Posterior Pituitary Flashcards

1
Q

Where is the pituitary located

A

Under the optic chiasm and hypothalamus in the brain

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2
Q

What are the 2 nucleus found in the posterior pituitary

A

The paraventricular nucleus and the supraoptic nucleus

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3
Q

Where does the posterior pituitary originate

A

From neuronal tissue- large numbers of glial type cells

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4
Q

What hormones does the posterior pituitary secrete

A

Vasopressin
Oxytocin

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5
Q

What is the function of vasopressin

A

It is an anti diuretic hormone which controls water secretion into urine

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6
Q

Where is vasopressin primarily secreted from in the posterior pituitary

A

The supraoptic nuclei

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7
Q

What is the function of oxytocin

A

Expression of milk from the glands of the breast to the nipples and promotes the onset of labour

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8
Q

Where is oxytocin primarily secreted from in the posterior pituitary

A

The paraventricular nuclei

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9
Q

What percentage of the human body is fluid

A

60%

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10
Q

How much of the 60% fluid sits in the extracellular

A

33% or 14L which is divided into intravascular at 3.5L and interstitial at 10.5L

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11
Q

How much of the 60% fluid makes up the intracellular fluid

A

66% or 28L

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12
Q

Where does vasopressin act upon in the nephron

A

The collecting tubule

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13
Q

What is the mechanism of action for vasopressin

A

Vasopressin binds to the membrane receptor which activates cAMP which is a secondary messenger system. This inserts aquaporin-2 water pores into the apical membrane meaning more water is absorbed by osmosis into the blood

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14
Q

Where are osmoreceptors found

A

In the hypothalamus

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15
Q

What doe osmorecptors detect

A

The change in osmolarity

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16
Q

What do baroreceptors located

A

Carotid sinus and aortic arch

17
Q

What do baroreceptors detect

A

Change in pressure

18
Q

What happens when you are dehydrated to restore osmolality

A

Loss of body water increases plasma osmolality which causes increased thirst and increased in AVP neurone firing, this leads to the release of AVP and increased fluid intake, this causes water reabsorption and the restoration of osmolality and circulating sodium concentration

19
Q

What can affect osmolality

A

Sodium
Potassium
Chloride
Bicarbonate
Urea
Glucose at high concentrations
Alcohol
Methanol
Polyethylene glycol/mannitol

20
Q

How can you suppress vasopressin release and thirst

A

Drinking rapidly

21
Q

What is polyuria

A

Large volumes of urine

22
Q

What is polydypsia

A

Large volumes of drinking

23
Q

What is cranial diabetes insipidus

A

Lack of vasopressin

24
Q

What is nephrogenic diabetes insipidus

A

Resistance to vasopressin

25
What are the 2 types of diabetes insipidus
Cranial and nephrogenic
26
What can cause cranial diabetes insipidus
Destruction of the hypothalamus Interruption of the connection of hypothalamus to pituitary
27
Why could a person get cranial diabetes insipidus
Idiopathic Tumours Trauma Infection
28
What can caused nephrogenic diabetes insipidus
Osmotic diuresis Drugs Chronic renal failure Post-obstructive uropathy Metabolic- hypercalcaemia/hypokalaemia
29
How can you manage cranial diabetes insipidus
Treat any underlying condition Desmopressin
30
How can you manage nephrogenic diabetes insipidus
Avoid drugs High/very high dose of desmopressin Hydrochlorothiazide
31
What is SIADH
Syndrome of anti diuretic hormone secretion Producing ADH when you shouldn’t be producing it Too much AVP when it should not be being secreted which causes low blood concentration so low osmolality. This causes urine to be inappropriately concentrated and plasma sodium will be low Patient must be euvolaemia
32
When does vasopressin start to be secreted
When plasma osmolality gets to 280
33
How is SIADH managed
Fluid restriction Sometimes demeclocycline Vaptans- V2 receptor antagonists Hypertonic saline Potential risk of central pontine myelinolysis