Unit 2 Hypothalamus and Pituitary Endocrine Physiology

anterior PG anatomy (3 lobes)

pars tuberlais

pars distalis (largest)

pars intermedia (separates glands)

neurohypopyseal bud

becomes dinecephalon and HT

what forms the pituitary gland

pharynx (rathke’s pouch)

neurohypopyseal bud

connections of PG + HT

control of symp output to adrenal medullae

prod of ADH + oxytocin

secretion of regulatory H to control activity of ant pit

control of sympathetic output to adrenal medullae

nerve fibers connect HT to adrenal medulla (kidney) by BS

secretes epi + nonrepinepherine

production of ADH + oxytocin

synth in HT

temp stored in post PG

released into BS

secretion of regulatory H to control activity of ant pit

tropic H

secretes 2nd set of H in ant pit

H from ant pit effect other endo organs

(ant pit regulates ANS + endo systems)

hypophyseal portal system: nuclei

supraoptic: on top of optic chiasm

paraventricular: adjacent to 3rd ventricle

ignore capillary beds + go straight to post PG

ADH + oxytocin synth here

hypophyseal portal system: hormones

release tropic H from HT to ant PG by portal veins + beds

released into BS/inhibited at ant PG

superior + inferior hypophyseal arteries

feed portal system oxygenated blood

drained by portal veins

sinusoid in the pituitary gland

wide capillary that allows passage of large molecules

form the portal system

what veins drain into the cavernous sinus + where does it exit the brain

hypophyseal veins

enter general circulation at internal jugular vein

hormones released from the neurohypophysis

anti-diuretic H (ADH)

oxytocin (OT)

antidiuretic H (ADH) function

prevents excess urination

released when HT detects change in osmolarity in blood

inc: blood vessel constriction, HR + BP

oxytocin (OT) function

inc uterus contraction during labor

released from mechanical stim of nipple during breastfeeding

anterior pituitary hormones

adrenocorticotropic H (ACTH)

thyroid-stimulating H (TSH)

growth H (GH)

prolactin (PRL)

follicle-stimulating H (FSH)

luteinizing H (LH)

melanocyte-stimulating H (MSH)

HT: direct control by NS

straight to organ

eg. adrenal medulla/cortex

HT: indirect release of H

through release of regulatory H by BS

goes to PG

what HT hormone is a catecholamine (ALL OTHERS PEPTIDES)

dopamine

(prolactin in ant pit)

HT released H function

hypophyseal tropic H

target ant pit

feedback loops of H regulation

HT

| release/inhibit H

ant pit

| tropic H

target gland

| target gland H

(can go back up at any level)

pathophysiology: benign adenomas

hyperpituitarism

hypopituitarism

hyperpituitarism types

gigantism: before puberty

acromegaly: after puberty (can’t grow vertically)

physical signs of hyperpituitarism

inc growth

hyperprolactenemia

gynecomastia + impotence

galactorrhea

visual disturbance

hyperpituitarism management: medical

surgery (thru nasal cavity)

radiation

hormone replacement therapy

hyperpituitarism management: inpatient PT

post surg: bed mobility, ambulation, therapeutic exercise

diaphragmatic breathing

contraindications: sneezing, coughing, blowing nose

hyperpituitarism management: outpatient PT

orthopedic + structural changes

joint mobility, muscle strength, ADLs

hypopituitarism mechanism of injury

radiation

resection

neoplasms

reversible

hypopituitarism clinical signs

dwarfism

development delays

paresis

fatigue

apathy

orthostatic hypotension

nail ben changes

(GH HAS DEC ACTIVITY)

diabetes insipidus overview

neurophypophysis impacted

ADH deficiency (BV)

signs: PPP + nocturia

diabetes insipidus managemnet

BP

GI

heart

red flags: lightheaded, confused, unsteady + passing out