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Dr: Azza Zaki

Pituitary Gland (Hypophysis Cerebri)


It is the master
endocrine gland,
because it controls the
other endocrine
glands & body
growth.
 It is attached to the
under-surface of the
brain (hypothalamus)
by the infundibulum
(stalk). Dr: Azza Zaki
Pituitary Gland
Location:
Small, slightly oval
gland lies in the
hypophyseal fossa
(sella turcica) of the
sphenoid bone.
It is covered by an
extension of the dura
matter, diaphragma
sellae.
Dr: Azza Zaki
Relations
Superiorly:
The diaphragma
sellae, which
separates the gland
from the optic
chiasma. Laterally:
cavernous sinus &its
contents.
Inferiorly:
body of the
sphenoid and
sphenoidal sinus
separating the gland
from nasopharynx. Dr: Azza Zaki
Relations
Anteriorly:
Tuberculum sellae
Sphenoidal sinus
The nasal cavity.
Posteriorly:
Dorsum sellae
Basilar artery.
The pons

Dr: Azza Zaki


Development Of The Pituitary Gland

The pituitary gland is ectodermal in origin, develops from 2 sources:


Anterior lobe or adenohypophysis: it arises from a small ectodermal
diverticulum (Rathke’s pouch) grows from the roof of the
stomodeum (mouth).
Posterior lobe or neurohypophysis: a small ectodermal diverticulum
(the infundibulum) which grows from the floor of the diencephalon.
Dr: Azza Zaki
Lobes Of The Pituitary Gland

Dr: Azza Zaki


Hypophysis cerebri actually consists of 2 glands
that are united anatomically but functions
differently.

Neurohypophysis Adenohypophysis

Infundibulum Pars Nervosa


Pars Pars Distalis
Intermedia (anterior lobe)
Pars
Tuberalis
Dr: Azza Zaki
Lobes Of The Pituitary Gland
The pituitary gland is divided into:
An anterior lobe, or adenohypophysis:
is subdivided into:
the pars anterior (pars distalis),
the pars intermedia, which may be
separated by a cleft (remnant of an
embryonic pouch)
The pars tuberalis
A posterior lobe or neurohypophysis:
pars nervosa & stalk
Dr: Azza Zaki
Blood Supply
Arterial supply:
from superior
&inferior hypophyseal
branches of the internal
carotid artery.
Venous drainage:
cavernous and
intercavernous sinuses.
Receives venous blood from
hypothalamus via
hypothalamo-hypophyseal
portal venous system which
transmits releasing factors
to the anterior lobe of the
pituitary gland to control the
release of its hormones.
Dr: Azza Zaki
Control Of The Pituitary Gland

Nervous Vascular
Hypothalamo- Hypothalamo
hypophyseal hypophyseal
tract to portal system to
posterior lobe anterior lobe

Dr: Azza Zaki


Connections Of The Hypothalamus With
The Hypophysis Cerebri
The hypothalamus is
connected to the pituitary
gland by:
Hypothalamohypophyseal
tract: nerve fibers that travel
from the supraoptic &
paraventricular nuclei to the
posterior lobe of the
hypophysis.
Hypophyseal portal system:
long & short portal blood
vessels that connect sinusoids
in the median eminence&
infundibulum with capillary
plexuses in the anterior lobe of
the hypophysis Dr: Azza Zaki
Hypothalamohypophyseal Tract
The hormones vasopressin
(antidiuretic ADH)& oxytocin are
synthesized in the supraoptic &
paraventricular nuclei.
The hormones are passed along
the axons of the
hypothalamophypophyseal tract
& are released at the axon
terminals, into the blood stream
in capillaries of the posterior
pituitary.
Oxytocin stimulates:
the contraction of the uterus
& myoepithelial cells of the ducts
of the breast Dr: Azza Zaki
Hormones of the Posterior Pituitary

Dr: Azza Zaki


hypothalamo-hypophyseal portal
venous system
The portal
system carry
releasing
hormones and
release –
inhibiting
hormones
from
hypothalamus
to anterior
lobe of
pituitary.
Dr: Azza Zaki
hypothalamo-hypophyseal portal system
The Superior hypophyseal
arteries arise from the
internal carotid arteries,
supply the median eminence,
the infundibulum and adjacent
parts of the anterior lobe.

form a primary capillary


plexus that irrigate
infundibulum and the median
eminence.

Rejoins to form hypophyseal


veins

that develops a secondary


capillary plexus (sinusoids)
that pass between the
secretory cells of the Dr: Azza Zaki
anterior lobe.
Hypothalamo- hypophyseal portal system

Dr: Azza Zaki


Dr: Azza Zaki
Hormones of the Anterior Pituitary

Dr: Azza Zaki Slide 9.17


The Hormones Of The Anterior Pituitary
ACTH: adrenocorticotropic hormone: stimulate adrenal
cortex
FSH: follicle stimulating hormone: stimulates growth of
follicles in the ovary & spermatogenesis in the testis.
LH: luteinizing hormone: stimulates secretion of estrogen
& progesterone & ovulation (in female)
Interstitial cell stimulating hormone (ICSH): stimulate
release of testosterone (in male).
TSH: thyrotropic hormone or thyroid stimulating hormone.
GH: growth hormone: stimulate the body growth
MSH: melanocyte- stimulating hormone
Prolactin (LTH): luteotropic hormone (lactogenic hormone:
stimulates milk secretion by mammary gland during lactation
Dr: Azza Zaki
Clinical Notes

Dr: Azza Zaki


Pituitary Enlargement (Tumor) And
The Optic Chiasm
Since the pituitary is located in the bony sella turcica,
enlargement causes it to expand superiorly.
A pituitary tumor classically pushes the diaphragma sellae
upward and causes pressure on the optic chiasma. This
results in interference with the function of the nerve fibers
crossing in the chiasma (from the inner quadrants of the
retina), and the patient presents with bitemporal
hemianopia is a loss of the lateral halves of the fields of
vision of both eyes (loss of function of the medial half of
both retinas).
Further expansion of the pituitary tumor causes erosion of
the body of the sphenoid bone (x-ray: ballooning
of the sella turcica).
Dr: Azza Zaki
Dr: Azza Zaki
Sella
turcica

Dr: Azza Zaki


Surgical Approach
Trans-cranial (subfrontal approach):
the gland can be approached through the
anterior cranial fossa by elevating the
frontal lobe of the brain .
Trans-sphenoidal approach:
entering the pituitary fossa through the
sphenoidal air sinus .

Dr: Azza Zaki


Dwarfism
A deficiency in the growth
hormone secreted by the
somatotrope cells of the pars
anterior during childhood leads to
pituitary dwarfism.
Growth does not stop entirely,
and the different parts of the
body are in relatively normal
proportions.
The person is of normal
intelligence, but the facial skin is
often wrinkled and sexual
Dr: Azza Zaki
Gigantism and Acromegaly
Excessive production of the growth
hormone by the somatotrope cells of
the pars anterior or by tumors of these
cells can produce abnormal growth of
the skeleton. Gigantism occurs in the
young before the epiphyses in long
bones fuse with the diaphysis.
Acromegaly is a form of abnormal
skeletal and soft tissue growth that
occurs after adolescence, following the
fusion of the epiphyses in long bones
with the diaphysis. In this disease, the
individual cannot grow taller, but
overgrowth occurs in the bones and
soft tissues of the forehead, nose,
lower jaw, hands, and feet.
Dr: Azza Zaki
Diabetes Insipidus
This syndrome results from a lesion of the
supraoptic and paraventricular nuclei of the
hypothalamus and a failure of these cells to
synthesize the antidiuretic hormone, or from
destruction of the hypothalamohypophysial tract.
 There are many causes of this syndrome, including
cerebral tumors, cerebral abscesses, surgical or
radiation damage, and head injuries.
Characteristically, the patient passes large volumes
of urine (polyuria) of low specific gravity. As a
result, the patient is extremely thirsty

Dr: Azza Zaki


Dr: Azza Zaki