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HYPOTHALAMUS - GL PITUITRY

HYPOTALAMUS G.H

BONE
TSH

PITUITRY ACTH ADRENAL CORTEX FSH LH

MAMAE

THYROID

GONADS

OVARIUM

TESTES

GL. PITUITRY ANTERIOR HORMONES

1. GROWTH HORMONE (G.H)


2. THYROID STIMULATING H (T.S.H) 3. ADRENOCORTICOTROPHIC H. (ACTH)

4. PROLACTIN (PRL)
5. FOLLICLE STIMULATING. H (FSH) 6. LUTEINIZING H. (LH) 7. INTERSTITIAL CELL STIMULATING H (ICSH)

HYPOTHALAMUS REGULATING HORMONES

1. GROWTH HORMONE RELASHING FACTOR (GHRF) 2. THYROTROPHINE RELEASING H (TRH)

3. CORTICOTROPHINE REALISING FAKTOR (CRF)


4. PROLACTIN INHIBITORY FACTOR (PIF) 4. GONADO TROPHINE RELEASING H (Gn.RF)

ANTERIOR PITUITRY HORMONES DEFICIENCY


- TSH : - REDUCES T4, T3 SECRETION - HYPOMETABOLISM - BRADYCARDIA - PROLACTIN : -REDUCES GONADAL - GONADOTROPHIN SCRETION - PREVENTS LACTATION - A MENORREA, LIBIDO - SKIM & HAIR CHANGES - ACTH : - REDUCE GLUCOCORTICOID SCRETION - ASTHENIA, HYPOGLYCEMIA - PALE (DECREASE MELANOSIT) - GH : PLASMA FOSFATE

ANTERIOR PITUITRY HORMONES


NORMAL : 10 kg/l ACTIVE DURING : - GIGANTISM - ACROMEGALY

HYPOACTIVE

: DWARFISM

FUNCTION ENHANCES GROWTH - REGULATES METABOLISM

- Na RETENTION IN TISSUE
- DIABETOGENIC, ANTI INSULIN

REGULATORYFEED BACK MECHANISM


OF THYROID HORMONES TRH TRH TRH

T4 T3

TSH

TSH

TSH

T4 T3

THYROXIN SINTHESIS YODIUM TRAPPING MONO DIJODOTIROSIN TRIJODO (T3) THYROXIN (T4) TISSUE

THYROXIN (HYPERTHYOIDY)
HYPER - ACCELERATE TISSUE OXIDATION - BODY HEAT TENSION ACTITY - TACHICARDIA - PALPITATION - DIABETOGENIC - ANTI INSULIN INCREASE GLUCONEOGENESIS - BL CHOLESTEROL LIPOPROTEIN HYPOACTIVITY : (HYPOTHYROIDY) - DECREASE TISSUE OXIDATION - BODY HEAT LAZY, INDUVE SLEEP

- BRADYCARDIA - MIXEDEMA - BL. CHOLESTEROL - B. WEIGHT - CREATIN (CONGENITAL)

THYROID FUNCTION TEST


1. T4 (=THYROXIN) 2. T3 (TRIJODOTIRONIN) T3 UPTAKE 3. FREE T4 INDEX (FT4 I)

4. FREE T3 INDEX (FT3T)


5. TSH 6. TRH

THYROID F. TEST RESULT

T4 1. EUTHYROIDY 2. HYPERTHYROIDY e.c. PITUITRY 3. HYPOTHYROIDY e.c. PITUITRY N

T3 N

FT4I N

TSH N

4. T3 THYROTOKSICOSIS

REGULATORY FEED-BACK MECHANISM OF ADRENAL CORTEX HORMONES


STRESS TRAUMA COLD OPERATION INFECTION CORTISOL PLASMA

HYPOTHALAMUS
CRF CRF CRF

GL. PITUITRY
CORTISOL PLASMA

ADRENAL CORTEX SINTHESIS OF : - GLUCOCORTICOIDS - ANDROGEN

ADRENAL CORTEX HORMONES


1. CORTICOSTEROIDS a. MINERAL CORTICOIDS
- ALDOSTERON N. 100 - 500 pmol/l

b. GLUCOCORTICOIDS - KORTISOL N 50 - 280 nmol/l (12.00 pm)


- KORTICOSTERONE 200 - 700 nmol/l

2. ANDROGEN - DIHYDRO EPIANDRO STERONE (DHEA) - DHEA -SO4 - ANDROSTENEDIONE - TESTOSTERONE - URINARY 17 OXOSTEROID * O 20-75 umol/24 H * O 15.60 umol/24 H

ADRENAL CORTEX HORMONES


FUNCTION OF : 1. MINERAL CORTICOIDS - ALDOSTERONE - Regulation of water and mineral (Na, K, Cl) 2. GLUCOCORTICOIDS - anti inflamation - reduce antibody production - antagonist insulin, gluconeogenesis - physiologie - protein anbolik exces - protein katabolik 3. ANDROGEN - Sex characteristics - Protein anabolik

ANDROGEN CIRCULATION IN WOMAN


STEROID
1. TESTOSTERONE 2. DIHYDRO - 3. DIHYDRO - EPIANDROSTERONE 4. DHEA - SO4 98% 2% -

ADRENAL OVARIUM PERIPHERI


25% 90% 25% 10% 50% 100% -

5. ANDROSTENEDIONE

50%

50%

USE IN D.D. : 1. HIRSUTISM

2. POLYCYSTIC OVARY SYNDROME


3. VIRILIZING TUMOR OVARY/ADRENAL

REGULATORY FEED BACK MECHANISM OF GONADO TROPHIC HORMONE

HYPOTHALAMUS

GL PITUITRY

TESTES OVARIUM

ADRENAL CORTEX ANDROGEN

GONADOTROPHINE HORMONES
FUNCTION ESTROGEN :
- FEMALE SEX HORMON TO PRODUCE FEMALE SEX CHARACTERS
- PROTEIN ANABOLIZER - REGULATES MENSTRUAL CYCLE AND FERTILITY

PROGESTERON :
- REGULATES MENSTRULA CYCLE, OVULATION - HIGH CONCENTRATION DURING PREGNANCY

BATH HORMONE ARE USED IN MIX CONCENTRATION FOR CONCENTRATION/BIRTH CONTROL HCG (HUMAN CHORIONIC GONADOTROPHIN ) IS PRODUCED FREGNANCY IN THE EARLY STAGES (+ 4 DAYS & MENORRHOE AND IS EXCRETED IN THE URINE . IS THE CONCENTRATION EXSSEDS > 2000 IN THE PREGNANCY TEST BECOMES + TESTOSTERONE - ANDROGEN - MALE SEX CHARACTERISTIC - PROTEIN ANABOLIZER - PLASMA CALSIUM POSITIF NITROGEN BALANCE

HORMONES OF NEUROHYPOPPHYSE GLAND

OXYTOCIN ACTS ON THE UTERUS IN PARTUS AND ON LACTATION WHEN THE BREASR IS SUKED VASOPRESSIN = ANTI DIURETIC HORMONE (ADH) ADH DEVICIENCY COUSES POLY URIA AND POLYDIPSY (DIABETES INSIPIDUS)

HORMONES OF THE ADRENAL MEDULLA

ADRENALIN (EPINEPHRIN NOR ADRENALIN


HYPERACTIVITY (by TUMOR : PHAEOCHROMUCYTOMA) CAUSE : - PROGRESSIVE PAROXIMAL HYPERTENSION - GLYCOGENESIS - KATECHOLAMIN IN SERUM - VMA (=VANYL MANDELIC ACID) IN URINE

OR HMMA (HYDROXI METOXY MANDELIC ACID)


IN THE URINE NORMAL : 35 mmOL/24 hour PHEOCHROMOCYTOMA : > 50 mmol (24 hour)

ACTION : VASOCONSTRICTION (PERIPHEAL)

IN STRESS CONDITION (TRAUMA, OPERATION, INFECTION, STARATION, SEVERE

ADRENALIN HYPERTENTION PAROXYSMAL

PARATHYROID HORMONE (PTH)


PTH WHEN PLASMA Ca ACTION OF PTH TO INCREASE PLASMACa AND TO LOWER PLASMA PHOSPHA BY : - ON BONES TO RELEASE Ca ==> PLASMA Ca
DEPENDS ON ADEQUATE VIT D - KIDNEY : - PHOSPHATE EXCRETION - Ca REABSORPTION IN TUBULUS INDEPENDENT OF VIT.D - INTESTINE : Ca ABSORPTION

KALSITONIN (THYROID) BY : -STABILIZED PLASMA Ca CONCENTRATION


- PREVENT RESORPTION OF Ca IN BONES - INCREASE Ca AND Oh SECRETION IN KIDNEY - LOWER PLASMA Ca AND Ph

PARATHYROID HORMONE (PTH)


REGULATES Ca - Ph METABOLISM/BALANCE HYPERPARATHYROIDY - BLOOD Ca - BLOOD Ph - HYPERCALCEMIA - HYPOPHOSPHATEMIA

- URINARY Ca
- ALKALI PHOSPHATSE N/ - PTH

HYPOPARATHYROIDY - - BLOOD Ca - BLOOD Ph - URINARY Ca - ALKALI PHOSPHATSE N/ - HYPERCALCEMIA - HYPOPHOSPHATEMIA

- PTH
NORMAL BLOOD PHOSPHATE : 30 - 45 mg/dl
(SERUM)

URINARY PHOSPHATE : 0,7 - 1.5 mg/24 hour

CALSIUM (BLOOD, PLASMA, SERUM) - REGULATED NORMAL BY 1. THYROKALSITONIN 2. VUTAMIN D 3. PTH - FUNCTION OF CALSIUM ION 1. REFLEX NEUROMUSCULAR 2. BLOOD CLOTING MECHANISM 3. ENZYMATIC ACTIVITY 4. MEMBRANE CELL PERMEABILITY - NORMAL CONCENTRATION BLOOD : 9 - 10.8 mg/dl URINE : 39 - 150 mg/24 hour - DEFICIENCY Ca : TETANY

CALSIUM - PHOSPHATE IMBALANCE


HYPERCALCEMIA : - SEVERAL BONE DISEASES

- HYPERPARATHYROIDY
- HYPERVITAMINOSIS D - MULTIPLE MYELOMA HYPOCALCEMIA : - OSTEOMALACY (HYPOVITA D) - HYPOPARATHYROIDY - IMPAIR RENAL FUNCTION - ACUTE PANCREATITIS

HYPERPHOSPHATEMIA : - HYPOPARATHYROIDY - HYPERVITA D - CHRONIC RENAL FAILLUR

HYPOPHOSPHATTEMIA : - HYPERPARATHYROIDY - RICKETTS AND OSTEOMALACY

- FANCONI SYNDROME

GASTROINTESTINAL HORMONES
- GASTRIN PLASMA : 5 - 50 pmol/l IN : - ACHLORHYDRIA - PERNICIOUS ANEMIA - ZOLLINGER ELLISON SYNDROME - PEPTIC ULCER - GASTRINOMA -SEROTONIN ARGENTAFIN CELLS ACTION : - VASOCONTRICTION (CAPILLARY) - MOTILY MALIGNANT CARCINOID TUMORS SEROTONIN