The Endocrine System – Hypothalamus & Pituitary Gland

The endocrine system is made up of hormone-producing glands within the body which facilitate communication between cells. Glands that make up the endocrine system include the hypothalamus, pituitary gland, and pineal gland, all of which can be found within the brain; the thyroid and parathyroid glands which can be found in the neck; the thymus which is situated between the lungs; the adrenals, which sit on the kidneys; the pancreas, which is found behind the stomach; and the ovaries (women) or testes (men) which are in the pelvic region.

endocrine system hypothalamus and pituitary gland
Retrieved from https://www.blendspace.com/lessons/tv-3ufAxEQI3pQ/group-3-307-313-331-endocrine-system on 3rd March 2022

Within the endocrine system, an endocrine gland or tissue releases an amount of hormone, which amount is determined by the body’s need for that hormone. Through sensing and signalling systems, hormone-producing cells receive information and regulate hormone release amount and duration. Released hormones are carried by the blood to target cells, which contain receptors that bind the hormone, leading to the desired effect. This effect is then recognised by secretory cells through a feedback signal. Once the required hormonal effect is fully accomplished, the hormones are either removed by the liver or the kidneys, or else degraded by the target cells.

Hormonal secretion is regulated by negative feedback control so homeostasis within the body is maintained.

The Hypothalamus

The hypothalamus, which is located below the thalamus, acts as a link between the nervous system and the endocrine system. It receives inputs from various parts of the brain, and sensory signals from internal organs and the retina. Changes are triggered in the hypothalamic activity due to pain, stress, and other emotional factors. The hypothalamus controls the autonomic nervous system and regulates various bodily factors such as temperature, hunger and thirst, sexual behaviour, and defensive reactions.

The Endocrine System - Hypothalamus & Pituitary Gland
Retrieved from https://kids.frontiersin.org/articles/10.3389/frym.2021.534184 on 3rd March 2022

Within the hypothalamus are clusters of specialised neurons – neurosecretory cells, which synthesise the hypothalamic hormones in their cell body. The hormones are transported inside vesicles by axonal transport.

Hypothalamus-Released Hormones

The hypothalamus is an important endocrine gland that produces hormones which, after being released into the blood, travel in the portal veins to a secondary capillary bed found in the anterior lobe of the pituitary, where their effects are produced. Hormones released in this way include:

  • Thyrotropin-releasing hormone (TRH) – related to thyroid gland growth and function
  • Gonadotropin-releasing hormone (GnRH) – related to the reproductive system
  • Growth hormone-releasing hormone (GHRH) – related to growth
  • Corticotropin-releasing hormone (CRH) – related to hormone secretion
  • Somatostatin – related to the growth hormone
  • Dopamine – acts as a neurotransmitter

Hormones which travel in the neurons to the posterior lobe of the pituitary before being released into circulation include:

  • Antidiuretic Hormone (ADH) / Vasopressin – promotes regulation of the amount of water within the body
  • Oxytocin – involved in childbirth and breastfeeding

The Pituitary Gland

The pituitary gland, which measures just about 1.3cm in diameter, is located in the cella turcica of the sphenoid bone. It is attached to the hypothalamus via the infundibulum – a stalklike structure. Pituitary gland hormones regulate body activities. The pituitary gland is divided into two lobes: the anterior lobe and the posterior lobe.

The pituitary gland anterior lobe accounts to around 80% of the pituitary gland. It is involved in growth regulation, metabolism, and reproduction, through its produced hormones. Hormone production happens through stimulation or inhibition by chemical messages originating from the hypothalamus. Thus, hypothalamic hormones act as a link between the nervous system and the endocrine system. They reach the anterior pituitary through the Hypophyseal Portal System.

The pituitary gland posterior lobe is involved in hormone transmission. Hormones originating from neurons within the region of the hypothalamus are secreted directly into peripheral circulation.

The lobes are divided by the pars intermedia – a relatively avascular zone.

The Endocrine System - Hypothalamus & Pituitary Gland
Retrieved from https://www.nature.com/articles/nrdp201692 on 5th March 2022

The 5 Types of Glandular Cells

  1. Somatotroph Cells – produce GH (growth hormone) which is responsible for general body growth
  2. Lactotroph Cells – synthesise PRL (prolactin) which promotes milk production by the mammary glands
  3. Corticolipothroph Cells – synthesise ACTH (adrenocorticotropic hormone) which stimulates hormone secretion, and MSH (melanocyte-stimulating hormone) which is responsible for skin pigmentation
  4. Thyrothroph Cells – produce TSH (thyroid-stimulating hormone), which controls the thyroid gland
  5. Gonadotroph Cells – produce FSH (follicle-stimulating hormone), which stimulates egg and sperm production in the ovaries and testes, and LH (luteinizing hormone), which stimulates other sexual and reproductive activities.
The Endocrine System - Hypothalamus & Pituitary Gland
Retrieved from http://www.pharmacy180.com/article/pituitary-gland-3595/ on 5th March 2022

Growth Hormone (GH)

  • is released through two regulating factors from the hypothalamus, namely GHRF (growth hormone releasing factor) and GHIF (growth hormone inhibiting factor) or Somatostatin
  • causes cells to grow and multiply by increasing the rate at which amino acids enter the cells to be built up into proteins
  • acts on the skeleton and the skeletal muscles firstly by increasing their growth rate, and then maintaining their size when growth is attained
  • increases the rate of protein synthesis a.k.a. protein anabolism
  • promotes fat catabolism by causing cells to change from burning carbohydrates to burning fats to produce energy
  • accelerates rate at which glycogen stored within the liver converts into glucose and releases itself into the blood
  • converts other factors into growth-promoting substances – somatomedins and insulin-like growth factors (IGF), both of which are similar to insulin yet more potent than insulin

Growth Hormone Secretion Stimuli and Inhibition

Retrieved from https://basicmedicalkey.com/normal-endocrine-function/ on 5th March 2022

Prolactin (PRL)

  • requires priming of the mammary glands through oestrogens, progesterone, corticosteroids, growth hormone, thyroxine, and insulin
  • initiates and maintains milk secretion by the mammary glands (amount of milk is determined by oxytocin)
  • has an inhibitory and an excitatory negative control system
  • level rises during pregnancy, falls right after delivery, and rises again during breastfeeding, which is why in the 1st two days following birth, mothers do not produce milk but colostrum

NOTE: women on oral contraceptives may experience lack of milk production due to their hormonal effect.

Melanocyte-Stimulating Hormone (MSH)

  • increases skin pigmentation through the stimulation of melanin granules dispersion in melanocytes
  • secretion is stimulated by the melanocyte-stimulating hormone releasing factor (MRF), or inhibited by the melanocyte-stimulating hormone inhibiting factor (MIF)
  • lack causes the skin to look pallid
  • excess causes the skin to look dark

Thyroid-stimulating factor (TSH)

  • stimulates the synthesis and secretion of hormonal production within the thyroid gland
  • secretion is controlled by the thyrotropin releasing factor (TRF), which is released based on thyroxine blood level, metabolic rate of the body, and other factors through a negative feedback system

Adrenocorticotropic Hormone (ACTH)

  • controls the production and secretion of some adrenal cortex hormones
  • is secreted by the hypothalamic regulating factor called corticotropin releasing factor (CRF), which is released depending on stimuli and hormones through a negative feedback system

Follicle-Stimulating Hormone (FSH)

  • in females initiates the development of an ova every month, and stimulates cells within the ovaries to secrete oestrogens
  • in males stimulates the testes to produce sperm
  • secretion depends on the hypothalamic regulating factor gonadotropin releasing factor (GnRF), which is released in response to oestrogens in females, and to testosterone in males through a negative feedback system

Luteinizing Hormone (LH)

  • along with oestrogens, in females it stimulates the release of an ovum within the ovary, prepares the uterus for the implantation of the fertilised ovum, stimulates the formation of the corpus luteum in the ovary to secrete progesterone, and prepares the mammary glands for milk secretion
  • in males it stimulates the interstitial endocrinocytes in the testes to develop and secrete testosterone
  • secretion is controlled by GnRF, which works through a negative feedback system

Pituitary Gland Posterior Lobe

The posterior lobe of the pituitary gland a.k.a. neurohypophysis, does not synthesise hormones. It releases hormones to the circulation via the posterior hypophyseal veins to be distributed to target cells in other tissues. The cell bodies of the neurosecretory cells produce Oxytocin (OT) and Antidiuretic Hormone (ADH) / Vasopressin.

Oxytocin (OT)

  • is released in high amounts just before birth
  • stimulates contraction of smooth muscle cells in the pregnant uterus
  • stimulates the contractile cells around the mammary gland ducts
  • affects milk ejection
  • works through a positive feedback cycle which is broken following birthing
  • is inhibited by progesterone, but can work in conjunction to oestrogens

Antidiuretic hormone (ADH)

  • affects urine volume; it causes the kidneys to excrete water from fresh urine and return it to the bloodstream, reducing urine volume
  • absence causes an increase in urine output
  • raises blood pressure by constricting arterioles
  • secretion varies based on the body’s needs
  • causes a decrease in sweat
Retrieved from https://slideplayer.com/slide/10623655/ on 6th March 2022

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Renal Physiology – Glomerular Filtration, Tubular Reabsorption & Secretion

Renal physiology is the study of the physiology of the kidney, specifically at the level of the nephron, which is the smallest functional unit of the kidney where blood entering the kidney goes through the process of filtration.

Overview of Renal Physiology

3 Important Functions of the Nephrons:

  • control blood concentration and volume through selected removal of water and solutes
  • regulate blood pH
  • remove toxic waste from the blood

Through these functions, materials from the blood is removed, others which are required are returned, and the remaining unneeded material is excreted collectively as urine. In other words, urine formation requires Glomerular Filtration, Tubular Reabsorption and Tubular Secretion.

Renal Physiology – Glomerular Filtration

Glomerular Filtration occurs in the renal corpuscle of the kidneys across the endohelial-capsular membrane, which results in the fluid called glomerular filtrate ( 150 lt in adult females; 180 lt in adult males). The blood plasma in the afferent arterioles which become the glomerular filtrate is called the filtration fraction.

renal physiology
Retrieved from https://slidetodoc.com/renal-functions-gfr-learning-objectives-enumerate-general-functions/ on 5th December 2021
renal physiology
Retrieved from https://slideplayer.com/slide/10629513/36/images/34/Glomerular+Filtration.jpg on 15th December 2021

Understanding the Glomerular Filtration Process

Pressures Causing Filtration & GFR Regulation

The Glomerular Filtration Rate (GFR) is the amount of filtrate formed in all the renal corpuscles of both kidneys per minute (rate in males = 125ml/min; rate in females = 105ml/min). Maintenance of a constant GFR ensures that useful substances are not lost.

A change in GFR indicates a change in the net filtration pressure – if the glomerular blood hydrostatic pressure (GBHP) falls to 45mmHg, the filtration process is halted as the opposing pressures equal to 45mmHg.

There are 3 mechanisms which control GFR by adjusting the blood flow into and out of the glomerulus, and by altering the glomerular capillary surface area for the process of filtration:

  1. Renal Autoregulation: Through the Myogenic Mechanism, stretching triggers contraction of smooth muscle cells in the afferent arteriole wall, causing normalisation of the renal blood flow and GFR within seconds following a change in blood pressure. Additionally, through the Tubuloglomerular Feedback, increased distal tubular sodium chloride concentration causes the release of adenosine, leading to a series of events that help regulate the GFR.
  2. Neural Regulation: The Sympathetic Nervous System, which supplies the renal blood vessels, is responsible for the release of norepinephrine. Through Moderate Sympathetic Stimulation, norepinephrine activates the a1 (alpha-1 adrenergic) receptor in the afferent and efferent arterioles, causing vasoconstriction, causing blood flow restriction, leading to a slight GFR decrease. In Greater Sympathetic Stimulation, vasoconstriction of the afferent arterioles predominates; blood flow in the glomerular capillaries is decreased, leading to a decrease in GFR.
  3. Hormonal Regulation: Angiotensin II, which is a vasoconstrictor, acts on the afferent and the efferent arterioles, reducing blood flow leading to a decrease in the GFR. Additionally, Atrial Natriuretic Peptide (ANP) is released through the stretching of the atrial walls when there is an increase in blood volume, leading to an increase in capillary surface area, causing an increase in the GFR.

Renal Physiology – Tubular Reabsorption

In the average adult, the Glomerular Filtration Rate (GFR) is approximately 125ml/min, meaning that around 180 litres are filtered in one day. However, only around 1ltr a day is excreted as urine by the body. This happens because throughout the filtration process, around 99% of the filtrate is reabsorbed back into the blood in what is called tubular reabsorption.

In tubular reabsorption, the proximal convoluted tubule cells process and reabsorb over 80% of the glomerular filtrate, whilst other parts of the nephron ensure homeostasis by controlling excretion amounts of electrolytes, water and hydrogen ions. Through tubular reabsorption, the following are reabsorbed back into the blood stream:

  • Sodium
  • Potassium
  • Calcium
  • Chloride
  • Bicarbonate
  • Phosphate

Peptides and small proteins are also reabsorbed through pinocytosis.

Substances completely reabsorbed from the filtrate are:

  • Water
  • Proteins
  • Chloride
  • Sodium
  • Bicarbonate
  • Glucose
  • Potassium

Urea and Uric Acid are partially reabsorbed from the filtrate.

renal physiology
Retrieved from https://baujiti.home.blog/2013/09/25/urine-formation-form-iii/ on 5th December 2021

Renal Physiology – Tubular Secretion

Tubular Secretion, which occurs in the proximal and distal tubules as well as in the collecting dugt, removes certain materials from the body such as Potassium ions, Hydrogen ions, Ammonium ions, Creatinine, and drugs.; it also helps control the blood’s pH.

Renin-Angiotensin-aldosterone System (RAAS)

RAAS
Retrieved from https://step1.medbullets.com/renal/115016/renin-angiotensin-aldosterone-system on 15th December 2021

Aldosterone causes increased sodium and water reabsorption from the distal tubule and collecting ducts, leading to an increase in the extracellular fluid volume. This allows the restoration of the blood pressure to its normal state. Additionally, Aldosterone has an affect on the secretion of potassium by the distal convoluted tubule and collecting duct.

Antidiuretic Hormone

The AntiDiuretic Hormone, which is produced by the hypothalamus, controls the concentration of the urine to be excreted.

When the blood-water concentration is low, ADH is released, which increases the permeability of the plasma membranes of the cells of the distal tubules and the collecting ducts. Increased permeability causes more water molecules to pass into the cells, and then into the blood.

With no ADH, the ducts become impermeable to water, causing water to be expelled into urine.

Atrial Natriuretic Peptide

Increased blood volume causes the atrial walls to stretch, leading to the release of the Atrial Natriuretic Peptide (ANP). ANP inhibits the reabsorption of sodium and water in the proximal convoluted tubule and collecting duct, suppresses the secretion of aldosterone, and suppresses the secretion of ADH. This results in increased excretion of sodium ions (natriuresis) and increased urine output (diuresis), leading to a decrease in the blood volume and blood pressure.

Note…

Tubular Reabsorption REMOVES substances from the filtrate into the blood… Tubular Secretion ADDS materials to the filtrate from the blood.

Renal Physiology – Solute Reabsorption

Solute Reabsorption happens within the ascending limb of the loop of henle.

Summary…

Retrieved from https://www.researchgate.net/figure/Nephron-segments-and-their-main-physiological-function-The-nephron-is-the-functional_fig1_321907177 on 15th December 2021

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