NU 545
Unit 3 Study Guide
Advanced Pathophysiology
University of South Alabama.
This document provides a focused
study guide
It summarizes key concepts, lecture highlights, and
exam-relevant material to support efficient last-minute
review. The guide is structured to help students
reinforce understanding, identify weak areas, and prepare
confidently for the assessment.
, Unit 3 study guide NU 545
Chapter 21 (ADH, Oxytocin, Epinephrine& Norepinephrine, Target cells, PTH, Water & Lipid soluble,
Calcium &Phosphate, Protein hormones, TSH, Calcitonin)
1. Know ADH. Antidiuretic hormone = vasopressin
Homeostatic function of the posterior pituitary is the control of plasma osmolarity, as regulated by ADH.
Acts on vasopressin 2 (V2) of renal tubular cells to increase permeability. Leads to increase water
reabsorption in the blood, concentrating urine and reducing serum osmolality. Inhibited by: hypercalcemia,
prostaglandins E, and hypokalemia. Regulated by osmoreceptors of the hypothalamus, located near
supraoptic nuclei. ADH Is released when plasma osmolality is increased, or intravascular volume is decreased.
More water reabsorbed from kidneys and plasma is diluted to it’s set point osmolality 280 mOsm/kg. Do not
have direct effect on electrolyte’s but increase water absorption, may decrease serum electrolyte concentration,
dilutional effect.
Intravascular changes are monitored by baroreceptors in left atrium, carotid arteries and aortic arch. Blood loss
of 7% to 25% act to stimulate ADH secretion. Stress, trauma, pain, exercise, nausea, nicotine, heat exposure
morphine (drugs), increases ADH secretion. ADH decreases with decrease in plasma osmolality, increase in
intravascular volume, HTN, estrogen, progesterone, and angiotensin II level and alcohol ingestion.
Physiologic levels or ADH do not significantly affect vessel tone. Pathophysiologic high serum
levels ADH acts on vasopressin 1 (V1) receptor causing vasoconstriction, increase arterial blood
pressure. May be given as a drug to raise b/p in shock to achieve hemostasis, increase b/p .
What is oxytocin?
Responsible for contraction of the uterus and milk ejection in lactating (acini cells) women after childbirth,
may affect sperm motility in men. In both sex, oxytocin has an antidiuretic effect similar to ADH. Oxytocin is
secreted by suckling and female reproductive trac from the hypothalamus. Binds to myoepithelial cells in the
mammy tissue and increase pressure which causes contraction and increase intramammary pressure and milk
expression. Stimulated by increased prolactin. Uterine contraction acts on positive feedback loop, increase
oxytocin, delivery of placenta, stimulate postpartum contractions and prevent excessive bleeding,
Pituitary stalk (axons) originates in supraoptic and paraventricular nuclei of the hypothalamus,
hypothalamus terminates in the pars nervosa which secretes hormones of the posterior pituitary which
secretes arginine-vasopressin (ADH) and Oxytocin. Major release stimulus is glutamate the major
inhibitory is gamma-aminobutyric. The two split before release from the neurophysins and are secreted in
unbound form.
Pars nervosa site for storing and releasing both, synthesized in the hypothalamus
2. Understand the roles of epinephrine and norepinephrine
The major products stored and secreted by the chromaffin cells (pheochromocytes) of the adrenal medulla
are the catecholamines epinephrine (adrenaline) and norepinephrine, which are synthesized from the
amino acid phenylalanine. The adrenal medulla, adrenal gland regulates and secretes epinephrine and
norepinephrine in response to stress and low b/p. epinephrine activates alpha and beta adrenoreceptors
whereas stimulate alpha adrenoreceptors.
Epinephrine -in response to danger, amygdala triggers the hypothalamus of the Autonomic
Nervous System which stimulates the adrenal gland to start pumping epinephrine into the blood
(fight of flight). Increases HR, fast breathing, elevated blood sugar.
Norepinephrine -Adrenal medulla produces norepinephrine in response to low blood pressure
and stress. Promotes vasoconstriction and increases blood pressure. Also increases HR and blood
sugar levels
,3. What is parathyroid hormone ( PTH)?
Antagonist of calcitonin-reduce serum calcium concentration
Two pairs of parathyroid glands are present behind the upper and lower poles of the thyroid gland but ranges from 2-
6.
Produces parathyroid hormone (PTH), single most important factor in the regulation of serum calcium
concentration. It secretes PTH to increase serum calcium concentration and decrease concentration of serum
phosphate. A decrease in serum ionized calcium level stimulates PTH secretion. Attaches to plasma
membrane, in target tissues, PTH mediated by activation of adenylyl cylase system. PTH Acts directly on
Bone, 2 effects. Acute Hypocalcemia, PTH stimulates osteoblasts to release receptor activator for nuclear factor
kB(NF-kB), release RANKL and MC-CSF, increase osteoclast maturation and release enzyme, mobilization of
calcium from bone, calcium increase, phosphate decrease. Acts on Kidney acts on the distal tubules of the
nephron to increase reabsorption of calcium, on the proximal tubules to decrease phosphorus and bicarbonate. Renal
cells activate 1a-hydroxylase, which mediates form of Vitamin D. Vitamin D- work as a cofactor with PTH to
promote calcium and phosphate in gut and bone mineral.
Parathyroid hormone related protein (PTHrP)-role in calcium and bone, important for endochondral bone
formation and bone modeling. Primary hormone in malignancy related hypercalcemia.
4. Know the relationship between calcium and phosphorus. See parathyroid hormone!
Increase calcium = decrease phosphorus regulated by parathyroid
5. Where are the target cells for each hormone located? Pg 647
Hormone receptors: (1) Recognize and bind with a high affinity to hormones, (2) Initiate a signal. The
more receptors, the more sensitive the cell is to stimulating effects of the hormone. Only target cells with
specific receptors for that hormone are affected. Depends on: blood levels of hormone, concentration of
target cell receptor and affinity of receptor.
Upregulation-low concentrations of hormones, increase the number of receptors per cell
Down regulation-high concentrations of hormones, decrease the number of receptors
Location- located in or on the plasma membrane or in the intracellular compartment of the target cell.
Some esteroid hormones bind to receptor molecules in the cytoplasm, then diffuse
into the nucleus, whereas others bind to receptors in the nucleus
Hormone Target cell
Growth hormone – cartilage, bone, skeletal, muscle, liver, body tissue.
TSH- thyroid gland Cortisol -liver, muscle, cells in body
defense
FSH- testes in male, ovaries in female Androgen-uterus, mammary gland
LH- testes in male, ovaries in female Norepi & Epinephrine-body cells in fight of flight
Prolactin -pituitary gland Progesterone & Estrogen-uterus, mammary glands, female
Adrenocorticotropic-adrenal cortex Testosterone-testes
Melanocyte stimulating hormone (msh) skin
Antidiuretic hormone ADH-kidneys
Oxytocin -uteres and mammary glands
Thyroxine-most body cells
Calcitonin- osteoclast cells in bone
Parathyroid hormone-osteoclast cells in bone
Aldesterone-kindeys
, 6. water soluble and which are lipid soluble hormones. Pg 645
Water soluble-proteins are polarized, high molecular weight, cannot diffuse across the lipid layer of the plasma
membrane, interact of bind with receptors in or on cell membrane, activate 2nd messenger to mediate short-
acting responses. Located on plasma membrane.
Lipid soluble steroids-diffuse freely across the plasma and nuclear membranes and bind the cytosolic of
nuclear receptor, some lipid soluble hormones are located in cell or on the plasma
Water Soluble Hormones
Structural Category Examples
Peptides Growth Hormone
Insulin
Leptin
Parathyroid hormone
Prolactin
Glycoproteins Follicle-stimulating hormone
Luteinizing hormone
Thyroid-stimulating hormone.
Polypeptides Adrenocorticotropic hormone
Antidiuretic hormone
Calcitonin
Endorphins
Glucagon
Hypothalamic hormones
Lipotropins
Melanocyte-stimulating hormone
Oxytocin
Somatostatin
Thymosin
Thyrotropin-releasing hormone.
Amines Epinephrine
Norepinephrine
Unit 3 Study Guide
Advanced Pathophysiology
University of South Alabama.
This document provides a focused
study guide
It summarizes key concepts, lecture highlights, and
exam-relevant material to support efficient last-minute
review. The guide is structured to help students
reinforce understanding, identify weak areas, and prepare
confidently for the assessment.
, Unit 3 study guide NU 545
Chapter 21 (ADH, Oxytocin, Epinephrine& Norepinephrine, Target cells, PTH, Water & Lipid soluble,
Calcium &Phosphate, Protein hormones, TSH, Calcitonin)
1. Know ADH. Antidiuretic hormone = vasopressin
Homeostatic function of the posterior pituitary is the control of plasma osmolarity, as regulated by ADH.
Acts on vasopressin 2 (V2) of renal tubular cells to increase permeability. Leads to increase water
reabsorption in the blood, concentrating urine and reducing serum osmolality. Inhibited by: hypercalcemia,
prostaglandins E, and hypokalemia. Regulated by osmoreceptors of the hypothalamus, located near
supraoptic nuclei. ADH Is released when plasma osmolality is increased, or intravascular volume is decreased.
More water reabsorbed from kidneys and plasma is diluted to it’s set point osmolality 280 mOsm/kg. Do not
have direct effect on electrolyte’s but increase water absorption, may decrease serum electrolyte concentration,
dilutional effect.
Intravascular changes are monitored by baroreceptors in left atrium, carotid arteries and aortic arch. Blood loss
of 7% to 25% act to stimulate ADH secretion. Stress, trauma, pain, exercise, nausea, nicotine, heat exposure
morphine (drugs), increases ADH secretion. ADH decreases with decrease in plasma osmolality, increase in
intravascular volume, HTN, estrogen, progesterone, and angiotensin II level and alcohol ingestion.
Physiologic levels or ADH do not significantly affect vessel tone. Pathophysiologic high serum
levels ADH acts on vasopressin 1 (V1) receptor causing vasoconstriction, increase arterial blood
pressure. May be given as a drug to raise b/p in shock to achieve hemostasis, increase b/p .
What is oxytocin?
Responsible for contraction of the uterus and milk ejection in lactating (acini cells) women after childbirth,
may affect sperm motility in men. In both sex, oxytocin has an antidiuretic effect similar to ADH. Oxytocin is
secreted by suckling and female reproductive trac from the hypothalamus. Binds to myoepithelial cells in the
mammy tissue and increase pressure which causes contraction and increase intramammary pressure and milk
expression. Stimulated by increased prolactin. Uterine contraction acts on positive feedback loop, increase
oxytocin, delivery of placenta, stimulate postpartum contractions and prevent excessive bleeding,
Pituitary stalk (axons) originates in supraoptic and paraventricular nuclei of the hypothalamus,
hypothalamus terminates in the pars nervosa which secretes hormones of the posterior pituitary which
secretes arginine-vasopressin (ADH) and Oxytocin. Major release stimulus is glutamate the major
inhibitory is gamma-aminobutyric. The two split before release from the neurophysins and are secreted in
unbound form.
Pars nervosa site for storing and releasing both, synthesized in the hypothalamus
2. Understand the roles of epinephrine and norepinephrine
The major products stored and secreted by the chromaffin cells (pheochromocytes) of the adrenal medulla
are the catecholamines epinephrine (adrenaline) and norepinephrine, which are synthesized from the
amino acid phenylalanine. The adrenal medulla, adrenal gland regulates and secretes epinephrine and
norepinephrine in response to stress and low b/p. epinephrine activates alpha and beta adrenoreceptors
whereas stimulate alpha adrenoreceptors.
Epinephrine -in response to danger, amygdala triggers the hypothalamus of the Autonomic
Nervous System which stimulates the adrenal gland to start pumping epinephrine into the blood
(fight of flight). Increases HR, fast breathing, elevated blood sugar.
Norepinephrine -Adrenal medulla produces norepinephrine in response to low blood pressure
and stress. Promotes vasoconstriction and increases blood pressure. Also increases HR and blood
sugar levels
,3. What is parathyroid hormone ( PTH)?
Antagonist of calcitonin-reduce serum calcium concentration
Two pairs of parathyroid glands are present behind the upper and lower poles of the thyroid gland but ranges from 2-
6.
Produces parathyroid hormone (PTH), single most important factor in the regulation of serum calcium
concentration. It secretes PTH to increase serum calcium concentration and decrease concentration of serum
phosphate. A decrease in serum ionized calcium level stimulates PTH secretion. Attaches to plasma
membrane, in target tissues, PTH mediated by activation of adenylyl cylase system. PTH Acts directly on
Bone, 2 effects. Acute Hypocalcemia, PTH stimulates osteoblasts to release receptor activator for nuclear factor
kB(NF-kB), release RANKL and MC-CSF, increase osteoclast maturation and release enzyme, mobilization of
calcium from bone, calcium increase, phosphate decrease. Acts on Kidney acts on the distal tubules of the
nephron to increase reabsorption of calcium, on the proximal tubules to decrease phosphorus and bicarbonate. Renal
cells activate 1a-hydroxylase, which mediates form of Vitamin D. Vitamin D- work as a cofactor with PTH to
promote calcium and phosphate in gut and bone mineral.
Parathyroid hormone related protein (PTHrP)-role in calcium and bone, important for endochondral bone
formation and bone modeling. Primary hormone in malignancy related hypercalcemia.
4. Know the relationship between calcium and phosphorus. See parathyroid hormone!
Increase calcium = decrease phosphorus regulated by parathyroid
5. Where are the target cells for each hormone located? Pg 647
Hormone receptors: (1) Recognize and bind with a high affinity to hormones, (2) Initiate a signal. The
more receptors, the more sensitive the cell is to stimulating effects of the hormone. Only target cells with
specific receptors for that hormone are affected. Depends on: blood levels of hormone, concentration of
target cell receptor and affinity of receptor.
Upregulation-low concentrations of hormones, increase the number of receptors per cell
Down regulation-high concentrations of hormones, decrease the number of receptors
Location- located in or on the plasma membrane or in the intracellular compartment of the target cell.
Some esteroid hormones bind to receptor molecules in the cytoplasm, then diffuse
into the nucleus, whereas others bind to receptors in the nucleus
Hormone Target cell
Growth hormone – cartilage, bone, skeletal, muscle, liver, body tissue.
TSH- thyroid gland Cortisol -liver, muscle, cells in body
defense
FSH- testes in male, ovaries in female Androgen-uterus, mammary gland
LH- testes in male, ovaries in female Norepi & Epinephrine-body cells in fight of flight
Prolactin -pituitary gland Progesterone & Estrogen-uterus, mammary glands, female
Adrenocorticotropic-adrenal cortex Testosterone-testes
Melanocyte stimulating hormone (msh) skin
Antidiuretic hormone ADH-kidneys
Oxytocin -uteres and mammary glands
Thyroxine-most body cells
Calcitonin- osteoclast cells in bone
Parathyroid hormone-osteoclast cells in bone
Aldesterone-kindeys
, 6. water soluble and which are lipid soluble hormones. Pg 645
Water soluble-proteins are polarized, high molecular weight, cannot diffuse across the lipid layer of the plasma
membrane, interact of bind with receptors in or on cell membrane, activate 2nd messenger to mediate short-
acting responses. Located on plasma membrane.
Lipid soluble steroids-diffuse freely across the plasma and nuclear membranes and bind the cytosolic of
nuclear receptor, some lipid soluble hormones are located in cell or on the plasma
Water Soluble Hormones
Structural Category Examples
Peptides Growth Hormone
Insulin
Leptin
Parathyroid hormone
Prolactin
Glycoproteins Follicle-stimulating hormone
Luteinizing hormone
Thyroid-stimulating hormone.
Polypeptides Adrenocorticotropic hormone
Antidiuretic hormone
Calcitonin
Endorphins
Glucagon
Hypothalamic hormones
Lipotropins
Melanocyte-stimulating hormone
Oxytocin
Somatostatin
Thymosin
Thyrotropin-releasing hormone.
Amines Epinephrine
Norepinephrine
