2-9-16-Suprarenal Gland (Cole) Flashcards
The renal cortex is derived from ___
The renal medulla is derived from ___
Mesoderm –> develops from the celomic epithelium of the posterior abdominal wall
Ectoderm –> develops from the neural crest cells
___ occur in up to 50% of newborn infants, but tend to atrophy and disappear in the early postpartum period. They can be detected anywhere along the path of the embryonic migration of adrenal cortex
Adrenocortical rests
___ are minor developmental anomalies arising from partly or completely detached rests of the coelomic epithelial primordia from which the adrenal cortex is derived. They are most frequently located in contact with the capsule at 1 pole of the adrenal but can occur completely separated from the adrenal gland in the retroperitoneal fat
Accessory adrenocortical nodules (i.e., ectopic adrenal tissue, accessory cortical tissue, hamartoma)
The developmental of adrenal zones occurs slowly after birth, in parallel with regression of the fetal cortex, and is not completed until ___
Late in the 1st year of life
The ____ persists and develops into the functional adrenal cortex, with distinct zonae glomerulosa and fasciculata present at birth. The zona reticularis develops during the 1st year of life
Definitive cortex
Both cortical and medullary elements appear between the ___ weeks of fetal growth
5th-6th weeks
The ___ and sympathetic NS develop in concert
Adrenal medulla
During the early stage of gestation, the adrenal cortex synthesizes ___, a precursor of the synthesis of estrogen by the placenta
DHEA
A lack of ___ enzyme activity prevents the synthesis of progesterone, glucocorticoids, and androstenedione
3-beta-hydroxysteroid dehydrogenase
The interaction between the fetal adrenal cortex and the placenta is known as the __
Fetoplacental unit
___ is an uncommon form of congenital adrenal hyperplasia that results from a mutation in the gene for (3beta-HSD) type II
3beta-hydroxysteroid dehydrogenase II deficient congenital hyperplasia (3beta-HSD CAH)
Milder forms of 3beta-HSD CAH type II can produce what?
Virilization of genetically female infants and undervirilization of genetically male infants. This form of primary hypoadrenalism is the only form of CAH that can cause ambiguous genitalia in both genetic sexes
Glucocorticoids are essential for these 3 main developmental events:
1-Production of surfactant by type 2 alveolar cells after the 8th month of fetal life
2-Development of a functional hypothalamopituitary axis
3-Induction of thymic involution
THe adrenal cortex is of mesodermal origin and produces ___
The adrenal medulla is of neuroectodermic origin and produces ___
Steroid hormones
catecholamines
What are the 3 zones of the adrenal cortex from the outer-most to inner-most layer?
Zona glomerulosa –> Zona fasciculata –> Zona reticularis
What does the zona glomerulosa primarily produce?
Mineralocorticoids, mainly aldosterone
Produced in response to Ang II (also ACTH)
__ lies under the capsule and represents 10-15% of the adrenal cortex. THe celles aggregate into a glomerulus-like arrangement and have a moderate amount of lipid droplets in the cytoplasm.
Zona glomerulosa
The zona glomerulosa lacks the enzyme ___ and cannot produce cortisol or sex steroids
17alpha-hydroxylase
Aldosterone stimulates renal __ reabsorption and renal secretion of ___
Na
K and H
___ is 75% of the renal cortex and secretes mainly glucocorticoids and androgens.
Zona fasciculata
What cell type is characteristic of the zona fasciculata?
Spongiocytes
Cells appear vacuolated (foamy appearance)
___ contains cuboid cells, with the structural features of steroid producing cell arranged in longitudinal cords separated by cortical fenestrated capillaries/sinusoids
Zona fasciculata
Which zones of the adrenal cortex contain 17alpha-hydroxylase to produce glucocorticoids?
Fasciculata and Reticularis
Also contain 17,20-hydroxylase –> produce sex hormones
Cortisol is converted in hepatocytes to ___
Cortisone
List the 2 major effects of cortisol:
- Metabolic –> stimulates gluconeogenesis to increase [glucose] in blood
- Anti-inflammatory –> suppresses tissue responses to injury and decreases cellular and humoral immunity
___ is the innermost layer of the adrenal cortex (~5-10% of total volume) and the cells are arranged in irregular cords that form an anastomosing network
Zona reticularis
What hormones does the zona reticularis characteristically secrete?
Gluocorticoids and androgens
The primary site of adrenal sex hormone production is the ___
Zona reticularis
___ are the predominant androgens produced by the cortex of the adrenal gland
DHEA and androstenedione
Chromaffin cells are associated with the ___
Adrenal medulla
___ are composed of polyhedral cells arranged in cords or clumps and regarded as modified sympathetic postganglionic neurons without postganglionic axons.
Chromaffin cells
Chromaffin cells are derived from ___
Neural crest
The adrenal medulla is innervated by sympathetic preganglionic fibers that release ____
Ach
___ are secreted into the blood instead of being secreted into a synapse, as in postganglionic terminals. They are secreted in response to intense emotional rxns., defensive rxn. To stress, increase HR, dilate BVs supplying cardiac and skeletal muscle, bronchiole dilation, and vasoconstrict BVs supplying GI tract, kidneys, skin
Catecholamines (epi, norepi)
List the arterial contributions of the adrenal gland capsule
Inferior phrenic a. –> superior adrenal a.
Aorta–> middle adrenal a.
Renal a. –> inferior adrenal a.
All form an arterial plexus
Regarding bloody supply of the adrenal gland, ___ supplies the capsule
The subcapsular plexus
Regarding blood supply to the adrenal gland, __ is the second set of arteries that enters the cortex forming straight fenestrated capillaries/sinusoids, percolating between the zona glomerulosa and fasciculata, and forming a capillary network in the zona reticularis before entering the medulla
Short cortical aa.
Regarding blood supply of the adrenal gland, ___ is the 3rd set generating medullary arteries that travel without branching and supplying blood ONLY to the medulla
Long cortical aa
A tumor that is localized in the zona glomerulosa that causes excessive secretion of aldosterone is known as ____
Conn’s syndrome (primary aldosteronism)
A more common cause of hyperaldosteronism is an increase in renin secretion and this is known as ___
Secondary hyperaldosteronism
An increase in aldosterone, cortisol, and adrenal androgen production-secondary to ACTH production-occurs in ___
Cushing’s disease
___ is caused by an ACTH-producing tumor of the anterior hypophysis
Cushing’s disease
___ is when a functional tumor of the adrenal cortex can also result in overproduction of cortisol, as well as of aldosterone and adrenal androgens
Cushing’s syndrome
Overproduction of cortisol caused by either a pituitary tumor, adrenal tumor, or some other unknown factor is a ___ cause of Cushing’s syndrome
Endogenous
Taking medications containing glucocorticoids, such as hydrocortisone, may be a ___ cause of Cushing’s syndrome
Exogenous
___ is a chronic destruction of the adrenal cortex by an autoimmune process or TB.
Addison’s disease
In Addison’s disease, ___ secretion increases because of the cortisol deficiency. It can cause an increase in skin pigmentation, in particular in the skin folds and gums
ACTH
In Addison’s disease, the loss of ___ leads to hypotension and circulatory shock. Also, a deficiency in ___ causes muscle weakness in Addison’s disease
Mineralocorticoids
Cortisol
List symptoms of Addison’s disease:
Fatigue, lassitude, malaise, weakness, anorexia
Postural dizziness, syncope
GI symptoms
Myalgias, arthralgias, rarely flexion contractures
Decreased libido, amenorrhea
What are signs of Addison’s disease?
Weight loss, hyperpigmentation, hypotension, thinning of axillary and pubic hair, vitiligo
___ is a benign tumor of the chromaffin cells that leads to episodic secretion of epi and norepi. Signs and symtpoms are those of sympathetic NS hyperactivity: elevated HR, BP, palpitations, diaphoresis, anxiety, headaches, nausea, pallor
Pheochromocytoma
The superior suprarenal artery arises from ___ artery
The middle suprarenal artery arise from ___
The inferior suprarenal arteries arise from ___ artery
Inferior phrenic
Abdominal aorta
Renal
