dwarfism & gh

Hypothalamus

*Region of the brain

* Composed of small nuclei *Act As Conduit between nervous &endocrine sys.

*Also regulate homeostatic function. ( hunger , thirst & body temp )

Hypothalamic HormonesHypothalamic Hormones

Pituitary gland anatomyPituitary gland anatomy

*Is an endocrine gland

* Size of a pea * Located at the base of the brain

* Rests in a small bony cavity

* Is divided into ???

* Connected to hypothalamus by ???

Anterior & posterior lobeAnterior & posterior lobe *The cells of the

Ant. Lobe are embryologically derived from an ???

*The Ant. Pituitary regulate many processes (stress, growth & reproduction ) & Are achieved through ??

*The post. Lobe is composed of the endings of nevre cells

*These nerve cells produce two

hormone???

Pituitary Hormones and Their Pituitary Hormones and Their TargetsTargets

The hormones of the anterior pituitary are synthesized in the cytoplasm of the cells as ????

The hormones of the post pituitary are released into the

circulation in response to????

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Growth hormoneGrowth hormone

Growth hormone is a protein hormone of about 190 amino acids that is synthesized and secreted by cells called somatotrophs in the anterior pituitary

It is a major participant in control of several complex physiologic processes, including growth and

metabolism.  

Control of SecretionControl of Secretion

GHIH (or)

SST (somatostatin)

(-)

Anterior Pituitary:

Hypothalamus: GHRH

(+)

GH(somatotropin)

Liver: IGF (somatomedins)

(+)

(-)

GROWTH HORMONE

direct effectsindirect effects

lipolysis in fat cells

+

carbohydratemetabolism

+

Insulin-like Growth Factor

+

fat cells muscle

chondrocytes

Protein synthesis

cartilage formation

lipogenesis

Increases FFA, glycerol, and sugars in circulation

BrainPituitary

Liver

IGF

IGF binding proteins (IGFBPs)

Growth

Growth Hormone (GH)

GH/IGF/IGFBP AxisGH/IGF/IGFBP Axis

IGFBPs—two main typesIGFBPs—two main types

IGFBP-3most abundant form of IGFBPmain carrier of IGF in circulationpromotes IGF mediated somatic growthhigh IGFBP-3 associated w/ growth stimulation

IGFBP-1typically present in small amountshigh IGFBP-1 associated w/ growth inhibition

IGFBP-3

IGF

IGF receptor

LIVER

Cell

Growth Functions

Growth Functions

Cell

IGF receptor

LIVER

IGFBP-1

IGF

Clinical AspectsClinical Aspects

GH

Adult

children

Acromegaly

gigantism

GH dwarfism

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Signs and symptomsSigns and symptoms

•Obvious sign is kids being much shorter then kids of the same age and gender

•Children with pituitary dwarfism have a slow rate of growth

•Children of this disorder still have normal intelligence and capabilities

Diagnostic proceduresDiagnostic procedures

•blood test for protien markers

•Pediatric nurses chart : The growth curve of children with pituitary dwarfism shows no growth or

minimal growth.

DiagnosisDiagnosis

X-rays to determine bone age can also help with the diagnosis

DiagnosisDiagnosis

.MRI of the brain can also be used to view the hypothalamus and pituitary gland

DiagnosisDiagnosis

Treatments

• Growth hormone injections.

Treatments

. Surgical

intervention is another option which may include:

-surgical operation on pituitary gland itself .

-Bone lenghthining usually on the femur and tibia.

PrognosisPrognosis

• Depends on whether there’s any permanent damage and the age of the child

• Earlier treated, the better chance child will grow to average adult height

• Growth improvement of the injections slowly decrease