The anterior pituitary is the larger front lobe of the pituitary gland, made of true glandular tissue that grew up from the roof of the embryonic mouth (Rathke's pouch). It makes six main hormones and is steered by releasing and inhibiting hormones that reach it from the hypothalamus through a private portal blood system.
| Location | Front part of the pituitary gland in the sella turcica, wrapping partly around the pituitary stalk (pars tuberalis) |
|---|---|
| Secretes |
|
| Blood Supply | Superior hypophyseal arteries (via the hypophyseal portal system) |
| Venous drainage |
|
Secretes hormones that drive the thyroid, adrenal cortex and gonads, promote growth and stimulate milk production. Its output is set by hypothalamic hormones such as TRH, CRH, GnRH, GHRH, somatostatin and dopamine, and by negative feedback from target glands.
Most pituitary tumours arise here. A prolactinoma causes milk discharge, missed periods and low libido and usually shrinks with dopamine agonists such as cabergoline. Excess growth hormone causes gigantism before growth plates close and acromegaly afterwards; excess ACTH causes Cushing disease. Because the portal blood supply is delicate, severe blood loss after childbirth can infarct the gland (Sheehan syndrome).
The commonest functioning pituitary tumour, secreting prolactin and causing galactorrhoea, menstrual disturbance and reduced fertility.
Growth hormone excess in adults, usually from an adenoma, causing enlarged hands, feet and jaw, coarse facial features, joint pain and diabetes.
Ischaemic necrosis of the anterior pituitary after major postpartum haemorrhage, presenting with failure of lactation and later hypopituitarism.
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