Adrenal Cotex/Medulla (lec 25)

Question 1

Adrenal glands regulate? (6)

Answer 1

Fluid/mineral balance
Electro balance
Energy
Tissue injury response
Stress survival
CV tone

Question 2

Mineralcorticoids are?

Secreted from?

Answer 2

hormones that regulate salt/H2O retention in kidney
e.g. aldosterone

Zona glomerulosa

Question 3

Glucocorticoids are?

Secreted from?

Answer 3

hormones that regulate plasma glucose
e.g. cortisol

Zona fasciculata

Question 4

Androgens are?

Secreted from?

Answer 4

sex hormones
e.g. DHEA, androstenedione

Zona reticularis

Question 5

Adrenal Medulla made of what type of cells?

Secrete what?

Answer 5

chromaffin

Epi&raquo_space; Norepi

Question 6

Adrenal Cortex hormes made from?

Answer 6

cholesterol

Question 7

Steroid hormone synthesis?

Answer 7

Cholesterol Δ to steroid in organ-specific rxn

Hormone NOT stored (used up at time of synth)

Question 8

Adrenalcortical Hormones: route of synth?

Answer 8

Hypothal: Corticotropin-Releasing Hormone (CRH) ->

Ant Pit cortitrophs: Adrenocorticotropic Hormone (ACTH) ->

Adrenal Cortex:
activates cholesterol desmolase

Question 9

Steroid synth precursor?

Answer 9

cholesterol

Question 10

Steroid synth Step 1?

Answer 10

cholesterol + desmolase -> pregnenolone

Question 11

Cortisol is?

Answer 11

glucocorticoid produced in zona fasciculata

Question 12

Enzymes needed for Cortisol syth are found where?

Answer 12

in the z. fasc

Question 13

Cortisol feedback regulation?

Answer 13

cortisol directly inhibits release of CRH and ACTH

ACTH stimulates release of more CRH

Question 14

ACTH effects? (2)

Answer 14

1) Activate cholesterol desmolase

2) Stim adrenal gland growth

Question 15

Cortisol released in response to?

Purpose?

Answer 15

stress

↑ glucose for CNS use

Question 16

Cortisol ↑ blood glucose how?

Answer 16

↑ protein catabolism -> AA release
↑ lipolysis -> ↑ glycerol
↓ tissue uptake of glucose
↑ gluconeogenesis

Question 17

Aldosterone is?

Answer 17

major mineralocorticoid

Question 18

Aldosterone synth: where?

Answer 18

z glomerulosa

Question 19

Aldosterone synth: route?

Answer 19

Same thru pregnenolone but NO 17-a-hydroxylase ->
Progesterone to corticosterone ->
+ aldosterone synthase (A via AngII) ->
aldosterone

Question 20

Why doesn’t z glom produce glucocorticoids/androgens?

Answer 20

does not have 17⍺ hydroxylase

Question 21

Aldosterone purpose?

Answer 21

regulate ECF vol via Na+ exc/reab

Question 22

Aldosterone released in response to?

Answer 22

↓ ECF, ↓ BP (Ang II)

↑ plasma K+

Question 23

Aldosterone results in?

Answer 23

Na+ reab
K+ excr
Expansion of ECF

Question 24

Androgens are?

Answer 24

sex hormones

Question 25

Androgens synth where?

Answer 25

z reticularis

Question 26

Androgens synth route?

Answer 26

Same thru 17-hydroxypregnenolone -> | 17.20 Lyase -> Androstenedione

Question 27

Adrenal Androgens most important for?

Answer 27

major source of androgens for females

Question 28

Cushing's disorders caused by?

Answer 28

excess glucocorticoids and androgens

Question 29

Cushing's Syndrome from? Sxs?

Answer 29

Primary adrenal hyperplasia ``` thin skin mm wasting/protein wasting central obesity round face buffalo hump hyperglycemia HTN virilization (male characteristics) ``` ↓ ACTH ↑ cortisol

Question 30

Cushing's Disease from? Sxs?

Answer 30

overactive ant pit -> excess ACTH same as syndrome ↑ ACTH

Question 31

Addison's Disease from?

Answer 31

primary adrenocortical insuff/autoimmune destruction of gland = ↓ synth of all adrenocortical hormones

Question 32

Addison's Dz sxs if ↓ cortisol?

Answer 32

hypoglycemia, anorexia, wt loss, weakness

Question 33

Addison's Dz sxs if ↓ aldosterone?

Answer 33

hyperK+, hypoTN, acidosis, salt craving

Question 34

Addison's Dz sxs if ↓ androgens?

Answer 34

Females: ↓ pub/ax hair, ↓ libido

Question 35

2º Adrenocortical Insuff caused by?

Answer 35

↓ CRH or cortitrophs Φ secrete ACTH Aldosterone levels U normal

Question 36

2º Adrenocortical Insuff sxs?

Answer 36

same as low cortisol/androgens

Question 37

Conn's Syndrome caused by?

Answer 37

Aldosterone hypersecretion (tumor)

Question 38

Conn's Synd results in?

Answer 38

↑ Na+ reab -> hyperNa+/hypervol/HTN ↑ K+ secr -> hypoK+ ↑ H+ secr -> meta alkalosis ↓ renin

Question 39

Androgenital Syndrome caused by?

Answer 39

hypersecretion of adrenal androgens

Question 40

Androgenital Synd sxs?

Answer 40

(from ↑ androgens) Females w/ male traits

Question 41

21 β-hydroxylase Deficiency cased by?

Answer 41

Cortex Φ sythn glucocort or mineralocort

Question 42

21 β-hydroxylase Deficiency results in?

Answer 42

steroids buildup -> Δd to androgens -> androgenital synd High ACTH due to Φ feedback control in pit

Question 43

17 ⍺-hydroxylase Deficiency caused by?

Answer 43

Cortex Φ sythn glucocort or andorgens

Question 44

17 ⍺-hydroxylase Deficiency results in?

Answer 44

steroids buildup -> Δd to mineralcort Low aldosterone due to HTN from high corticosterone (HTN ↓ renin)

Question 45

Adrenal Medulla innervation?

Answer 45

Sympathetic

Question 46

Medulla purpose?

Answer 46

secrete epi/norepi Rapid mediation of fuel metabolism Release glu and FFA during stress Stim CV Reg vascular sm mm fxn

Question 47

Epi/Norepi synth where? Regulated by?

Answer 47

Adrenal medulla Symp stim

Question 48

Acute Symp stim of medulla results in?

Answer 48

activates tyrosine hydroxylase

Question 49

Chronic symp stim of medulla results in?

Answer 49

↑ [tyrosine hydroxylase]

Question 50

Cortisol affects Epi/Norepi synth how?

Answer 50

activates phenyl-N-methyl

Question 51

Epi purpose for metabolism?

Answer 51

mobilize/produce glucose for CNS during stress

Question 52

Epi effects on skeletal mm and liver?

Answer 52

↑ glycogenolysis

Question 53

Epi effects on fat?

Answer 53

↑ lipolysis

Question 54

Epi effects on CV?

Answer 54

``` ↑ contract ↑ HR ↑ conduction ↑ BP ↑ arteriolar vasoconst (renal, splanchnic, cutaneous) ```

Question 55

Epi other effects?

Answer 55

bronch dila pupil dila ↓ GI ↑ alertness