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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.

662

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.