Professional Documents
Culture Documents
Definitions
Some Anatomy & Histology (Morphology)
Some Biochemistry (Chemical Measurements)
Some Physiology (Regulation)
The Pathology (Morphology)
The Laboratory Diagnosis
What
What
is its purpose?
Maintain Homeostasis Between Organs
How
Reproduction
Growth/Development
Cortisol
Peptides
Insulin
Amino Acids
Epinephrine
Interaction of Hormones
1 Hormone
Multiple Actions
Spermatic Genesis
Hormone Interaction
1 Function, Multiple Hormones
(Excess)
Hypofunction
Lesions (Neoplasia)
Non-functioning (No hormone)
Functioning (Hormone)
Hypothalamus
The true master gland
so far
Corticotroph/ACTH Adrenal/Cortisol
Gonadotropin (GnRH)
Gonadotroph/LH &
FSH
Growth Hormone
(GHRH)
Somatotroph/GH
Gonads/Estrogen/
Progesterone/Test
-osterone
Growth/Metabolic
Hypothalamic Suppressor
Hormone Interactions
Hypothalamic
Somatostatin
Dopamine
Anterior Pituitary
Target Cell/Hormone
Somatocyte/Growth
Hormone
Prolactocyte/Prolactin
Pituitary Diseases
Hyperpituitarism
Adenoma
Sella Turcica
Visual Field 's
IC Pressure
Hypopituitarism
Destructive Processes
Ischemic Injury
Radiation
Inflammation
Non-Functioning*
Macroadenomas
(>1cm)
Late Sxs
Mass Effect*
Visual Field Changes
Increased Cranial
Pressure - Headache,
N&V
Hypopituitarism can
Occur
* Null Cell (20%)
Mass Effect
Prolactin, ACTH,
GH, TSH, Etc.
Sella Turcica Erosion
Visual Field Defects
Intracranial Pressure
Growth Hormone
Prolactin
ACTH
Prolactinomas
Prolactin Effects
Prolactin
Amenorrhea
Galactorrhea
Libido Loss
Pregnancy
Prolactin
Hypothyroidism
Hypothalamic
Supracellular Mass
Amenorrhea
Galactorrhea
Libido Loss
Infertility
Prolactinoma - Rx
1.
2.
3.
GH - Secreting Adenoma
Before Epiphyseal
Closure (Prepubertal)
Gigantism
Body Size
Long Legs/Arms
After Epiphyseal
Closure (Adults)
Acromegaly
Prognathism
Enlarged Hands/Feet
Cortisol
Cushing's Disease
Weight Gain
BP
Truncal Obesity
Muscle Mass
Diabetes Mellitus
Nelson's Syndrome
Pre-Existing Corticotroph Adenoma
Adrenalectomy Removes Feed Back,
hipercortosolism does not develop.
Aggressive Enlargement of Adenoma,
produces Mass Effect and Invasion
ACTH precursor molecule on
melanocyte hyperpigmentation
"Mass Effect"
Gonadotroph (~10%-15%)
"Mass Effect"
Libido
Thyrotroph (~1%)
Rare (<1%)
Hypopituitarism
(Anterior Pituitary-AP)
Loss or Absence of > 75% of AP
Most Common Causes:
Nonsecretory Pituitary Adenomas
Ischemic Necrosis (Sheehan's Syndrome)
Ablation by Surgery or Radiation
Hypopituitarism
(Anterior Pituitary-AP)
Loss or Absence of > 75% of AP
Less Common Causes:
Hypothalamic Tumors
Empty Sella Syndrome
Inflammation Trauma
Metastatic Disease
AP - Hypofunction - Clinical
Sheehan's Syndrome
Most Common Cause of Ischemic Necrosis
Normal in AP in Pregnancy
Ischemia During Delivery (Hypotension)
Posterior Pituitary Spared
Posterior Pituitary
Is composed of modified glial cells (pituicytes) and
axonal processes extending from nerve cell bodies
in the supraoptic & paraventricular cells of the
hypothalamus.
ADH (Vasopressin)
Osmotic Pressure----> ADH----> Reabsorption
(>280)
RT-H20
Blood Volume
(~5% to 10%)
Urine Volume
Urine - Na
BP
Serum H2O
Serum Na+
Serum Osmotic Pressure
ADH Deficiency
(Diabetes Insipidus)
Clinical
Polyuria
Thirst (Polydipsia)
Dehydration
No hyperglycemia
Lab
Large Volumes of Dilute
Urine
Sp Gr
U/Na+
Serum Sodium
Serum Osmolality
( Serum Na+)
SIADH
Body Water But No Edema
SIADH - Rx
Remove Offending Cause (e.g. malignancy,
medication)
Trauma - Usually Resolves
Fluid Restriction
ADH Antagonist