PITUITARY GLAND

Faculty:Dr. Fatima Mam Dr. Ankur Sir Dr. Sonal Mam

Presented by:Monica Gurupanchayan Keerti Roopwani

DEFINITION

The pituitary gland or hypophysis is an endocrine gland about the size of a pea and about the size of a pea and weighing 0.5 g (0.02 oz.).

INTRODUCTION

It is a protrusion off the bottom of the hypothalamus at the base of the brain, and rests in a small, bony cavity (sella turcica) covered by a dural fold (diaphragma sellae). The pituitary is functionally connected to the hypothalamus by the median eminence via a small tube called the infundibular stem (Pituitary Stalk). The pituitary fossa, in which the pituitary gland sits, is situated in the sphenoid bone in the middle cranial fossa at the base of the brain. The pituitary gland secretes nine hormones that regulatehomeostasis.

TYPES

Anterior Pituitary Posterior Pituitary

ANTERIOR PITUITARY (Adenohypophysis)

The anterior pituitary synthesizes and secretes the following important endocrine hormones: Adrenocorticotropic hormone (ACTH Thyroid-stimulating hormone (TSH Growth hormone Prolactin (PRL) Luteinizing hormone Follicle stimulating hormone Melanocytestimulating hormones (MSH's)

POSTERIOR PITUITARY (Neurohypophysis)

The posterior pituitary stores and releases: Oxytocin Antidiuretic hormone (ADH)

FUNCTIONS
Hormones secreted from the pituitary gland help control the following body processes: Growth (Excess of HGH can lead to gigantism and acromegaly.) Blood pressure Some aspects of pregnancy and childbirth including stimulation of uterine contractions during childbirth Breast milk production Sex organ functions in both men and women Thyroid gland function The conversion of food into energy (metabolism) Water and osmolarity regulation in the body Water balance via the control of reabsorption of water by the kidneys Temperature regulation

TYPES OF DISEASES
PITUITARY TUMOUR DIABETES INSIPIDUS DISEASES

PITUITORY TUMOR

DIABETES INSIPIDUS

PITUITARY TUMOR
DEFINITION An abnormal growth in the pituitary gland.

SIGN & SYMPTOM

Headache Nausea and vomiting Fatigue Weakness Cold intolerance Constipation Low blood pressure Body hair loss Sexual dysfunction

CAUSES

Uncontrolled cell growth in the pituitary gland, creating a tumor, remains UNKNOWN. A small percentage of pituitary tumor cases run in families, but most have no aparent HEREDITARY factor.

RISK FACTOR

Pituitary tumors can occur at any age, they're most likely to occur in OLDER ADULTS. People with a family history of MULTIPLE ENDOCRINE NEOPLASIA type I (MEN I) have an increased risk of pituitary tumors.

DIAGNOSTIC TEST

Physical examination Endocrine function test include: Cortisol level FSH level LH level Serum Prolactin level Testosterone level Brain imaging - computerized tomography (CT) or magnetic resonance imaging (MRI) Vision testing.

Contd.

Thyroid hormone level ( T4 test & TSH test ) Test that help confirm the diagnosis: MRI of head CT brain

BRAIN MRI

COMPLICATIONS

Vision loss. Permanent hormone imbalance. Sudden bleeding into the tumor.

TREATMENT

Surgery Hypophysectomy or remove the tumor. Radiation therapy Shrink the tumor. Medication Bromocriptine or cabergoline(1st line therapy for tumor that release prolactin ) line therapy for tumor that release prolactin ). Ocreotide or pegvisomant ( suppress growth hormone ).

DIABETES INSIPIDUS
DEFINITION ADH insufficiency from neurogenic ornephrogenic origin.

CAUSES

Diabetes insipidus (DI) is an uncommon condition that occurs when the kidneys are unable to conserve water as they perform their function of filtering blood. The amount of water conserved is controlled by antidiuretic hormone (ADH), also called vasopressin.

SIGNS & SYMPTOMS

Excretes large amounts of dilute urine Polyuria Polydipsia Nocturia Bladder enlargement Hydronephrosis

DIAGNOSTIC

Fluid deprivation test Plasma vasopressin response to increase plasma osmolality Measure vasopressin after period of fluid restriction Trial of low dose desmopressin

TREATMENT

Antidiuretic hormone (ADH) Desmopressin - for ADH deficiency in central DI or gestational DI Various treatments for NDI: Hydrochlorothiazide (HCTZ) Indomethacin Amiloride - combined with HCTZ

COMPLICATIONS

Osmolality raised (plasma) Chloride levels raised (plasma or serum) Hypernatraemia Hypotension Dehydration Hypovolaemic shock