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the middle group, which includes the tuberal, arcuate, ventromedial, and dorsomedial nuclei; and (3) the posterior group, comprising the mammillary and posterior hypothalamic nuclei Nauta and Haymaker have subdivided the hypothalamus sagitally The lateral part lies lateral to the fornix; it is sparsely cellular and its cell groups are traversed by the medial forebrain bundle which carries nely myelinated and unmyelinated ascending and descending bers to and from the rostrally placed septal nuclei, substantia innominata, nucleus accumbens, amygdala, and piriform cortex and the caudally placed tegmental reticular formation The medial hypothalamus is rich in cells, some of which are the neurosecretory cells for pituitary regulation and visceral control It contains two main efferent ber systems the mammillothalamic tract of Vicq d Azyr (named for the physician to Louis XIV, a paramour of Marie Antionette), which connects the mammillary nuclei with the anterior thalamic nucleus (which, in turn, projects to the cingulate gyrus), and the mammillotegmental tract Additional structures of importance are the stria terminalis, which runs from the amygdala to the ventromedial hypothalamic nucleus, and the fornix, which connects the hippocampus to the mammillary body, septal nuclei, and periventricular parts of the hypothalamus The lateral and medial parts of the hypothalamus are interconnected and their functions are integrated The inferior surface of the hypothalamus, just posterior to the pituitary stalk, bulges downward slightly; this region is known as the tuber cinerium From the center of the tuber arises the median eminence or infundibulum; the latter stands out because of its vascularity (the hypophysial-portal system of veins courses over the surface) The infundibulum extends into the pituitary stalk, which, in turn, enters the pars nervosa of the hypophysis (Fig 27-1) The median eminence assumes special importance because of the intimate relation of its cell groups to the anterior lobe of the pituitary gland It represents the interface between converging pathways from the brain and the master gland of the endocrine system The supraopticohypophysial bers terminate on capillaries of the outer zone of the median eminence (Martin and Reichlin) The tuberoinfundibular neurons of the arcuate nucleus and anterior periventricular nuclei synthesize most of the releasing factors described below (Fig 27-1) The abundant blood supply of the hypothalamus (from several feeding arteries) is of importance to neurosurgeons who attempt to obliterate aneurysms that derive from adjacent vessels Many small radicles, arising from the posterior and anterior communicating arteries as well as from the most proximal portions of the anterior and posterior cerebral arteries, form a network of such redundancy that infarction of the hypothalamus is infrequent Readers requiring a more extensive source of information on anatomic and other aspects of the hypothalamus are directed to the comprehensive material by Swaab in the two-volume Handbook of Clinical Neurology and to the monograph by Martin and Reichlin.

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For the bar chart type used for the averages, I turned on the 25D view of the bars and adjusted the titles for the Y-axis to diagonal To increase the display view of the information, I adjusted two parameters in the Web Item Parameters tab in the WAD First, I increased the width and height of the pixels from the default 300 each to 400 each Second, I used the parameter Swap Display Axis for each of the charts to make sure that the data structures can be formatted to the chart type After making these adjustments, the dashboard was complete Although this dashboard doesn t have any wow factor, it does have a solid and consistent look and feel that would be very inviting to an analyst who just wants to be able to get the information they need from the KPIs to run the business and then work to improve those metrics Let s take a look at another dashboard, for Sales Analysis, shown next In this case, the KPIs being used are more practical, meaning they include not only indicators that give us information about the results but also leading indicators that will help us in terms of growing

Thyrotropin-Releasing Hormone (TRH) This was the rst of the releasing hormones to be identi ed; its tripeptide structure was determined in 1968 The hormone is elaborated by the anterior periventricular, paraventricular, arcuate, ventromedial, and dorsomedial neurons but not by those of the posterior hypothalamic or thalamic nuclei Mainly, it stimulates the release of thyroidstimulating hormone (TSH) from the pituitary gland; TSH, in turn, effects the release of T4 (thyroxine) and T3 (triiodothyronine) Pituitary cells that release dopamine and somatostatin are also stimulated to a slight degree; the latter has an inhibitory effect on TSH There is also an inhibitory feedback of T3 on TSH and TRH Actually, more than half of brain TRH is found outside the hypothalamus in brainstem raphe nuclei, tractus solitarius, and the anterior and lateral horn cells of spinal cord suggesting that TRH may function as a central regulator of the autonomic nervous system Growth Hormone Releasing Hormone (GHRH) This hormone and somatostatin (also known as GH-release inhibiting hormone, or SRIH) are both secreted by specialized tuberoinfundibular neurons and released into the hypophysial-portal circulation, by which they are carried to speci c GH-secreting cells of the anterior pituitary gland (somatotropes) Immunohistochemical staining has shown the sources of GHRH and somatostatin to be neurons of the posterior part of the arcuate and ventromedian hypothalamic nuclei and other neurons of the median eminence and premammillary area Somatostatin, a 14 amino acid peptide, is produced more anteriorly by neurons in the periventricular area and small-cell part of the paraventricular nucleus The amygdala, hippocampus, and other limbic structures project to the arcuate nuclei via the medial

peptides thyroid-releasing factor, vasoactive intestinal peptide, peptide-histidine-isoleucine, and oxytocin also have the capacity to raise the levels of prolactin in the blood The hypothalamopituitary axis is responsive to sensory stimuli from the nipples, via pathways in the spinal cord and brainstem, accounting for the effect of suckling on milk production The normal blood levels of prolactin are 5 to 25 ng/mL The release of prolactin is also in uenced by an inhibitory dopaminergic innervation of pituitary lactotrophic cells This latter mechanism accounts for galactorrhea and reproductive disorders, which occur with tumors that compress the pituitary stalk and interrupt the venous portal transport of dopamine from the hypothalamus

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