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Block 3 Week 5 > Physio Cobine- The pituitary and hypothalamus > Flashcards

Physio Cobine- The pituitary and hypothalamus Flashcards

1
Q

Where is the hypothalamus located?

A

located inferior to the thalamus (i.e hypo-thalamus)

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2
Q

How big is the pituitary and where is it located?

A

it is 1 cm and located in the sella turcica (side of head behind eyes kind of

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3
Q

How is the hypothalamus connected to the pituitary?

A

pituitary stalk (aka the infundibulum or hypophysial stalk)

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4
Q

What plays a role in connecting the nervous system to the endocrine system and regulates the pituitary gland?

A

the hypothalamus

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5
Q

What does gonadotropin releasing hormone (GnRH) stimulate?

A

FSH and LH

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6
Q

What does growth hormone releasing hormone stimulate?

A

growth hormone

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7
Q

What inhibits growth hormone?

A

somatostatin

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8
Q

What does thyrotropin releasing hormone (TRH) do?

A

TSH (thyroid stimulating hormone)

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9
Q

What does dopamine (DA) do?

A

inhibits prolactin

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10
Q

What does CRH (corticotropin releasing hormone) do?

A

releases ACTH (adrenocortropic hormone)

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11
Q

What all does the hypothalamus secrete?

A

DA, GnRH, GHRH, CRH, TRH, SS,

Danielle Great Grandfather Captained The SS

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12
Q

The pituitary gland is comprised of what 2 lobes.

A

the anterior lobe AKA adenohypophysis

the posterior lobe AKA nerohypophysis

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13
Q

What separates the two lobes of the pituitary gland and what blood vessels flow through this?

A

the Pars Intermedia

None, it is avascular

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14
Q

In the adenohypophysis (anterior lobe) of the pituitary gland, what do we find?

A

hormone-producing adenoid (glandular cells)

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15
Q

In the neurohypophysis (posterior lobe) of the pituitary gland, what do we find?

A

axon terminal of neurosecretory cells originating in the hypothalamus

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16
Q

Explain the embryonic development of the pituitary gland

A

Anterior lobe comes from pharyngeal epithelium (rathke’s pouch)
Posterior lobe comes from neural tissue outgrowth from hypothalamus

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17
Q

What does the posterior pituitary gland function in?

A

ADH and oxytocin release

made in hypo, secreted by posterior pituit.

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18
Q

What does the anterior pituitary gland function in?

A 
prolactin
LH
FSH
AdrenoCorticotropin
growth Hormone
TSH
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19
Q

Secretion of the anterior pituitary is contolled by hormones secreted by neurons within the (blank)

A

hypothalamus

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20
Q

Secretion from the posterior pituitary is from (blank) which originate in the hypothalamus and terminate in the posterior lobe.

A

magnocellular neurons

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21
Q

What artery supplies the anterior lobe?

What artery supplies the posterior lobe?

A

superior hypophyseal artery

inferior hypophyseal artery

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22
Q

Which lobe of the pituitary is darker purple

Why?

A

the anterior lobe

There are a bunch of basophil cells that make it look dark

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23
Q

What are the acidophil cells of the anterior pituitary?

A

Somatotropes -> makes GH

Lactotropes-> makes prolactin

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24
Q

what do somatotropes of the anterior pituitary gland make?

A

growth horomone (GH)

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25
Q

What do lactotropes of the anterior pituitary gland make?

A

prolactin (PRL)

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26
Q

What are the basophilic cells of the anterior pituitary gland?

A

Corticotropes
thyrotropes
gonadotropes

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27
Q

What do corticotropes secrete?

A

adrenocorticotropic hormone (ACTH)

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28
Q

What do thyrotropes secrete?

A

Thyroid-stimulating homrone (TSH)

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29
Q

What do gonadotropes secrete?

A

FSH and LH

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30
Q

What are the three hormone types?

A

peptide and protein hormones
tyrosine-derived hormones
steroid hormones

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31
Q

What are these:

e.g. ACTH, ADH, oxytocin, etc.

A

peptide and protein hormones

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32
Q

What are these:

thyroid hormones and catecholamine hormones

A

tyrosine-derived hormones

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33
Q

What are these:

Glucocorticoids, mineralocorticoids, sex hormones.

A

Steroid hormones

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34
Q

What are the majority of hormones and how are these synthesized?

A

peptide and protein hormones

synthesized as preprohormones

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35
Q

What do peptide and protein hormones need and what is their half-life?

A

need post-translational processing

4-170 minutes

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36
Q

Explain protein hormone synthesis

A

mRNA -> preprohormone-> signal sequence directs preprohormone into ER-> enzymes snip off signal sequence-> prohormone (inactive)->golgi->secretory vesicles w/ prohormone and enzymes-> active peptides-> exocytosis-> hormones in circulation

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37
Q

(blank) of amino acids alters the function and structure of proteins. This occurs in the ER, Golgi and secretory vesicles.

A

Post-translational modification

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38
Q

What are these:
cleavage
attachment of biochem groups (acetate, phosphates)
changing chemical nature of AA (citrullination)
Change structure (disulfide bridges)
Folding

A

post-translational processing

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39
Q 
Cells and hormones of anterior pituitary glands:
Somatotropes-GH
lactotropes-Prolactin
corticotropes-ACTH
thyrotropes-TSH
gonadotropes-FSH and LH
These are all (blank) hormones.
A

peptide and protein hormones

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40
Q

What are the three anterior pituitary hormone families?

A

1) glycoprotein family
2) growth hormone/prolactin family
3) Pro-opiomelanocortin

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41
Q

What does pro-opiomelanocortin effect?

A

adipose tissue, and the adrenal gland

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42
Q 
What are these:
TSH
LH
FSH
HCG
Alpha-fetoprotein
Erythropoietin (EPO)
A

hormones that are glycoproteins

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43
Q

(blank) are proteins that are comprised of alpha and beta subunits and a carb chain.

A

glycoproteins

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44
Q

The alpha unit of a glycoprotein is (blank) while the beta subunit is (blank)

A

common

unique

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45
Q

How is the carbohydrate attached to the protein in glycoproteins?

A

glycosylation

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46
Q

What does glycosylation determine?

A

the hormone half-life

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47
Q

What does TSH do?

A

it makes the thyroid gland to increase synthesis and secretion of thyroid hormones

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48
Q

What does FSH do?

A

in the ovary it increases folliculogenesis and estrogen synthesis
in the testis it increases sperm maturation

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49
Q

What does LH do in the ovary follicle?

What does LH do in the ovary corpus luteum?

A

in the ovary, it increases ovulation and formation of corpus luteum
in the ovary corpus luteum, there is increased estrogen and progesterone synthesis

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50
Q

What does LH do in the Testis?

A

increases testosterone synthesis

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51
Q

Growth hormone and prolactin belong to the same (blank)

A

gene family

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52
Q

What kind of hormones are growth hormone and prolactin?

A

polypeptide hormones

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53
Q

How big are growth hormones?

A

190 AA

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54
Q

How many types of prolactin are there, how big is prolactin, how do you change the size of your prolactin?

A

3
190 AAs
remove disulfide bonds

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55
Q 
What increases ;
growth
IGF-i production
protein synthesis
glucose utilization
fat utilization?
A

growth hormones, works on most tissues

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56
Q

What increases milk secretion, growth of mammary glands, and decreases GnRH?
Where does this work?

A

prolactin

Mammary glands and hypothalamus

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57
Q

(blank) is the organized addition of new tissue that occurs normally in development.

A

growth

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58
Q

(blank) involves genetic, nutritional and environmental factors as well as actions of the endocrine system.

A

Growth

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59
Q

Why is growth hormone different from other anterior pituitary hormones?

A

It exerts its effects directly on almost all tissues of the body (not a specific gland)

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60
Q

Explain skeletal growth

A

proliferation of epiphyseal cartilage
increased conversion of cartilage to new bone
increased bone thickening
increased bone remodeling

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61
Q

When does increased conversion of cartilage to new bone (i.e increased length of long bone and skeleton) end?

A

ends when epiphyses of long bone fuse with shafts

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62
Q

What is the proliferation of periosteal osteoblasts?

A

increased bone thickening

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63
Q

What does GH do to metabolism?

A 
Increased protein synthesis
decreased protein breakdown (BUN)
Increased fat utilization
decreased glucose uptake and utilization
increase glucose production by liver
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64
Q

What does GH do to body organs?

A

increases size and number of cells and causes specific differentiation of certain cell types

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65
Q

Some growth effects of GH are mediated by (blank)

A

IGFs (insulin-like growth factors)

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66
Q

What are somatomedins?

A

insulin-like growth factors

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67
Q

Where is somatomedins created?

A

in liver and at local site of action (i.e bone and tissues)

68
Q

What do somatomedins do to chondrocytes and osteoclasts?

A

stimulate both of these thus increase bone elongation

69
Q

What is the most important IGF?

A

Somatomedin C (IGF-I)

70
Q

If you dont have IGF-I (somatmedin C) what will happen?

A

you will be a dwarf or pygmie

71
Q

Is there a negative feedback mechanism for growth hormone secretion?

A

yes

72
Q

When is GH secretion stimulated?

A 
GHRH
Ghrelin
Decreased blood glucose
Decreased blood fatty acids
exercise
excitement
trauma
estrogen and androgens
sleep
73
Q

When is GH secretion inhibited?

A 
somatostatin
obesity
increased blood glucose
increased blood fatty acids
aging
somatomedins (IGF)
Growth hormone (-ve feedback)
74
Q

What causes panhypopituitarism in the adult?

A

pituitary tumors, thrombosis of pituitary blood vessels, trauma

75
Q

What are the effects of panhypopituitarism in adults?

A 
lethargy (hypothyroidism), 
weight gain (lack of adrenocortical and thryoid hormones)
loss of sexual function (decreased gonadotropic hormones)
76
Q

What is the treatment for panhypopituitarism?

A

thryoxine, cortisol

77
Q

What is the cause of dwarfism?

A

congenital defect
pituitary tumor
trauma causing panhypopituitarism (decreased secretion of all anterior pituitary hormones)
isolated GH or IGF-I deficiency

78
Q

What is the effect of dwarfism?

A

slow and reduced growth (around 4 ft)
juvenile appearance
if due to panhypo…. then hypothyroidism, hypogonadis, and low glucocorticoids

79
Q

What is the treatment for dwarfism?

A

human GH, thyroxine, cortisol

80
Q

What does GH hypersecretion in ADOLESCENSE result in?

A

gigantism

81
Q

What is the cause of gigantism?

A

hyperactivity of otherwise normal cells

or pituitary tumor happening during adolescence

82
Q

What is the effect of gigantism?

A

Rapid growth of all tissues

hyperglycemia (sometimes get diabetes)

83
Q

What is the treatment of gigantism?

A

somatostatin analogs, surgery

84
Q

In general, excessive growth hormone can cause (blank) and (blank) due to metabolic disturbances.

A

ketosis

insulin resistance

85
Q

What is acromegaly?

A

GH hypersecretion in the adult

86
Q

What is the cause of acromegaly?

A

Pituitary tumor after adolescence

87
Q

What are these the effects of:
bones grow in thickness (not length),
enlargement of nose, cranium, supraorbital ridges, mandible, vertebrae (kyphosis), enlargement of hands and feet, elongation of ribs, enlarged tongue, liver, kidneys, heart, diabetes.

A

acromegaly

88
Q

What is the treatment of acromegaly?

A

somatostatin analogs, surgery

89
Q

Do humans have an intermediate lobe?

A

no

90
Q

What does the pro-opiomelanocortin family do?

A

it gets cleaved by POMC endopeptidases

91
Q

What will cleavage of the pro-opiomelanocortin family create?

A

B-lipotropin
ACTH
y-lipotropin

92
Q

Where does ACTH come from and what does it do?

A

it comes from cleavage of POMC and targets the adrenal cortex to increase synthesis and secretion of adrenal cortical steroids

93
Q

Where does B-lipotropin come from and what does it do?

A

comes from the cleavage of POMC and targets fat to increase fat mobilization (little activity in humans)

94
Q

What can ACTH and B-LPH be further cleaved into?

A

beta endorphins and alpha melaocyte stimulating hormones

95
Q

When ACTH levels are increased, (blank) can be produced and may lead to hyperpigmentation of the skin via its effect on melanocytes.

A

alpha-MSH

96
Q

(blank) plays a role in appetite regulation and sexual behavior

A

Alpha-MSH

97
Q

What is prolactin inhibitory hormone also called?

A

dopamine agonist

98
Q

(blank) is a peptide synthesized from a 92 AA preprohormone

A

GnRH

99
Q

(blank) is a 44 AA peptide.

A

GHRH

100
Q

(blank) are preprohormone cleaved into 2 active formes (one 14 AA , one 28 AA)

A

SS

101
Q

(blank) is synthesized as a 242 AA peptide with 6 copies of the hormone sequence cleavage.

A

TRH

102
Q

(blank) is an amine formed by removing a carboxyl group for a molecule of L-DOPA

A

DA

103
Q

(blank) is a 41 AA peptide derived from a 196 AA preprohormone

A

CRH

104
Q

What does SS do?

A

It inhibits growth hormone

105
Q

What does this:

↑ Synthesis & secretion of thyroid-stimulating hormone (TSH) & prolactin (PRL)

A

TRH (thyrotropin releasing hormone)

peptide structure

106
Q

What does this:

↑ Synthesis & secretion of luteinizing hormone (LH) & follicle-stimulating hormone (FSH)

A

GnRH (gonadotropin-releasing hormone)

peptide

107
Q

What does this:

↑ Synthesis & secretion of adrenocorticotrophic hormone (ACTH)

A

CRH (corticotropin-releasing hormone)
AVP (arginine vasopressin)
(peptide)

108
Q

What does this:

↑ Synthesis & secretion of growth hormone (GH)

A

Growth hormone releasing hormone (GHRH)

peptide

109
Q

What does this:

↓ GH secretion

A

Growth hormone inhibitory hormone (PHIH, somatostatin)

peptide

110
Q

What does this:

↓ Synthesis & secretion of prolactin (PRL)

A

Prolactin-inhibiting hormone (PIH)

amine

111
Q

What is the amine hormone of the hypothalamic releasing hormones?

A

prolactin inhibiting hormone

112
Q

Hypothalamic releasing/inhibitory hormones are secreted in the hypothalamus and collect in the (blank)

A

median eminence

113
Q

Where do the hormones secreted by the hypothalamus go?

A

collect in median eminence and then head into portal system and are conducted to anterior pituitary where they influence secretion from glandular cells

114
Q

The (Blank) blood flow only represents a tiny fraction of the cardiac output/

A

hypophysial portal

115
Q

The (blank) artery supplies the posterior lobe of the pituitary gland

A

inferior hypophyseal

116
Q

The (blank) artery supplies the anterior lobe and the infundibulum of the pituitary gland and median eminence of the hypothalamus and gives rise to the hypophyseal portal system

A

superior hypophyseal

117
Q

What join up together to create the median eminence?

A

Superior hypophyseal and inferior hypophyseal

118
Q

Where is there a release of hormones from hypothalamus into the portal system?

A

the median eminence

119
Q

What is a fast and highly specific and uses the hypothalamus to regulate hormone secretion?

A

neuroendocrine

120
Q

Several hypothalamic hormones are released in a (blank) fashion but only GnRH release is critical for pituitary (gonadotropin) secretion

A

pulsatile

121
Q

What is critical for pituitary (gonadrotropin) secretion?

A

pulsatile GnRH secretion

122
Q

WHen GnRH is released by hypothalamic neurons what happens in the anterior pituitary?

A

LH is released

123
Q

(blank) is a collecting center for environmental and sensory information.

A

hypothalamus

124
Q

Release of hypothalamic releasing/inhibitory factors can be influenced by (blank)

A 
pain
emotions
light and dark
sleep
exercise
electrolytes
hormones
125
Q

What are the three feedback loops that the anterior pituitary is a part of?

A

long loop negative feedback
ultra-short loop negative feedback
short loop negative feedback

126
Q

(blank) is the regulation of a systemic hormone on the hypothalamus or pituitary

A

Long loop negative feedback

127
Q

What is this:
CRH secreted from hypothalmus→
ACTH secreted from anterior pituitary→
Cortisol secreted from adrenal cortex;

THEN
Cortisol inhibits ACTH release and CRH release.

A

example of long loop negative feedback

128
Q

(Blank) is when pituitary hormones act upon the hypothalamus

A

short loop negative feedback

129
Q

What is this:
Example:
CRH secreted from hypothalmus→
ACTH secreted from anterior pituitary;

THEN
ACTH inhibits CRH release.

A

short loop negative feedback

130
Q

(blank) is when the hypothalamic or pituitary hormones directly regulate the cells that secrete the hormone.

A

ultra short loop negative feedback

131
Q

What is this:
CRH secreted from hypothalmus;

THEN
CRH inhibits further CRH release.

A

Ultra-short loop negative feedback

132
Q

(blank) are classified as primary, secondary, or tertiary.

A

endocrinopathies

133
Q

Endocrinopathies at the level of target organ is (blank)

A

primary

134
Q

(blank) is a disease marked by dysfunction of an endocrine gland. Excess/insufficiency of hormone or binding to receptors.

A

endocrinopathies

135
Q

An endocrinopathy at the level of pituitary.

A

secondary

136
Q

An endocrinopathy at the level of hypothalamus

A

tertiary

137
Q

ADH (vasopressin) and oxytocin are secreted by the (blank)

A

posterior pituitary

138
Q

The posterior pituitary is primarily comprised of (blank). These cells do not secrete hormones.

A

glial cells called pituicytes

139
Q

Do pituicytes (glial-like cells) secrete hormones?

A

no

140
Q

Hormones of the posterior pituitary are secreted by (blank)

A

neurons

141
Q

The hormones secreted by neurons into the posterior pituitary have their bodies located in the (blank)

A

hypothalamus

142
Q

The hormones that are secreted in the posterior pituitary are synthesized in the cell bodies of the hypothalamus and transported down the nerve (blank) into the posterior pituitary.

A

axons

143
Q

ADH and oxytocin are similiar in structure differing by only (blank) AAs

A

2

144
Q 
What is the structure of oxytocin?
where is its origin?
What is its half-life?
What is its function?
Binding carrier protein?
A

nonapeptide
magnocellular neurons in the paraventricular nuclei
~2 min
Milk ejection and hastens delivery (promotes delivery of placenta, reduces bleeding, contracts uterine smooth muscle)
neurophysin I

145
Q

Is oxytocin the physicological trigger for parturition (giving birth)?

A

no

146
Q 
What is the structure of ADH?
where is its origin?
What is its half-life?
What is its function?
Binding carrier protein?
A 
nonapeptide
magnocellular neurons in the supraoptic
2 mins
reabsorption of water and vascular smooth muscle contraction
Neurophysin II
147
Q

What does ADH do molecularly?

A

Reabsorption of water:
v2 receptor-> cAMP-> insertion of aquaporin into luminal membrane of collecting tubule
Vascular Smooth muscle:
V1 recptor-> IP3-> DAG-> increased Ca2+

148
Q

What is this:

Problem: Unable to conserve water due to ↓ADH synthesis (central DI) or insensitivity to ADH at the collecting ducts (nephrogenic DI)

Causes: trauma, tumors, infection (e.g. meningitis)

Principle symptoms: ↑water loss from kidneys (polyuria) triggers ↑ thirst (polydipsia)

A

diabetes insipidus

149
Q

What is this:
increased Water retention-> atria of heart stretched-> increased ANF, decreased plasma renin activity-> sodium loss-> hyponatremia and decreased plasma osmolality; concentrated urine

Causes: Ectopic: ADH secreted from lung cancer, etc.
Eutopic: Stroke, infection

Principle symptoms: asymptomatic during early stages especially if serum sodium falls slowly. Rapid fall associated with confusion, drowsiness, convulsions, coma and death.
A

Syndrome of inappropriate ADH secretion

SIADH

150
Q 
What is this:
Causes: 
Damage from malnutrition (e.g. anorexia, bulimia), 
Genetic disorders, 
Radiation, 
Surgery, 
Head trauma, 
Lesion, 
Tumor, 
Other physical injury to the hypothalamus.
Effects - disruptions in:
Body temperature regulation, 
Growth, 
Weight, 
Sodium and water balance, 
Milk production, 
Emotions, 
Sleep cycles.
Associated conditions:
Hypopituitarism, 
Neurogenic diabetes insipidus (not enough ADH), 
Tertiary hypothyroidism, 
Developmental disorders.
A

Hypothalamic disease

151
Q

What is this:
Abnormal growths that develop on the pituitary gland (10mm – macroadenoma)
Usually benign adenomas
May produce excess hormone or restrict activity of the pituitary to lessen hormone production
May be removed surgically - endoscopic transnasal transsphenoidal approach (most common), transcranial approach (craniotomy) for larger tumors.

A

pituitary gland tumors

152
Q

What is the most common pituitary gland tumor?

What is the most rare pituitary gland tumor?

A

prolactinomas

rarely thyrotroph adenomas

153
Q

(blank) is increased prolactin, increased milk production, decreased reproductive function (can manifest as hypogonadism

A

prolactinomas

154
Q

(blank) is increased GH, increased bone/soft tissue growth, acrogmegaly.

A

somatotrophic adenomas

155
Q

(blank) is increased ACTH and increased Cortisol (cushings syndrome symptoms)

A

corticotrophic adenomas

156
Q

(blank) is decreased LH and FSH

A

gonadotrophic adenomas

157
Q

(blank) is rare, usually large when diagnosed and the most rare pituitary gland tumor.

A

thyrotrophic adenomas

158
Q

Sometimes when you have a pituitary gland tumor what can happen to your eyes?

A

visual impairment because tumor is compressing optic nerve

159
Q

What is a complication of surgical removal of a tumor of the pituitary gland?

A

may permanently alter hormone supply

160
Q

ACTH deficiency would lead to (blank)

A

adrenal (cortisol) insufficiency

161
Q

TSH deficiency would lead to (blank)

A

hypothyroidism

162
Q

Gonadotropin deficiency will lead to (blank)

A

hypogonadism

163
Q

GH deficiency can result in what?

A

failure to thrive and short stature in child (dwarfism);most adults are asymptomatic and some may experience fatigue and weakness and decreased quality of life.

164
Q

What can ADH deficiency lead to?

A

polyuria and polydipsia

165
Q

What are these:

ACTH deficiency -Adrenal (cortisol) insufficiency
TSH deficiency -Hypothyroidism
Gonadotropin deficiency -Hypogonadism
GH deficiency - Failure to thrive and short stature in children (pituitary dwarfism); most adults are asymptomatic, but some may experience fatigue and weakness and decreased quality of life
ADH deficiency - Polyuria and polydipsia
Other presenting features may be attributable to the underlying cause. A patient with a space-occupying lesion may present with headaches, double-vision, or visual-field deficits.
A patient with large lesions involving the hypothalamus may present with polydipsia/polyuria or, rarely, syndrome of inappropriate secretion of antidiuretic hormone (SIADH).

A

Pituitary hormone insufficiency

Block 3 Week 5 (7 decks)

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