西安交通大学医学院内分泌系统疾病课件 Hypopituitarism.pptVIP

Hypopituitarism Lecture Guo Hui The Anatomy and physiology of pituitary gland 1.location: Under the brain in the sella turcica or hypophyseal fossa of the skull 2.morphology： The pituitary is an oval, bean-shaped, symmetrical,brownish red organ.It averages 13mm transversely,9mm anterior-posteriorly,and 6mm vertically.The weight of the pituitary in adults averages 0.6g(range 0.4 to 0.9g).The anterior lobe constitutes 80% of the gland. The Anatomy and physiology of pituitary gland 3. blood supply: The anterior pituitary ---superior hypophyseal arterial blood . The posterior lobe --- inferior hypophyseal arterial blood 4. Pituitary Hormones Anterior lobe: ACTH related peptides (LPH, MSH, Endorphins) glycoproteins (TSH, LH, FSH, ) somatomammotropins (GH, PRL) Posterior lobe: ADH, OT The Anatomy and physiology of pituitary gland The Anatomy and physiology of pituitary gland The Anatomy and physiology of pituitary gland Hypopituitarism ---Definition Definition Hypopituitarism is a syndrome manifested by diminished or absent secretion of one or more pituitary hormones. It is either a primary event caused by destruction of the anterior pituitary gland or a secondary phenomenon resulting from deficiency of hypothalamic stimulatory factors normally acting on the pituitary.That due to postpartum hemorrhage is called Sheenhan’s syndrome. That due to hypothalamus disease or primary pituitary disease is secondary or primary hypopituitarism, respectively Hypopituitarism- Etiology and pathogenesis A.Invasive(Neoplasms) B.Infarction(Ischemic damage to the pituitary) C.Infiltrative D.Injury E.Immunologic F.Iatrogenic G.Infections H.Idiopathic I. Isolated Hypopituitarism- Etiology and pathogenesis A.Invasive(Neoplasms) 1. Pituitary tumors 2.Hypothalamic tumors, e.g.cranio-pharynigioma 3.Metastatic tumors, lymphoma, etc. Hypopituitari