NSG 6330 question with answers
What 3 hormonal axes are attributed to most physical changes in adolescents? - -1)
Hypothalamic-pituitary-gonadal (HPG) axis
2) Hypothalamic-pituitary-adrenal axis (HPA)
3) Growth hormone (GH) axis
-What hormones are attributed to Hypothalamic-pituitary-GONADAL (HPG) axis? - -
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)? - -1.
Adrenocorticotropic hormone
2. Dehydroepiandrosterone (ACTH)
3. DHEA sulfate (DHEA-S)
-What hormones are attributed to Growth hormone (GH)?axis - -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? - -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 - -
Sexual Maturity Rating (SMR) scale (also called the Tanner scale)
-Girls major events of puberty - -1. Thelarche
2. Growth Spurt
3. Menarche
-Thelarche - -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 - -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 - -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 ? - -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 ? - -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? - -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? - -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 - -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. - -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.
-Testosterone. - -The testes produce most of the circulating testosterone, but a
small amount comes from extratesticular conversion of the adrenal hormone
androstenedione in both males and females. Testosterone is responsible for the
voice change in males and the attainment of male body habitus, while
dihydrotestosterone, the product of conversion of testosterone by 5a-reductase,
causes growth of the phallus and prostate.
, -GnRH Pulse Generator - -At the time of puberty, GnRH is secreted from the GnRH
pulse generator in the hypothalamus, leading to pituitary secretion of LH and FSH
and subsequent secretion of estradiol from the ovaries or testosterone from the
testes. The exact triggers are still incompletely understood, although new research
has elucidated new potential regulators and key players in the awakening of this
system. These include leptin, the genes GPR54/KiSS-1, as well as several
neuropeptides and neurotransmitters.
-ADRENARCHE - -The increased secretion of androgens from the adrenal gland,
called adrenarche, in the prepubertal and pubertal periods is independent of HPG
changes.
-What is the Local conversion of DHEA-S to testosterone and then to
dihydrotestosterone is responsible for? - --hair growth in the androgen-dependent
areas (face, chest, pubic area, axillae). Axillary and pubic areas are the most
sensitive to the effects of androgens, which is why these areas are the first to
develop sexual hair.
-local conversion of DHEA-S within the apocrine glands of the axillae causes body
odor,
-conversion within sebaceous glands is responsible for the development of acne.
-What is the height spurt during puberty attributed to? - -primarily upon growth
hormone and the insulin-like growth factors, but many other hormones may
influence growth as well, especially the sex steroids. Without prompt recognition
and treatment, premature or delayed puberty may have marked effects on height.
-What is most linear growth contributed to? - -Growth hormone and its feedback
loop
-GH during Puberty - -GH secretion is increased by growth hormone-releasing
hormone (GHRH) and decreased by somatostatin from the hypothalamic arm of the
loop. Growth hormone has been shown to double during the pubertal growth spurt.
Like many hormones, GH is secreted in pulsatile fashion, with maximum rates at the
onset of slow-wave sleep. It is this pulsatile secretion that renders random testing of
GH unhelpful. GH exerts its effects through IGFs, mainly IGF-I (formerly
somatomedin-C) and IGF-II.
-Prediction of Final Height for girls - -(fathers height-13 cm or 5 inches) + mothers
height/2
-Growth Velocity during puberty - -Growth velocity during the pubertal growth spurt
is at its highest levels outside of infancy. It should be noted that in calculating
growth velocity, it is important to have an interval of 6 to 12 months, as growth is
greatest in the spring and summer months. Although males and females are
roughly the same height upon entry into puberty, males emerge taller by 13 cm on
average. This is primarily due to boys' 2-year lag behind girls in attaining their peak
height velocity, but a small amount of height may be accounted for by the higher
peak velocity. Girls gain their peak height velocity of 8.3 cm/year at an average age
of 11.5 years (Tanner stages B2 to B3) while boys do not reach their peak height
What 3 hormonal axes are attributed to most physical changes in adolescents? - -1)
Hypothalamic-pituitary-gonadal (HPG) axis
2) Hypothalamic-pituitary-adrenal axis (HPA)
3) Growth hormone (GH) axis
-What hormones are attributed to Hypothalamic-pituitary-GONADAL (HPG) axis? - -
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)? - -1.
Adrenocorticotropic hormone
2. Dehydroepiandrosterone (ACTH)
3. DHEA sulfate (DHEA-S)
-What hormones are attributed to Growth hormone (GH)?axis - -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? - -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 - -
Sexual Maturity Rating (SMR) scale (also called the Tanner scale)
-Girls major events of puberty - -1. Thelarche
2. Growth Spurt
3. Menarche
-Thelarche - -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 - -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 - -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 ? - -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 ? - -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? - -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? - -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 - -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. - -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.
-Testosterone. - -The testes produce most of the circulating testosterone, but a
small amount comes from extratesticular conversion of the adrenal hormone
androstenedione in both males and females. Testosterone is responsible for the
voice change in males and the attainment of male body habitus, while
dihydrotestosterone, the product of conversion of testosterone by 5a-reductase,
causes growth of the phallus and prostate.
, -GnRH Pulse Generator - -At the time of puberty, GnRH is secreted from the GnRH
pulse generator in the hypothalamus, leading to pituitary secretion of LH and FSH
and subsequent secretion of estradiol from the ovaries or testosterone from the
testes. The exact triggers are still incompletely understood, although new research
has elucidated new potential regulators and key players in the awakening of this
system. These include leptin, the genes GPR54/KiSS-1, as well as several
neuropeptides and neurotransmitters.
-ADRENARCHE - -The increased secretion of androgens from the adrenal gland,
called adrenarche, in the prepubertal and pubertal periods is independent of HPG
changes.
-What is the Local conversion of DHEA-S to testosterone and then to
dihydrotestosterone is responsible for? - --hair growth in the androgen-dependent
areas (face, chest, pubic area, axillae). Axillary and pubic areas are the most
sensitive to the effects of androgens, which is why these areas are the first to
develop sexual hair.
-local conversion of DHEA-S within the apocrine glands of the axillae causes body
odor,
-conversion within sebaceous glands is responsible for the development of acne.
-What is the height spurt during puberty attributed to? - -primarily upon growth
hormone and the insulin-like growth factors, but many other hormones may
influence growth as well, especially the sex steroids. Without prompt recognition
and treatment, premature or delayed puberty may have marked effects on height.
-What is most linear growth contributed to? - -Growth hormone and its feedback
loop
-GH during Puberty - -GH secretion is increased by growth hormone-releasing
hormone (GHRH) and decreased by somatostatin from the hypothalamic arm of the
loop. Growth hormone has been shown to double during the pubertal growth spurt.
Like many hormones, GH is secreted in pulsatile fashion, with maximum rates at the
onset of slow-wave sleep. It is this pulsatile secretion that renders random testing of
GH unhelpful. GH exerts its effects through IGFs, mainly IGF-I (formerly
somatomedin-C) and IGF-II.
-Prediction of Final Height for girls - -(fathers height-13 cm or 5 inches) + mothers
height/2
-Growth Velocity during puberty - -Growth velocity during the pubertal growth spurt
is at its highest levels outside of infancy. It should be noted that in calculating
growth velocity, it is important to have an interval of 6 to 12 months, as growth is
greatest in the spring and summer months. Although males and females are
roughly the same height upon entry into puberty, males emerge taller by 13 cm on
average. This is primarily due to boys' 2-year lag behind girls in attaining their peak
height velocity, but a small amount of height may be accounted for by the higher
peak velocity. Girls gain their peak height velocity of 8.3 cm/year at an average age
of 11.5 years (Tanner stages B2 to B3) while boys do not reach their peak height
