Exam 2 Material Flashcards
The endocrine system provides ____ of many tissues
broadcast regulation
The specificity of the endocrine system is due to:
receptors
Compared to the nervous system, the responses of the endocrine system are:
slower but longer lasting
List the 3 functions of hormones:
- maintenance of homeostasis
- growth and differentiation
- reproduction
Endocrine organs can be divided into what two categories?
- major endocrine glands
- organs w/ endocrine cells
Primary function is to make a hormone and release it when the stimuli are present
major endocrine organ
organs that happen to have endocrine cells allowing them to release a hormone although their primary fxn is NOT endocrine regulation
organs containing endocrine cells
List specialized endocrine glands (major endocrine organs)
- parathyroid gland
- thyroid gland
- pituitary gland
- adrenal gland
- pineal gland
List some organs that contain endocrine cells but their primary function is not endocrine regulation:
- hypothalamus
- skin
- adipose tissue
- thymus
- heart
- liver
- stomach
- pancreas
- small intestine
- kidneys
- gonads
A hormone that causes secretion of a hormone by an endocrine gland:
tropic hormone
How do we classify hormones?
based on their structure
What are the 3 classifications of hormones?
- proteins or polypeptides
- steroids
- tyrosine derivatives
Describe the time period in which protein and polypeptide hormones are made and released:
made in advance and stored in vesicles until signal for release
Protein and polypeptide hormones are synthesized first as ____.
Preprohormone
The preprohormone will be converted into:
prohormone
In protein and polypeptide hormones what is packed into vesicles of the endocrine cell prior secretion?
prohormone
After the prohormone gets cleaved, it is now:
active hormone
Mnemonic for protein and polypeptide hormones:
Protein/Polypeptide/Pre & Pro hormones (Everything with P’s)
in addition to the active hormone, what gets released in when the prohormone gets cleaved?
inactive fragment
What is the first thing that gets cleaved from preproinsulin?
signal peptide
After the signal peptide is cleaved from preproinsulin, what occurs?
protein folding
Following cleavage of the signal peptide from preproinsulin and protein folding, what results:
Proinsulin
Proinsulin gets stored in:
vesicles
Upon receiving a a signal for release into the bloodstream, what gets cleaved from proinsulin to convert to active insulin?
C-peptide
Along with insulin release into the bloodstream, what also gets released?
C-peptide
If you wanted to measure someones baseline endogenous production and release of insulin, you could measure the:
c-peptide levels in the blood stream
protein and polypeptide hormones are often made as an:
inactive precurser
The inactive precursor of protein and polypeptide hormones:
preprohormone
What does the signal peptide in insulin serve as?
A marker that tells the cell that insulin needs to undergo exocytosis
Where are the receptors located for protein/polypeptide hormones?
In the plasma membrane
Describe the time period in which steroid hormones are made and released:
Made and released on demand
Where are the receptors located for steroid hormones?
Inside the cell
Why are steroid hormone receptors located inside the cell?
steroid hormones can cross the plasma membrane and bind to receptors inside target cells
Hormones from the hypothalamus, anterior pituitary, posterior pituitary, and pancreas:
protein and polypeptide hormones
Hormones from the adrenal cortex, ovaries and testes:
steroid
Steroid hormones are synthesized from (derivatives of):
cholesterol
What are two hormones that are derived from cholesterol that are STRUCTURALLY very similar?
Aldosterone & Cortisol
DHEA, Androstenedione, testosterone, and estradiol are all steroid hormones involved in:
reproduction
What determines what steroid hormone will be produced from the precursor cholesterol?
compliment of enzymes present
Describe the time period in which amine hormones are made and released:
made early and stored until secreted
Amine hormones are derived from:
amino acid tyrosine
Thyroid hormone, Noepinephrine and Epinephrine are all:
amine hormones
Epinephrine and norepinephrine are both:
adrenal medullary neurohormones
Thyroid hormone binds to the protein:
thyroglobulin
Epinephrine and norepinephrine are stored in vesicles and released via:
exocytosis
structurally what is the difference between T3 and T4?
the # of Iodide atoms attached
What is a precursor to epinephrine and norepinephrine?
Dopamine
Hormones released into circulation can either circulate ____ or ____.
Freely or with binding proteins
The majority of ____, ____, and _____ hormones circulate in their free form.
amines, peptides and proteins
What is the exception to most amines circulating in their free form? Why?
Thyroid hormones because its double ring structure makes it soluble enough to where it needs help getting through the plasma
Describe the solubility of amines, peptides/protein hormones:
water soluble
_____ & _____ circulate bound to specific transport proteins
steroid and thyroid hormones
Some binding proteins are specific for a given hormone but some plasma proteins such as ____ & ____ can bind to many hormones
globulin & albumin
What is a shuttle bus found in the plasma (plasma protein) that transports a lot of things such as lipid soluble hormones and fatty acids:
albumin
Most binding proteins are synthesized in the:
liver
Patients with a compromised liver may show signs of:
endocrine deficiencies
Why might a patient with a comprised liver show endocrine deficiencies?
Because most binding proteins are synthesized in the liver and if you can’t make enough binding proteins you can’t get enough hormone into the blood
It is always the ____ version of the hormone that binds to the receptors and affect the target cell.
Free version (binding protein stays in blood vessel)
The constitutive level of plasma hormones
basal level
The stimulated level of plasma hormones
peak levels
The variable patterns of hormone release (oscillation) is determined by the interaction and integration of multiple control mechanisms which include: (4)
hormonal, neural, nutritional, and environmental
When a hormone is constantly secreted in small amounts all of the time:
tonic release
Hormone fluctuations that happen dependent on the time of day:
circadian rhythm
Give an example of a hormone that follows circadian rhythm release:
cortisol
When does cortisol spike?
early morning hours
What can work in addition to circadian rhythm release to regulate the release of hormones?
stimuli
Growth hormone is secreted during sleep following a circadian rhythm release pattern but also displays:
pulsatile secretion
Secreted in pulses (secretes, stops, secretes, stops)
pulsatile secretions
The location of the hormone receptor depends on the ____ properties of the hormone
chemical
The chemical properties of the hormone that determine the location of the hormone receptor:
lipophilic/lipophobic
Ligand/receptor binding demonstrates:
- specificity
- affinity
- saturation
Which classes of hormones bind to plasma membrane receptors?
polypeptide/protein and amine hormones
What amine hormone does not bind to plasma membrane receptors (exception)
thyroid hormone
Which class of hormones binds to nuclear receptors?
steroids hormones + thyroid hormone
which amine hormones bind to plasma membrane receptors?
epinephrine and norepinephrine
What type of receptors would the following hormones bind to and why?
Glucagon
Angiotensin
GnRH
SS
GHRH
FSH
TSH
ACTH
Plasma membrane receptor - they are peptide and protein hormones
In general, many of the receptors that protein/peptide hormones and amine hormones bind to in the PM are:
GPCR
Involved in turning on or off a protein that is already in the cell
plasma membrane receptors
What class of hormone receptors are involved in causing a change in gene expression to get a biological response
nuclear receptors
Class of hormone receptors involved in making new proteins
nuclear receptors
Thyroid hormone and steroid hormones bind to receptors in the:
cytoplasm or nucleus
once the steroid hormone or thyroid hormone binds to the receptor located in the nucleus or cytoplasm what occurs next?
transformation of receptor to expose DNA-binding domain
Following binding of the steroid or thyroid hormone to the receptor and transformation of the receptor to expose the DNA binding domain, what next occurs?
Binding to enhancer like element in DNA
Examples of plasma membrane hormone receptors:
- g-protein coupled receptor
- tyrosine kinase
Why do plasma membrane hormone receptor numbers vary greatly in different target tissues?
this provides a way to achieve specific tissue activation
What are two examples of plasma membrane hormone receptors that are more widely distributed?
- thyroid hormone receptors
- insulin receptors
Why are thyroid hormone receptors and insulin receptors more widely distributed?
Because there actions are something that most cells participate in
How do IGF-1 and insulin work?
By activating a tyrosine kinase receptor
If it is a plasma membrane receptor, generally it will activate or inhibit _____ to _____.
an existing protein to yield a faster response
Where are nuclear hormone receptors located?
cytoplasm or nucleus
Nuclear hormone receptors typically leads to:
formation of new proteins
Nuclear hormone receptors all act to:
increase or decrease gene expression
In a nuclear hormone receptor, the hormone receptor complex binds to a _______, in the _____ region of the gene which leads to either activation or repression of _____.
hormone responsive element; promotor region; gene trasncription
Because nuclear hormone receptors binding a hormone leads to the formation of a new protein, describe the timeline involved:
It takes a little bit longer to get the response and the response will last a bit longer
Hormones that bind to nuclear receptors (thyroid hormone & steroid hormones) undergo _____ to get through the plasma membrane
simple diffusion
The body often releases multiple hormones…
at the same time
What are the effects of combined hormone actions? (4)
- antagonism
- additive
- synergistic
- permissiveness
When two hormones change one variable in opposite directions:
antagonism
When the response of a hormone is equal to the two portions that each hormone provides (2+3=5)
additive
Ramps of up the systems response when there is a present of more than one hormone- the combined response is greater than each would give individually (2+3=10)
synergistic
The presence of one hormone is necessary for another hormone’s maximum effect:
permissiveness
Determine which hormone interaction is being described:
Parathyroid increases plasma calcium levels; calcitonin decreases plasma calcium levels:
antagonistic
Determine which hormone interaction is being described:
Glucagon, cortisol and epinephrine all increase blood glucose more than the sum of their individual effects:
synergistic
Determine which hormone interaction is being described:
Thyroid hormone causes expression of B adrenergic receptors in bronchiolar smooth muscle:
permissiveness
What determines whether the negative feedback will be short loop or long loop?
The location of the hormone that acts as negative feedback in the system
When the last hormone in the pathway inhibits the system upstream:
long loops negative feedback
When an intermediate hormone in the pathway inhibits the system upstream:
short loop negative feedback
Feedback where the hormonal product or an intermediate hormone enhances the hormone secretion
positive feedback
Causes an endocrine gland to secrete a hormone:
tropic hormone
Stabilizes the system and prevents oversecretion:
negative feedback
Hormones that have other endocrine glands as their targets:
tropic hormones
A tropic hormone that from the hypothalamus that acts on the anterior pituitary to release TSH:
TRH
TRH comes from
Hypothalamus
TRH acts on the:
anterior pituitary
TSH (thyroid stimulating hormone) is released from the:
anterior pituitary
TSH is release from the anterior and acts on the:
thyroid gland
In the regulation of thyroid hormone: A stimulation causes the hypothalamus to secrete _____ which acts on ____.
thyrotropin releasing hormone (TRH); anterior pituitary
In the regulation of thyroid hormone: ______ cells in the anterior pituitary release _____.
thyrotropic cells; thyroid stimulating hormone (TSH)
In the regulation of thyroid hormone: TSH stimulates _____cells of the thyroid gland to release ______
follicular cells; thyroid hormone
Thyroid hormone produces effects in the body that include:
- increase in metabolic activity
- Increase in body temperature
In the regulation of thyroid hormone: Thyroid stimulates target cells to increase _____ activities, resulting in an increase in basal body temperature
metabolic activities
In the regulation of thyroid hormone: Increased body temperature is detected by the hypothalamus and the secretion of ____ by the hypothalamus is ____.
TRH; inhibited
In the regulation of thyroid hormone: Thyroid hormone also blocks TRH receptors on thyrotropic cell, inhibiting synthesis and release of ____. Both effects indirectly dampen ____ production in the thyroid.
TSH; TH
Thyroid hormone working to negatively feedback is an example of:
long loop negative feedback
If hormone levels are NOT kept in balance via negative feedback mechanisms, what occurs?
endocrine disorders/ pathologies
Enlargement of the thyroid due to increased of decreased thyroid hormone levels:
thyroid goiter
Disease characterized by increased cortisol levels:
Cushing’s Disease
Abnormality in the last endocrine organ secreting the hormone leading to either hypo- or hyper-secretion:
primary endocrine disorder
List the causes of primary hyposecretion:
- partial destruction of the gland
- dietary deficiency
- Enzyme deficiency required for hormone synthesis
List the causes of primary hypersecretion:
endocrine gland tumor
Abnormality in tropic hormone leading to either hypo- or hyper-secretion
secondary endocrine disorder
List the causes of secondary hypersecretion:
A lack of sufficient tropic hormone
List the causes of secondary hypersecretion:
A tumor (either in an endocrine gland that secretes tropic hormones or in a non-endocrine tissue that secretes hormones)
When you see an endocrine hormone disturbance as a result of cancer:
paraneoplastic endocrine syndrome
When you think of primary endocrine dysfunction, you should think:
LAST GLAND IN PATHWAY
Type of diagnostic endocrine function test in which you give something to make hormone levels go up to see if the hormone levels actually go up:
Type of diagnostic endocrine function test in which you give something to inhibit the hormone levels in question and look to see if that actually works:
stimulation test
supression test
Suppression test would be used to detect what type of endocrine dysfunction?
hyperfunction
List the types of diagnostic test of endocrine function: (7)
- Plasma hormone levels
- Autoantibodies
- Urine hormone/ hormone metabolite levels
- Stimulation tests by admin of topic or stimulating hormone
- Suppression when hyperfunction of endocrine organ is suspected
- Measurement of hormone receptor presence, number and affinity
- Imaging
Stimulation test work by administering a ____ hormone.
tropic or stimulating
An example of measuring hormone receptor presence as an endocrine diagnostic function test:
estrogen receptors in breast tumors
What autoantibodies might be tested when doing diagnostic tests of endocrine function?
- Hashimoto thyroiditis
- Type I DM
- Graves Disease
- Addison disease
- Autoimmune hypothyroidism
Glucagon, angiotensin, Gonadotropin releasing hormone (GnRH), Somatostatin (SS), Growth hormone releasing hormone (GHRH), follicle stimulating hormone (FSH), Lutenizing hormone (LH), Thyroid stimulating hormone (TSH), Adrenocorticoptropin hormone (ACTH) are all _____ hormones.
When are they made?
polypeptide/protein hormone
made in advance & stored
Epinephrine and Norepinephrine are both ____ hormones.
When are they made?
amine hormones
made in advance and stored
Thyroid hormone is a ____ hormone.
When is it made?
EXCEPTION:
amine hormone
made in advance and stored (does bind to nuclear receptor though)
Aldosterone, Crotisole, Estradiol and testosterone (mineralcorticoids, glucocorticoids and androgens) are all _____ hormones.
When are they made?
steroid hormones
made on demand
List things that would cause stimulation of growth hormone release
growth hormone releasing hormone, dopamine, catecholamines (in times of stress and exercise), excitatory amino acids, thyroid , fasting (hypoglycemia)
List things that would cause inhibition of growth hormone release
Somatostatin (SS), IGF-1 (due to negative feedback), Glucose (at high levels- hyperglycemia), and free fatty acids
GHRH, Dopamine, Catecholamines, Excitatory amino acids, and thyroid hormone would cause _____ of growth hormone release:
stimulation
Somatostatin, IGF-1, Glucose, and FFA would cause ____ of growth hormone release:
inhibition
portion of the pituitary that is truly filled with endocrine cells- a true endocrine gland:
Adenohypophysis
adenohypophysis is referring to what portion of the pituitary gland?
anterior pituitary
portion of the pituitary that contains axons terminals of hypothalamic neurons:
Neurohypophysis
Neurohypophysis is referring to what portion of the pituitary gland?
posterior pituitary
The pituitary gland is located in the _____ ventral to the ____.
sella turcica; diaphragma sella
List the hormones secreted by the anterior pituitary: (6)
- FSH
- LH
- Adrenocorticotropin (ACTH)
- TSH
- Prolactin
- Growth hormone
List the hormones secreted by the posterior pituitary:
- antidiuretic hormone/vasopressin (ADH)
- oxytocin
The pituitary gland secretes _____ hormones:
peptide
What are the most prevalent cells in the anterior pituitary and what do they secrete?
somatotrophs; GH
What percentage of cells do somatotrophs comprise in the anterior pituitary?
30-40%
What is the second most prevalent type of cell in the anterior pituitary and what do they secrete?
Corticotrophs; ACTH
What percentage of cells do corticotrophs comprise in the anterior pituitary?
20%
Aside from corticotrophs and somatotrophs what other types of cells make up the anterior pituitary and what do they secrete?
Thyrotrophs-TSH
Gonadotrophs- LH & FSH
Mammotrophs- prolactin
Adenomas involving somatotropic cells can cause ____ if occurring in children before closure of the long bones epiphyseal plates or _____ in adults with musculoskeletal, neurologic, and other medical consequences.
gigantism; acromegaly
Benign tumors of epithelial cells that make hormones:
Adenoma
Endocrine cells are derived from:
epithelial cells
If a benign tumor is involved in somatotropic cells, this would cause over secretion of:
growth hormone
Majority of cells in the anterior pituitary are devoted to making ____ & ____.
GH & ACTH
Neurons in the hypothalamus synthesize and secrete _______ hormones that control endocrine cells in the ____.
hypothalamic releasing and inhibiting; anterior pituitary
The hypothalamic hormones are released into the ____ in the ____ (in the hypothalamus)
primary capillary plexus; median eminence
responsible for carrying the hypothalamic hormones to the sinuses of the anterior pituitary:
hypothalamic-hypophyseal portal blood vessels
The hypothalamic-hypophyseal portal blood vessels carry the hypothalamic hormones to the ____ of the anterior pituitary
sinuses
Regulation of Anterior Pituitary Secretion
- the _____ releases hormones that enter into the blood
- the hormones travel through the _____.
- the hormones continue down through the capillary bed to the ____ where they can leave the blood and regulate the activity of endocrine cells
- hypothalamus
- primary capillary plexus
- sinus
Two capillary beds in series
portal system
The hypothalamic-hypophyseal portal vessel is comprised of:
primary capillary plexus+ sinus
The hypothalamic-hypophyseal portal vessel allows for:
communication from hypothalamus to anterior pituitary
Where do releasing hormones come from?
hypothalamus
Where do stimulating hormones come from?
anterior pituitary
The hypothalamic regulatory hormones bind to _____ in the various endocrine cells of the anterior pituitary
G-protein coupled receptors
Following the binding of the hypothalamic hormones to the g-protein coupled receptors in the anterior pituitary, what will stimulate or inhibit anterior pituitary hormone secretion?
second messengers (examples= cAMP via adenylate cyclase, IP3, and DAG vis phospholipase C)
Growth hormone inhibiting hormone (GHIH)=
somatostatin
Prolactin Inhibiting Hormone (PIH)=
Dopamine
Growth hormone is secreted by somatotrophs in the anterior pituitary. The releasing hormone (secreted by hypothalamus) would be ______ (GAS),while the inhibiting hormones would be _____ (BRAKES)
GHRH; GHIH
GH, a peptide hormone acts ____ on target tissues and as a ______ to the liver.
directly; tropic hormone
GH; a peptide hormones acts directly on target tissues and as a tropic hormone to the ____ which releases ____.
Liver; IGF-1
In what situation might growth hormone significantly increase and quickly?
prolonged starvation/fasting
Growth hormone acts tropically in the liver to activate ____, a cell signaling pathway that causes release of _____.
JAK-STAT; IGF-1
A cell signaling pathway in the liver activated by growth hormone that responds by release of IGF-1
JAK-STAT
What are some target tissues of growth hormone? (6)
- liver
- chondrocytes
- muscle cells
- adipose cells
- anterior pituitary (short loop negative feedback)
- hypothalamus (long loop negative feedback)
If GH acts on chondrocytes, what are some effects?
- increased amino acid uptake
- increased protein synthesis
GH acting on chondrocytes to increase amino acid uptake as well as protein synthesis is ultimately necessary for:
linear growth
In addition to GH acting on chondrocytes being necessary for linear growth, what is also necessary for linear growth?
IGF-1
GH can act on muscles to :
increase protein synthesis
In addition to growth hormone acting on muscles to increase protein synthesis what is also necessary for protein synthesis?
IGF-1
In excess, how does growth hormone affect adipose tissue?
anti-insulin action
What are two locations of negative feed back of the growth hormone?
- directly feeding back to anterior pituitary (short loop)
- feeding back to hypothalamus (long loop)
If negative feedback via growth hormone occurs on the hypothalamus, what hormone may be released?
Somatostatin
Describe the secretion of growth hormone:
pulsatile secretion; lower concentration during day with highest levels a few hours after sleep
When is the GH secreted at the highest levels?
a few hours after sleep
Growth hormone secretion can be stimulated by: (5)
- starvation (protein deficiency)
- fasting (hypoglycemia)
- acute stress
- exercise
- excitement
The secretion of GH during neonatal period:
The secretion of GH during childhood:
The secretion of GH during puberty:
The secretion of GH during adulthood:
- high secretion
- decreased secretion
- peak levels of secretion
- decreased secretion with age
Stimulation of GH release (5):
- GHRH
- Dopamine
- Catecholamines
- Excitatory amino acids
- Thyroid hormone
Inhibition of GH release (4):
- Somatostatin
- IGF-1 (due to negative feedback)
- High glucose levels
- FFA (High levels of free fatty acids)
Many of the growth and metabolic effects of GH are mainly produced by:
IGFs
IGFs can also be called:
somatomedins
IGF-1 is produced in most tissues and acts on neighboring cells in a _____ manner.
paracrine
The major site of IGF-1 synthesis:
liver
How many IGF binding proteins are there?
6
_____ in adults is one of the main growth promoting insulin-like growth factors
IGF-1
Osteocytes responding to mechanical sensors can release:
IGF-1
Osteocytes responding to ______ can release IGF-1
mechanical sensors
After osteocytes release IGF-1 what happens?
IGF-1 binds to receptors on osteoblasts to enhance bone formation
Mechanisms of action of GH and IGF-1:
Growth in nearly all tissues of the body, mainly IGF-1 occurs through what mechanisms?
- increased cell size
- mitosis
- differentiation of bone and muscle cells
Mechanisms of action of GH and IGF-1:
What is the overall outcome of the effects of GH and IGF-1 causing growth in nearly all tissues of the body?
- increased organ size
- increased organ function
- increased linear growth
Mechanisms of action of GH and IGF-1:
The effect of amino acid uptake protein synthesis in most cells results in:
increased lean body mass
Mechanisms of action of GH and IGF-1:
How does this effect glucose?
reduced glucose utilization
Mechanisms of action of GH and IGF-1:
Reduced glucose utilization is due to:
- decreased uptake
- increased hepatic glucose production
- increased insulin secretion
Mechanisms of action of GH and IGF-1:
The reduced glucose utilization can lead to:
insulin resistance ; diabetogenic
Mechanisms of action of GH and IGF-1:
Describe the effects on fatty acids:
mobilization of fatty acids from adipose tissue (lipolysis)
Mobilization of fatty acids from adipose tissues:
lipolysis
Mechanisms of action of GH and IGF-1:
Lipolysis results in:
increases FFA in blood and use of FFA for energy
Before fusion of the epiphyseal plates, GH and IGF-1 stimulate:
chondrogenesis and widening of the epiphyseal plates
Following GH and and IGF-1 stimulating chorndrogenesis and widening of the epiphyseal plates, what occurs?
Bone matrix deposition stimulating linear growth
In adults, GH and IGF-1 play a role in regulating the normal physiology of:
bone formation
In adult, how do GH and IGF-1 play a role in regulating the normal physiology of bone formation?
by increasing bone turnover
How do GH and IGF-1 stimulate the increase in bone turnover (there by regulating bone formation)
- activation of osteoblasts (MAINLY)
- increasing bone resorption via osteoclasts (lesser extent)
Kids: GH and IGF-1 =
Adults: GH and IGF-1=
chondrogenesis
increased bone turnover
Osteoblasts are of what origin?
mesenchymal precursers
What is responsible for the formation of active osteoblasts from the osteoblast precursor?
IGF-1
Gigantism occurs in _____; while acromegaly occurs in ____.
children; adults
Excess growth hormone in children leading to gigantism is typically caused by:
pituitary tumor (90%)
What areas are commonly involved with pituitary tumors that give rise to gigantism?
sella and cavernous sinus
Tumor causing excessive growth hormone release:
somatotropic adenoma of the pituitary
Describe the facial features associated with Gigantism/acromegaly: (4)
Coarse facial features, large fleshy nose, frontal bossing, jaw malocclusion
Coarse facial features, large fleshy nose, frontal bossing, and jaw malocclusion are collectively referred to as:
acromegalic faces
What issue with the thyroid may occur with gigantism/acromegaly
goiter
Describe the potential affects on the heart and what conditions may occur as a result due to gigantism/acromegaly:
cardiomegaly; hypertension and coronary heart disease
Describe the chest and spine in individuals affected by acromegaly/gigantism:
barrel chest and kyphosis and hyperostosis
The abnormal glucose tolerance and secondary insulin resistance in an acromegaly/gigantism individual may result in:
diabetes mellitus
Growth hormone shifts the body from utilizing ______ to _____ for metabolisms:
carbs to fats
Describe the reproductive consequences of gigantism/acromegaly:
male sexual dysfunction and menstrual disorders
Describe what can occur due to the thickened skin and hypertrophy of sebaceous and sweat glands in gigantism and acromegaly:
Hyperhidrosis and oily skin
Hyperhidrosis and oily skin in acromegaly/gigantism individuals can occur due to:
thickened skin (hypertrophy of sebaceous and sweat glands)
What can occur in the joints of individuals with gigantism/acromegaly
degenerative arthritis
Describe the neuronal effects caused by gigantism/acromegaly:
parathesias due to peripheral neuropathy
What is a potential treatment for pituitary microadenoma?
adenectomy via transphenoid approach followed by medications
Oral manifestations of GH excess: (7)
- thick rubbery skin, enlarged nose and thick lips
- macrocephaly
- macrognathia
- disproportionate mandibular growth
- anterior open bite and malocclusion
- macroglossia, dyspnea, dysphagia, dysphonia, sialorrhea,
- Hypertrophy of pharyngeal and laryngeal tissues
enlarged head =
enlarged jaw =
macrocephaly
macrognathia
The disproportionate mandibular growth caused by excess growth hormone includes:
mandibular prognathism- jaw jets forward
generalized diastemata- separation of teeth
The anterior open bite and malocclusion in caused by excess GH is due to:
combo of macrognathia and tooth migration
- Macroglossia:
- Dyspnea:
- Dysphagia:
- Dysphonia:
- Sialorrhea:
- enlarged tongue
- difficulty breathing
- difficulty swallowing
- difficulty speaking
- slobbering
The hypertrophy of the pharyngeal and laryngeal tissues in individuals with excess GH can cause_____ and how?
sleep apnea - because of the increased growth of the pharyngeal and laryngeal tissues obstructing the airway
What are the causes of growth hormone deficiency? (5)
- hypothalamic disorders
- mutations
- combined pituitary deficiencies
- radiation
- psychosocial deprivation
Combined pituitary hormone deficiencies=
panhypopituitarism
What type of mutations may lead to GH deficiency?
GHRH receptor, GH gene, GH receptor, IGF-1 receptor
A decrease in GHRH or an increase in GHIH could lead to:
growth hormone deficiency
What depends on the time of onset and severity of hormone deficiency? (talking about GH)
clinical manifestations
The clinical manifestations caused by complete growth hormone deficiency include: (4)
- slow linear growth rates (shorter stature)
- normal skeletal proportions
- pudgy, youthful appearance (decreased lipolysis)
- In setting of cortisol deficiency –> hypoglycemia
most common form of dwarfism, autosomal dominant condition, resulting from a mutation in the FGF-3 receptor in the cartilage and brain.
achondroplasia
The FGF-3 receptor mutation in achondroplasia makes the receptor overly active and it inhibits cartilage growth at growth plates so:
limb growth is reduced (growth of trunk is not is not impacted)
mutated receptor in achondroplasia:
FGF-3
Oral manifestations of GH deficiency include:
- disproportionate delayed growth of the ____ and ____ = ____ facial appearance
- ____ and ___ of the ___ regions of the jaws are abnormal and may be disproportionately smaller than adjacent anatomic structures.
- solitary ______.
- eruption of primary and secondary dentition and shedding of deciduous teeth are _____.
- skull and facial skeleton; small
- tooth formation and growth ; alveolar
- median maxillary central incisor
- delayed
How are the oral manifestations of GH deficiency managed?
correction of dental and skeletal malocclusion
Incisor defects in a child with growth hormone deficiency occurs in both:
primary and permanent dentition
In oral manifestation of GH deficiency:
The tooth formation and growth of the alveolar regions of the jaws are abnormal and may be disproprotionately smaller than adjacent anatomic structures, this can cause:
- tooth crowding and malocclusion
- plaque accumulation
- poor oral hygiene
- gingivitis and perio disease
The posterior pituitary contains ~100,000 ______ whose cell bodies are in the ____.
unmyelinated axons of neurons; hypothalamus
Areas of concentrated neuronal cell bodies in the hypothalamus that haev axons that go through the infundibulum with their synaptics terminals located in the posterior pituitary gland
paraventricular nucleus and supraoptic nucleus
The paraventricular nucleus produces:
oxytocin
The supraoptic nucleus produces:
ADH
List all the names for the abreviation ADH:
- Antidiuretic hormone
- Arginine Vasopressin (AVP)
Both ADH and Oxytocin are classified as:
neurohormones
Both ADH and Oxytocin are neurohormones made of:
polypeptides of nine amino acids
While the paraventricular nucleus secretes Oxytocin and the and the supraoptic nucleus secretes ADH, they both have the ability to:
secrete some of the other neurohormone
Describe the similarities between ADH and Oxytocin:
VERY Similar structure
What are the 2 primary functions of ADH:
- vasocronstriction (smooth muscle and blood vessels)
- antidiuretic (holds on to water)
ADH/AVP mechanism of action:
- Contaction of vascular smooth muscle via _____
V1 receptors
When ADH causes contraction of vascular smooth muscle through V1 receptors, what results:
increase in BP
V1 stands for:
Vasopressin 1 receptor
When ADH acts on V1 receptors, what occurs?
Contraction of vascular smooth muscle (blood vessels) (leading to increase in BP)
ADH/AVP mechanism of action:
ADH functions in the renal tubules via:
V2 receptors
Where are the V2 receptors (for ADH) located?
Late distal tubule and collecting duct
What results when ADH binds to V2 in the late distal tubule and collecting duct?
AQP2 proteins are inserted into the apical membrane of tubular epithelial cells
Where is APQ2 inserted following ADH binding to V2 receptors?
the apical membrane of tubular epithelial cells
Following ADH binding to V2 receptors in the renal tubule, and AQP2 being inserted into the apical membrane of tubular epithelial cells, what results?
This allows for water resabsorption (in accordance with AQP3 and AQP4) on the basolateral membrane)
For whater reabsorption to occur, through AQP2, what also has to be present?
AQP3 and AQP4 in the basolateral membrane
The V2 receptors in the late distal tubule and collecting duct and _____ receptors
GPCR
Although water can go through the apical membrane via simple diffusion, the aquaporins allow for:
water channels so a lot more reabsorption can occur
______ allows for water to enter the apical membrane, and _______ are always on the basolateral membrane and allow for the continuation of the water.
Aquaporin 2; Aquaporin 3&4
Stimuli for ADH secretion:
- Decreased blood volume
- Increased osmolarity
- Decreased BP
In regard to ADH secretion, decreased blood volume is considered:
Isotonic
In regard to ADH secretion, increased osmolarity is considered:
Isovolemic
