Adrenal Gland Flashcards
there are 2 endocrine organs in the adrenal gland
- (inner or outer?) adrenal medulla secretes __,____,____
- (inner or outer?) adrenal cortex secretes ____ hormones
Inner; adrenaline, noradrenaline, dopaminergic
Outer; steroid
ADRENAL CORTEX
*divided into 3 zones
- zona glomerulosa forms __% of the gland . Only one capable of secreting ______ in a significant amount
- zona fasciculata forms __% of the gland mass. Secretes mainly _____
- zona reticular is forms __% of the gland mass. Secretes mainly ____,____,and____
15 ; aldosterone
75; cortisols
10; adrogens, small estrogens and glucocorticoids
Zona fasciculata also secretes small Androgens and estrogens
T/F
T
MINERALOCORTICOIDS
-aldosterone has 3 actions on the ______ and ______ of the kidney:
- increases Na _____ (on _____ cells)
- increases K _____ (on _____ cells)
- increases H ______ (on ______ cells)
late distal tubule
collecting ducts
reabsorption; principal
secretion; principal
secretion; alpha intercalated
when aldosterone levels are increased (eg due to _____ tumour), it results in ECF volume (expansion or contraction ?) and (hypotension or hypertension?) , (hypokalemia or hyperkalemia ?) and metabolic (alkalosis or acidosis?)
aldosterone-secreting
expansion ; hypertension ; hypokalemia ; alkalosis
conversely when aldosterone levels are decreased (eg due to renal insufficiency ), leads to ECF volume (expansion or contraction ?) , (hypotension or hypertension?) , (hypokalemia or hyperkalemia ?), and metabolic (alkalosis or acidosis?)
Contraction
Hypotension
hyperkalemia
Acidosis
Actions of Glucocorticoids
- ___eases gluconeogenesis
- ___eases proteolysis (catabolic)
- ___eases lipolysis
- ___ease glucose utilization
- ___ease insulin sensitivity
- ___eases GFR
- ____eases REM sleep
incr
incr
incr
Decr
Decr
Incr
Decr
Glucocorticoids have an inflammatory function
T/F
F
Anti inflammatory
Glucocorticoids have an immunosuppressive function
T/F
T
Glucocorticoids reduce vascular responsiveness to Catecholamines
T/F
F
They maintain it
Glucocorticoids stimulate bone formation
T/F
F
inhibits
Regulation of cortisol secretion
- controlled entirely by ____
- also by other stimuli like any type of ___ or ___ stress
ACTH
mental or physical stress
ADRENAL ANDROGENS
- has (masculinizing or femininizing?) effect
- it is (Anabolic or catabolic?)
- controlled by ____
masculinizing
Anabolic
ACTH
Actions of adrenal androgen
In Female: presence of ___ and ____, ____?
In Male: same function as _____
pubic and axillary hair
libido
testosterone
Abnormalities of adrenal cortex hormones
(1) primary adrenal insufficiency
- _____ disease
- failure of secretion of cortex hormones due to _____ of the cortex
- xtericsed by weight (loss or gain?) , (elevated or depressed ?) ACTH levels, chronically (hypotensive or hypertensive?) leading to ___ (_____ crisis)
Addison’s
atrophy
Loss
elevated
hypotensive
shock
addisonian
Abnormalities of adrenal cortex hormones
secondary adrenal insufficiency
- _____ disease causing ___ease ACTH secretion
pituitary
Decr
Abnormalities of adrenal cortex hormones
tertiary adrenal insufficiency : _____ disorder that disrupts ____ secretion
hypothalamic
CRH
CUSHING’s Syndrome
-prolonged ___ease In plasma cortisol
Incr
ACTH-dependent Cushing disease due to _____ tumors of the anterior pituitary of Hypothalamus that secretes CRH
-ACTH-independent Cushing disease due to _______ tumor
acth secreting
glucocorticoid-secreting adrenal
Characteristics of CUSHING’s syndrome
- protein (increment or depletion?) due to excess __bolism except in ____ and ___
- very (thin or thick ?) skin
- muscles (well or poorly?) developed
- wounds heal (well or poorly?)
depletion
cata
liver and plasma
Thin
poorly
Poorly
Characteristics of CUSHING’s syndrome
Generally (thin or thick?) hair but (thin or thick?) hair in face and acne due to _____
thin
Thick
androgen
Characteristics of CUSHING’s syndrome
fat distribution is such that
*extremities are (thin or thick ?) but fat deposition in face is ___eased ( ____ face)
*__eased upper back ‘_____’
*___eased abdominal wall (_____ abdomen)
Thin
Incr ; Moon
Incr ; Buffalo hump
Incr; pendulus
21 Beta Hydroxylase deficiency
Features:
- _______ of females
- (early or late?) acceleration of linear growth
- (early or late?) appearance pubic and axillary hair
- symptoms of deficiency of ____ and _____
viriliZation
Early
Early
glucocorticoid and mineralocorticoid
17 alpha hydroxylase deficiency
- lack of ___ and ____ in females
- symptoms of (excess or deficiency?) of glucocorticoids
- symptoms of (excess or deficiency?) mineralocorticods
pubic hair and axillary hair
deficiency
excess
The adrenal medulla
-it’s a (sympathetic or parasympathetic ?) ganglion in which the postganglionic neurons have _______ and become _____ cells
-the cells secrete when stimulated by preganglionic nerve fibers that reach the gland through the ______ nerves
sympathetic
lost their axons
secretory
splanchnic
adrenal medullary hormones are essential to life
T/F
F
They are not
Adrenal medullary hormones help prepare the individual for ______
emergencies
Physiological effect of catecholamines
-effects are exerted on target tissues by binding to a ____ site on cell membrane influencing the activity of _____
Receptor
adenyl cyclase
beta adrenergic agents ___ease cyclic AMP levels while alpha adrenergic agents ___rease it
incr
Decr
adrenaline and noradrenaline have both alpha but not beta adrenergic effects
T/F
F
They have both alpha and beta adrenergic effects
Physiological effect of catecholamines
exert metabolic effect - glycogenolysis in ____ and _____ muscles via __-receptor
- ___eases mobilization of FFA
- ___eases metabolic rate
- ___eases force and rate of heart contraction and myocardial excitability
liver and skeletal
B
Incr
Incr
Incr
Norepinephrine Elicits vaso_____ through alpha receptor
constriction
epinephrine elicits ____ of blood vessels in liver and muscles via beta-receptor
dilation
Physiological effect of catecholamines
increased alertness
T/F
T
Physiological effect of catecholamines
cause initial ___ease in plasma K then prolong (rise or fall?) in plasma K as K entry into cell is ___eased
Incr
Fall
Incr
ACTION OF DOPAMINE
- physiological function in circulation is unknown but its injection :
- produces renal vaso___ and elsewhere vaso____
- (positive or negative?) inotropic on heart
- ___eased systolic BP with __ change in diastolic pressure
dilation
constriction
positive
Incr
no
Dopamine is used in treating traumatic and carcinogenic shock
T/F
T
Control of dopamine
- under (neural or hormonal?) control
- increased secretion is provoked by _____ stimulation causing increased ____ discharge
Neural
emergency
sympathetic
hyperglycemia is a potent stimulus of dopamine
T/F
F
Hypo
pheochromocytoma is an hormone secreting tumor that can occur in the adrenal gland
T/F
T
Features of pheochromocytoma
- catecholamines ___secretion
- ___tension
- (reduced or excessive?) sweating
hyper
hyper
excessive
Features of pheochromocytoma
flushing
nervousness and weakness
Vomiting
T/F
T
T
T
Features of pheochromocytoma
palpitations
tremor
headaches
nausea
T/F
T
The adrenal cortex, is of ___dermal origin and has three distinct layers.
It composes ___% of the adrenal tissue
meso
80
The adrenal cortex differentiates by gestational week ___ and is responsible for the production of fetal adrenal steroids throughout intrauterine life
8
Soon after birth, the fetal adrenal cortex begins to ______, eventually ______, and is replaced by the ___-layered adult adrenal cortex.
involute
disappears
three
The adrenal medulla composes approximately ___% of the tissue.
20
The adrenal medulla is of _____dermal origin
neuroecto
widest zone of the adrenal cortex is called the zona _____
fasciculata
cholesterol are ___-carbon steroids
progesterone are __-carbon steroids
the glucocorticoids are __-carbon steroids
the mineralocorticoids are __-carbon steroids
androgens are __-carbon steroids
estrogens are ___-carbon steroids.
21
21
21
21
19
18
Most of the cholesterol is provided to the adrenal cortex via the _____, and small amounts are synthesized by _______ within the adrenal cortical cells.
circulation
de novo
Cholesterol circulates bound to ______ ——proteins.
low-density lipo
17 hydroxylase deficiency causes??
11 hydroxylase deficiency causes??
21 hydroxylase deficiency causes??
Hypertension
Hypertension
Virilization
Deoxycorticosterone is 30 times more potent than aldosterone
T/F
F
1/30
if the 17α-hydroxylase step is blocked, the zona fasciculata still can’t produce corticosterone
T/F
F
It can
______ and _____ are drugs that inhibit glucocorticoid biosynthesis.
Metyrapone and ketoconazole
DHEA and androstenedione
VS
Testosterone
Which is more potent?
Testosterone
Adrenal androgens have a ____ group at C___ that distinguishes them from cortisol, aldosterone, and testosterone
ketone
17
Cortisol and aldosterone have ____ at C17 while ____ has a hydroxyl group at C17.
side chains
Testosterone
major adrenal androgens can be measured in the urine.
T/F
T
Aldosterone is the only steroid with mineralocorticoid activity
T/F
F
It’s not
______ and _____ also have mineralocorticoid activity besides also
11-deoxycorticosterone (DOC) and corticosterone
The zonae fasciculata/reticularis, are under the exclusive control of the ______
hypothalamic-pituitary axis
The zona glomerulosa,depends on ACTH for ______, but otherwise it is controlled separately via the ______ system.
the first step in steroid biosynthesis
renin-angiotensin-aldosterone
Cortisol is released in a pulsatile manner and nocturnal
T/F
F
Pulsatile and diurnal
The daily profile of blood cortisol levels is characterized by an average of ___ secretory bursts during a 24-hour period
10
The lowest secretory rates of cortisol occur during the ____ hours and just (before or after ?) falling asleep and the highest secretory rates occur just (before or after?) awakening in the morning
evening
After
Before
ACTH __ amino acids
Glucagon __ amino acids
39
29
ACTH has a pulsatile and diurnal secretory pattern
T/F
T
Cortisol directly inhibits secretion of CRH from the hypothalamus
T/F
T
Cortisol (directly or indirectly ) inhibits CRH secretion by effects on ____ neurons, which synapse on the hypothalamus.
indirectly
hippocampal
Cortisol inhibits the action of CRH on the anterior pituitary, resulting in inhibition of ____ secretion.
ACTH
The dexamethasone suppression test is based on the _____ effects of cortisol on the_____ axis.
negative feedback
CRHACTH
Dexamethasone is a synthetic ____
glucocorticoid
Dexamethasone has all of the actions of cortisol excluding the negative feedback effect on ACTH secretion.
T/F
F
Including
When a low dose of dexamethasone is given to a healthy person, it (stimulates or inhibits?) ___ secretion
Inhibits
ACTH
The major use of the dexamethasone suppression test is in persons with _____
hypercortisolism
The dexamethasone suppression test is used to determine whether the hypercortisolism is due to an ______ tumor or a _____ tumor of the adrenal cortex.
ACTHsecreting
cortisol-secreting
If the cause of hypercortisolism is an ACTH-secreting tumor of the anterior pituitary, a low dose of dexamethasone ______ cortisol secretion while a high dose of dexamethasone _____ because The __________[_____
does not suppress
does
tumor’s ACTH secretion is less sensitive to negative feedback by glucocorticoids than is normal anterior pituitary tissue.
If the cause of hypercortisolism is an adrenal cortical tumor, then _____________ cortisol secretion because The ___________
neither low-dose nor high-dose dexamethasone suppresses
tumor’s secretion of cortisol is autonomous and is not affected by changes in the ACTH level
ACTH has a tonic effect on aldosterone secretion.
T/F
T
Factors Affecting ACTH Secretion
Stress hyperglycemia ADH α-Adrenergic agonists β-Adrenergic agonists Serotonin Opioids
Inhibits or stimulates
Stimulates Inhibits Stimulates Stimulates Inhibits Stimulates Inhibits
Increases in serum K+ concentration increase aldosterone secretion
T/F
T
The adrenal cortex produces the androgenic compounds, _____ and _____ , which are converted to _____ primarily in the testes.
DHEA and androstenedione
testosterone
Cushing syndrome vs Cushing disease
Adrenal hyperplasia
Excess ACTH
Conn Syndrome ( _______ -Secreting Tumor)
Aldosterone
ACTH levels of Cushing syndrome?
Reduced
Treatment of Cushing disease is
________
Treatment of Cushing syndrome is
________
Surgical removal of ACTH-secreting tumor
Ketocanazole
Metyrapone
In secondary adreno-cortical insufficiency, ACTH levels are ____
low
Treatment of Conn syndrome consists of administration of an aldosterone antagonist such as ________ followed by ______ of the ______ tumor.
spironolactone
surgical removal
aldosterone-secreting
Addison’s disease
\_\_\_\_glycemia weight \_\_\_\_ \_\_\_\_tension \_\_\_\_kalemia Metabolic \_\_\_\_\_ \_\_\_\_eased pubic and axillaryhair in females \_\_\_\_pigmentation
Hypo
loss
Hypo
Hyper
acidosis
Decr
Hyper
Addison’s disease causes Anorexia
T/F
T
Addison’s disease
Causes Weakness
T/F
T
Primary aldosteronism Results from a tumor of the zona ______ resulting in _____ aldosterone
glomerulosa
excess
In conn’s syndrome there is
___kalemia
Slight ___eased in ECF vol. and blood vol.
____tension
Hypo
Incr
Hyper
