内分泌生殖系统教学课件：03 腺垂体 下丘脑.ppt

单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,*,*,Chapter 4.The Hypothalamus and Pituitary Part II,The Anterior Pituitary,Reference-Textbook,Reference Course Website,3,The Anterior Pituitary,Introduction,Growth Hormone,Prolactin,INTRODUCTION,Important peptide hormones that secreted by the anterior pituitary and the targets,6,TSH,Thyroid stimulating hormone,ACTH,Adrenocorticotropin hormone,FSH,Follicle-stimulating hormone,LH,Luteinizing hormone,MSH,Melanophore-stimulating,hormone,GH,Growth Hormone,PRL,Prolactin,7,Anatomical,Relationship,Between the Hypothalamus and Anterior Pituitary,Hormones Secreted by the Hypothalamus and Their Effects on Anterior Pituitary,8,Growth Hormone and Prolactin,9,Receptor and Transmembrane Signaling,Member of cytokine receptors,Signals through JAK-STAT pathway,Located throughout the body,GH hormones:Most significant in liver,muscle and adipose,Prolactin Receptors:breast,liver,ovary and prostate,GROWTH HORMONE,Change of Mr.Robert in 37 Years,Greenspan&Strewler,Basic&Clinical Endocrinology,5th Ed.,1997 From Reichlin S.Acromegaly.Med Grand Rounds 1982;1:9,28 yrs,49 yrs,65 yrs,55 yrs,The Problem of Mr.Robert,Case history(In 5 years),Develop swelling in hands and feet,Pins and needles in hands,Increased sweating,particularly at night,Pain in the left hip on walking,The Problem of Mr.Robert,Signs and Syndromes,Large,Feet and hands,Jaw,lower teeth protruded in front of the upper teeth,Teeth widely separated,Tongue,Chest like a barrel,Blood pressure 155/95 mmHg,Blood glucose 12 mmol/L,Question,What cause the problem?,Diagnosis?,Mechanism?,Treatment?,Physiological,F,unctions,Growth,Regulation of Metabolism,16,Plasma Concentration of GH,Decline with age,5 20 years old,6 ng/ml,20 40 years old,3 ng/ml,40 70 years old,1.6 ng/ml,Circadian,17,Growth,E,ffect,stimulates cell division,muscle and epiphyseal cartilage（骨骺软骨）of long bones.,muscular growth as well as linear growth,Growth of,heart,skin,connective tissue,liver,kidney,pancreas,intestines,adrenals and parathyroids,Hypersecretion leads to cause,gigantism,in children and,acromegaly,in adult.,Hyposection results in,dwarfism,during childhood.,19,Receptor mechanism of the growth hormone effect,GH somatomedins(SM),（,also called insulin-like growth factor,IGF)in the liver growth of bone and other peripheral tissues,.,20,Dwarfism,21,Growth of E,piphyseal,C,artilage,Following GH Treatment,22,Dwarfism,Treatments for Dwarfism,Daily injections of Human Growth Hormone(HGH),rhGH,developed in 1985,$10,000-40,000 a year depending on severity,25,GIGANTISM,Tallest Man to ever Live:Robert 2.72 m,lived to age 22,Tallest Woman to ever Live:Zeng Jinlian:,2.45 m,lived,to age 17,Acromegaly,26,Regulation of Metabolism,Protein Metabolism,Fat metabolism,Glucose metabolism,27,On Protein Metabolism,increase rate of protein synthesis by,enhance amino acid transport to the interior of the cells,increase RNA translation and nuclear transcription of DNA to form mRNA,reduces the breakdown of cell proteins,On,F,at,M,etabolism,Cause release of fatty acids from adipose tissue,increase the concentration of fatty acids.,utilization of fat for providing energy,in preference,to both carbohydrates and proteins.,29,On,G,lucose,M,etabolism,Decreases cellular uptake of glucose and glucose utilization,leads to increase of the blood glucose concentration.,30,Regulation of GH Secretion,Role of hypothalamus and feedback mechanism,Other factors,Role of hypothalamus and feedback mechanism,32,Hypothalamus,Pituitary,Liver,SM,Target tissues,GH,+,increase the secretion;,-,inhibit the secretion,+,GRH,-,SS,-,-,-,Other factors that affect the GH secretion,Starvation,especially with severe protein deficiency,Hypoglycemia or low concentration of fatty acids in the blood,Exercise,Excitement,Stress(trauma),Sex,Sleep,Other Hormones,such as thyroid hormone,estrogen,testosterone,glucogen,33,Change of Mr.Robert in 37 Years,Greenspan&Strewler,Basic&Clinical Endocrinology,5th Ed.,1997 From Reichlin S.Acromegaly.Med Grand Rounds 1982;1:9,28 yrs,49 yrs,65 yrs,55 yrs,The Problem of Mr.Robert,Case history(In 5 years),Develop swelling in hands and feet,Pins and needles in hands,Increased sweating,particularly at night,Pain in the left hip on walking,The Problem of Mr.Robert,Signs and Syndromes,Large,Feet and hands,Jaw,lower teeth protruded in front of the upper teeth,Teeth widely separated,Tongue,Chest like a barrel,Blood pressure 155/95 mmHg,Blood glucose 12 mmol/L,Pathophysiology of Acromegaly,Arthritis,Overstimulation of cartilage and peri-articular bone,High Blood Pressure,The internal organ grow and the resulting cardiac hypertrophy,Sweating,Growth of skin and sweat gland,Carpal tunnel syndrome,Growth of the soft tissue surrounding the medial nerve resulting in compression under the carpal tunnel,Carpal tunnel syndrome(,腕管综合征）,Growth of the soft tissue surrounding the medial nerve resulting in,compression under the carpal tunnel,PROLACTIN,Physiological Function,On breast development and prolactation,On Sexual organs,On Stress,On immunological function,Breast Development,In women,breasts development,at puberty,stimulated by estrogen,progesterone,growth hormone,cortisol,insulin,thyroid hormones and,prolactin,.,During pregnancy,great growth of breast tissues,by stimulation of estrogen,progesterone and,prolactin,estrogen and progesterone inhibit the secretion of milk.,41,42,Lactation,Immediately after the,baby is born,sudden loss of estrogen and progesterone secreted by the placenta allows,lactogenic effect of PRL,initiating milk secretion,Widely used in dairy farming,（乳品业）,Lactation(cont.),After birth of the baby,the basal level of PRL,returns,to normal,Lactation is maintained by surge in Prolactin secretion,nursing baby,causes a 10 to 20 fold secretion of PRL and lasts for 1 h,Unconditioned and conditioned reflex,Prolactin surge inhibit gonadotropin releasing hormone(GnRH),Inhibits ovulation,Natural contraception,Effect on sexual organs,In women,combined with PRL receptors in granulosa cells in ovary,stimulates production of LH receptors(permissive effect),LH promotes ovulation and then formation of corpus luteum.(permissive effect),In male,Promotes growth of prostate glands and seminal vesicle,Enhances the effect of LH on the interstitial cells to produce testosterone.,45,Regulation of Prolactin Secretion,Hypothalamic hormones and feedback mechanism,Milk ejection reflex,Hypothalamic,H,ormones and,F,eedback,M,echanism,47,Hypothalamus:PIF PRF,Anterior pituitary:Prolactin,+,+,-,PIF,Dopamine,Tonic inhibitory control,PRF,TRH,（,thyrotropin releasing hormone),Less physiological importance,48,Milk,ejection reflex,Sucking,tactile stimulation,Afferent nerve(somatic nerve),Centers including spinal cord and hypothalamus,PRF secretion,Oxytocin secretion,PRL secretion,Myoepithelial cells contraction of mammary glands,Milk production increase,Milk flows,49,PROLACTIN,SECRETION,Hyperprolactinaemia,Caused by Excess secretion of Prolactin,Prolactinoma,（泌乳素瘤）,Tumor in the pituitary fossa,Adverse effect of drug that reduce dopaminergic transmission,Antipsychotic Drugs Risperidone,（利培酮）,Signs and Symptoms,Galactorrhoe,（溢乳症）,in women,Cessation of the menstrual cycle,Inappropriate lactation,Gynaecomastia,（男性乳房发育症）,in men,Growth of breast tissue,Hypopituitarism,Caused by,Trauma,Infarction,Hypophysectomy,Space-occupying tumours affect,Growth hormone,LH/FSH,ACTH and TSH,Panhypopituitarism(,全垂体功能减退症）,Hypotension,Hypglycomia,Lethargy,Weekness,