Pituitary Gland PDF

 31 year old female presented with complains of:  Weight gain  Abnormal marks on abdomen  Uncontrolled blood pressure and sugar  Facial swelling  Acne  Easy bruising  35 year old female presented with complains of:  Weight gain  Menstrual i...

 31 year old female presented with complains of:  Weight gain  Abnormal marks on abdomen  Uncontrolled blood pressure and sugar  Facial swelling  Acne  Easy bruising  35 year old female presented with complains of:  Weight gain  Menstrual irregularities  Cold intolerance  Mood swings  Muscle ache  Constipation  Laziness  45 year old man presented with complains of:  Weight loss  Increased elasticity of skin  Darkening of skin  Increased thirst  Hair loss  Decreased appetite  55 year old male presented with complains of:  Headache  Blurring of vision  Unable to see cars passing by  Increased size of breast  Erectile dysfunction  14 year old boy brought by parents in OPD with complains of:  Large jaw size  Large hands and feet  Abnormally taller than all his siblings  Difficulty finding shoe size for his age  Swollen neck size  Dizziness  High blood sugars  Anterior pituitary  Growth Hormone (GH)  Thyroid Stimulating Hormone (TSH)  Prolactin  Gonadotrophins (FSH and LH)  Adrenocorticotropic Hormone (ACTH)  Posterior pituitary  Oxytocin  Anti- Diuretic Hormone (ADH)  It is the process by which a constant balanced environment is maintained.  This ‘constant balanced environment’ is called homeostasis.  It is used by most hormones to maintain an average amount of substance/chemicals in the body.  It occurs by auto-regulation and self inhibition once a specific hormone/chemical level is achieved.  TSH is an important hormone as it controls release of thyroid hormone which is responsible for metabolic functions and is responsible for growth and development of brain and soft tissues.  It is also an important diagnostic marker in medicine as it helps in diagnosis of hypothyroidism and hyperthyroidism.  A condition in which there are high levels of thyroid hormone. Symptoms include: 1. Weight loss 2. Increased appetite 3. Heat intolerance 4. Sweating profusely 5. Diarrhea 6. Hot flushes 7. Hand tremors 8. Fast heart rate 9. Bulging eyes  A condition in which there are low levels of thyroid hormone. Symptoms include: 1. Weight gain 2. Decreased appetite 3. Cold intolerance 4. Constipation 5. Menstrual irregularities 6. Dry skin 7. Fatigue 8. Slow heart rate  Hyperthyroidism  Grave’s disease  Toxic Goitre  Thyroid tumors (most)  Hypothyroidism  Hashimoto thyroiditis  Autoimmune thyroidits  Thyroid adenoma  Infantile hypothyroidism (Cretinism)  ACTH is a releasing hormone which acts on the cortex of adrenal gland  Adrenal gland is divided into 2 main divisions:  Cortex  Medulla  The cortex is further divided into 3 parts:  Zona Glomerulosa  Zona Fasciculata  Zona Reticularis  The medulla contains enterochromaffin cells which are derived from neural crest cells  The cortex is further divided into 3 parts:  Zona Glomerulosa- releases aldosterone  Zona Fasciculata- releases cortisol  Zona Reticularis- releases androgens  The medulla releases catecholamines  Aldosterone  Used to maintain blood pressure and sodium levels throughout the body.  Cortisol  Also called the ‘stress hormone.’ Released normally in minute amounts. Involved in several reactions and systems  Androgens  A group of hormones responsible for development of gender specific characteristics. Common example is testosterone.  Catecholamines  Responsible for simulation of ‘flight and fight’ response, usually present in trace amounts except for certain situations.  It is the body’s natural response to stress.  It is stimulated by ACTH which is released from the pituitary gland  Main functions include:  Stress response  Metabolism  Blood pressure  Glucose regulation  Inflammation  Plays a part in maintaining circadian rhythm Cushing’s Syndrome  High blood pressures  Uncontrolled sugars  Abnormal abdominal marks (striae)  Weight gain  Moon face  Buffalo hump  Muscle weakness  Easy bruising Addison’s Disease  Fatigue  Weakness  Unintentional weight loss  Loss of appetite  Skin darkening (pigmentation)  Increased thirst (Polydipsia)  Low blood pressure  Also called Somatotropin.  Secreted by Somatotroph cells of pituitary gland.  Involved in development of soft tissues, bones and overall growth.  Prominent facial features  Enlarged nose  Prominent forehead  Enlarged lips and tongue (macroglossia)  Prominent chin and jaw  Enlarged stature (Excessively large height)  Large hands and feet  Low levels of Growth Hormone  An adult height of < 4 feet 10 inches  Characteristically, the only sign and symptom is slow and stunted growth.  It is, per se, not a disease, but is at high risk of other diseases such as heart and kidney problems.  ‘Milk-maker’ hormone.  Secreted by Mammotroph cells of pituitary gland.  Chief purpose is production of breast milk.  In both, males and females, contributes to breast development.  These are collectively known as gonadotrophins.  in females, they play a crucial role in mantaining the menstrual cycle as well as take part in formation of mature follicle and TIMELY release of follicle.  In males, they are required for sperm development and maturation.  Any imbalance will ultimately result in subfertility and menstrual irregularities.  The entire control system is called ‘Hypothalamic- Pituitary-Ovarian Axis.’  Released from Paraventricular nuclei.  Responsible for ‘getting things out.’  Letdown reflex of milk  Expulsion of fetus from uterus  Hormone activates smooth muscles of breast and uterus which causes contraction and expulsion.  Also released when physical contact is made such as handshaking and hugging.  Released from SupraOptic nuclei of posterior pituitary gland.  Diuresis is the process of urination.  This hormone helps to retain water within the body. As the name suggests, it is working in opposition to excretion of urine.  ADH acts by inserting water channels in the collecting tubules of kidney and reabsorbs water as it passes through.  High levels  Certain tumors cause excessive levels of ADH like small cell lung cancer.  Usually asymptomatic  Low Levels  Usually occurs in diabetes insipidus or by some drugs such as lithium.  Diabetes Insipidus is of 2 types ▪ Central- No ADH available from Pituitary gland ▪ Peripheral- available ADH can’t act on vessels or kidneys