NSG 6430 WEEK 4 STUDY GUIDE WITH FULL
SOLUTIONS 2026
◉ What hormones are attributed to Hypothalamic-pituitary-
GONADAL (HPG) axis? Answer: 1. Gonadotropin-releasing hormone
(GnRH), also called luteinizing hormone-releasing hormone (LHRH)
2. Luteinizing hormone (LH)
3. Follicle stimulating hormone (FSH)
4. Estrogen
5. Testosterone
◉ What hormones are attributed to Hypothalamic-pituitary-
ADRENAL axis (HPA)? Answer: 1. Adrenocorticotropic hormone
2. Dehydroepiandrosterone (ACTH)
3. DHEA sulfate (DHEA-S)
◉ What hormones are attributed to Growth hormone (GH)?axis
Answer: 1. Growth hormone-releasing hormone (GHRH)
2. Growth hormone (GH)
3. Insulin-like growth factors (IGFs)
,◉ What is thought to be three distinct changes in the hypothalamic-
pituitary unit that may trigger puberty? Answer: three distinct
changes in the hypothalamic-pituitary unit:
(1) a nocturnal sleep-related augmentation of pulsatile LH secretion;
(2) a decrease in the sensitivity of the hypothalamus and the
pituitary to estradiol and testosterone, so that the gonadotropins LH
and FSH begin to increase; and
(3) in the female, development of a positive feedback system,
whereby critical levels of estrogen trigger a large release of GnRH,
stimulating LH to initiate ovulation.
◉ What scale allows for the accurate classification of physical
pubertal maturation Answer: Sexual Maturity Rating (SMR) scale
(also called the Tanner scale)
◉ Girls major events of puberty Answer: 1. Thelarche
2. Growth Spurt
3. Menarche
◉ Thelarche Answer: Often the earliest physical sign of puberty in
girls, although a minority develop pubic hair as the first sign. On
average, breast development starts at age 10.0 for Caucasian girls
and 8.9 years for African-American girls
,◉ Growth Spurt Answer: Thelarche and pubarche (pubic hair) may
both be preceded by about 1 year by the growth spurt; thus the
growth curve is an essential tool in the evaluation of precocious
puberty.
◉ Menarche Answer: This event usually occurs during SMR B3 or B4
and about 3.3 years after the growth spurt, or roughly 2 years after
breast budding.
◉ What is the average length of time for completion of puberty ?
Answer: 4 years, but it can range from 1.5 to 8 years
◉ What is the first physical sign of puberty in the majority of boys ?
Answer: Testicular Growth: The first physical sign of puberty in the
majority of boys is increased testicular volume, although the most
noticeable first event of male puberty is the growth of pubic hair
◉ What are other signs of male puberty? Answer: 2. Growth Spurt:
Midpuberty, or the time of rising testosterone concentrations, is
associated with the period of most rapid linear growth in boys, in
contrast to the early growth spurt in girls. It is also at this time that
the voice changes axillary hair appears, and possibly also acne.
Facial hair growth typically starts about 3 years after pubic hair
growth. The hair on the face, chest, back, and abdomen may
continue to appear throughout and beyond puberty into adulthood,
its amount and distribution being quite variable and dependent on
ethnicity and family patterns.
, 3. Attainment of Fertility: Ejaculation usually occurs at SMR G3, as
does the first evidence of spermarche, but fertility is not usually
attained until SMR G4.
◉ What is the average length of time for completion of puberty for
boys? Answer: average length of time for the completion of puberty
is 3 years, but it can range from 2 to 5 years.
Genital development is initiated at about 10.1 years for white boys,
9.5 years for African-American boys, and 10.4 years for Mexican-
American boys, with completion of puberty at 15.9 years in white
boys, 15.7 years in African-American boys, and 14.9 years in
Mexican-American boys.
◉ Gonadal Steroids Answer: The target tissues of LH and FSH are
the ovaries and testes, which produce estradiol and testosterone,
respectively. Testicular Leydig cells also produce androstenedione,
dihydrotestosterone, and estradiol, but to a much lesser extent.
◉ Estrogen. Answer: Estradiol from the ovary accounts for the
majority of the circulating estrogens, although there is a small
amount of extraovarian conversion from androstenedione and
testosterone. In addition to stimulating breast growth and
maturation of the vaginal mucosa, estrogen has been found to have a
major impact on the skeleton, being the primary hormone
responsible for epiphyseal closure.
SOLUTIONS 2026
◉ What hormones are attributed to Hypothalamic-pituitary-
GONADAL (HPG) axis? Answer: 1. Gonadotropin-releasing hormone
(GnRH), also called luteinizing hormone-releasing hormone (LHRH)
2. Luteinizing hormone (LH)
3. Follicle stimulating hormone (FSH)
4. Estrogen
5. Testosterone
◉ What hormones are attributed to Hypothalamic-pituitary-
ADRENAL axis (HPA)? Answer: 1. Adrenocorticotropic hormone
2. Dehydroepiandrosterone (ACTH)
3. DHEA sulfate (DHEA-S)
◉ What hormones are attributed to Growth hormone (GH)?axis
Answer: 1. Growth hormone-releasing hormone (GHRH)
2. Growth hormone (GH)
3. Insulin-like growth factors (IGFs)
,◉ What is thought to be three distinct changes in the hypothalamic-
pituitary unit that may trigger puberty? Answer: three distinct
changes in the hypothalamic-pituitary unit:
(1) a nocturnal sleep-related augmentation of pulsatile LH secretion;
(2) a decrease in the sensitivity of the hypothalamus and the
pituitary to estradiol and testosterone, so that the gonadotropins LH
and FSH begin to increase; and
(3) in the female, development of a positive feedback system,
whereby critical levels of estrogen trigger a large release of GnRH,
stimulating LH to initiate ovulation.
◉ What scale allows for the accurate classification of physical
pubertal maturation Answer: Sexual Maturity Rating (SMR) scale
(also called the Tanner scale)
◉ Girls major events of puberty Answer: 1. Thelarche
2. Growth Spurt
3. Menarche
◉ Thelarche Answer: Often the earliest physical sign of puberty in
girls, although a minority develop pubic hair as the first sign. On
average, breast development starts at age 10.0 for Caucasian girls
and 8.9 years for African-American girls
,◉ Growth Spurt Answer: Thelarche and pubarche (pubic hair) may
both be preceded by about 1 year by the growth spurt; thus the
growth curve is an essential tool in the evaluation of precocious
puberty.
◉ Menarche Answer: This event usually occurs during SMR B3 or B4
and about 3.3 years after the growth spurt, or roughly 2 years after
breast budding.
◉ What is the average length of time for completion of puberty ?
Answer: 4 years, but it can range from 1.5 to 8 years
◉ What is the first physical sign of puberty in the majority of boys ?
Answer: Testicular Growth: The first physical sign of puberty in the
majority of boys is increased testicular volume, although the most
noticeable first event of male puberty is the growth of pubic hair
◉ What are other signs of male puberty? Answer: 2. Growth Spurt:
Midpuberty, or the time of rising testosterone concentrations, is
associated with the period of most rapid linear growth in boys, in
contrast to the early growth spurt in girls. It is also at this time that
the voice changes axillary hair appears, and possibly also acne.
Facial hair growth typically starts about 3 years after pubic hair
growth. The hair on the face, chest, back, and abdomen may
continue to appear throughout and beyond puberty into adulthood,
its amount and distribution being quite variable and dependent on
ethnicity and family patterns.
, 3. Attainment of Fertility: Ejaculation usually occurs at SMR G3, as
does the first evidence of spermarche, but fertility is not usually
attained until SMR G4.
◉ What is the average length of time for completion of puberty for
boys? Answer: average length of time for the completion of puberty
is 3 years, but it can range from 2 to 5 years.
Genital development is initiated at about 10.1 years for white boys,
9.5 years for African-American boys, and 10.4 years for Mexican-
American boys, with completion of puberty at 15.9 years in white
boys, 15.7 years in African-American boys, and 14.9 years in
Mexican-American boys.
◉ Gonadal Steroids Answer: The target tissues of LH and FSH are
the ovaries and testes, which produce estradiol and testosterone,
respectively. Testicular Leydig cells also produce androstenedione,
dihydrotestosterone, and estradiol, but to a much lesser extent.
◉ Estrogen. Answer: Estradiol from the ovary accounts for the
majority of the circulating estrogens, although there is a small
amount of extraovarian conversion from androstenedione and
testosterone. In addition to stimulating breast growth and
maturation of the vaginal mucosa, estrogen has been found to have a
major impact on the skeleton, being the primary hormone
responsible for epiphyseal closure.
