[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Anatomy](https://durgical.com/en/anatomy/) › [Head and neck](https://durgical.com/en/anatomy/region/head-and-neck/) › Pituitary gland [Endocrine system](https://durgical.com/en/anatomy/system/endocrine-system/) · [Head and neck](https://durgical.com/en/anatomy/region/head-and-neck/) # Pituitary gland The pituitary is a pea-sized gland hanging below the brain; as the master gland it controls the thyroid, adrenals, growth, milk and the sex glands. [See in 3D →](https://durgical.app/?from=durgipedia&lang=en#region=head_neck&select=pituitary_gland&side=r) Opens in the Durgical app, no sign-up needed. ## What it is A pea-sized gland hanging from the brain in the sella turcica. ## What it does The master gland: controls the thyroid, adrenals, growth, milk and the sex glands. ## Key points - Two glands in one: the anterior lobe comes from Rathke's pouch (mouth ectoderm) and is run by blood-borne hypothalamic hormones; the posterior lobe is brain tissue made of hypothalamic axons - A tumour rising from below presses on the crossing nasal fibres of the optic chiasm: bitemporal hemianopia, often starting in the upper outer quadrants - Prolactinoma, the most common hormone-secreting adenoma: absent periods and milk discharge in women, low libido and erectile problems in men; usually treated with medicine first - Pituitary apoplexy: sudden bleeding or infarction into an adenoma, with thunderclap headache, sudden visual loss, double vision and risk of adrenal crisis ## Key facts **Where** Sella turcica, under the optic chiasm, between the cavernous sinuses **Blood supply** Superior and inferior hypophyseal arteries (internal carotid); portal system **Nerve** Hypothalamus: releasing hormones (anterior), nerve tract (posterior) **Function** Anterior: GH, PRL, TSH, ACTH, FSH, LH; posterior: ADH, oxytocin ## Relations **Above** Diaphragma sellae, pierced by the stalk; above it the [optic chiasm](https://durgical.com/en/anatomy/optic-chiasm/) and the [hypothalamus](https://durgical.com/en/anatomy/hypothalamus/) **Below** Floor of the [sella turcica](https://durgical.com/en/anatomy/sella-turcica/) and, below it, the [sphenoid sinus](https://durgical.com/en/anatomy/sinus-of-sphenoid-bone/), the route used in transsphenoidal surgery **Lateral** [Cavernous sinus](https://durgical.com/en/anatomy/cavernous-sinus/) on each side, containing the [internal carotid artery](https://durgical.com/en/anatomy/internal-carotid-artery/) and the oculomotor, trochlear, abducens, ophthalmic and maxillary nerves **In front** Tuberculum sellae and the anterior clinoid processes of the [sphenoid bone](https://durgical.com/en/anatomy/sphenoid-bone/) **Behind** Dorsum sellae and, behind it, the [basilar artery](https://durgical.com/en/anatomy/basilar-artery/) in front of the [pons](https://durgical.com/en/anatomy/pons/) ## How to find it Not palpable. It sits in the hypophyseal fossa of the sella turcica, directly above the sphenoid sinus; in endoscopic transsphenoidal surgery the sellar floor is the bulge in the upper back wall of the sinus, between the carotid bulges on each side and the [optic nerve](https://durgical.com/en/anatomy/optic-nerve/) bulges above them. ## Examination - Confrontation visual fields, followed by formal perimetry: loss in both temporal fields points to compression of the optic chiasm by a sellar mass ## On imaging Contrast MRI in thin coronal and sagittal slices. Adenomas under 10 mm are microadenomas and larger ones macroadenomas; a microadenoma usually enhances less than the normal gland. On T1 images the posterior lobe is normally bright (stored ADH); the bright spot is lost in central diabetes insipidus. The gland normally swells in puberty and pregnancy. ## Common problems - Pituitary adenoma: a benign tumour that can make too much of a hormone or press on the optic chiasm (losing side vision in both eyes). ## How it is diagnosed Hormone blood tests, visual field test and MRI. ## Treatment - Medicines for some hormone-making tumours. - Surgery through the nose and sphenoid sinus (transsphenoidal). - Hormone replacement when the gland is underactive. ## Clinical notes - Transsphenoidal surgery reaches the sella through the nose and sphenoid sinus; risks include CSF leak, diabetes insipidus (often temporary) and injury to the internal carotid artery - Sheehan syndrome: after severe postpartum haemorrhage, the gland, enlarged by pregnancy, infarcts; failure to breastfeed and absent periods are early clues of hypopituitarism - An adenoma growing sideways invades the cavernous sinus and can palsy the [oculomotor nerve](https://durgical.com/en/anatomy/oculomotor-nerve/) (drooping lid, eye turned down and out) - Excess growth hormone causes acromegaly (gigantism before the growth plates close); excess ACTH from an adenoma is Cushing disease ## Anatomical variants - Empty sella: the sella is mostly filled with CSF and the gland is flattened against its floor; often an incidental MRI finding with normal pituitary function - The gland is normally larger in adolescence and in pregnancy, which should not be mistaken for a tumour on MRI ## Development Rathke's pouch grows up from the roof of the primitive mouth to meet the infundibulum growing down from the diencephalon; leftover cells along this path can give rise to craniopharyngioma. ## Memory aid Anterior lobe hormones: FLAT PiG (FSH, LH, ACTH, TSH, Prolactin, GH). ## Related conditions - [Hyponatraemia](https://durgical.com/en/conditions/hyponatraemia/) - [Syndrome of inappropriate antidiuretic hormone secretion (SIADH)](https://durgical.com/en/conditions/syndrome-of-inappropriate-antidiuretic-hormone-secretion/) - [Hypothyroidism](https://durgical.com/en/conditions/hypothyroidism/) - [Pituitary adenoma](https://durgical.com/en/conditions/pituitary-adenoma/) - [Diabetes insipidus (central and nephrogenic)](https://durgical.com/en/conditions/diabetes-insipidus/) - [Prolactinoma (hyperprolactinaemia)](https://durgical.com/en/conditions/prolactinoma/) - [Acromegaly and gigantism](https://durgical.com/en/conditions/acromegaly-and-gigantism/) - [Hypopituitarism (incl. Sheehan syndrome and pituitary apoplexy)](https://durgical.com/en/conditions/hypopituitarism/) - [Multiple endocrine neoplasia (MEN 1, 2A, 2B)](https://durgical.com/en/conditions/multiple-endocrine-neoplasia/) - [Male hypogonadism](https://durgical.com/en/conditions/male-hypogonadism/) - [Childhood brain tumours (medulloblastoma, pilocytic astrocytoma, craniopharyngioma)](https://durgical.com/en/conditions/childhood-brain-tumours/) - [Functional hypothalamic amenorrhoea](https://durgical.com/en/conditions/functional-hypothalamic-amenorrhoea/) - [Anorexia nervosa](https://durgical.com/en/conditions/anorexia-nervosa/) - [Perinatal depression and postpartum psychosis](https://durgical.com/en/conditions/perinatal-depression-and-postpartum-psychosis/) - [Premenstrual dysphoric disorder (PMDD)](https://durgical.com/en/conditions/premenstrual-dysphoric-disorder/) - [Gender dysphoria](https://durgical.com/en/conditions/gender-dysphoria/) ## Test yourself Think of the answer, then tap the question to see it. ## What visual field defect does a pituitary tumour growing upward classically cause? Bitemporal hemianopia, from pressure on the crossing nasal fibres of the optic chiasm, often starting in the upper outer quadrants. ## How do the anterior and posterior lobes of the pituitary gland differ in origin? The anterior lobe comes from Rathke's pouch (mouth ectoderm); the posterior lobe is brain tissue made of hypothalamic axons. ## Which is the most common hormone-secreting pituitary adenoma and how does it present? Prolactinoma: absent periods and milk discharge in women, low libido and erectile problems in men; usually treated with medicine first. ## What is Sheehan syndrome? Infarction of the pituitary gland, enlarged by pregnancy, after severe postpartum haemorrhage; failure to breastfeed and absent periods are early clues. ## Which structures lie in the cavernous sinus beside the pituitary gland? The internal carotid artery and the oculomotor, trochlear, abducens, ophthalmic and maxillary nerves; a sideways adenoma can palsy the oculomotor nerve. [Add to my cards (5)](https://durgical.app/estudiar/?add=/en/anatomy/pituitary-gland/) Educational information, not medical advice. For any symptom, see a health professional. ## Its names **Official Latin (TA2)** glandula pituitaria TA2 3854 **Official Spanish (DeCS)** Hipófisis **English (TA2)** Pituitary gland **Also called** hypophysis ## Related - [Optic chiasm](https://durgical.com/en/anatomy/optic-chiasm/) - [Sella turcica](https://durgical.com/en/anatomy/sella-turcica/) - [Hypothalamus](https://durgical.com/en/anatomy/hypothalamus/) Sources: Terminologia Anatomica (TA2); [Anatomy, Head and Neck, Pituitary Gland](https://www.ncbi.nlm.nih.gov/books/NBK551529/); [7.2 The Skull](https://openstax.org/books/anatomy-and-physiology-2e/pages/7-2-the-skull) (OpenStax (Rice University), 2022) · adapted, [CC BY 4.0](https://creativecommons.org/licenses/by/4.0/). ## **Spotted a mistake?** We are always improving for the community. Tell us what is wrong and our team will review it. Report a mistake Representative model, for educational purposes only. --- Source: https://durgical.com/en/anatomy/pituitary-gland/ License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/anatomy/pituitary-gland/