go right into the blood stream

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19
Q

Posterior Pituitary: Pars Nervosa and Herring Bodies;

What are herring bodies?

A

Pars Nervosa:

Herring bodies are dilations of unmyelinated axons near their terminals

Contain vesicles of either AVP or oxytocin plus a binding protein called neurophysin (the copeptide)

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20
Q

Anterior Pituitary- Adenohypophysis:;

The median eminence (ME) is the interface for all hypophysial hormones

ME lies _____ the BBB and forms the floor of the third ventricle (explain what that means)

A

Anterior Pituitary - Adenohypohysis:

The median eminence (ME) is the interface for all hypophysial hormones

ME lies outside the BBB and forms the floor of the third ventricle

This means that hormones can also be regulated from things outside of the blood stream

21
Q

**Explain which cells within the anterior pituitary are responsible for producing the following hormones:

LH/FSH

TSH

ACTH

GH

Prolactin

A

LH and FSH : gonadotrophs

TSH: thyrotrophs

ACTH: corticotrophs

GH: somatotrophs

Prolactin: lactotrophs

22
Q

Anterior Pituitary Cell Types and Hormones:
_______ are the most abundant hormone producing cell type (include which two types of cells)

Basophils - dark stain (which three types of anterior pituitary cells are basophils)

What are chromophobes?

A

Anterior Pituitary Cell Types and Hormones:

Acidophils - most abundant hormone producing cell type (light stain)

  • somatotrophs : GH
  • lactotrophs: prolactin

Basophils: dark stain

  • corticotrophs: ACTH
  • gonadotrophs: LH and FSH
  • Thyrotrophs: TSH

Chromophobes have clear appearnace, paracrine actions, often pituitary tumors are in these and show no symptoms

23
Q

Explain the regional distribution of anterior pituitary cell types:

Are are the kind of cells that are located on the outside?

Inside

A

Look at the diagram:

Most somtotrophs and lactotrophs are located outside

24
Q

KEY CONCEPT:
Draw out the differences between the hypothalamus to anterior pituitary general axis vs the hypothalamus to posterior pituitary axis

A
25
Q

AVP: (posterior pituitary tract)

AVP is made in the _____ neurons within the hypothalamus, travels down the ________ tract to the posterior pituitary, where it goes into systemic circulation and targets _____ and _____

AVP: is processed as a _____ peptide

What does it look like as a preprohormone and a prohormone? (which copeptide does AVP vs OXY have)

A

AVP is made in the magnocellular neurons within the hypothalamus, travels down the axons (neurohypophysial tract) to the posterior pituitary where it goes into systemic circulation and targets the vasculature and the kidneys.

AVP is a nonapeptide (9 AA)

Transcribed as a preprohormone (means signal peptide still attached)

Prohormones: AVP and neurophysin II, and OXY is neurophysin I

26
Q

AVP is made in cell bodies within the ___ and ___

The PVN has two types of cells: magnocellular and parvocellular

Only _______ neurons project to the posterior pituitary

Parvocellular neurons that contain AVP project to ___ and are important for _____

AVP in magnocellular SON and PVN is important for maintaining _______

A

AVP is made in cell bodies in the PVN and SON

PVN has two types of cells: magnocellular and parvocellular

Only magnocellular neurons project to the posterior pituitary

Parvocellular PVN neurons that contain AVP project to median eminence and are important for regulating mood/anxiety/stress

AVP in magnocellular SON and PVN is important for maintaining fluid balance

27
Q

***AVP Release Posterior Pituitary:

Explain the signaling pathways that trigger AVP release from the posterior pituitary and how sensitive they are relative to one another

  1. Plasma osmolarity

2, Significant blood loss

A
  1. Plasma Osmolarity (VERY sensitive)

When plasma osmolarity increases, the osmoreceptors in the brain shrink. The shrinkage of those osmoreceptors decreases the inhibition that is normally on magnocellular neurons, allowing them to release AVP and target vasculature (constrict to increase BP) and kidneys (increase water reabsorption)

  1. Significant blood loss (less sensitive, have to lose 5-10% of blood volume):

A decrease in mean arterial BP causes a decrease in baroreceptor stretch and thus a decrease in baroreceptor firing, the brain then increases sympathetic tone. Also, the osmoreceptors now respond to lower osmolarity (shifts curve to left)

28
Q

AVP Targets:

The first target of AVP is the vasculature

AVP as a peptide hormone will bind to ______ receptors to cause _______

What does this do to vascular resistance?

A

AVP Targets:

First target of AVP is the vasculature

AVP as a peptide hormone will bind to a surface receptor, and for vascular smooth muscle the receptor is called the V1 receptor to cause vasoconstriction

AVP causes vasoconstriction- increases vascular resistance

29
Q

AVP:

AVP targets the vasculature and the ____ (which organ)

On the _____ it binds to the ___ receptor

AVP causes ____ insertion on the cell membrane facing the lumen, thus causing water _____

A

AVP:

second target is the KIDNEY
On the kidney it binds to the V2 receptor

AVP causes AQP2 insertion in cell membrane facing the lumen, increases water reabsorption

30
Q

SUMMARY of AVP affects:

In the vasculature, AVP binds to the __ receptor, causing _____ and an ____ in vascular resistance

In the kidney, AVP binds to the ___ receptor, causing _______ and thus ______

A

In the vasculature, AVP binds to the V1 receptor, causing vasoconstriction and an increase in vascular resistance

In the kidney, AVP binds to V2 receptor, causing AQP2 insertion in cell membrane facing the lumen, increasing water reabsorption

31
Q

OXYTOCIN:

Oxytocin causes smooth muscle _____

Where does it have its effects, and what does that cause?

Example of _____ feedback loops

A

Oxytocin:

Oxytocin causes smooth muscle contraction

  1. Breast: contracts myoepithelial cells and causes milk ejection
  2. Uterine contraction: giving birth
    (note: “PITOCIN” is synthetic oxytocin used to induce labor)

POSITIVE FEEDBACK

32
Q

HPL Axis:

What are the three parts of the HPL Axis

Explain the axis briefly

A

HPL Axis: (regulation of growth overall)

Hypothalamus : arcuate nucleus makes GHRH

P: anterior pituitary somatotrope releases GH

Liver: releases IGF-1

GHRH is made by the arcuate nucleus and is released into portal vein, targets pituitary somatotrope to activate PKA and release GH. The three major targets of GH are muscle, adipose tissue, and the liver (and the liver is what makes IGF-1)

33
Q

Somatostain is the ______ of GHRH

______ is made in the hypothalamus and pancreatic delta cells (_____)

Most of the somatostatin in the body is made where?

A

Somatostatin is the inhibitor of GHRH (it does this two ways, explained on another card)

SS14 is made in the hypothalamus and pancreatic delta cells PC1/PC2

SS14 is the inhibitor of GHRH

Most of the somatostatin in the body is SS28 and that is made by D cells in the stomach and cleaved by the enzyme furin

34
Q

GHRH and somatostatin:

Somatostatin inhibits GHRH in two ways:

1.

2.

Also, explain what graphs would look like that compare the relationship between somatostatin, GHRH, and GH levels (somatostatin and GHRH/GH have an ____ relationship_

A

GHRH and somatostatin:

Somatostatin inhibits GHRH at two levels:

  1. Somatostatin modulates GHRH pulsatility in the hypothalamus (decreasing its pulsatile frequency)
  2. Somatostatin inhibits PKA in the pituitary thereby inhibiting GH release

There is an inverse relationship between somatostatin levels and levels of both GHRH and GH

35
Q

Key Concept: GH Intermediates

Many downstream target organ effects of GH are mediated through ______
GH stimulates ____ production in the ____

A

Key Concept: GH Intermediates:

Many downstream target organs effects of GH are mediated through IGF-1

GH stimulates IGF-1 production in the liver (and this stimulation is insulin dependent)

36
Q

HPL Axis:

GHRH is released from hypothalamus and travels to the anterior pituitary where it stimulates PKA to release GH.

GH has three major targets: _____, ____, _____
GH stimulates IGF1 in the liver (____ dependent)

Explain the feedback loop of IGF-1 in the HPL axis

A

HPL Axis:

GHRH is released from hypothalamus, travels to anterior pituitary and activates PKA to create and release GH

GH has three targets: adipose tissue, muscle, and the liver

In the liver, GH stimulates IGF-1 production as long as there is insulin (IGF-1 stimulation is insulin dependent)

IGF-1 acts as negative feedback: in a long loop, IGF-1 inhibits GH release at the pituitary gland AND IGF-1 stimulates somatostatin in the hypothalamus (both of these cause negative feedback)

37
Q

Explain the negative feedback loop that IGF-1 has on the HPL axis

A

IGF-1 is stimulated by GH in the presence of insulin

IGF-1 asserts negative feedback on the HPL axis via:

inhibiting GH release at the pituitary somatotropes

AND
stimulating somatosatin (so that somatostatin can inhibit the pathway as well)
38
Q

Explain the Physiological Effects of GH (and IGF-1) in the fed vs fasted state

A

Fed State:

  • GH stimulates liver to increase RNA and protein synthesis, and to increase IGFBPs and IGFs
  • GH stimulates muscle to increase AA uptake and increase protein synthesis

GH goal in fed state is to increase lean body mass

  • also in fed state, IGF-1 will increase organ size and bone size

Fasted State:

  • in fasted state, GH will cause adipose tissue to decrease glucose uptake and increase lipolysis
  • Liver: increase gluconeogenesis
  • Muscle: decrease glucose uptake
39
Q

Explain what happens in the following scenarios within the HPL axis:

  1. eating only protein
  2. eating a donut
  3. fasted state
A
  1. eating only protein: amino acids stimulate GHFH, increase GH levels, increase IGF-1 levels, increase protein synthesis and growth
  2. donut: low AA, high glucose will inhibit GHRH
  3. fasting state: low glucose stimulates GHRH but no IGF-1, GH will then increase (without IGF-1 increase), and that GH will ause caloric mobilization in lipids
40
Q

IGF-1 peaks are critical during _____ periods

IGF-1 levels are at the highest during _____ (life stage)

A

IGF-1 peaks during critical growth periods - highest during puberty

41
Q

What are the main stimulators and inhibitors of GH?

GH is increased by ___, ____, ___

GH is decreased by ____, ____, ____

A

Stimulators and Inhibitors of GH:

Main stimulator of GH is GHRH, other stimulators include dopamine, NE/Epi (exercise/stress), Amino Acids (protein building), and thyroid hormone

Main inhibitor of GH is somatostatin, other inhibtors of GH are IGF-1 (negative feedback loop), glucose (hyperglycemia), and free fatty acids (obesity)

GH is increased by stress, exercise, starvation

GH is decreased by aging, high blood glucose, and obesity

42
Q

GH Excess- somatotrope tumor (20%)

Explain the differences between gigantism and acromegaly:

Gigantism: extremely ____, occurs before _____

Acromegaly: usually diagnosed in ____

  • gradual enlargement of ____ and ____
  • changes in facial features
  • possible increased organ size
  • most often caused by ___
A

GH Excess - somatotrope tumor (20%)

Gigantism - extremely rare, occurs before the closing of the epiphyseal plate during childhood

Acromegaly: usually diagnosed in middle age

  • gradual enlargement of hands and feet
  • changes in facial features
  • possible increased organ size
  • most often caused by pituitary adenoma
43
Q

GH Deficiency:

Dwarfism (children): related to GH

  • Laron Syndrome: genetic defect in _____, causing ______ of IGF-1. Plasma GH levels are_____
  • African Pygymy (explain)

Adult GH Deficiency:

  • caused by _____
  • increased ___ deposition, muscle wasting
    • risk of fractures, reduced bone density
A

GH Deficiency:

Dwarfism (children): related to GH

  • Laron Syndrome: genetic defect in GH receptor - NO production of IGF-1. Plasma GH levels are normal to high (lack of negative feedback)
    • treatment for laron syndrome is giving the pt IGF-1
  • African Pgymy: partial defect in GH receptor, some IGF-1 response
  • plasma levels of Gh normal

Adult GH Deficiency:

  • caused by pituitary tumor/surgery
  • increased fat deposition and muscle wasting
44
Q

Explain what you would expect to see in terms of GH levels for:

Laron Syndrome

African Pgymy

A

Laron Syndrome: genetic defect in GH receptor, causing no production of IGF-1. Due to that lack of negative feedback, GH levels are normal to high

African Pgymy: partial defect in GH receptor, some IGF-1 response, plasma GH levels are normal

45
Q

Prolactin:

Prolactin is made in pituitary ______

Prolactin is tonically inhibited by ______

Early antihypertensive drugs inhibited ___, thereby causing what?

Prolactin is released in response to ____

A

Prolactin:

Prolactin is made in pituitary somatotropes

Under normal conditions, dopamine tonically inhibits prolactin

early antihypertensive drugs inhibited dopamine, caused prolactin release and caused galactorrhea (milk production in breasts)

Prolactin is released in response to suckling (positive feedback loop)

Prolactin is important in milk production

46
Q

_____ inhibits prolactin

Prolactin inhibits _______

(so in instances where prolactin is abnornally high, then what?)

A

Dopamine inhibits prolactin

Prolactin inhibits GnRH

At times where prolactin is high, you will have diminished FSH and decreased menstral cycles

47
Q

Prolactin:

Prolactin hormone is in the same family as ___ hormone

This means that ___ can bind the prolactin receptor, and prolactin can bind the ___ receptor

Explain what they means for acromegaly patients

A

Prolactin

Prolactin is in the same family as GH hormone

This means that prolactin can bind the GH receptor. and GH can bind the prolactin receptor

In patients with acrogemaly (high GH levels), the extra GH can bind to prolactin receptors and cause galactorrhea (milk production)

48
Q

Prolactin Excess:

  • prolactinomas are common pituitary adenomas
  • cause _____ prolactin levels
  • causing ______ (increased milk production)
  • reproductive ________

Prolactin Deficiency:

  • Sheehan’s syndrome (explain what this is…. it was in small group)
A

Prolactin Excess:

  • prolactinomas are common pituitary adenomas
  • cause increased prolactin levels
  • causing galactorrhea (milk discharge from breast)
  • reproductive dysfunction (prolactin inhibits GnRH release)

Prolactin Deficiency:

  • Sheehan’s Syndrome:
    • occurs as a result of hemorrhage during childbirth
    • causes pituitary cell death
    • affects lactotrophs, causing an inability to produce milk, and also causes loss of pubic hair
49
Q

Predict the GH level for the following scenarios:

  1. Insulin induced hypoglycemia should cause an ___ in GH levels
  2. Administration of IGF-1 should cause an __ in GH levels
A
  1. Insulin induced hypoglycemia should cause an increase in GH levels (low blood sugar stimulates GHRH release, thereby increasing GH levels)
  2. Administration of IGF-1 causes a decrease in GH levels (due to negative feedback)