Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Physiology 2 > Endocrine - Pituitary > Flashcards

Endocrine - Pituitary Flashcards

1
Q

What is the “master gland”?

A

pituitary gland

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is responsible for brain-endocrine interactions?

A

Hypothalamic pituitary axis (HPA)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Coordinating center of the endocrine system

A

hypothalamus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

The hypothalamus consolidates signals from what 4 sources?

A
  1. Upper cortical inputs
  2. Autonomic fx
  3. Environmental cues
  4. Peripheral endocrine feedback
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

T/F: The hypothalamus delivers vague signals to the pituitary gland which will release hormones that influence other endocrine systems.

A

False. the hypothalamus delivers PRECISE signals

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Where is the pituitary gland located?

A

Sella tursica (area of the the sphenoid bone)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

4 divisions of the pituitary gland

A
  1. anterior pituitary / adenohypophysis (largest)
  2. Pars intermedius (gone after baby develops)
  3. Pars tubular (highly vascular, no known hormones secreted)
  4. Neurohypophysis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Name three ways in which the anterior and posterior portions of the pituitary are distinct from one another

A
  1. different connections to the hypothalamus
  2. different cell types
  3. secrete different hormones
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is another name for the anterior pituitary?

A

adenohypophysis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

How is the anterior pituitary connected to the hypothalamus?

A

portal venous network (the anterior pituitary is highly vascularized)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

The adenohypophysis is responsible for the regulation of which 6 things?

A
  1. thyroid gland
  2. adrenal glands
  3. mammary glands
  4. growth hormone
  5. gonads
  6. melanocytes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Type of anterior pituitary cell that is the most abundant and secretes growth hormone

A

Somatotropes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Type of anterior pituitary cell that secretes adrenocorticotropic hormone (ACTH)

A

Corticotropes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Type of anterior pituitary cell that secretes thyroid stimulating hormone (TSH)

A

Thyrotropes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Type of anterior pituitary cell that secretes lutenizing and follicle stimulating hormones (FSH and LH)

A

Gonadotropes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Type of anterior pituitary cell that secretes prolactin (PRL)

A

Lactotropes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is another name for the posterior pituitary gland?

A

Neurophypophysis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

T/F: The posterior pituitary is largely a collection of axonal projections from the hypothalamus.

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What 2 hormones are produced by the posterior pituitary? What do they regulate?

A
  • Oxytocin and vasopressin

- Uterine contractions and water balance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

After hormones are synthesized in the hypothalamus, how are they transported to the posterior pituitary for secretion?

A

intracellularly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Where is vasopressin primarily synthesized?

A

supraoptic nucleus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What are the actions of vasopressin, and what are the results of those actions?

A
  • Increases permeability of collecting ducts –> increased free water reabsorption
    1. increased urine osmolality
    2. decreased plasma osmolality
    3. increased ECF volume
  • Causes contraction of vast smooth muscle
    1. vasoconstriction
    2. more prevalent in larger doses
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What do effects do the V1 and V2 receptors have?

A

V1 - pressor effect; prevalent w extreme increases in circulating levels, i.e. hemorrhage

V2 - ADH effect

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is the stimulus for vasopressin release?

A

Osmoreceptor in hypothalamus (HT) activated by plasma osmolality >290 mOsm/kg

(other receptors in HT send sensation of thirst)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
_____________ activates stretch receptors in the great veins, atria, and pulm veins for ADH release
Decreased ECF volume
26
Name 5 things (other than osmolality >290) that stimulate ADH release
``` angiotensin II nicotine nausea pain stress ```
27
How is release of ADH depressed?
- decreased plasma osmolality - increased ECF volume - ETOH
28
How are baroreceptors in the carotid sinus and aortic arch activated?
large volume changes
29
Describe SIADH
Autonomous release from pituitary (or tumor) cause water retention, low Na with concentrated urine, and hypoosmolar (dilute) plasma
30
Causes of SIADH
- CNS disorders - Cold stress - Trauma - Drug induced - Squamous cell lung CA
31
How to treat SIADH
1. Find cause | 2. Limit fluid intake
32
T/F: Symptoms of hyponatriema relate to rapidity of onset
True
33
A hyponatremic pt is usually asymptomatic until Na is ____ mEq/L, with serious symptoms below ____ mEq/L
125 | 120
34
Mild, mod, and severe s/s of hypoNa
Mild: anorexia, nausea, weakness Moderate: lethargy, confusion Severe: sz, coma, death
35
Na >____ is safe for elective procedures
130
36
Na < ____ may lead to cerebral edema, and elective procedures should be held.
130
37
If doing an emergent procedure on a pt with Na <130, what would you expect to see intra-op and post-op related to the hypoNa?
Intra-op: decrease MAC Post-op: agitation, confusion, somnolence
38
Why must hypoNa be corrected slowly?
Risk for Central Pontine Myelinolysis
39
What is Central Pontine Myelinolysis?
- demyelinating lesions in the pons R/T rapid correction of hypoNa
40
Central Pontine Myelinolysis is seen with a change in Na > ____ mEq/L/hr
0.5
41
What are some of the possible outcomes of central pontine myelinolysis?
- Serious permanent neurologic sequelae - Death - Spastic quadriplegia - pseudo bulbar palsy (inability to control facial movements) - varying degrees of encephalopathy or coma from acute, noninflammatory demyelination that centered within the basis pontis
42
Conditions that predispose its to CPM
- alcoholism - liver disease - malnutrition - hypoNA
43
Risk factors for CPM in the hyponatremic pt
- serum Na <120 mEq/L for >48hrs - aggressive IVF therapy with hypertonic saline solutions - development of hyperNa during tx
44
Symptoms of CPM usually occur within _____ hours post therapy
48-72
45
2 causes of diabetes insipidus (DI)
ADH deficiency caused by: - inability to release ADH (central/most common) - inability of kidney to respond to ADH (renal)
46
Results of DI
Excretion of lg acts of hypoosmotic urine withhyperosmotic plasma and polydipsia polyuria w/o hyperglycemia
47
What keeps DI its from severe dehydration?
Water intake
48
Tx for DI - central - renal
central: exogenous ADH (desmopressin nasal spray) renal: demeclocycline (decreases responsiveness of collecting tubules to ADH)
49
When is transient central DI common?
- post head injury or surgery
50
Causes of nephrgenic DI
- CKD - lithium toxicity - hypercalcemia - hypokalemia - tubulointerstitial disease (Drugs) - hereditary (rare)
51
Anesthetic considerations for DI/hypernatremia
- increased MAC - decreased uptake of IAs from decreased CO - decreased doses of IV agents (b/c of hypovolemia)
52
Elective surgery should be postponed for Na >____
150
53
S/S of hyperNa
- restlessness - lethargy - hyperreflexia - sz - coma - death
54
T/F symptoms of hyperNa correlate w rapidity of development
true
55
Rapid correction of hyperNa results in:
- sz - brain edema - permanent neurologic damage - death
56
Oxytocin is secreted from the _______
supraoptic nucleus of the posterior pituitary
57
What are the actions of oxytocin
- contraction of the uterus during labor | - contraction of myopeithelial cells of the lactating breast and sm muscle of the uterus
58
Labor effects and breast feeding effects of oxytocin are an example of _________ feedback.
positive
59
How is oxytocin used in OB?
to increase contraction of the uterus to organize labor to contract the uterus and decrease blood loss after birth
60
Complications of oxytocin (pitocin)
- fetal distress r/t hyperstimulation - uterine tetany - maternal water intoxication (ADH effects, rare)
61
Rapid IV infusion of pitocin can cause:
- HTN - Tachycardia - N/V - Sz (rare)
62
How to reconstitute Pitocin
Add 20 units (no more than 40 units) of Pitocin to 1 L crystalloid and titrate to uterine contraction
63
How are pituitary tumors often found?
as a result compression on adjacent structures, such as visual changes with impingement of optic chiasm
64
Compression of the optic chiasm can result in ________
bitemoral hemianopsia (seeing only the medial half of both visual fields)
65
T/F: Pituitary tumors can manifest with systemic effects due to hormonal changes.
True
66
Patients undergoing pituitary resection should undergo evaluation of their hormonal function to detect either:
hypersecretion or panhypopituitarism
67
Anesthetic implications of pre-existing hormonal disorders: 1. GH 2. TSH 3. ACTH 4. Panhypopituitarism
1. GH - acromegaly, difficult airway 2. TSH - hyperthyroid, tachycardia, wt loss 3. ACTH - Cushing's disease, difficult airway and access 4. Panhypopituitarism - need HRT with cortisol, synthroid, or DDAVP (vasopressin)
68
T/F: Most pituitary resections are done with trasnsphenoidal approach, tho some may require craniotomy
True
69
Patients undergoing pituitary surgery may develop _____ but to loss of ADH
DI - may be temporary or permanent; may be evident intra-op or post op
70
Intraoperatively, what would cause an anesthetist to suspect DI in a pt undergoing pituitary surgery?
high UOP; confirm w specific gravity <1.005
71
Intraoperative tx of DI during pituitary surgery
DDAVP 0.5-1 mcg IV or SQ with volume replacement

Physiology 2 (8 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions