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Pituitary Gland Flashcards

1
Q

What two lobes form the pit gland?

A

Anterior and posterior

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2
Q

What kind of cells is the anterior pit made up of?

A

Glandular

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3
Q

What kind of cells is the posterior pit made up of?

A

Neuronal (axons mainly)

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4
Q

What hormones does the anterior pit secrete?

A 
Growth Hormone
Follicle stimulating Hormone
ACTH
Thyroid stimulating hormone
Prolactin
Luteinizing hormone
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5
Q

What hormones does the posterior pit secrete?

A

ADH

Oxytocin

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6
Q

Where is the pit gland located?

A

In the pit fossa.

Below the hypothalamus and above the sella turcica of the sphenoid bone.

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7
Q

What surrounds the pit gland?

A

Cavernous sinuses (R and L).

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8
Q

What links the R and L cavernous sinuses?

A

Anterior intercavernous sinus

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9
Q

What forms the lateral border of the cavernous sinuses?

A

Dura mater

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10
Q

What is the dura mater?

A

A meningi that forms the floor of the cranial fossae.

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11
Q

What is the diaphragm sellae?

A

Part of the dura mater that coverers the pit fossa

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12
Q

What coverers the pit fossa?

A

Diaphragm sellae from dura mater.

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13
Q

What is the main content of the cavernous sinuses?

A

Venous blood vessels that drain into the internal jugular vein

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14
Q

Where do the venous blood vessels in the cavernous sinus drain into?

A

Internal jugular vein

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15
Q

What six points of interest can be seen in the cavernous sinuses?

A 
Internal carotid artery
Oculomotor (CNIII)
Trochlear (CNIV) 
Abducens (CNVI)
Ophthalmic and maxillary divisions of trigeminal (CNV1+2)
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16
Q

List the 4 lateral cranial nerves in the cavernous sinuses from superior to inferior.

A

Oculomotor (CNIII)
Trochlear (CNIV)
Ophthalmic division of trigeminal (CNV1)
Maxillary division of trigeminal (CNV2)

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17
Q

What can be found directly above the pit gland?

A

Optic chiasm

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18
Q

What is the optic chiasm?

A

Where the optic (CNII) nerves cross.

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19
Q

Where is the optic chiasm located?

A

Directly above the pit gland.

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20
Q

What links the posterior pit to the hypothalamus?

A

Infundibulum

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21
Q

What are the two options for approaching the pit gland for surgery?

A

Transcranial- Subfrontal lobe

Transsphenoid- Via nasal cavity and sphenoid sinuses

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22
Q

What bones need broken when accessing the pit gland via the transsphenoid route?

A

Separation of nasal septum (+/- Le Fort 1)

Floor and roof of sphenoid sinuses

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23
Q

What bones make up the nasal cavity?

A

Vomer

Ethmoid

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24
Q

What are the four paranasal sinuses?

A

Frontal
Maxillary
Ethmoid air
Sphenoid

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25
What is the function of the optic chiasm?
Conducts AP bilaterally from nasal retinae
26
How does functional deficit of optic chiasm present?
Bitemporal hemianopia
27
What is the function of the oculomotor nerve?
Motor movement of eye | Sphincter of iris
28
How does a problem with the oculomotor nerve present?
Problems with eye movement | Dilated pupils
29
What does the trochlear nerve do?
Depresses eye
30
How do problems with the trochlear nerve present?
Inability to look inferior and laterally
31
What does the trigeminal do?
Sensory to most of face | Motor to muscles of mastication
32
How does damage to the trigeminal nerve present?
Sensory loss of face | Inability to chew
33
What does the abducens nerve do?
Abducts the eye
34
How do issues with the abducens nerve present?
Inability to abduct eye
35
What does the cavernous sinuses do?
Drain venous blood
36
What can cause problems with the cavernous sinuses?
Venous harmorrhage
37
What do the internal carotid arteries do?
Supply blood to brain and orbit
38
What can cause issue with the internal carotid arteries?
Catastrophic haemorrhage
39
What does the dura mater do?
Protects the structures of the cranial cavity
40
What can cause damage to the dura mater?
CSF leak
41
What five hormones regulate the anterior pit?
``` Thyrotropin Releasing Hormone Corticotropin Releasing Hormone Gonadotropin Releasing Hormone Growth Hormone Releasing Hormone Dopamine ```
42
What does TRH do?
Stim TSH release
43
What does CRH do?
Stim ACTH release
44
What does GnRH do?
Stil LH and FSH release
45
What does GHRH do?
Stim GH release
46
What does DA do?
Inhibit Prolactin release
47
Where are ADH and OXT produced?
Hypothalamus then migrate to post pit
48
On what tissue does TSH act?
Thyroid gland
49
What does TSH do?
Stim thyroid gland to produce thyroxine
50
On what tissue does ACTH act?
Adrenal cortex
51
What does ACTH do?
Stim cortisol release
52
On what tissues do LH and FSH act?
Testes and ovaries
53
What do FSH and LH do?
Stim oestrogen and testosterone production
54
What does GH do?
Stimulates growth through IGF-1
55
On what tissues does GH act?
All of them
56
On what tissue does prolactin act?
Mammary tissue
57
What does prolactin do?
Stim milk production
58
On what tissue does ADH work?
Kidneys
59
What does ADH do?
Stim water retention
60
On what tissues does oxytocin act?
Uterus SM Ductus deferens SM Prostate SM
61
What are the three broad categories of pathology of the pit?
Too little hormone Too much hormone Gland is too big
62
How do you test for too much/little hormone?
Blood tests
63
How do you test for a pit gland that is too big?
Imaging- MRI or US
64
In a dynamic endocrine test for too much hormone what do you do?
See if you can suppress the hormone
65
In a dynamic endocrine test for too little hormone what do you do?
See if you can stim hormone
66
Give examples of a dynamic endocrine test for too little hormone?
Insulin stress test Water deprivation test Synacthen test
67
How does the insulin stress test work?
Drop blood glucose to <2.2 using insulin to stim cortisol and GH release
68
What is a safer alternative to the insulin stress test?
Prolonged glucagon test
69
What should cortisol rise to in the insulin stress test for it to be normal?
>500
70
What should GH rise to in the insulin stress test for it to be normal?
>7 micrograms/l
71
How does the water deprivation test work?
Deprive of liquid for 8h and check is Ur/Serum osmol ratio is >2.
72
What does a Ur/Serum osmol ratio of <2 suggest?
Diabetes insipidus
73
When do you not need to do a water deprivation test?
If the baseline reading is >2
74
What is the second part of the water deprivation test?
Give desmopressin. If it improves after DDAVP then problem with pit/hypo if not problem with kidneys.
75
What kind of cells is the anterior pit made of?
Acidophils Basophils Chromophobes
76
What kind of acidophil cells are present and what do they produce?
Somatotrophs- GH | Mammotrophs- PRL
77
What colour do acidophils appear on staining?
Red
78
What colour do basophils appear on staining?
Blue
79
What kind of basophil cells are present and what do they produce?
Corticotrophs- ACTH Thyrotrophs- TSH Gonadotrophs- FSL/LH
80
What colour do chromophobes appear on staining?
Clear
81
How does the posterior pit appear on T1 MRI scans?
Very bright

Endocrine (23 decks)

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