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Anatomy of pituitary gland. Pituitary gland lies in the base of the skull in a portion of sphenoid bone called s.tIt consist of tow lobe anterior lobe (adenohypophysis),and posterior lobe (neurohypophysis)The size of the gland which the anterior lobe consist 2/3 varies considerably It measures 15
                
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1. Pituitary gland Anatomy
Histology
Physiology
Diseases of pituitary gland 
2. Anatomy of pituitary gland Pituitary gland lies in the base of the skull in a portion of sphenoid bone called s.t
It consist of tow lobe anterior lobe (adenohypophysis),and posterior lobe (neurohypophysis)
The size of the gland which the anterior lobe consist 2/3 varies considerably 
It measures 15X10X6 mml wt 500-900 mg
It may double in size during pregnancy    
5. Blood supply Most richly vascularized of all mammalian tissues,receiving 0.8 ml/min from portal circulation.
It supply by middle inferior and superior hypophysial arteries from the internal carotid arteries    
7. Histology of the PG 1    Anterior pituitary cells were originally classified as
Acidophils cells
Basophils cells
Chromophope cells
 
8. Histology of PG 2    Now with immunocytochemical and electron microscopic techniques,classified cells by their secretary products
Somatotrophs cells                                      a.  GH secreting cells                                   b.  Account about 50% of anterior P.G       c.  Acidophilic stained          
9. Histology of PG 3 Lactotrophic                                                  a. Prl secreting cells                                     b. acidophilic stained                                   c. 10-15% of anterior PG
Thyrotrophis                                                a. TSH secreting cells                                  b. basophilic cells                                         c. < 10% of anterior PG 
10. Histology of PG 4 Corticotrophs                                                 a. ACTH secretary cells                               b. basophilic cells                                          c. 15-20% of anterior PG
Gonadotrophs                                               a. LH,FSH secretary cells                             b. basophilic staining                                   c. 10-15% of anterior PG  
11. Anterior pituitary hormone GH
PRL
TSH
ACTH
LH
FSH 
13. Posterior pituitary hormone VASOPRESSIN
OXYTOCIN 
14. hypopituitarism Hypopituitrism is manifested by diminished or absent secretion of one or more PH
The development of sign and symptom is often slow and insidious
Hypo pit is either primary event caused by destruction of APG or 2ndary resulting from deficiency of hypothalamic SF
Treatment and prognosis depend on the extent of hypofunction,the underlying cause and the location of the lesion      
15. Hypopituitarism Is usually gradual and may have single hormone deficiency or multiple hormone
GH deficiency 
   a.    deficiency in children lead to short stature 
   b.   deficiency in adult lead to vague non   specific symptoms,fatigue decrease muscle mass,loss of libido  
  
16. Gonadotrophin H.D            (hypogonadism)  In women 
 a.   before puberty primary amenorrhea and failure of puberty development 
  b.  after puberty 2ndary amenorrhea and regression of 2ndary sexual characteristic
  c.  infertility
 
17. hypogonadism In men 
a.     before puberty                                    failure of puberty development 
b.     after puberty                                            decrease libido or impotence                       loss of 2ndary sexual characteristic             infertility    
18. TSH deficiency lead to 2ndary hypothyroidism Clinical feature
      cold intolerance 
      dry skin,loss of hair
      mental dullness
      constipation
      increase in wt
      bradycardia,slow reflexes
      hoarseness, puffiness of the face
 
19. ACTH deficiency lead to 2ndary adrenocortical insufficiency Clinical feature
    Weakness
    Nausea and vomiting
    Anorexia
    Wt loss
    Postural hypotension 
20. Causes of hypopituitarism Infarction
      postpartum necrosis (Sheehan syndrome)
      vascular disease 
      head trauma
Infections
       tuberculosis , fungi
       pyogenic , syphilis
       toxoplasmosis 
21. Hypopituitarism 2 Granulomas
       Sarcoidosis
       Histiocytosis
Autoimmune lymphocytic hypophysitis
Neoplasm's involving pituitary
        Pituitary adenoma
        Craniopharyngioma
        Metastasis or or primary carcinoma (rare) 
22. Hypopituitarism 3 Aneurysm of internal carotid artery 
Hemochromatosis
Idiopathic or genetic
       deficient production of pituitary hormone
       synthesis of abnormal hormone
Iatrogenic 
        stalk section
        radiation
        hypophysectomy 
23. Hypopituitarism 3 Primary hypothalamic disorders
        tumor (craniopharyngioma)
        granulomas (histiocytosis x)
        genetic or idiopathic releasing H.D
        head trauma
        structural anomalies of hypothalamus 
24. Diagnosis of PD by PH stimulation test 
25. Pituitary stimulation test 2 
26. Treatment of hypopituitrism 
27. Pituitary tumors Nearly always benign account for 10% of intracranial neoplasm  
Pituitary microaadenoma is intrasellar adenoma less than 1 cm in diameter 
Pituitary macroadenoma are those larger than 1 cm in diameter   
28. Type of pituitary tumors  
31. Treatment of P.T Surgical
        Transfrontal or transsphenoidal
Radiological 
       Conventional irradiation,heavy particle I
Medical 
       Dopamine agonist (bromocriptin)
       Somastatin analog (octreotide)