Muhtasari wa Tezi ya Pituitari

NaJohn D. Carmichael, MD, Keck School of Medicine of the University of Southern California
Imepitiwa/Imerekebishwa Apr 2023

    The pituitary is a pea-sized gland that is housed within a bony structure (sella turcica) at the base of the brain. The sella turcica protects the pituitary but allows very little room for expansion.

    The pituitary controls the function of most other endocrine glands and is therefore sometimes called the master gland. In turn, the pituitary is controlled in large part by the hypothalamus, a region of the brain that lies just above the pituitary. By detecting the levels of hormones produced by glands under the pituitary's control (target glands), the hypothalamus or the pituitary can determine how much stimulation the target glands need.

    The Pituitary and Its Target Organs

    The pituitary has two distinct parts:

    • Front (anterior) lobe, which accounts for 80% of the pituitary gland's weight

    • Back (posterior) lobe

    The lobes are connected to the hypothalamus by a stalk that contains blood vessels and nerve cell projections (nerve fibers, or axons). The hypothalamus controls the anterior lobe by releasing hormones through the connecting blood vessels. It controls the posterior lobe through nerve impulses.

    The hormones produced by the pituitary are not all produced continuously. Most are released in bursts every 1 to 3 hours, with alternating periods of activity and inactivity. Some of the hormones, such as adrenocorticotropic hormone (ACTH), growth hormone, and prolactin, follow a circadian rhythm: The levels rise and fall predictably during the day, usually peaking just before awakening and dropping to their lowest levels just before sleep. The levels of other hormones vary according to other factors. For example, in women, the levels of luteinizing hormone and follicle-stimulating hormone, which control reproductive functions, vary during the menstrual cycle.

    Pituitary: The Master Gland

    The pituitary, a pea-sized gland at the base of the brain, produces a number of hormones. Each of these hormones affects a specific part of the body (a target organ or tissue). Because the pituitary controls the function of most other endocrine glands, it is often called the master gland.

    Hormone

    Target Organ or Tissue

    Adrenocorticotropic hormone (ACTH)

    Adrenal glands

    Beta-melanocyte–stimulating hormone

    Skin

    Endorphins

    Brain and immune system

    Enkephalins

    Brain

    Follicle-stimulating hormone

    Ovaries or testes

    Growth hormone

    Muscles and bones

    Luteinizing hormone

    Ovaries or testes

    Oxytocin*

    Uterus and mammary glands

    Prolactin

    Mammary glands

    Thyroid-stimulating hormone

    Thyroid gland

    Vasopressin (antidiuretic hormone)*

    Kidneys

    * These hormones are produced in the hypothalamus but are stored in and released from the pituitary.

    Homoni za lobe ya mbele

    The anterior lobe of the pituitary produces and releases (secretes) six main hormones:

    • Adrenocorticotropic hormone (ACTH), also called corticotropin, which stimulates the adrenal glands to produce cortisol and other hormones

    • Follicle-stimulating hormone and luteinizing hormone (the gonadotropins), which stimulate the testes to produce sperm, the ovaries to produce eggs, and the sex organs to produce sex hormones (testosterone and estrogen)

    • Growth hormone, which regulates growth and physical development and has important effects on body shape by stimulating muscle formation and reducing fat tissue

    • Prolactin, which stimulates the mammary glands of the breasts to produce milk

    • Thyroid-stimulating hormone, which stimulates the thyroid gland to produce thyroid hormones

    The anterior lobe also produces several other hormones, including one that causes the skin to darken (beta-melanocyte–stimulating hormone) and ones that inhibit pain sensations (enkephalins and endorphins) and help control the immune system (endorphins).

    Homoni za lobe ya nyuma

    The posterior lobe of the pituitary produces only two hormones:

    • Vasopressin

    • Oxytocin

    Vasopressin (also called antidiuretic hormone) regulates the amount of water excreted by the kidneys and is therefore important in maintaining water balance in the body.

    Oxytocin causes the uterus to contract during childbirth and immediately after delivery to prevent excessive bleeding. Oxytocin also stimulates contractions of the milk ducts in the breast, which move milk to the nipple (the let-down) in lactating women. Oxytocin has some additional roles in both men and women.

    Kutofanya kazi kwa tezi ya pituitari

    The pituitary gland can malfunction in several ways, usually as a result of developing a noncancerous tumor (adenoma). The tumor may overproduce one or more pituitary hormones, or the tumor may press on the normal pituitary cells, causing underproduction of one or more pituitary hormones.

    The tumor may also cause enlargement of the pituitary gland, with or without disturbing hormone production. Sometimes there is overproduction of one hormone by a pituitary tumor and underproduction of another at the same time due to pressure.

    Sometimes excess cerebrospinal fluid can fill the space around the pituitary gland and compress it (resulting in empty sella syndrome). The pressure may cause the pituitary to overproduce or underproduce hormones.

    Too little or too much of a pituitary hormone results in a wide variety of symptoms.

    Overproduction of pituitary hormones causes disorders, including

    Underproduction of pituitary hormones causes disorders, including

    Doctors can diagnose pituitary gland malfunction using several tests. Imaging tests, most commonly magnetic resonance imaging (MRI), can show whether the pituitary has enlarged (for example, if a pituitary tumor is present) or shrunk (for example, in hypopituitarism). Such tests can usually determine whether a tumor exists in the gland.

    Doctors can measure the levels of pituitary hormones, usually by a simple blood test. Doctors select which pituitary hormone levels they want to measure depending on the person's symptoms. Sometimes, levels of pituitary hormones are not easy to interpret because the levels vary greatly during the day and according to the body's needs. For these hormones, measuring a random blood sample does not provide useful information.

    For some of those hormones, doctors give a substance that would normally affect hormone production and then they measure the level of the hormone. For example, if a doctor injects insulin, the levels of ACTH, growth hormone, and prolactin should increase. Rather than measuring growth hormone levels directly, doctors often measure another hormone, insulin-like growth factor 1 (IGF-1). Growth hormone is produced in bursts and its levels quickly fall, but IGF-1 levels reflect the overall daily production of growth hormone. For all of these reasons, interpreting the results of blood tests for pituitary hormones is complex.