ANTERIOR PITUITARY

GLAND

By
Dr. M. Anthony David, MD
Professor of Physiology

02/09/08 EndoPhysio AntPitPara 1

02/09/08 EndoPhysio AntPitPara 2
 PITUITARY GLAND
 Synonym: Hypophysis Cerebri.
 Pituita = Mucus (Latin)
 So named by the Scientist Galen
 Hypophysis Cerebri = Outgrowth
from the Cerebrum.
 Has two important parts:
 Anterior Pituitary: Adenohypophysis
 Posterior Pituitary: Neurohypophysis
02/09/08 EndoPhysio AntPitPara 3
 EMBRYOLOGY OF THE PITUITARY

 Anterior Pituitary or
Adenohypophysis:
 Derived from an upward evagination of
the Rathke’s pouch.(Ectoderm)
 Posterior Pituitary or
Neurohypophysis:
 Derived from a downward growth of the
Infundibulum from the Diencephalon, a
structure of the Neurectoderm.
02/09/08 EndoPhysio AntPitPara 4
 PITUITARY GLAND

 DIMENSIONS:
 1 cm in diameter.
 0.5 to 1 gm in weight.
 LOCATION:
 Sella turcica
 A bony cavity.
 DIVISIONS:
 Anterior Lobe
 Posterior Lobe
 Pars Intermedia

02/09/08 EndoPhysio AntPitPara 5

 ADENOHYPOPHYSIS:
CLASSICAL CLASSIFICATION OF
CELLS
 CHROMOPHOBES:
 50% of the cells
 Agranular, quiescent & Non secretory
 CHROMOPHILS:
 Acidophils: 35%
 Secrete: Growth Hormone & Prolactin
 Basophils: 15%
 Secrete:
 Glycoproteins : FSH, LH & TSH
 Polypeptides : ACTH & MSH

02/09/08 EndoPhysio AntPitPara 6

 MODERN CLASSIFICATION
OF ADENOHYPOPHYSIAL CELLS
 SOMATOTROPHS:  GONADOTROPHS:
 Secrete Growth  Are of two types:
Hormone  FSH type: secrete
FcH
 MAMMOTROPHS:  LH type: secrete LH
 Secrete Prolactin  CORTICOTROPHS
 THYROTROPHS: (ADRENOCORTICO
 Secrete TSH MELANOTROPHS)
 Secrete ACTH &
MSH
02/09/08 EndoPhysio AntPitPara 7
 ADENOHYPOPHYSIAL HORMONES
 GROWTH HORMONE: SOMATOTROPIN
 THYROTROPIN: THYROID STIMULATING
HORMONE (TSH)
 ADRENOCORTICOTROPIC HORMONE(ACTH)
 GONADOTROPIC HORMONES:
 FOLLICLE STIMULATING HORMONE (FSH)
 LUTEINISING HORMONE (LH); Interstitial Cell
Stimulating Hormone (ICSH)
 PROLACTIN

02/09/08 EndoPhysio AntPitPara 8

 Adenohypophysial
Hormones:
A Mnemonic for you!
 “Those Giant Gonads Prolong the
Action”
 T = Thyroid Stimulating Hormone (TSH)
 G = Growth Hormone
 G = Gonadotropins: FSH & LH
 P = Prolactin
 A = Adreno Cortico Tropic Hormone
(ACTH)
02/09/08 EndoPhysio AntPitPara 9
 GROWTH HORMONE:
FUNCTIONS
 ON GROWTH:
 In Children ( As the epiphyses are
unfused)
 Increased Chondrogenesis.
 Increased Linear Growth.( Both in

conjunction with Somatomedins)

 In Adults, where the epiphyses
have fused:
 Thickening of bones.
02/09/08 EndoPhysio AntPitPara 10
 GROWTH HORMONE:FUNCTIONS ON
METABOLISMS:
 PROTEINS: ”Anabolism”
 Anabolic effect by:
 Amino acid transport into cells
  m & t RNA activity

  Nitrogen, Calcium, Sodium &

Potassium in the cells

 Protein Catabolism
02/09/08 EndoPhysio AntPitPara 11
 GROWTH HORMONE:FUNCTIONS ON
METABOLISMS:

 CARBOHYDRATES: “DIABETOGENIC”
 Hyperglycemia caused by:
 Gluconeogenesis.
 Peripheral Utilisation of Glucose: “Anti-
Insulin”
 Glycolysis
  FFA causing need for glycolysis
 FAT:
 Increased FFA: Used for energy
02/09/08 EndoPhysio AntPitPara 12
 GROWTH HORMONE:FUNCTIONS ON
METABOLISMS:

 ELECTROLYTES:

 Increased Calcium
absorption
 Retention of:

Sodium

Potassium

02/09/08 Chloride EndoPhysio AntPitPara 13

 SOMATOMEDINS
 Are Intermediate compounds,
polypeptide growth factors.
 They facilitate the functions of
Growth Hormone.
 Growth Hormone will not be able to
function in the absence of these
somatomedins.
 The most important of the
somatomedins is Somatomedin C or
IGF I.
02/09/08 EndoPhysio AntPitPara 14
 SOME 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)
02/09/08 EndoPhysio AntPitPara 15
 FACTORS INFLUENCING GROWTH HORMONE
SECRETION
FASTING DEEP
EXERCISE HYPOTHALAMIC SLEEP V
A.As
FACTORS  l DOPA

GLUCAGON STRESS:
ANDROGENS SURGERY
ESTROGEN ANESTHESIA
PROSTAGLANDINS HEMORRHAGE
GROWTH HORMONE EXCITEMENT
“COLD”
SECRETION

HYPERGLYCEMIA PROTEIN ANABOLISM  FFA OXIDATIO

 ENERGY
02/09/08 EndoPhysio AntPitPara 16
THYROTROPIN (TSH)
 FUNCTIONS:  LEVELS:
 Releases stored
  Midnight
T3,T4  Evening
 REGULATION:
 Facilitates:
 Iodination
 TRH
 Coupling (Hypothalamus)
 Other stages of  Negative feedback:
Biosynthesis.  T3, T4
 Via TRH
02/09/08 EndoPhysio AntPitPara 17
 CORTICOTROPIN: ACTH

 ACTIONS:  EXTRA ADRENAL:

 Melanocytes
 ADRENAL:
 Adipokinetic
 Hypertropy &
effect
Hyperplasia of
 Circadian
z.fasciculata &
reticularis Rhythm.
 REGULATION:
  Vascularity
 CRF & -VE Feedback
 Basal & Stress
 LEVELS: Circadian
induced
  4 – 6 AM
Cortisol levels.
EndoPhysio AntPitPara Evening

02/09/08 18
 PROLACTIN
 In Males?
 Potentiates effect of ICSH ( Interstitial Cell
Stimulating Hormone )
 In Females:
 Promotes Milk Production in Estrogen &
Progesterone primed Mammary tissues.
 Baby’s suckling increases Prolactin secretion
by the Milk Ejection/Secretion Reflex

02/09/08 EndoPhysio AntPitPara 19

 PROLACTIN

 Inhibits Ovulation by:

 Secretion & effect of LHRH on Pituitary gland
 Action of FSH/LH on Ovary
 Lactational Amenorrhea
 On the CNS:
 Maternal Instinct, protective Behaviour (Limbic
System)
 Regulation:
 PIH/DOPAMINE: Depresses Prolactin
production.
02/09/08 EndoPhysio AntPitPara 20
 GONADOTROPINS

 FSH:
 Early maturation & Nutrition of Ova
 Release of Estrogens
 LH:
 Final Maturation of Ova
 Ovulation
 Corpus Luteum formation.
 In Males: ICSH:  Production of
Testosterone.
02/09/08 EndoPhysio AntPitPara 21
NOW FOR A
COFFEE!

02/09/08 EndoPhysio AntPitPara 22

02/09/08 EndoPhysio AntPitPara 23
 GROWTH
 Physiological Growth is defined as an
increase in the number and size
of cells with sequential changes
in maturation.
 Growth is normal and physiological in
children and adolescents
 It becomes pathological in
Malignancies or Cancers.

02/09/08 EndoPhysio AntPitPara 24

 HYPERTROPY & HYPERPLASIA

 HYPERTROPY:  HYPERPLASIA:
 Increase in the size  Increase in the
of the cells. number of cells.

02/09/08 EndoPhysio AntPitPara 25

 FACTORS CONTROLLING
GROWTH
1. GENETIC FACTORS:
 Genes decide the tissue responsiveness
to GH.
2. EXTRINSIC FACTORS:
 Diet/ Nutrition: PEM :
KWASHIORKOR/MARASMUS
3. ENDOCRINE FACTORS:

02/09/08 EndoPhysio AntPitPara 26

 MARASMUS

02/09/08 EndoPhysio AntPitPara 27

 ENDOCRINE FACTORS AFFECTING
GROWTH

 GROWTH HORMONE
 THYROXIN
 INSULIN
 SEX HORMONES:
 ANDROGENS
 ESTROGEN
 GLUCOCORTICOIDS
 GONADOCORTICOIDS

02/09/08 EndoPhysio AntPitPara 28

 GENERAL GROWTH CURVE

 X – AXIS: AGE IN YEARS

 Y – AXIS: GROWTH% SIZE AT 20
YEARS
 HAS FOUR PHASES:
 I : RAPID GROWTH: 0 – 3 Years
 II : SLOW PHASE: 3 – 13 Years
 III: ACCELERATED PHASE: 13 – 16 Years
 IV : SLOW INCREASE: 16 – 20 Years.
02/09/08 EndoPhysio AntPitPara 29
 GENERAL GROWTH
CURVE
120

100
% GROWTH AT 20yrs

80

60

40

20

0
0 2 4 6 8 10 12 14 16 18 20 22
AGE I N YEARS
02/09/08 EndoPhysio AntPitPara 30
 SPECIFIC GROWTH CURVES

 NEURAL & HEAD CURVE:

 Peaks by 3 to 6 years.
 LYMPHOID CURVE:
 Peaks to 200% at 12 – 14 Years.
 SPLANCHNIC CURVE:
 Similar to the General growth
curve.
 REPRODUCTIVE CURVE:
 Peaks at 13 – 16 years.
02/09/08 EndoPhysio AntPitPara 31
 SPECIFIC GROWTH CURVES :
NEURAL & HEAD
120

100
% GROWTH AT 20yrs.

80

60

40

20

0
2 4 6 8 10 12 14 16 18 20 22
AGE I N YEARS
02/09/08 EndoPhysio AntPitPara 32
 SPECIFIC GROWTH CURVES:
LYMPHOID TISSUE
250
% GROWTH AT 20 Yrs

200

150

100

50

0
2 4 6 8 10 12 14 16 18 20 22
AGE I N YEARS

02/09/08 EndoPhysio AntPitPara 33

 SPECIFIC GROWTH CURVES:
SPLANCHNIC TISSUES
120

100
% GROWTH AT 20yrs

80

60

40

20

0
0 2 4 6 8 10 12 14 16 18 20 22
AGE I N YEARS
02/09/08 EndoPhysio AntPitPara 34
 SPECIFIC GROWTH CURVES:
RPRODUCTIVE TISSUES
120

100
% GROWTH AT 20yrs.

80

60

40

20

0
2 4 6 8 10 12 14 16 18 20 22
AGE I N YEARS

02/09/08 EndoPhysio AntPitPara 35

 ANTERIOR PITUITARY: APPLIED
ASPECTS
 PAN HYPOPITUITARISM:
 Simmond’s: Sheehan’s Syndrome
 Frohlich’s Syndrome: Both Ant & Post Pit are
deficient.(Dystropia Adiposa GenItalis)
 HYPOSECRETION OF ANT PIT HORMONES
 ADULTS: Acromicria
 INFANTS: Dwarfism: Laron type:
Somatomedins
 Sexual Ateloitic: Intelligent Dwarfs

02/09/08 EndoPhysio AntPitPara 36

 ANTERIOR PITUITARY: APPLIED
ASPECTS
 HYPERSECRETION OF
GH:
 ADULTS: ACROMEGALY
 INFANTS: GIGANTISM

02/09/08 EndoPhysio AntPitPara 37

 G
I
G
A N
N O
T R
I M
S A
M L
02/09/08 EndoPhysio AntPitPara 38
 ACROMEGALY : ABC
 A: ARTHROPATHY: Joint Disorders
 B: BIG BOGGY HANDS
 C: CARPAL TUNNEL SYNDROME

02/09/08 EndoPhysio AntPitPara 39

 ACROMEGALY : DEF
 D: DIABETES MELLITUS
 E: ENLARGED:
 TONGUE
 HEART: CARDIOMEGALY
 THROAT
 F: FIELD DEFECT OF VISION:
Bitemporal Hemianopia

02/09/08 EndoPhysio AntPitPara 40

 ACROMEGALY : GHI
 G: GYNECOMASTIA, GALACTORRHEA &
GREASY SKIN
 H: HYPERTENSION: 20 – 50% CASES
 I: INCREASING SIZE OF:
 SHOES
 HATS
 GLOVES
 DENTURES
 RINGS

02/09/08 EndoPhysio AntPitPara 41

02/09/08 EndoPhysio AntPitPara 42
 ACROMEGALY: JK
 J: JAW
ENLARGED:
PROGNATHISM
 K: KYPHOSIS:
VERTEBRAL
DEFORMITY

02/09/08 EndoPhysio AntPitPara 43

 REVIEW
 Growth: an increase in the number and
size of cells with sequential changes
in maturation.
 General & Specific Growth Curves
 Applied Aspects:
 Adults:
 Acromegaly
 Acromicria
 Infants:
 Gigantism
 Dwarfism: Intelligent!

02/09/08 EndoPhysio AntPitPara 44

 REVIEW: ACROMEGALY
 A : ARTHROPATHY
 B : BIG, BOGGY HANDS
 C : CARPAL TUNNEL SYNDROME
 D : DIABETES MELLITUS
 E : ENLARGED:
 TONGUE
 HEART
 THROAT
 F : FIELD DEFECT: Bitemporal
Hemianopia
02/09/08 EndoPhysio AntPitPara 45
 REVIEW: ACROMEGALY
 G : GYNECOMASTIA, GALACTORRHEA &
GREASY SKIN
 H : HYPERTENSION
 I : INCREASED SIZES OF
 HATS
 SHOES
 GLOVES
 RINGS
 DENTURES
 J : JAW ENLARGED: PROGNATHISM
 K : KYPHOSIS
02/09/08 EndoPhysio AntPitPara 46
 THANK YOU

02/09/08 EndoPhysio AntPitPara 47