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Neuro Endo 3 > Hypothalamic-Pituitary Relationship and Biofeedback Pt. 1 > Flashcards

Hypothalamic-Pituitary Relationship and Biofeedback Pt. 1 Flashcards

1
Q

What area do tumors in the pituitary gland expand and impinge on?

A

Optic nerve

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2
Q

What are the 2 hypothalamic nuclei send axons to posterior pituitary?

A

Supraoptic nucleus

Paraventricular Nucleus

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3
Q

What neuropeptides do the hypothalamic nuclei secrete to the posterior pituitary?

A

ADH (SON)

Oxytocin (PVN)

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4
Q

What is the difference in communications between hypothalamus to the anterior pituitary and posterior pituitary?

A

Posterior pituitary communication = Neural

Anterior pituitary communication = Neural and Hormonal

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5
Q

What hormones does the anterior pituitary secrete?

A

FLAT PeG

FSH, LH, ACTH, TSH, Prolactin, GH

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6
Q

How is the anterior pituitary connected to the hypothalamus?

A
  • hypothalamic-hypophysial portal blood vessels

- allows direct delivery to anterior pituitary in high concentrations

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7
Q

List the hypothalamic-anterior pituitary hormones, their target, and the hormone secreted

A 
TRH- thyrotrophs- TSH
CRF- corticotrophs- ACTH
GnRH- gonadotrophs- LH, FSH
Somatosatin (-)- somatotrophs- GH
PIF(-)- lactotrophs- PRL
TRH- lactotrophs- PRL
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8
Q

Primary endocrine disorder

A

low/high levels of hormone due to defect in peripheral endocrine gland

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9
Q

Secondary endocrine disorder

A

low/high levels of hormone due to defect in pituitary gland

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10
Q

Tertiary endocrine disorder

A

low/high levels of hormone due to defect in hypothalamus

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11
Q

HPG axis in males

A

1) Hypothalamus releases GnRH into pituitary
2) Pituitary releases LH in Leydig cells and FSH in Sertoli cell
3) Leydig cell produces testosterone and Sertoli cell produces androgen binding protein and sperm

Feedback inhibition from Sertoli cell to pituitary and from testosterone to pituitary and hypothalamus

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12
Q

HPG axis in females

A

1) Hypothalamus releases GnRH into pituitary
2) Pituitary releases LH in Theca cell and FSH in granulosa cell
3) Theca cell secretes androgens and granulosa cell secretes estrogens

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13
Q

Function of LH and FSH

A
  • promotes estrogen and progesterone secretion in females

- promotes testosterone production in males

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14
Q

How are FSH and LH regulated?

A

Hypothalamic GnRH pulsatile release; secreted by gonadotrophs

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15
Q

Acromegaly

A
  • excessive growth of soft tissue, cartilage, and bone in the face, hands, and feet
  • gradual development
  • prolonged/excess secretion of GH in adult life
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16
Q

What type of cell produces GH?

A

Somatotropes

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17
Q

What organs does GH target?

A

liver- signal transduction

bone- growth

18
Q

What inhibits GH?

A

somatostatin, IGF-1

19
Q

What causes stimulation of GH?

A
  • fasting/hunger/starvation
  • hypoglycemia
  • hormones of puberty
  • exercise
  • sleep
  • stress
20
Q

Direct actions of GH

A

1) Hypertrophy- increase in size/volume of cells
2) Hyperplasia- increase in number of cells or proliferation rate via mitosis
3) Increase glycogen and fat breakdown for energy; increase protein synthesis

21
Q

Indirect actions of GH

A
  • signals liver to produce insulin like growth factors (IGF)
  • targets almost every cell in body
  • stimulates hypertrophy and hyperplasia
22
Q

Treatment for defective release of GHRH

A

Semorelin

tertiary deficiency

23
Q

Treatment for GH replacement

A

Somatotropin
Somatrem
(secondary deficiency)

24
Q

Treatment for failure of IGF-1 release via GH, GH deficiency, and patients with GH antibodies

A

Mecasermin

primary deficiency

25
Q

What does excess of growth hormone before closure of bone epiphysis cause?

A

Gigantism- due to IGF-1 stimulated long bone growth

26
Q

What does excess GH after closure of bone epiphysis closure cause?

A

Acromegaly- due to promotion of growth of deep organs and cartilaginous tissue

27
Q

What occurs in growth promoting conditions?

A

1) increased CHO and Pro intake
2) liver produces IGF-1
3) mitogenesis, lypolysis, differentiation

28
Q

What occurs during unfavorable growth conditions?

A

1) increased CHO intake; decreased Pro intake
2) GH inhibited, liver will not produce IGF-1
3) lipogenesis, CHO storage, weight gain

29
Q

How do growth factors shift in the fasted state?

A

1) decreased CHO intake; increased Pro intake
2) GH levels increase, liver will produce IGF-1
3) lipolysis, ketogenic metabolism, diabetogenic

GH promotes lipolysis, but can also promote insulin insensitivity

GH raises blood glucose by decreasing glucose uptake and stimulating hepatic gluconeogenesis

30
Q

Diagnosis for acromegaly

A

1) elevated serum GH and IGF-1 levels

2) failure to suppress GH production in response to oral load of glucose

31
Q

When are GH levels highest?

A

Sleep and exercise

32
Q

During what life stage is GH secretion highest?

A

Puberty, followed by childhood

33
Q

Results of GH deficiency

A
  • decreased secretion of GHRH, decreased growth hormone secretion
  • failure to generate somatomedins
  • GH or somatomedin resistance
34
Q

Results of GH excess

A
  • usually due to GH secreting pituitary adenoma

- consequences depend on developmental stage (before puberty = gigantism; after puberty = acromegaly)

35
Q

What is prolactin synthesized by?

A

lactotropes

36
Q

When does prolactin secretion begin?

A

5th week of pregnancy

pulsatile

37
Q

Actions of prolactin

A
  • stimulate and maintain lactation

- suppress GnRH (inhibit LH and FSH) in order to decrease reproductive function and suppress sexual drive

38
Q

How does PRL feedback work?

A

Prolactin released from the anterior pituitary to the breast inhibits more release by the anterior pituitary via acting on dopamine; also inhibits GnRH release

39
Q

What are the major stimulating factors affecting PRL secretion?

A
  • pregnancy
  • breast feeding
  • sleep
  • stress
  • TRH
40
Q

What are the major inhibitory factors affecting PRL release?

A
  • dopamine
  • dopamine agonists
  • somatostatin
  • prolactin via negative feedback
41
Q

Causes of hypopituitarism

A

1) brain damage
2) pituitary tumors
3) non-pituitary tumors
4) infections
5) infarction
6) autoimmune disorders
7) pituitary hypoplasia or aplasia
8) genetic disorders

42
Q

What are the actions of oxytocin released from the posterior pituitary?

A

1) milk ejection

2) uterine contraction

Neuro Endo 3 (13 decks)

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