Question

Patient W has recently gained a lot of weight in the face, chest and abdomen, contrasting with slender arms and legs. Patient W also has recently developed high blood pressure, bruise marks, muscle weakness, and mood swings. You suspect excess cortisol secretion, and sure enough, a blood test shows that patient W has very high cortisol levels. You suspect that the patient might have a tumor producing excess hormone. Describe the anatomical locations of the hypothalamus, anterior pituitary and adrenal cortex. 4 pts Name the hormones secreted by the hypothalamus and the anterior pituitary, and how these are involved in the control of cortisol secretion. 4 pts If the tumor is in the hypothalamus, which of these hormones will be high, normal or low (relative to normal)? 4 pts If the tumor is in the anterior pituitary, which of these hormones will be high, normal or low (relative to normal)? 4 pts If the tumor is in the adrenal cortex, which of these hormones will be high, normal or low relative to normal? 4 pts

Answer 1

1. Hypothalamus is a part of fore brain. It is present above the mid brain and on the ventral side of the thalamus. Attached to the hypothalamus is pituitary. Pituitary is a small pea sized gland attached to hypothalamus with a stalk. Adrenal cortex is present in the adrenal gland which is present attached to kidneys on its anterior end. Adrenal gland has 2 parts. Adrenal cortex and adrenal medulla. Adrenal cortex is the outer part of the adrenal gland. Interior is called adrenal medulla.

2. Hypothalamus secretes neuro hormones which are released in to the anterior pituitary. These hormones are releasing hormones , which help in the release of the anterior pituitary hormones. Hypothalamus produces Cortico tropin releasing hormone (CRH) in to anterior pituitary. This stimulates the release of Adreno - corticotrophic hormone (ACTH). The release of ACTH will stimulate the production of cortisol from the adrenal cortex. Cortisol is one of the many hormones released by adrenal cortex.

3. If the tumor is in the hypothalamus, CRH will be more. High CRH will result in more ACTH. This stimulates the production of more cortisol. This results in the imbalance of the hormones.

4. If the tumor is in the anterior pituitary, only ACTH will be produced more. This will result in more synthesis of Cortisol from adrenal cortex. But CRH will be low.

5. If there is a tumor in adrenal cortex, there will be more cortisol produced by adrenal cortex. In this case, ACTH and CRH will be low because of the feed back loop.