PPE61202: ES Self-Learning Package

MBBS Program
SELF-LEARNING PACKAGE

(Student’s copy)

Course
Endocrine System

Semester/Year
2/ 1

Topic
Hypothalamus and Pituitary II

Date
5th April 2022

Time
15.30 – 16.30 am

Student’s Name/ ID Fadzil Nur Bin Muhamad Riadzuddin

Lecturer Name
Dr.Husam Yousef Ibrahim Elmehrik

Overview

Hypothalamus is part of the brain that is present in the posterior part of the forebrain.
It connects the midbrain with the cerebral hemisphere and encloses the third ventricle.
Hypothalamus extends from optic chiasma to mamillary body and it is formed by a
group of nuclei in the wall and floor of third ventricle.

The hypothalamus has three main regions. Each one contains different nuclei. These are
clusters of neurons that perform vital functions, such as releasing hormones.

The pituitary gland, also called the hypophysis, is a small gland-about 1 centimeter in
diameter and 0.5 to 1 gram in weight-that lies in the sella turcica, a bony cavity at the
base of the brain, and is connected to the hypothalamus by the pituitary (or hypophysial)
stalk. Physiologically, the pituitary gland is divisible into two distinct portions: the
anterior pituitary, also known as the adenohypophysis, and the posterior pituitary, also
known as the neurohypophysis. Between these is a small, relatively avascular zone
called the pars intermedia, which is much less developed in the human being but is
larger and much more functional in some lower animals

When the hypothalamus and pituitary don’t work properly, they will play role in many
conditions, including:

• Diabetes insipidus. If the hypothalamus doesn’t produce and release enough

vasopressin, the kidneys can remove too much water. This causes increased
PPE61202: ES Self-Learning Package
urination and thirst. Unlike people with diabetes mellitus, people with diabetes
insipidus have stable blood sugar levels.

• Prader-Willi syndrome. This is a rare, inherited disorder. It causes the

hypothalamus to not register when someone is full after eating. People with
Prader-Willi syndrome have a constant urge to eat, increasing their risk of
obesity. Additional symptoms include a slower metabolism and decreased
muscle.
• Hypopituitarism. This disorder happens when the pituitary gland doesn’t
produce enough hormones. While it’s usually caused by damage to the pituitary
gland, hypothalamic dysfunction can also cause it. Many hormones produced
by the hypothalamus directly affect those produced by the pituitary gland.

Topic Learning Outcomes (TLOs)

Students should be able to:

• Describe the functions of hypothalamus

• Describe the regulation of hypothalamus and posterior pituitary function.
• Describe growth hormone –structure, mechanism of action, physiologic effects of
growth hormone and somatomedins.
• Describe the consequences of pituitary hyperfunction and pituitary insufficiency. 
Describe the physiologic effects of vasopressin and oxytocin.

References:

1. Guyton A C Guyton and HLl Textbook of MedicL Physiology. 12th Edition,

2010. Saunders.
2. Barrett K E Ganong’s Review of MedicL Physiology. 24th Edition, 2011.
McGraw-Hill.
3. Fox: Human Physiology, Eight Edition
 PPE61202: ES Self-Learning Package
Using the references provided and other possible resource materials in the library
provide the answers to the following:

1. Growth hormone has a half-life of about 10 to 20 minutes, it is short because of rapid

clearance (∼12 min) from the circulation & ………………………………….. .

(3 marks)

2. Regarding tubero infundibular tract, state the answer to the following: (5 marks)

Releasing hormones Release inhibiting hormones

1. Growth hormone releasing hormone 1. Growth hormone inhibitory hormone

(GHRH) (GHIH)
2. Gonadotropin releasing hormone 2. Dopamine/Prolactin inhibiting factor
(GnRH)
3. Thyrotropin releasing hormone (TRH)

3. Explain how hypothalamus controls autonomic functions of the body. (2 marks)

Firstly, the hypothalamus plays a role in the autonomic nervous system. It processes sensory
impulses received from the smooth muscle within the body which lines organs such as the
intestines and stomach, as well as blood vessels. By processing the impulses, the
hypothalamus is able to regulate the movement of food, heart rate, and the contraction of the
bladder.

Furthermore, the hypothalamus is considered by some to be the vital interaction between the
body’s central systems: the endocrine system which is responsible for regulating bodily
states by releasing hormones; and the nervous system which coordinates and sends synaptic
information. The hypothalamus detects changes within the body and coordinates responses
by stimulating the release of hormones from organs and glands. These pathways enable the
hypothalamus to regulate a series of processes within the body.

4. TRUE OR FALSE? (5 marks)

Anterior pituitary secretes:

A. ACRH (FALSE)
B. ACTH (TRUE)
C. Estrogen (FALSE)
D. LH (TRUE)
E. Prolactin (TRUE)
 PPE61202: ES Self-Learning Package
5. Explain the mechanism in which GH stimulating growth of long bone with unfused /
unclosed epiphysis by chondrogenesis. (3 marks)

GH promotes mainly the growth of the long bones in terms of final height. Longitudinal
bone growth is the result of chondrocyte proliferation and subsequent endochondral
ossification in the epiphyseal growth-plates. The growth-plate is a cartilaginous template
that is located between the epiphysis and the metaphysis of the long bones. GH and insulin-
like growth factor-I (IGF-I) have different target cells in the epiphyseal growth-plate. GH
stimulates the slowly dividing prechondrocytes in the germinative cell layer while IGF-I
promotes the clonal expansion in the proliferative cell layer of a GH primed cell.

6. Explain why people over 40 years starts to have sagging and wrinkled skin? (1 mark)

As you get older, your skin naturally becomes less elastic and more fragile. Decreased
production of natural oils dries your skin and makes it appear more wrinkled.

Fat in the deeper layers of your skin diminishes. This causes loose, saggy skin and more-
pronounced lines and crevices.

7. State the Effects of prolonged use of human GH (hGH). (7 marks)

Effect The cause

1. Carpal tunnel syndrome Mechanism of carpal tunnel syndrome in

acromegaly is that edematous synovial
tissues compress the median nerve because
oversecretion of growth hormone causes
increase of sodium and water retention in the
extracellular fluid.

2. Nerve, muscle, or joint pain The drug's tendency to increase water

retention

3. Swelling Due to fluid in the body's tissues (edema)

and reduce the levels of C-reactive protein
(CRP), an important marker of inflammation
in GH-deficient patients

4. High cholesterol levels Growth hormone decreases LDL cholesterol

levels, in part by augmenting liver LDL
receptor activity.

5. Numbness and tingling of the skin Carpal tunnel syndrome, which affects the
median nerve that runs between the hand and
forearm
 PPE61202: ES Self-Learning Package
6. Growth of cancerous tumors Raise blood levels of a substance called
insulin-like growth factor type I (IGF-I).
Animal studies show that high levels of IGF-
I cause cancer. Colon-cancer cells grow
faster when exposed to IGF-I.

7. Increase the risk of diabetes Increases in insulin concentrations and other

evidence of insulin resistance.

8. Explain the regulation of Oxytocin. (3 marks)

Oxytocin production and secretion is controlled by a positive feedback mechanism where

release of the hormone causes an action that stimulates more of its own release. For
example, when contraction of the uterus starts during childbirth, oxytocin is released.

9. Explain the regulation of Vasopressin. Use mind map.

PPE61202: ES Self-Learning Package