nomad: anterior pituitary physiology
DESCRIPTION
An account of the Anterior Pituitary Gland, the hormones secreted by this gland and their functions. Also an account of the Physiology of growth.TRANSCRIPT
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ANTERIOR PITUITARY ANTERIOR PITUITARY GLAND GLAND
ByBy
Dr. M. Anthony David, MDDr. M. Anthony David, MD
Professor of PhysiologyProfessor of Physiology
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PITUITARY GLANDPITUITARY GLAND Synonym: Synonym: Hypophysis CerebriHypophysis Cerebri.. Pituita = Mucus (Latin)Pituita = Mucus (Latin) So named by the Scientist So named by the Scientist GalenGalen Hypophysis Cerebri = Outgrowth Hypophysis Cerebri = Outgrowth
from the Cerebrum.from the Cerebrum. Has two important parts:Has two important parts:
Anterior Pituitary: Anterior Pituitary: AdenohypophysisAdenohypophysis Posterior Pituitary: Posterior Pituitary: NeurohypophysisNeurohypophysis
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EMBRYOLOGY OF THE PITUITARYEMBRYOLOGY OF THE PITUITARY
Anterior Pituitary or Adenohypophysis:Anterior Pituitary or Adenohypophysis: Derived from an upward evagination of the Derived from an upward evagination of the
Rathke’s pouchRathke’s pouch.(Ectoderm).(Ectoderm) Posterior Pituitary or Neurohypophysis:Posterior Pituitary or Neurohypophysis:
Derived from a downward growth of the Derived from a downward growth of the InfundibulumInfundibulum from the Diencephalon, a from the Diencephalon, a structure of the structure of the NeurectodermNeurectoderm..
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PITUITARY GLANDPITUITARY GLAND
DIMENSIONS:DIMENSIONS: 1 cm in diameter.1 cm in diameter. 0.5 to 1 gm in weight.0.5 to 1 gm in weight.
LOCATION:LOCATION: Sella turcicaSella turcica A bony cavity.A bony cavity.
DIVISIONS:DIVISIONS: Anterior LobeAnterior Lobe Posterior LobePosterior Lobe Pars IntermediaPars Intermedia
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ADENOHYPOPHYSIS:ADENOHYPOPHYSIS:CLASSICAL CLASSIFICATION OF CLASSICAL CLASSIFICATION OF
CELLSCELLS CHROMOPHOBES:CHROMOPHOBES:
50% of the cells50% of the cells Agranular, quiescent & Non secretoryAgranular, quiescent & Non secretory
CHROMOPHILSCHROMOPHILS:: AcidophilsAcidophils: 35%: 35%
Secrete: Growth Hormone & ProlactinSecrete: Growth Hormone & Prolactin BasophilsBasophils: 15%: 15% Secrete: Secrete:
Glycoproteins : FSH, LH & TSHGlycoproteins : FSH, LH & TSH Polypeptides : ACTH & MSHPolypeptides : ACTH & MSH
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MODERN CLASSIFICATIONMODERN CLASSIFICATION OF ADENOHYPOPHYSIAL CELLSOF ADENOHYPOPHYSIAL CELLS
SOMATOTROPHS:SOMATOTROPHS: Secrete Growth Secrete Growth
HormoneHormone MAMMOTROPHS:MAMMOTROPHS:
Secrete ProlactinSecrete Prolactin THYROTROPHS:THYROTROPHS:
Secrete TSHSecrete TSH
GONADOTROPHS:GONADOTROPHS: Are of two types:Are of two types:
FSH type: secrete FSH type: secrete FcHFcH
LH type: secrete LHLH type: secrete LH
CORTICOTROPHS CORTICOTROPHS ((ADRENOCORTICOADRENOCORTICOMELANOTROPHSMELANOTROPHS)) Secrete ACTH & Secrete ACTH &
MSHMSH
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ADENOHYPOPHYSIAL HORMONESADENOHYPOPHYSIAL HORMONES
GROWTH HORMONEGROWTH HORMONE: SOMATOTROPIN: SOMATOTROPIN THYROTROPINTHYROTROPIN: THYROID STIMULATING : THYROID STIMULATING
HORMONE (HORMONE (TSHTSH)) ADRENOCORTICOTROPIC HORMONE(ADRENOCORTICOTROPIC HORMONE(ACTHACTH)) GONADOTROPIC HORMONES:GONADOTROPIC HORMONES:
FOLLICLE STIMULATING HORMONE (FOLLICLE STIMULATING HORMONE (FSHFSH)) LUTEINISING HORMONE (LUTEINISING HORMONE (LHLH); Interstitial Cell ); Interstitial Cell
Stimulating Hormone (Stimulating Hormone (ICSHICSH)) PROLACTINPROLACTIN
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Adenohypophysial Adenohypophysial Hormones:Hormones:
A A MnemonicMnemonic for you! for you! ““TThose hose GGiant iant GGonads onads PProlong the rolong the
AAction”ction” TT = Thyroid Stimulating Hormone (TSH) = Thyroid Stimulating Hormone (TSH) GG = Growth Hormone = Growth Hormone GG = Gonadotropins: FSH & LH = Gonadotropins: FSH & LH P P = Prolactin= Prolactin A A = Adreno Cortico Tropic Hormone (ACTH) = Adreno Cortico Tropic Hormone (ACTH)
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GROWTH HORMONE: GROWTH HORMONE: FUNCTIONSFUNCTIONS
ON GROWTH:ON GROWTH: In Children ( As the epiphyses are In Children ( As the epiphyses are
unfused)unfused) Increased Chondrogenesis.Increased Chondrogenesis. Increased Linear Growth.( Both in Increased Linear Growth.( Both in
conjunction with Somatomedins)conjunction with Somatomedins) In Adults, where the epiphyses In Adults, where the epiphyses
have fused:have fused: Thickening of bones.Thickening of bones.
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GROWTH HORMONE:FUNCTIONS ON GROWTH HORMONE:FUNCTIONS ON METABOLISMS: METABOLISMS:
PROTEINS: ”PROTEINS: ”AnabolismAnabolism”” Anabolic effect by:Anabolic effect by:
Amino acid transport into cellsAmino acid transport into cells m & t RNA activitym & t RNA activity Nitrogen, Calcium, Sodium & Nitrogen, Calcium, Sodium & Potassium in the cellsPotassium in the cells
Protein CatabolismProtein Catabolism
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CARBOHYDRATES: “DIABETOGENIC”CARBOHYDRATES: “DIABETOGENIC” Hyperglycemia caused by:Hyperglycemia caused by:
Gluconeogenesis.Gluconeogenesis. Peripheral Utilisation of Glucose: “Anti-Peripheral Utilisation of Glucose: “Anti-
Insulin”Insulin” GlycolysisGlycolysis FFA causing FFA causing need for glycolysis need for glycolysis
FAT:FAT: Increased FFA: Used for energyIncreased FFA: Used for energy
GROWTH HORMONE:FUNCTIONS ON GROWTH HORMONE:FUNCTIONS ON METABOLISMS: METABOLISMS:
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ELECTROLYTES:ELECTROLYTES: Increased Calcium absorptionIncreased Calcium absorptionRetention of:Retention of:
SodiumSodiumPotassiumPotassiumChlorideChloride
GROWTH HORMONE:FUNCTIONS ON GROWTH HORMONE:FUNCTIONS ON METABOLISMS: METABOLISMS:
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SOMATOMEDINSSOMATOMEDINS
Are Intermediate compounds, Are Intermediate compounds, polypeptide growth factors.polypeptide growth factors.
They facilitate the functions of They facilitate the functions of Growth Hormone.Growth Hormone.
Growth Hormone will not be able to Growth Hormone will not be able to function in the absence of these function in the absence of these somatomedins.somatomedins.
The most important of the The most important of the somatomedins is Somatomedin C or somatomedins is Somatomedin C or IGF I.IGF I.
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SOME SOMATOMEDINSSOME SOMATOMEDINS Sulfation Factor Nerve Growth Factor (NGF) Epidermal Growth factor (EGF) Ovarian Growth Factor (OGF) Fibroblast Growth Factor (FGF) Platelet Derived Growth Factor (PDGF) Insulin like Growth Factor I (IGF I or
Somatomedin C) Insulin like Growth Factor II (IGF II)
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FACTORS INFLUENCING GROWTH HORMONE FACTORS INFLUENCING GROWTH HORMONE SECRETIONSECRETION
HYPOTHALAMIC FACTORS
FASTINGEXERCISE
DEEPSLEEP V
A.As l DOPA
GLUCAGONANDROGENSESTROGEN
PROSTAGLANDINS
GROWTH HORMONE SECRETION
STRESS:SURGERY
ANESTHESIAHEMORRHAGEEXCITEMENT
“COLD”
HYPERGLYCEMIA PROTEIN ANABOLISM FFA OXIDATION ENERGY
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THYROTROPIN (TSH) FUNCTIONSFUNCTIONS::
Releases stored Releases stored TT33,T,T44
Facilitates:Facilitates: IodinationIodination CouplingCoupling Other stages ofOther stages of
Biosynthesis.Biosynthesis.
LEVELS:LEVELS: MidnightMidnight EveningEvening
REGULATIONREGULATION:: TRH TRH
(Hypothalamus)(Hypothalamus) Negative feedback:Negative feedback:
TT33, T, T44
Via TRHVia TRH
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CORTICOTROPIN: ACTHCORTICOTROPIN: ACTH
ACTIONS:ACTIONS: ADRENAL:ADRENAL:
Hypertropy & Hypertropy & Hyperplasia of Hyperplasia of z.fasciculata & z.fasciculata & reticularisreticularis
VascularityVascularity Basal & Stress Basal & Stress
inducedinduced
Cortisol levels.Cortisol levels.
EXTRA ADRENAL:EXTRA ADRENAL: MelanocytesMelanocytes Adipokinetic effectAdipokinetic effect Circadian Rhythm.Circadian Rhythm.
REGULATION:REGULATION: CRF & -VE FeedbackCRF & -VE Feedback
LEVELS: CircadianLEVELS: Circadian 4 – 6 AM4 – 6 AM EveningEvening
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PROLACTINPROLACTIN In Males?In Males?
Potentiates effect of ICSH ( Potentiates effect of ICSH ( IInterstitial nterstitial CCell ell SStimulating timulating HHormone )ormone )
In Females:In Females: Promotes Milk Production in Estrogen & Promotes Milk Production in Estrogen &
Progesterone primed Mammary tissues.Progesterone primed Mammary tissues. Baby’s suckling increases Prolactin secretion Baby’s suckling increases Prolactin secretion
by the by the Milk Ejection/Secretion ReflexMilk Ejection/Secretion Reflex
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Inhibits Ovulation by:Inhibits Ovulation by: Secretion & effect of LHRH on Pituitary glandSecretion & effect of LHRH on Pituitary gland Action of FSH/LH on OvaryAction of FSH/LH on Ovary Lactational AmenorrheaLactational Amenorrhea
On the CNS:On the CNS: Maternal Instinct, protective Behaviour (Limbic Maternal Instinct, protective Behaviour (Limbic
System)System) Regulation:Regulation: PIH/DOPAMINE: Depresses Prolactin PIH/DOPAMINE: Depresses Prolactin
production.production.
PROLACTINPROLACTIN
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GONADOTROPINSGONADOTROPINS
FSHFSH:: Early maturation & Nutrition of OvaEarly maturation & Nutrition of Ova Release of EstrogensRelease of Estrogens
LHLH:: Final Maturation of OvaFinal Maturation of Ova OvulationOvulation Corpus Luteum formation.Corpus Luteum formation. In Males: ICSH: In Males: ICSH: Production of Production of
Testosterone.Testosterone.
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NOW FOR ACOFFEE!
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GROWTHGROWTH Physiological Growth is defined as Physiological Growth is defined as an an
increase in the number and size increase in the number and size of cells with sequential changes of cells with sequential changes in maturationin maturation..
Growth is normal and physiological in Growth is normal and physiological in children and adolescentschildren and adolescents
It becomes It becomes pathologicalpathological in in Malignancies or Malignancies or CancersCancers..
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HYPERTROPY & HYPERPLASIAHYPERTROPY & HYPERPLASIA
HYPERTROPY:HYPERTROPY: Increase in the size Increase in the size
of the cells.of the cells.
HYPERPLASIA:HYPERPLASIA: Increase in the Increase in the
number of cells.number of cells.
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FACTORS CONTROLLING FACTORS CONTROLLING GROWTHGROWTH
1. 1. GENETIC FACTORSGENETIC FACTORS:: Genes decide the tissue responsiveness Genes decide the tissue responsiveness
to GH.to GH.
2. 2. EXTRINSIC FACTORSEXTRINSIC FACTORS:: Diet/ Nutrition: PEM : Diet/ Nutrition: PEM :
KWASHIORKOR/MARASMUSKWASHIORKOR/MARASMUS
3. 3. ENDOCRINE FACTORS:ENDOCRINE FACTORS:
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MARASMUSMARASMUS
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ENDOCRINE FACTORS AFFECTING ENDOCRINE FACTORS AFFECTING GROWTHGROWTH
GROWTH HORMONEGROWTH HORMONE THYROXINTHYROXIN INSULININSULIN SEX HORMONES:SEX HORMONES:
ANDROGENSANDROGENS ESTROGENESTROGEN
GLUCOCORTICOIDSGLUCOCORTICOIDS GONADOCORTICOIDSGONADOCORTICOIDS
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GENERAL GROWTH CURVEGENERAL GROWTH CURVE
X – AXIS: AGE IN YEARSX – AXIS: AGE IN YEARS Y – AXIS: GROWTH% SIZE AT 20 Y – AXIS: GROWTH% SIZE AT 20
YEARSYEARS HAS FOUR PHASES:HAS FOUR PHASES:
I : I : RAPIDRAPID GROWTH: 0 – 3 Years GROWTH: 0 – 3 Years II : II : SLOW SLOW PHASE: 3 – 13 YearsPHASE: 3 – 13 Years III: III: ACCELERATEDACCELERATED PHASE: 13 – 16 Years PHASE: 13 – 16 Years IV :IV : SLOW INCREASE SLOW INCREASE: 16 – 20 Years.: 16 – 20 Years.
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GENERAL GROWTH GENERAL GROWTH CURVECURVE
0
20
40
60
80
100
120
0 2 4 6 8 10 12 14 16 18 20 22 AGE IN YEARS
% G
RO
WTH
AT 2
0yr
s
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SPECIFIC GROWTH CURVESSPECIFIC GROWTH CURVES
NEURAL & HEAD CURVE:NEURAL & HEAD CURVE: Peaks by 3 to 6 years.Peaks by 3 to 6 years.
LYMPHOID CURVE:LYMPHOID CURVE: Peaks to Peaks to 200% 200% at 12 – 14 Years.at 12 – 14 Years.
SPLANCHNIC CURVE:SPLANCHNIC CURVE: Similar to the General growth Similar to the General growth
curve.curve. REPRODUCTIVE CURVE:REPRODUCTIVE CURVE:
Peaks at 13 – 16 years.Peaks at 13 – 16 years.
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SPECIFIC GROWTH CURVES : SPECIFIC GROWTH CURVES : NEURAL & HEAD NEURAL & HEAD
0
20
40
60
80
100
120
2 4 6 8 10 12 14 16 18 20 22
AGE IN YEARS
% G
RO
WTH
AT 20yrs
.
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SPECIFIC GROWTH CURVES: SPECIFIC GROWTH CURVES: LYMPHOID TISSUELYMPHOID TISSUE
0
50
100
150
200
250
2 4 6 8 10 12 14 16 18 20 22
AGE IN YEARS
%G
RO
WTH
AT 2
0 Y
rs
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SPECIFIC GROWTH CURVES: SPECIFIC GROWTH CURVES: SPLANCHNIC TISSUESSPLANCHNIC TISSUES
0
20
40
60
80
100
120
0 2 4 6 8 10 12 14 16 18 20 22 AGE IN YEARS
% G
RO
WTH
AT 2
0yrs
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SPECIFIC GROWTH CURVES: SPECIFIC GROWTH CURVES: RPRODUCTIVE TISSUESRPRODUCTIVE TISSUES
0
20
40
60
80
100
120
2 4 6 8 10 12 14 16 18 20 22
AGE IN YEARS
% G
RO
WTH
AT 20yrs
.
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ANTERIOR PITUITARY: APPLIED ANTERIOR PITUITARY: APPLIED ASPECTSASPECTS
PAN HYPOPITUITARISM:PAN HYPOPITUITARISM: Simmond’s: Sheehan’s SyndromeSimmond’s: Sheehan’s Syndrome Frohlich’s Syndrome: Both Ant & Post Pit are Frohlich’s Syndrome: Both Ant & Post Pit are
deficient.(Dystropia Adiposa GenItalis)deficient.(Dystropia Adiposa GenItalis) HYPOSECRETION OF ANT PIT HORMONESHYPOSECRETION OF ANT PIT HORMONES
ADULTS: ADULTS: AcromicriaAcromicria INFANTS:INFANTS: Dwarfism Dwarfism: Laron type: : Laron type:
SomatomedinsSomatomedins Sexual Ateloitic: Intelligent DwarfsSexual Ateloitic: Intelligent Dwarfs
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ANTERIOR PITUITARY: APPLIED ANTERIOR PITUITARY: APPLIED ASPECTSASPECTS
HYPERSECRETION OF HYPERSECRETION OF GH:GH: ADULTS: ACROMEGALYADULTS: ACROMEGALY INFANTS: GIGANTISMINFANTS: GIGANTISM
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GIGANTISM
NORMAL
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ACROMEGALY : ABCACROMEGALY : ABC
AA: ARTHROPATHY: Joint Disorders: ARTHROPATHY: Joint Disorders BB: BIG BOGGY HANDS: BIG BOGGY HANDS CC: CARPAL TUNNEL SYNDROME: CARPAL TUNNEL SYNDROME
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DD: DIABETES MELLITUS: DIABETES MELLITUS EE: ENLARGED:: ENLARGED:
TONGUETONGUE HEART: CARDIOMEGALYHEART: CARDIOMEGALY THROATTHROAT
FF: FIELD DEFECT OF VISION: : FIELD DEFECT OF VISION: Bitemporal HemianopiaBitemporal Hemianopia
ACROMEGALY : DEFACROMEGALY : DEF
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GG: GYNECOMASTIA, GALACTORRHEA & : GYNECOMASTIA, GALACTORRHEA & GREASY SKINGREASY SKIN
HH: HYPERTENSION: 20 – 50% CASES: HYPERTENSION: 20 – 50% CASES II: INCREASING SIZE OF:: INCREASING SIZE OF:
SHOESSHOES HATSHATS GLOVESGLOVES DENTURESDENTURES RINGSRINGS
ACROMEGALY : GHI ACROMEGALY : GHI
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JJ: JAW : JAW ENLARGED: ENLARGED: PROGNATHISMPROGNATHISM
KK: KYPHOSIS: : KYPHOSIS: VERTEBRAL VERTEBRAL DEFORMITYDEFORMITY
ACROMEGALY: JKACROMEGALY: JK
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REVIEWREVIEW Growth: Growth: an increase in the number and an increase in the number and
size of cells with sequential changes size of cells with sequential changes in maturationin maturation..
General & Specific Growth CurvesGeneral & Specific Growth Curves Applied Aspects:Applied Aspects:
Adults:Adults: AcromegalyAcromegaly AcromicriaAcromicria
Infants:Infants: GigantismGigantism Dwarfism: Intelligent!Dwarfism: Intelligent!
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REVIEW: ACROMEGALYREVIEW: ACROMEGALY AA : ARTHROPATHY : ARTHROPATHY B B : BIG, BOGGY HANDS : BIG, BOGGY HANDS CC : CARPAL TUNNEL SYNDROME : CARPAL TUNNEL SYNDROME DD : DIABETES MELLITUS : DIABETES MELLITUS EE : ENLARGED: : ENLARGED:
TONGUETONGUE HEARTHEART THROATTHROAT
FF : FIELD DEFECT: Bitemporal : FIELD DEFECT: Bitemporal HemianopiaHemianopia
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GG : GYNECOMASTIA, GALACTORRHEA & : GYNECOMASTIA, GALACTORRHEA & GREASY SKINGREASY SKIN
HH : HYPERTENSION : HYPERTENSION II : INCREASED SIZES OF : INCREASED SIZES OF
HATSHATS SHOESSHOES GLOVESGLOVES RINGSRINGS DENTURESDENTURES
JJ : JAW ENLARGED: PROGNATHISM : JAW ENLARGED: PROGNATHISM KK : KYPHOSIS : KYPHOSIS
REVIEW: ACROMEGALYREVIEW: ACROMEGALY
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THANK YOU