Hypothalamic-Pituitary Axes Flashcards
Where do the hormones released from the pituitary gland act (generally)?
- Target organs
- Peripheral hormones
What hormones are released from the anterior pituitary gland?
- ACTH
- TSH
- LH
- FSH
- GH
- Prolactin (PRL)
What hormones are released from the posterior pituitary gland?
- ADH
- Oxytocin
The hormone released from the hypothalamus which acts on the pituitary gland is known as what?
Neurohormone
The hormone which is released from the pituitary gland which acts on the peripheral gland is known as what?
Trophic hormone
Which hormones released from the pituitary gland are active hormones?
GH and prolactin
Which hormones released from the pituitary gland stimulate the release of another hormone?
TSH
ACTH
LH
FSH
Which is the only hormone released from the pituitary gland to not have a direct stimulating hormone released from the hypothalamus?
Prolactin
What three things are measured to evaluate thyroid function?
fT3, fT4 and TSH
When may TSH not be a good marker of thyroid function?
Pituitary tumours or other causes of secondary thyroid problems
The hypothalamus releases what stimulating hormone in the thyroid axis?
Thyrotropin releasing hormone (TRH)
The anterior pituitary releases what hormone in the thyroid axis? What does this stimulate the release of?
TSH- releases thyroid hormones from the thyroid gland
What are the long and short negative feedback loops in the thyroid axis?
TSH from anterior pituitary inhibits further TRH from the hypothalamus
Thyroid hormones inhibit release of TRH from the hypothalamus and TSH from the anterior pituitary
What hormone does the hypothalamus produce in the adrenal axis?
Corticotrophin releasing hormone (CRH)
What hormone does the anterior pituitary produce in the adrenal axis? Where does this act?
ACTH- acts on the adrenal cortex to produce cortisol
How is cortisol secreted?
In a diurnal rhythm
What is cortisol deficiency?
Adrenal insufficiency
What is primary adrenal insufficiency?
Addison’s Disease
Where is the problem in primary adrenal insufficiency?
Adrenal glands
What is secondary adrenal insufficiency?
Pituitary disease
What is cortisol excess?
Cushing’s Syndrome
ACTH is high in a patient with Cushing’s syndrome. Give two possible causes?
- Pituitary origin
- Ectopic ACTH
ACTH is low in a patient with Cushing’s syndrome. Give the cause?
Adrenal origin
What is the difference between Cushing’s disease and Cushing’s syndrome?
Cushing’s Disease- the problem is from the pituitary gland
Cushing’s syndrome- the problem comes from anywhere else
When is a stimulation test used in adrenal disorders? What is the stimulation test?
Synacthen Test- used when there is suspected adrenal insufficiency
When is a suppression test used in adrenal disorders? What is the suppression test?
Dexamethasone suppression test- used when there is suspected excess cortisol (Cushing’s)
What is secreted from the hypothalamus to increase the production of growth hormone from the anterior pituitary?
Growth hormone releasing hormone
What is secreted from the hypothalamus to decrease the production of growth hormone from the anterior pituitary?
Somatostatin
What hormone released from the stomach increases the production of GHRH from the hypothalamus and GH from the pituitary?
Ghrelin
What hormone released from adipose tissue increases the production of GHRH from the hypothalamus and GH from the pituitary?
Leptin
Growth hormone once it has been released acts mainly where to produce what?
Mainly at the liver to produce IGF-1
As well as the liver, where else can growth hormone act directly?
Adipose tissue and other target tissues
Where does IGF-1 act?
Target tissues
Free fatty acids have what effect on the stimulation of GHRH and GH?
Inhibit production
What non-hormonal factors can also stimulate the hypothalamus to produce more GHRH?
Sleep Exercise Stress Amino acids Sex hormones
Can GH be measured randomly?
No
What is usually measured instead of growth hormone?
IGF-1
If GH is consistently high, what does this indicate?
GH secreting pituitary tumour
If IGF-1 is normal, what does this indicate?
Good control of the GH axis
If IGF-1 is high, what can this be indicative of?
Acromegaly
What is the result if there is excess secretion of growth hormone in childhood? Why is this?
Pituitary gigantism because the growth plates have not yet closed
What are the two functions of the gonadal axis?
- Regulate steroid hormone synthesis
- Regulate gamut maturation and production
What sex hormone displays diurnal variation?
Testosterone
When is the only time testosterone should be measured?
Between 8 and 10am
What does the evaluation of female sex hormones depend on?
Timing in the menstrual cycle
What hormone is released from the hypothalamus in the gonadal axis?
Gonadotrophin releasing hormone (GnRH)
What two hormones does the anterior pituitary produce in the gonadal axis?
LH and FSH
Prolactin is secreted by what cells of the anterior pituitary?
Lactotroph cells
What is released from the hypothalamus in the prolactin axis? What effect does this have on prolactin secretion?
Dopamine- inhibits release of prolactin
If dopamine wasn’t present, what would happen to secretion of prolactin?
It would be continually secreted
Where is the target tissue of prolactin?
The breasts
What can too much prolactin result in?
Hypogonadism
What receptors regulate thirst and water balance? Where are these found?
Osmoreceptors in the brain
What are 4 factors which act on the hypothalamus to signal there is too much water and more needs to be reabsorbed (i.e. more ADH needs to be produced)?
- Hyperosmolality
- Angiotensin II
- Sympathetic stimulation
- Decreased atrial receptor firing
What effect does the release of ADH have on the blood vessels?
Constriction
What does vasoconstriction result in?
Increased systemic vascular resistance
What effect does the release of ADH have on the kidneys?
Fluid reabsorption to increase blood volume
What is the overall action of ADH?
Increased arterial pressure