Anterior Pituitary Gland

Dr. Magpale

PITUITARY GLAND Pituitary has many capillaries and the axons are usually
located at the hypothalamic-hypophyseal portal system.
Pea sized structure that is approximately 1cm in diameter Once the signals is released from the hypothalamus it goes
and 0.5 -1 gram in weight. down here  going to your hypophyseal portal vein either
Also known as HYPOPHYSIS to your APG or PPG.
Connected to the hypothalamus by the infundibular stalk.
Located inside a sphenoid depression called the Sella turcica Hypothalamic releasing and inhibiting hormones – are
and since it lies inside the sella turcica, any tumor that secreted to stimulate the APG.
involves the pituitary gland usually goes up outside this
depression and compresses the optic chiasm. Examples:
Most of the time, patients with tumor involving the pituitary
gland experience visual field problems. a. Thyrotropin releasing hormone – signals the APG to
release TSH  goes to the thyroid gland  T3 and T4
Divided into : secretion
ANTERIOR PITUITARY GLAND/ POSTERIOR PITUITARY GLAND/ b. Coritcotropin releasing hormone –responsible for the
ADENOHYPOPHHYSIS NEUROHYPOPHYSIS release of ACTH
c. Growth hormone releasing hormone – responsible for
the release of growth hormone
Is mostly pars distalis Is mostly pars nervosa d. Growth hormone inhibiting hormone/ somatostatin –
inhibits the release of GH
From the rathke’s pouch  which is From a neural tissue outgrowth of e. Gonadotropin releasing hormone
an invagination of the pharyngeal the hypothalamus f. Prolactin inhibiting hormone
epithelium.
Storage of 2 hormones
Has 6 hormones i. Oxyctocin When you say sex steroid hormones, it not the
i. Growth hormone ii. ADH/ Vasopressin gonadotropins, you’re talking about your estrogen and
ii. ACTH progesterone as well as the testosterone.
iii. TSH
iv. Prolactin When you’re talking about the endocrine axis in your
v. FSH pituitary gland it is usually hypothalamic-pituitary and
vi. LH specific target gland.
Example: sex steroid axis: HPO axis ang tawa. ( H-
Major type of cells:
The hormones is secreted by the Hypothalamus, P-pituitary, O-ovaries)
Chromophils – granulated secretory
cells paraventricular nucleus (oxytocin)
ANTERIOR PITUITARY GLAND
i. Acidophils – and supraoptic nucleus (ADH).
lactotrophs and a. ACTH
somatotrophs These two nucleus is usually - Has a diurnal pattern:
stimulated by neuronal nerve.
Early morning – PEAK
ii. Basophils – Late afternoon - lowest
gonadotrophs,
- It has pulsatile secretion
thyrotrophs and
- Regulators include neurogenic factors or systemic
coricotrophs.
factors.
Chromophobes - Hypothalamic- Pituitary -Adrenal axis
- This acts on the adrenal cortex
Mostly the endocrine cells of the - Affects the metabolism of glucose, proteins and fats
pituitary belongs from the - Once your ACTH is released from the APG, secondary to
chromophils and most of these cells your CRH, it acts on the on zona fasciculata (for cortisol
are the acidophils (80%). release) and zona reticularis (for androgen release)

Release of hormone is due to Androgen, present in both male and female. Pero
inhibitory or releasing hormones by nacocontrol naman daw kasi sa babae.
the hypothalamus (highest axis).

Cortisol – it increases your blood glucose and usually it

decreases your inflammatory response.

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 Anterior Pituitary Gland
Dr. Magpale

b. TSH GNRH – is usually secreted in a pulsatile manner; bakit pulsatile?

- Released according to a diurnal pattern: if ever the secretion is continuous, nasasaturate yung mga receptors,
Overnight – Highest may desensitization na nangyayari so hindi na siya nagrereact.
Daytime – Lowest
FSH LH
- Has two types of glycoproteins: alpha and beta sub-units.
Usually secreted at a lower rate in secreted one pulse every hour.
Alpha Subunits Beta subunits which it is secreted one pulse
every 3 hours.
The common alpha subunits is Specific subunit belongs to the
similar with the gonadotropins beta subunit of this hormone.
- Sex steroid hormones is secreted for the development of
(FSH and LH).
the secondary sexual characteristic when you’re talking
Example: about puberty. But aside from puberty, it is also secreted
Increase in secretion of your TSH, for ovulation/procreation.
can cross-link and increase the
secretion of your FSH. d. Growth hormone
- If your thyroid hormone, corticotropic hormones and
gonadotrophic hormones acts on specific target gland,
the GH usually acts on almost on all parts of the body. It
So yung alpha sub units ng FSH, LH and TSH ay magkakaparehas, but doesn’t necessarily mean that your GH only acts on the
yung beta sub-unit is specific for that particular hormone.  long bones, it also acts on your muscles; it can also act to
increase the size of your viscera (organs).
- Secreted in a circadian rhythm.
- Hypothalamic- Pituitary- Thyroid Axis  TRH will - GHRH is the one that stimulates the release of this
stimulate your APG to release TSH  which will in turn hormone.
activate the thyroid gland to release your T3 and T4. - Has different functions aside from the growth of bones
- Responsible for the different metabolic activity of the and tissues, it also increases your blood glucose.
body. It controls most of the intracellular and chemical
reactions of the body. 3 major functions of GH

Example: i. Excess of GH promotes protein synthesis for

anabolic reasons (to increase the lean body
- You have a decrease in the secretion of your thyroid muscles)
gland, what happens is mababa din yung metabolism. ii. Lipolytic and Ketogenic hormone in a sense
With negative feedback control that your fatty acid are the one that is being
used as energy instead of your glucose and
Hypothalamus  TRH (-) protein. (pag ang fat ay naconvert sa
(+) (-) acetoacetic acid, usually nagpproliferate so
Anterior PG  TSH what does it do, it goes to your body fluid and
(+) then it will produce your ketone bodies – ketosis.
Thyroid gland  T3,T4 Excess
So again, your GH is anabolic (protein synthesis) in such a
way that it will inhibit the utilization of glucose in the
muscle. Once the glucose utilization in the muscles
decreases, nagkakaroon ng gluconeogenesis  tataas ang
c. Gonadotrophin
blood glucose sa body fluid  and it stimulates now the
- FSH and LH which responsible ofr the secretion of sex
pancreas to secrete insulin.
steroids.
- GNRH – sends signal to your APG to release FSH and LH
- GH is also known as diaketogenic (it inhibits the
and from then on they will act on a specific target glands.
utilization of glucose)– cause it promotes
- FSH & LH – acts on both your testis and ovaries.
gluconeogenesis.
MALE FEMALE
FSH – Spermatogenesis FSH – Follicle growth - Plasma level of GH is higher in infants and children
LH – sex steroids secretion LH - ovulation compared to adults, so it doesn’t mean na kapag adult
tayo wala ng growth hormone, meron padin but it’s not
anymore for the linear growth of your body, kasi once the

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Anterior Pituitary Gland
Dr. Magpale

epiphyseal plate has been closed, stop na rin ang paglaki

ng tao.
Actions of GH
- Has a diurnal rhythm:
i. Diaketogenic
Early in the morning, just before awakening – peak
ii. Increases lipolysis
Daytime – lowest
iii. Increases protein synthesis
- GH is one of the stress hormones because this hormone
iv. Actions of GH in the liver producing your insulin-like
is released in response to stress; aside from this one, one
growth factor (also called the somatomedin C).
of your GH is cortisol.

Things that stimulate GH release The insulin-like growth factor is the one that is responsible
for the linear growth of the bone not specifically your GH.
i. decrease blood glucose Meaning, kahit my GH ka at hindi naman nastimulate ang
ii. decrease in blood free fatty acid insulin-like growth factor, hindi magkakaroon ng linear
iii. starvation/fasting growth ang long bones.
iv. stress
v. excitement
vi. exercise
Actions of IGF/ Somatomedin C

Hypoglycemia - the most potent stimulator for the release i. Promotes protein synthesis in chondrocytes and
of GH. And aside from that, it also includes the deep sleep. muscles, and most of the protein synthesis in the
organs.
GH release is also stimulated by sex steroid hromones which
peaks at puberty para magkaroon ng growth. The GH and IGF both promotes protein synthesis and
important for the epiphyseal growth.
GH secretion depends most of the time on the nutritional
status of the patient. Remember, one of the mechanism of GH The difference between GH and IGF, is that IGF-1 is not a
release is starvation.
diaketogenic hormone, it has a insulin-like activity and not
like your GH that produces lipolysis, IGF has an anti-
Things that inhibit RH release
lipolytic activity.
i. increase blood glucose
ii. increase in blood free fatty acid
Another hormone that is important for human growth is the
iii. aging
thyroid hormone which is important starting at the
iv. obesity
embryonic life until infancy. Usually, thyroid hormones
v. somatostatin
decline after toddler years. Kaya siya mataas during
vi. exogenous growth hormone (has a negative
embryonic-infancy, its because your thyroid hormone is
feedback)
important for human growth.
vii. somatomedin C/ insulin like growth factor
Congenital hypothyroidism – is a secondary problem from
- The metabolic activity of GH is usually anabolic; it
the mother. Mababa ang hormone during fetal life, yung baby
promotes gluconeogenesis that’s why it is called an anti-
is stunted ang growth or pwede magkaroon ng intra-uterine
insulin hormone. (not sure about this one, di ko kasi
growth restriction. Since thyroid hormone is also for the
maintindihan yung recording haha  )
brain development, insufficient amount of thyroid hormone
may lead to mental retardation.
Diaketogenic –decrease in glucose uptake in the tissues such
as your skeletal muscles and fats increases the glucose
- GH is also important for upper growth, usually after the
production in the liver (Gluconeogenesis), and now it
toddler years, dapat yung GH secretion is plateau lang
increases your insulin secretion thus your insulin resistance.
siya up to the time of puberty.
So in excess of your growth hormone, can cause insulin
resistance (kaya daw yung sobrang tangkad has a full blown
Sex steroid hormones – peak during puberty.
DM)
GH, Sex steroid hormones and thyroid hormone  important
When you talk about the ketogenic part of the excess growth for human growth.
hormone secretion, there will be great fat mobilization that
can increase acetoacetic acid in the liver and it will be
released in the body fluid producing ketosis.

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Anterior Pituitary Gland
Dr. Magpale

DIFFERENT ABNORMALITIES OF THE PITUITARY GLAND

i. Panhypopituitarism
- Halos lahat ng pituitary hormones mababa.
- It affects the APG and PPG. Treatment:
- Can be secondary mostly to tumors involving the
Human GH replacement – talking about Laron dwarfism,
pituitary gland (it can either be a craniopharyngioma or
even if you give GH they will not have increase in size kasi nga
chromopobe tumors)
yung receptor sa GH ang may problem.
- Or it can also be due destruction of the APG (e.g.
Sheehan’s syndrome) An excess in glucocorticoids can lead to dwarfism
Cretinism – thyroid hormone deficiency. Usually babies with
ii. Flourish syndrome congenital hypothyroidism and they are mentally retarded.
- Adenogenitalis syndrome that involves the
hypothalamus and pituitary gland. ( not sure sa narinig GROWTH HORMONE EXCESS
ko ) Gigantism Acromegaly
- Rare childhood metabolic disorder characterized by
having an obesity, stunted growth, with retarded Proportional growth Not proportional growth
development of the genital organs (no secondary sexual
characteristics). GH excess happens usually before GH excess happens after the
the closure of the epiphyseal closure of the epiphyseal plates.
plates that’s why they have the
iii. Simmond’s disease
continuous growth of the long Secondary mostly to an acidophilic
- Destruction of the hypothalamus and pituitary gland. bones. tumor that secretes excessive
amount of GH.
iv. Sheehan’s syndrome Before adolescence
- Destruction of your adenohypophysis Adulthood
- Secondary to a hypoxia after delivery (usually yung With full blown diabetes (again,
mommy kapag naghypovolemia, kasi nagkaroon ng diaketogenic kasi ang GH) Actions of the GH is not actually on
hemorrhage after deliver. What happens is mababa yung the linear bone growth, its action
blood supply sa pituitary gland, so decrease ang blood lies on the membranous bone (e.g.
supply  nagkakaroon ng hypoxia  nasisira yung APG. bones that can be found on the
face, forehead jaw supraorbital
ridge etc.)That continues to grow
Aside from the endocrine secretion abnormalities of the GH,
even if the epiphyseal plate is
you also have a growth hormone deficiency and excessive
already closed.
conditions.
Aside from the membranous
GROWH HORMONE DEFICIENCY
bones, the excess GH can also act
on the viscera. (tongue, liver and
i. Panhypopituitary Dwarfism kidneys)
- A generalized deficiency of anterior pituitary secretion.
Skin thickening
- Usually proportional body structures
- No mental retardation. Nagiging kuba din ung patients
- Panhypo – meaning mababa, at hindi ibig sabihin na because yung vertebrae ay
walang hormones. Meron, kaso mababa lang ung amount. membranous bone 
- Can pro-create.
Thick fingers and nails
ii. Dwarfism secondary to a congenital
hypothyroidism Galactorrhea with hypertension
and cardiomegaly
iii. Laron dwarfism
- The genetic defect lies in the GH receptor

iv. African kidneys

- GH secretion is normal or high but the IGF-1 fails to
increase at the time of puberty.

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Anterior Pituitary Gland
Dr. Magpale

e. PROLACTIN Essential for water balance in such a way that when there is
For the milk production increase in ADH secretion, there will also be increase in
Stimulated by the TRH and PRF. water reabsorption in the DCT and CD. One of the excitatory
In pregnancy, usually it is the estrogen that increases your stimuli for ADH release is the increase in ECF in the form of
prolactin secretion for the milk production. dehydration and hypovolemia.
It is called vasopressin because one of the receptors is called
FACTORS THAT INCREASES PROLACTIN SECRETION the V1a that has a vasoconstricting effect.
1. Breast feeding
2 types of receptors of ADH:
2. Dopamine antagonist
3. Sleep
a. V1a –
4. Stress
b. V2 -
5. Estrogen in pregnancy

If there is a decrease in water, there will be an increase in the

FACTORS THAT DECREASES PROLACTIN SECRETION extracellular  stimulation of ADH secretion  increase in
water permeability in the DCT and CD  decrease in urine
1. Dopamine agonist – a tablet given to patient to inhibit volume.
galactorrhea (male of female patient na hindi pa
nanganganak) or lactation (for post partum patients)
2. Somatostatin
FACTORS THAT INHIBIT ADH RELEASE
3. If there is negative feedbackfluid osmolality
1. Decrease in ECF osmolality (there is an excess in water,
So notice if we’re talking about the decrease prolactin nadidilute ung mga nasa ECF kaya bumababa yung
secretion, we have dopamine agonist. osmolality  )
2. Over hydration
ACTIONS OF PROLACTIN
3. Hypertension
1. Production of breastmilk 4. Hypervolemia
2. It inhibits ovulation – prolactin in excess is can be used as 5. Alcohol intake
a means for birth control. So patients exclusively
breastfeeding (4hr/day or 6hr/night) can used prolactin
as a form of contraception. In excess of prolactin, it DISORDERS OF ADH SECETION
increases dopamine and remember, dopamine sends
signal to your GnRH to inhibit its secretion thereby 1. Central Diabetes Insipidus
decreasing for FSH and LH. - The problem is in the higher centers that decreases
3. Inhibits spermatogenesis- because remember, a secretion of ADH.
prolacting secreting tumor can also happen in males. So
when it happens in males, it inhibits your spermatogenesis 2. Nephrogenic Diabetes Insipidus
by decreasingthe signals to the higher center in the form - Absence of nephrogenic receptors
of your GnRH. Most of the male patients with galactorrhea - Polyuria, polydipsia
is said to be infertile (no FSH production); there is also no - Sometimes patients develop hypotension
testosterone production reducing to low potency (by LH). - Hypernatremia,

ABNORMALITIES ON PROLACTIN SECRETION

1. Hypoprolactinemia 3. SIADH
2. Hypeprolactinemia – pathologic; you have galactorrhea - Tumors producing ADH, usually ay nasa lungs 
bronchogenic
POSTERIOR PITUITARY GLAND - Halos lahat ng tubig ay narereabsorb
The signals is usually via direct neural control. From the - Water retention, edema
hypothalamus  axons  PPG  ADH or oxytocin release - Sometimes can develop hypertension because of fluid
overload.
ADH/ Vasopressin - There is also a serum dilution or hyponatremia.

ADH secretion is sensitive to hyper or hypotension; it

responds to pressures in the body.
Has a life of 15-20minutes

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Anterior Pituitary Gland
Dr. Magpale

OXYTOCIN

Usually has effects on the myoepithelial cells of the breast

and the myometrium.
It has 2 effects on the uterus: when you’re talking about a
patient in labor or parturition, what the uterus does is to
contract the uterus para ilabas yung baby. But when
you’re talking about a non-pregnant patient after
intercourse, usually during orgasm, you’re oxytocin is being
released to contract the uterus for the transport of sperm.

Secreted by the pars nervosa.

One of the stimulus for oxytocin release: sucking the nipple

 which will induce milk ejection. (different ito sa prolactin
na nagpPRODUCE ng milk  )

ACTIONS OF OXYTOCIN

1. Contraction of the myoepithelial cells of the breast for

milk ejection.
2. Contraction of the uterus for the initiation of labor and
the transport of sperm cell for non-pregnant women.

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