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HORMONES OF POSTERIOR PITUITARY

AND RELATED DISORDERS

LEARNING OBJECTIVES
At the end of the lecture the student should be able to know the

• Overview of the posterior pituitary

• The function of Oxytocin and ADH

• Disorders of ADH

• Clinical correlate

THE PITUITARY GLAND


• The pituitary gland is often portrayed as the "master gland" of the

body

• Secretes a battery of hormones that collectively

influence all cells and affect virtually all physiologic

processes
PITUITARY GLAND (HYPOPHYSIS)

• Lies in the sella turcica, a bony cavity at the base of the brain

• Connected to the hypothalamus by the pituitary (or hypophysial) stalk

• Anterior Pituitary (adenohypophysis)

• Posterior pituitary (neurohypophysis)

POSTERIOR PITUITARY HORMONES

• Antidiuretic • Kidney • Conservation of body

hormone water

• Oxytocin • Uterus, • Stimulates milk ejection

Breast and uterine contractions


SITE OF SYNTHESIS OF HORMONES OF
POSTERIOR PITUITARY

• Synthesized in hypothalamus

• ADH primarily in Supraoptic

• Oxytocin primarily in Paraventricular nucleus

• Neurohormones

• Stored and released form posterior pituitary


EFFECT OF LESION OF POSTERIOR PITUITARY

• Loss of Posterior Pituitary results in only a TRANSIENT deficiency if

hypothalamic function(cell bodies that synthesize ADH) remains

intact
OXYTOCIN

• Breast-feeding

• Contracts the myoepithelial cells of the alveoli

• Classic neuroendocrine reflex

• Childbirth (parturition)

• In late pregnancy, uterine smooth muscle (myometrium) becomes

sensitive to oxytocin

• Positive feedback

CONTROL OF OXYTOXIN SECRETION


POSITIVE FEEDBACK
CONTROL OF ADH RELEASE

• Osmotic pressure
secretion parallels osmotic pressure.

• Volume effects

as ECF drops, ADH secretion increases

Baroreceptor mediated.

• Others

pain, trauma, emotion, alcohol.


REGULATION OF ADH
ACTIONS OF ADH

1. Antidiuretic actions
• Increases permeability of the collecting ducts to water

• V2 receptors

2. Vasopressor actions

• constricts vascular smooth muscle cells

• V1 receptors, non-hormonal

ACTION OF ADH

• Main target is Renal Collecting Duct

• Increases permeability by increasing water channels (Aquaporins)

• Water absorbed PASSIVELY

• Urea can pass with water

• ELECROLYTES CANNOT PASS with water


ACTION OF ADH
DISORDERS OF ADH SECRETION

• Diabetes Insipidus

• Syndrome of Inappropriate Appropriate Antidiuretic Hormone

Secretion (SIADH)

DIABETES INSPIDUS

• TYPES

• Central Diabetes Insipidus

• Insufficient ADH to effect renal collecting tubules

• Nephrogenic Diabetes Insipidus

• Inability of KIDNEYS to respond to ADH


CAUSES OF CENTRAL DI
• Damage to pituitary or hypothalamus

• Surgery

• Tumor

• Illness

• Head Injury
NEPHROGENIC DIABETES INSIPIDUS

• Defect in the kidneys tubules

• Inherited (genetic) disorder or a chronic kidney disorder.

• Certain drugs, such as lithium and tetracycline

CAUSES OF SIADH

• Central nervous system disease

• Pulmonary disease

• Carcinoma (Lung)

• Drugs

• Surgery

• Idiopathic
References

1. Textbook of Medical Physiology. Eleventh Edition. Guyton

2. Syndrome of Inappropriate Antidiuretic Hormone Secretion. Bora

K, Chaudhry M.
3. Causes. By Mayo Clinic staff.

http://www.mayoclinic.com/health/diabetes-

insipidus/DS00799/DSECTION=causes