1.
Anis Ashraf
Senior Nursing Faculty

2.
At the end of this lecture we will be able to:
1. Demonstrate understanding of endocrine system.
2. Review anatomy and physiology of pituitary
gland.
3. Explain Disorders of pituitary gland.
4. Utilize nursing process in the provision of care
for patients with disorder of pituitary gland and
for patients undergoing surgery of the gland.

3.
The endocrine system is the collection of glands
that produce hormones that regulate metabolism,
growth and development, tissue function, sexual
function, reproduction, sleep, and mood, among other
things.
The endocrine system is made up of the pituitary
gland, thyroid gland, parathyroid glands, adrenal
glands, pancreas, ovaries (in females) and testicles
(in males)

4.
Hormone levels that are too high or too
low indicate a problem with the
endocrine system.
Hormone diseases also occur if body
does not respond to hormones in the
appropriate ways.
Stress, infection, and changes in the
blood's fluid and electrolyte balance can
also influence hormone levels,

5.
The pituitary gland or hypophysis is commonly referred to
as the master gland is located on the inferior aspect of the
brain and is divided into anterior and posterior lobes. It is
controlled by the hypothalamus.
The major hormones of the anterior pituitary gland are
FSH, LH, prolactin, adrenocorticotropic hormone ACTH,
TSH, and GH.
The important hormones secreted by the posterior lob of
the pituitary gland are vasopressin, also referred to as
antidiuretic hormone (ADH) controls the excretion of
water by kidney.

6.
Hyperpituitarism : Is a condition due to the
primary hypersecretion of pituitary hormones, it
typically results from a pituitary adenoma.
Etiology: Tumors of the pituitary gland are
common cause of hyper function. Pituitary hyper
function also can result from pituitary hyperplasia.

7.
Neurological manifestation
Endocrinal
 Prolactin hypersecretion
 Growth hormone hypersecretion
(acromegaly)
 Gonadotropic
hypersecretion.(FSH,LH)

8.
 History taking
 Physical examination
 Diagnosis confirmed by routine pituitary
studies.
 Pituitary adenomas are treated with
surgery, Radiation or drug to suppress
hypersecretion by adenomas.
 (Adenomas are benign tumors starting in the epithelial tissue of a gland or gland-like structure.
The epithelial tissue is the thin layer of tissue covering organs, glands, and other structures)

9.
Prolactin hypersecretion is the most common endocrine
abnormality caused by hypothalamic pituitary disorders
and prolactin is the hormone most commonly secreted in
excess by pituitary adenoma.
Normal serum prolactin levels are usually less than 20mg/ml.
Prolactin is a normal contraceptive (inhibits gonadotropin
releasing hormone) and is necessary for lactation.

10.
Growth hormone (GH) an anabolic
hormone promotes protein synthesis and
mobilizes glucose and free fatty acids.
Overproduction of GH which is usually
caused by a benign pituitary adenoma
(tumor) causes gigantism or acromegaly
characterized by soft tissue and bony
overgrowth.

11.
Hypopituitarism is rare disorder that involves a
decrease in one or more of the anterior pituitary
hormones e.g. GH, ACTH, GTH, PRL, TSH.
Hormones that influence nearly every part of
body.
This deficiency can affect any number of body's
routine functions such as growth, blood pressure
and reproduction.

12.
 Definition of ACTH
 : a protein hormone of the anterior lobe of the
pituitary gland that stimulates the adrenal cortex—
called also adrenocorticotropic hormone
 A prolactin (PRL) test measures the level of
prolactin in the blood. Prolactin is a hormone made
by the pituitary gland, a small gland at the base of
the brain. Prolactin causes the breasts to grow and
make milk during pregnancy and after birth.
Prolactin levels are normally high for pregnant
women

TSH stands for thyroid stimulating hormone.
A TSH test is a blood test that measures this
hormone. The thyroid is a small, butterfly-shaped
gland located near your throat.

13.
Several disorders can interfere with the function of
interior pituitary gland and cause hypo secretion of one
or more hormones which includes following
 Tumors
 Infections
 Ischemic changes
 Autoimmune disorders
 Radiation
 Trauma

14.
Signs and symptoms of hypopituitarism vary, depending on
which pituitary hormones are deficient and how severe the
deficiency is.
They may include:
Fatigue, Weight loss, Decreased sex drive, Sensitivity to
cold or difficulty staying warm, Decreased appetite,
Anemia, Infertility, Hot flashes, and inability to produce
milk for breastfeeding in women Decreased facial or
body hair in men, Short stature in children

15.
Blood tests. They can help detect deficits
in hormones as a result of pituitary
failure. For example, blood tests can
identify low levels of thyroid, adrenal or
sex hormones, and can determine if these
low levels are associated with inadequate
pituitary hormone production.

16.
Waugh, A,. & Grant, A. (2011). Ross and Wilson: Anatomy and Physiology in
Health and Illness (11thed.). Hong Kong: Livingstone.
Smeltzer, C.S. et al. (2010). Brunner & Suddarth’s Medical Surgical Nursing
(12thed.). India: Wolters Kluwer/Lippincott Williams & Wilkins.
Lippincott. (2008). Medical Surgical Nursing Made Incredibily Easy (2nded.).
India: Wolters Kluwer.
Chintamani. (2010). Lewis’s Medical Surgical Nursing: Assessment and
Management of Clinical Problems (1sted.). India: Elsevier.
Gingrich, M.M. (2000). Medical Surgical Nursing (2nd ed.). USA: Springhouse.
McKenzie, G., & Porter, T. (2008). Clinicle Companion Medical Surgical
Nursing. New York: Mosby, Elsevier.
Basavanthappa, BT. (2009). Medical Surgical Nursing (2nded.). India: Jaypee.
Priscilla, L. & Burke, K. (2008). Medical Surgical Nursing (4thed.)
India:Pearson.
Digiulio, M. & Jackson, D. (2007). Medical Surgical Nursing Demystified. New
York: Mc.Graw.Hill.
Rashmi, A. (2010). Applying Nursing Process: A tool for critical thinking
(1sted.). India : Anmol Publicattions.
Basavanthappa. (2011). Essentials of Medical Surgical Nursing (1sted.). India:
Jaypee.
Munden.J.et.al(2002) Medical Surgical Nursing Certification(3rd.ed)USA
:Lippincott Williams & Wilkins.