Adrenal and Pancreas Histology Flashcards

1
Q

What are the cells that the pancreatic islets are derived from?

A

Endoderm

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2
Q

Where in the pancreas are most of the pancreatic islet cells located?

A

Slightly more numerous in the tail of the pancreas

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3
Q

What forms the supporting framework for the pancreatic islet cells? What are the other two major components of the supportive framework?

A

Reticular fibers

ANS fibers
Capillary network

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4
Q

What percent of the pancreas is composed of beta cells? Alphas cells?

A

70% beta cells

20% alpha cells

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5
Q

Where are the beta cells of the pancreas located? What hormone do these secrete, and what is its function?

A

Scattered throughout

Secrete insulin to decrease BG levels

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6
Q

Where are the alpha cells of the pancreas located? What hormone do these secrete, and what is its function?

A

Peripherally

Secrete glucagon to decrease BG levels

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7
Q

Where are the delta cells of the pancreas located? What hormone do these secrete, and what is its function?

A
Scattered
Somatostatin secretion to inhibit:
-TSH
-GH
-Contraction of GI tract and gallbladder
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8
Q

Where are the G cells of the pancreas located? What hormone do these secrete, and what is its function?

A

Scattered throughout

Gastrin secretion–Stimulates HCl secretion by parietal cells

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9
Q

Where are the PP cells of the pancreas located? What hormone do these secrete, and what is its function?

A

Scattered

  • Pancreatic polypeptide
  • Inhibit pancreatic exocrine secretion
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10
Q

Where are the D1 cells of the pancreas located? What hormone do these secrete, and what is its function?

A

Scattered

VIP to increase motility and stimulates GI fluid secretion

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11
Q

Where are the EC cells of the pancreas located? What 3 hormones do these secrete?

A

Scattered

Secretes Motilin, substance P, and serotonin

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12
Q

What is the function of Motilin secreted by EC cells of the pancreas?

A

Promotes gastric and intestinal motility

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13
Q

What is the function of Secretin secreted by EC cells of the pancreas?

A

Stimulates secretion from the exocrine pancreas

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14
Q

What is the function of Substance P secreted by EC cells of the pancreas?

A

Neurotransmitter

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15
Q

What is the major neoplasm or symptoms that arises from Beta cells?

A

Insulinomas that cause hypoglycemia

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16
Q

What is the major neoplasm or symptoms that arises from Alpha cells?

A

Gluconoma

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17
Q

What is the major neoplasm or symptoms that arises from delta cells?

A

Somatostatinoma

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18
Q

What is the major neoplasm or symptoms that arises from G cells?

A

Gastrinoma

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19
Q

What is the major neoplasm or symptoms that arises from PP cells?

A

Asymptomatic

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20
Q

What is the major neoplasm or symptoms that arises from D1 cells?

A

Secretory diarrhea

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21
Q

What is the major neoplasm or symptoms that arises from EC cells?

A

Carcinoid syndrome

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22
Q

True or false: insulinomas are benign

A

True, but can cause BG to fall below 45 mg/dL

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23
Q

Pancreatic islet cells secrete a lot of proteins. What organelles, then, predominate throughout these cells?

A

rER

Golgi

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24
Q

What are the structures that hold pancreatic cells together?

A

Desmosomes

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25
Q

Which type of genetic material is available for transcription: euchromatic or heterochromatic DNA?

A

Euchromatic

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26
Q

What is the maturation process of insulin?

A

Proinsulin is secreted into clathrin coated vesicles, where an enzyme cleaves it into insulin and C-peptide

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27
Q

What happens to the vesicles that contain proinsulin as they mature?

A

Lose clathrin, and gain pumps to increase cell [H+]

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28
Q

What is the MOA of insulin release?

A

Beta cells take in glucose through GLUT-2, which inhibits K exporter, causing CA influx and release of insulin

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29
Q

What GLUT transporter is found on beta cells of the pancreas? Is this insulin dependent?

A

GLUT2

Non-insulin dependent

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30
Q

What are the drugs that Inhibit the sulfonylurea receptors to induce insulin secretion?

A

Gliclazide

Glimepiride

31
Q

What is the MOA of gliclazide?

A

Inhibits the sulfonylurea receptor on beta cells, to induce Ca influx, and thus insulin release

32
Q

What is the MOA of Glimepiride?

A

Inhibits the sulfonylurea receptor on beta cells, to induce Ca influx, and thus insulin release

33
Q

What is the side of the Golgi that faces the rER? Cell membrane?

A

face rER = cis

cell membrane = trans

34
Q

What happens to the beta cells in DM II?

A

There is a loss of GLUT-2 mRNA, leading to an impairment of glucose stimulated secretion of insulin

35
Q

What is the MOA of insulin on target cells?

A

Induces the movement of GLUT4-containing endosomes to the cell membrane

36
Q

What is Cushing’s disease? Syndrome?

A

Disease is a pituitary issue

Syndrome is primary

37
Q

Where are the target cells for ACTH chiefly located in the adrenal gland, and what hormones are secreted by the target cells?

A

Zona fasciculata and reticularis

38
Q

What cells give rise to pheochromocytomas?

A

Chromaffin cells

39
Q

What are the two signalling molecules are essential in the differentiation of cells into chromaffin cells?

A

Cortisol

Nerve growth factor (NGF)

40
Q

In chromaffin cells, why is cortisol required for the synthesis of epinephrine?

A

Activates Phenylethanolamine N-methyltransferase

41
Q

What is the role of plasma chromogranin A? Why is it elevated in a pt with a pheochromocytoma?

A

Binds to excess catecholamines, so an aberrant increase in catecholamines will cause an increase in this binding protein

42
Q

Where in chromaffin cells are the enzymes located for the conversion of tyrosine to dopamine? Dopamine to norepi? Norepi to epi?

A

From Y to dopamine, all the enzymes are in the cytoplasm

Dopamine to NE is found in secretory vesicles

NE to epi is in the cytosol, so NE must be transported out of the vesicle to the cytosol

43
Q

Sympathetic outflow to the adrenal medulla arises from which spinal cord segments?

A

Preganglionic sympathetic neurons of T8-L1

44
Q

What germ layer is the outer cortex of the adrenal glands derived from?

A

Mesoderm

45
Q

What germ layer is the inner medulla of the adrenal glands derived from?

A

Neural crest cells of the neuroectoderm

46
Q

What are the three major arteries that supply the adrenal gland, and what is the parent artery of each?

A
  • Superior suprarenal artery (inferior phrenic)
  • Middle suprarenal artery (aorta)
  • Inferior suprarenal artery (renal)
47
Q

What are the components of the mnemonic to recall the arterial supply to the suprarenal arteries?

A

IPAR

Inferior phrenic
Aorta
Renal

48
Q

What is the plexus that is formed from the suprarenal arteries when they penetrate the capsule? What are the two sets of arteries that issue from this plexus?

A

Subcapsular plexus

  • Cortical arteries form a network of sinusoidal capillaries in the cortical parenchyma
  • Medullary arteries penetrate the cortex and enter the medulla where they form a capillary network
49
Q

What do the cortical arteries that issue from the subcapsular plexus go?

A

Form a network of sinusoidal capillaries in the cortical parenchyma

50
Q

What do the medullary arteries that issue from the subcapsular plexus go?

A

Penetrate the cortex and enter the medulla where they form a capillary network

51
Q

What is the order of veins that drain the confluence of the capillaries formed by the renal arteries?

A

Medullary venules are the confluence of the capillaries&raquo_space; medullary veins&raquo_space; suprarenal vein&raquo_space; IVC (right side) or left renal vein (left side)

52
Q

What forms the capsule of the suprarenal gland?

A

Dense irregular collagenous tissue

53
Q

What is the major difference between the right and left suprarenal veins? What is the clinical significance of this?

A

Right is much shorter, meaning that this vein may be avulsed during surgery or high-energy deceleration injuries

54
Q

What is the largest layer of the adrenal cortex?

A

Zona fasciculata (78% of total volume)

55
Q

Explain how it gets sweeter as you get deeper?

A

mineralcorticois synthesized at glomerulosa, then glucocorticoids, then sexy

56
Q

What are the general histological characteristics of the adrenal areas?

A

Large amount of sER to synthesize steroids, and lipid droplets

No secretory vesicles, since lipid soluble

57
Q

Why don’t the adrenal cells have vesicles for secretion?

A

Only produce lipid soluble hormones

58
Q

What are the two tropic chemicals that influence the zona glomerulosa?

A

Angiotensin

Potassium

59
Q

What is the major hormone that influences the zona fasciculata?

A

ACTH

60
Q

What are the major hormones that influence the zona reticularis?

A

ACTH

61
Q

What happens to the zones to the adrenal cortex with Cushing’s disease?

A

hypertrophy of the Zona fasciculata and reticularis

62
Q

What are the steps of epi synthesis? (5)

A
  1. Tyrosine
  2. DOPA
  3. Dopamine
  4. NE
  5. Epi
63
Q

What is the enzyme that converts Y into dopa?

A

Tyrosine hydroxylase

64
Q

What is the enzyme that converts DOPA to dopamine?

A

DOPA decarboxylase

65
Q

What is the enzyme that converts dopamine to NE?

A

Dopamine beta-hydroxylase

66
Q

What is the enzyme that converts NE to epi? What is the stimulus that is necessary for this enzyme?

A

Phenylethanloamine N-methyltransferase

Cortisol

67
Q

What is the organ of Zuckerkandl?

A

medullary tissue located around the abdominal aorta between its bifurcation and the IMA. Chromaffin cells primarily produce norepinephrine with small amounts of epinephrine.

68
Q

What is the tubercle of Zuckerkandl?

A

Extension of thyroid tissue

69
Q

What hormone does the organ of Zuckerkandl primarily produce? Why?

A

NE, since there is a lack of cortical tissue here

70
Q

What hormones are produced by the adrenal medulla?

A

NE /epi

71
Q

What is the radiological finding of blood supply to the adrenal gland look like?

A

Mercedes benz

72
Q

What is congenital adrenal hyperplasia?

A

Enzyme to produce cortisol is defective, driving precursor steroids to be driven toward androgen production. The pituitary reacts by increasing ACTH, making matters worse

73
Q

What is the enzyme that is defective in congenital adrenal hyperplasia?

A

21-hydroxylase