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NE3 > hypothalamic and pituitary part 1 > Flashcards

hypothalamic and pituitary part 1 Flashcards

1
Q

what is the pituitary gland composed of?

A

anterior pituitary

posterior pituitary

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2
Q

what is the neural portion of the pituitary?

A

neurohypophysis (posterior)

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3
Q

what is the epithelial portion of the pituitary?

A

adenohypophysis (Anterior)

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4
Q

what connects hypothalamus and pituitary gland?

A

hypophyseal stalk

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5
Q

where do tumors of the pituitary put their pressure, what symptoms do these cause?

A

on optic nerves

visual issues, dizziness

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6
Q

where is posterior pituitary derived from?

A

neural tissue

cell bodies of axons and nerves whose cell bodies
are in hypothalamus

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7
Q

what are the nuclei of posterior pituitary? what do they secrete?

A

Supraoptic nucleus (ADH)

paraventricular nucleus (Oxytocin)

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8
Q

what are the connections between the hypothalamus and anterior pituitary?

A

neural and hormonal

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9
Q

what is the anterior pituitary derived of?

A

endocrine cells from primitive foregut

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10
Q

what does anterior pituitary secrete?

A 
ACTH
TSH
LH
FSH
GH
Prolactin
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11
Q

How is anterior pituitary connected to hypothalmus?

A

Hypothalamic-hypophysial portal blood vessels

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12
Q

How does the hypothalamic-hypophysial portal system work? what occur?

A

releasing or release inhibiting hormones delivered directly

from hypothalamus to anterior pituitary in high

concentrations

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13
Q

do hormones from hypothalamic-hypophysial portal system appear in systemic circulation?

A

not in high concentrations

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14
Q

what are the hormone families of the anterior pituitary?

A

ACTH Fam

TSH, FSH, LH Fam

GH, Prolactin fam

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15
Q

what secretes ACTH

A

Corticotrophs

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16
Q

what secretes TSH

A

thyotrophs

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17
Q

what secretes FSH and LH

A

gonadotrophs

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18
Q

what secretes GH

A

somatotrophs

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19
Q

what secretes Prolactin

A

lactotrophs

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20
Q

describe how TSH is secreted?

what are the steps from the hypothalamus to anterior pituitary?

A

TRH from hypothalamus

target thyrotrophs in anterior pituitary

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21
Q

describe how ACTH is secreted?

what are the steps from the hypothalamus to anterior pituitary?

A

CRF from hypothalamus

target corticotrophs in anterior pituitary

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22
Q

describe how LH, FSH is secreted?

what are the steps from the hypothalamus to anterior pituitary?

A

GnRH from hypothalamus

target gonadotrophs in anterior pituitary

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23
Q

describe how Prolactin is secreted?

what are the steps from the hypothalamus to anterior pituitary?

A

Increase in TRH and decrease in PIF from hypothalamus

target lactotrophs in anterior pituitary

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24
Q

How are endocrine axes maintained?

A

around a set point via negative feedback inhibition

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25
Q

what is one of the most common ways that hypothalamic hormones are secretes?

A

in a pulsatile manner through circadian rhythms

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26
Q

what is a primary endocrine disorder?

A

defect in peripheral endocrine gland causes hormone imbalance

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27
Q

what is a secondary endocrine disorder?

A

defect in pituitary gland causes hormone imbalance

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28
Q

what is a tertiary endocrine disorder?

A

defect in hypothalamus causes hormone imbalance

29
Q

name the major anterior pituitary gland axes

A

hypothalamus- pituitary- gonad

hypothalamus- pituitary- liver

hypothalamus- pituitary- prolactin

hypothalamus- pituitary- thyroid

hypothalamus- pituitary- adrenal

30
Q

where are FSH and LH released from?

how are they regulated

A

from anterior pituitary gonadotropes

they are regulated by hypothalamic GnRH (pulsatile release)

31
Q

why is FSH and LH important?

A

estrogen and progesterone in females
(normal menstrual cycle depends on it especially!)

testosterone in males

32
Q

what can inhibit GnRh production?

A

extreme energy deficits, extreme exercise, depression

33
Q

What is acromegaly caused by? symptoms?

A

excessive secretion of growth hormone in adulthood

too much growth of soft tissue, cartilage, bone in face hands and feet

shows gradually

34
Q

What is growth hormone produced by and what does it target?

what inhibits it?

A

somatotropes in anterior pituitary

targets liver and bone

Somatostatin and IGF1 as part of negative feedback

35
Q

what type of signalling is GH receptor linked to?

A

JAK-STAT signalling

36
Q

what stimulated GH?

A

FASTING/HUNGER/STARVATION
HYPOGLYCEMIA

GHRELIN CAN STIMULATE IT!

puberty
exercise
sleep
stress

37
Q

what are the three direct actions of GH?

A
  1. Growth
    - hypertrophy
  2. cell reproduction
    - hyperplasia
  3. metabolism
    - increase protein synthesis
    - increase glycogen and fat breakdown
38
Q

what are the indirect actions of GH and how is it relevant?

A

most growth is indirect

tells liver cells to make IGF1, targetting almost every cell in body

stimulates hypertrophy and hyperplasia

39
Q

What two cells are produced by the hypothalamus that affect anterior pituitary GH?

how do they do it?

A

GhRh stimulates GH production in anterior pituitary

GHIH(somatostatin) inhibits GH

40
Q

greater production of GH has what feedback effect?

A

decreases GHRH from hypothalamus

increases IGF1 from liver

41
Q

greater production of IGF1 from liver has what feedback effect?

A

decreases GH

increases GHIH

42
Q

what two hormones affect GH production? from where and how

A

ghrelin from stomach
GHRH from hypothalamus

two different receptors

43
Q

what is a secondary deficiency in production of GH?

A

not enough GH from anterior pituitary

44
Q

what is a tertiary deficiency in production of GH?

A

not enough ghrelin and GHRH

45
Q

what can be used to treat defective release of GHRH?

A

semorelin

46
Q

what can be used as replacement of GHRH?

A

somatropin

somatrem

47
Q

what can be used due to failure of IGF1 release from GH, GH deficiency or patients with GH antibody?

A

mecasermin

48
Q

what causes gigantism?

A

in youth, before closure of bone epiphyses due to IGF1 stimulation!!

49
Q

what factors cause liver to produce IGF1?

what will this cause the liver to do?

what is this called?

A

increased carb uptake which allows for insulin availability
increased protein uptake, amino acids are available

causes mitogenesis, lypolysis, differentiation

FAVORABLE GROWTH PROMOTING FACTORS

50
Q

describe unfavorable conditions that will stop GH and the liver will not make IGF1

what will happen?

A

enough carbs to have insulin
not enough protein to have amino acids

lipogenesis and carb storage will occur

WEIGHT GAIN!

51
Q

what will cause a fasted state?
what will happen to GH levels and IGF1?

what will this cause?

A

decreased carbs and little insulin
increased protein for amino acids

gh levels will go up, so will IGF1

lipolysis, ketogenic metabolism and diabetogenic

52
Q

how is GH related to insulin insensitivity?

A

raises blood glucose by decreasing peropheral glucose intake,
stimulate hepatic gluconeogenesis

53
Q

what is a sensitive test for acromegaly

A

patient has :

high GH and IGF1

doesnt suppress GH production in response to oral glucose

ALSO PITUITARY ENLARGEMENT ON MRI!

54
Q

what are the main metabolic functions of GH?

A

diabetogenic effect

increased protein synthesis and growth factor

increased linear growth

55
Q

how does GH cause a diabetogenic effect?

A

decreases glucose uptake by target tissues

increase lipolysi in fat

incraes blood insulin levels

56
Q

how does GH cause an increase in protein synthesis?

what is the main mediator

A

increases uptake of amino acids

stimulates DNA, RNA and protein

is mediated by IGF1

57
Q

how does GH cause an increase in linear growth?

what is the main mediator

A

stimulates DNA, RNA and protein synthesis

increase in metabolism in cartilage forming cells and chondrocytes

mediated by IGF1

58
Q

when is GH level highest during the day?

during life?

A

sleep, exercise

puberty, lowest during adulthood

59
Q

what can disturb GH secretion?

A

sleep disturbances, fluctuates throughout day

60
Q

what causes GH deficiency, why is it bad?

A

decreases GHRH causes it (hypothalamus issue)

can’t make IGF1 (somatomedins)

61
Q

What causes GH excess? why is it bad?

A

pituitary adenoma

Gigantism and acromegaly!

62
Q

what does prolactin do?

A

primarily makes lactation happen

also suppresses GnRH, stopping LH and FSH
decreases sexual drive and reproduction

63
Q

what makes prolactin and when

what stops it?

A

lactotropes, 5th week of pregnancy, pulsatile

inhibited by hypothalamic dopamine, feedback by prolactin causes dopamine to be made

64
Q

what stimulates prolactin secretion?

A 
pregnancy
breast feeding
sleep
stress
TRH
65
Q

what inhibits prolactin secretion?

A

dopamine/ agonists
somatostatin
prolactin itself

66
Q

what are pituitary adenomas, what do they cause?

A

adenomas release active hormone into blood excessively

usually prolactinoma!

67
Q

what causes hypopituitarism?

A

brain damage such as a stroke or injury

tumors

non pituitary tumors such as craniopharyngioma (most common tumor affecting HP axis in kids)

infections

infarction such as sheehan syndrome

autoimmune

pituitary hypoplasia

genetic disorders

68
Q

describe steps in oxytosin secretion?

A

preprooxyphysin

to prooxyphysin in hypothalamus

to hypothalamic-hypophyseal tract( neurophysins cleaved)

to posterior lobe of pituitary as oxytocin

to breast

69
Q

what does oxytocin do?

A

milk letdown

  • contraction of cells lining milk ducts
  • caused by sucking, sight of infant

uterine contraction

  • caused by dilation of cervix
  • causes uterine contractions
  • induces labor

NE3 (15 decks)

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