chapter3 the hypothalamus and pituitary part i the hypothalamus and posterior pituitary
TRANSCRIPT
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Chapter3 The Hypothalamus and Pituitary Part I
The Hypothalamus and Posterior Pituitary
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Reference - Textbook
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Reference – Course Website
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Content
• Introduction• Oxytocin• Vasopressin
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INTRODUCTION
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Anatomical and Functional Connection Between the Hypothala
mus and Pituitary
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• hypophyseal portal system
• Hypothalamo hypophyseal tract
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Case: Mr. Jones, a 30-year-old man
• 6 weeks earlier– began passing a lot of urine
• Once or twice per hour• Full bladder four or five times during the night
– Unusually thirsty• Constantly drinking water• Urine was very pale
• in recent weeks– Headaches at night or waking– Forgetful– Erection dysfunction
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Case: Mr. Jones, a 30-year-old man• Test at GP (General Physician)
– Urine test• No protein, no glucose
– Blood test• Glucose and calcium level normal
• Test at endocrine clinic– Looked uncomfortable– Dehydrated with a dry mouth and tongue– Body Temperature normal– Resting pulse rate: 100 b.p.m.– Blood pressure: 105/65 mmHg– Fundoscopy: optic nerve to be swollen in both eyes– Visual field test:
• loss of vision in both temporal (outer) halves of the field– Memory problem:
• Confuse and could not remember how he had got to the hospital or what he eaten that day
• Knew the name of his girlfriend and could remember distant events
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Visual Field Defect
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Oxytocin and VasopressinThe Hormone of the Posterior
Pituitary• Small peptides – nine amino peptide
– Seven of them are common
• Synthesized in the hypothalamus by magnocellular neurons
• Action potential initial release in the nerve
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Synthesis and Release of Vasopressin and Oxytocin
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OXYTOCIN
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Role of Oxytocin (OXT)
• Effect on mammary glands. – Cause the contraction of the myoepithelial cells ---
milk ejection
– Unconditioned and conditioned reflex
• Effect on uterus– stimulate the smooth muscle contraction, especially
that towards the end of gestation.
– at least partially responsible for causing birth of the baby
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OXYTOCIN
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Oxytocin Release: Neuroendocrine Reflex
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Clinical Use
• Oxytocin– Induce labor– Increase uterine contractions during labor– Reduce postpartum bleeding after labor
• Atosiban: the antagonist of oxytocin receptor– Treatment of the preterm labor
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Recent Work about Oxytocin
OxytocinBehavior Hormone
Cardiovascular Hormone
Gastrointestinal Hormone?
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VASOPRESSIN (ADH)
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Roles of ADH
• Antidiuretic effect
• Pressure effect
– constricting the arterioles everywhere
• Neurotransmitter
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Vasopressin ReceptorsVasopressin ReceptorsV2-receptor:
collecting ductVascular endothelial cells
V1(a)-receptor: vascular smooth muscle
V3(1b) receptor: neurons (in CNS and ENS)Corticotropin cells (in pituitary gland)
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Disorders of Vasopressin
• Deficiency– Caused by a tumour or trauma of the brain– Diabetes inspidus (hypothalamic or cranial)– Polyuria – large volumes of very dilute urine– Polydipsia (烦渴) - excessive thirst– Treatment:
• Desmopressin – a synthetic analogue of vasopressin
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Disorders of Vasopressin
• Excess– Causes:
• Neoplasm-Lung cancer• Neurological disease – meningitis (脑膜炎)• Lung disease – pneumonia and tuberculosis• Prescribed drug – carbamazepine (立痛定)
– Syndrome of inappropriate ADH (SIADH)• Urine more concentrated • Hyponatraemia
– Headache, nausea, vomiting, confusion, coma
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Clinical Use of Vasopressin
• To teat the diabetes insipidus• Reduce bleeding during gastrointestinal
surgery• Boost factor VIII concentration in mild
haemophilia
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Explanation of Mr. Jones’ Syndromes and Signs
• 6 weeks earlier– began passing a lot of urine– Unusually thirsty
• in recent weeks– Headaches at night or waking– Forgetful– Erection dysfunction
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Explanation of Mr. Jones’ Syndromes and Signs
• Test at endocrine clinic– Looked uncomfortable– Dehydrated with a dry mouth and tongue– Body Temperature normal– Resting pulse rate: 100 b.p.m.– Blood pressure: 105/65 mmHg– Fundoscopy: optic nerve to be swollen in both
eyes– Visual field test: loss of vision in both temporal
(outer) halves of the field– Memory problem