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ENDOCRINE SYSTF.�
661
Table 1 1·5. TargeT Sites and Actions of PitUltaf)' Gland Hormones
Hormone(s)
Targer Slre(s)
Acrion(s)
Anterior lobe
Growth hormone
Systemic
Growth of bones, muscles,
and other organs
Liver
Formation of somatomedin
ThyrorroplIl
Th),roid
Growth and secrerion activiry
of rhe rhyroid gland
Adrenocorricorropln
Adrenal correx
Growth and secretion 3ctiviry
of the adrenal cortex
Foil icle·stimula ting
Ovaries
Development of follicles and
hormone
secretion of estrogen
Testes
Development of seminiferous tubules and spermarogenesis
Luteinizing or II1tcr-
Ovaries
Ovulation, formation of cor·
5t1tial cell SfIIllUpus luteum, and secretion
lating hormone
of progesterone
Testes
Secretion of tesrosterone
Prolacrll1 or lacroge
Mammary
Secretion of milk
nic hormone
glands
l\ Iclanocyte-srimu
Skin
Pigmentation
lating hormone
Postcrior lobe
Amidlllretic hor
Kidney
Reabsorption of water
monc'" (also called
Fluid and electrolyte balance
l,asopressin)
Oxytocin'"
Artenoles
Blood pressure regulation
Uterus
Contraction
Breast
Expression of milk
• Actually produced In Ihe hypoilulamu<; bm stOred III Ihe pituitary gland.
Sources; Dala from BF Fuller. Anatomy Jnd PhYSiology of the Endocrine System. In
eM Hudak. I�M Gallo (eds). Critical Care Nursing: A HolistIC Approach (6th ed). Phil·
adelplml: LIppinCott, 1994;875; and RA Sacher, itA McPherson, JM Campos (eds).
Widman's C1LllIt.ll lnrerpret3110n o f Laboratory Tests (11th ed). PhIladelphia: FA
Dol"is. 2000;744.
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AClITE CARE HANDBOOK FOR PHYSICAL TH.ERAPISTS
Table 1 1-6. Pituitary Hormone Tests
Hormone(s)
Test Description
Growth hor
Serum level measurement by radioimmunoassay (RIA);
mone (GH)
normal values for men are 0-5 nglml; for women, 0-\0
nglml.
Growth hormone stimttlat;on test (arginine tcst or insulin
tolerance test). Indicated for children with retarded
growth and if pituitary tumor is suspected. A baseline
level of GH is established, then arginine or insulin is
administered to the patient, and serial blood draws are
performed to measure GH levels. GH should normally
rise. Decreased GH values, despite stimulation, could
indicate pituitary dwarfism or tumors.
Growth hormone suppression test (glucose load test).
Indicated to confirm diagnoses of gigantism in children
and acromegaly in adults. A baseline level of GH is
established, followed by patient ingestion of a glucose
solution. After 1-2 hrs, levels of GH are remeasured.
Normally, glucose inhibits the secretion of GH. If GH
levels remain high despite the glucose load, then gigantism or acromegaly can be confirmed.
Adrenocortico
Plasma ACTH levels are measured by RIA. Normal values
tropic horarc 25-100 pglml ill the morning and 0-50 pglml in the
mone
evening.
(ACTH)
ACTH stimulation test (rapid ACfH resting, cosynrropin
rest, or Corrrosyn stimulating test). Indicated for diagnosing primary and secondary adrenal insufficiency.
Cosynrropin (Cortrosyn) (synthetic form of ACfH) is
administered to a patient after a baseline level of cortisol is measured. ACTH acts to increase conisol secretion from the adrenal gland. Normal results show an increased plasma corrisol level to >20 pg/dl after 30-60
mins.
Antidiuretic
Normal plasma levels of ADH are 2-12 pglml if serum
hormone
osmolality is >290 mOsm/kg and <2 if serum osmolal
(ADH or
ity is <290 mOsm/kg.