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endocrine > adrenal gland > Flashcards

adrenal gland Flashcards

1
Q

What are the two separate endocrine glands in the adrenal gland

A

Adrenal medulla

Adrenal cortex

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2
Q

What is the adrenal medulla

A

Neuroendocrine gland which secretes catecholamines - epinephrine (adrenaline), norepinephrine and dopamine

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3
Q

What is the adrenal cortex

A

True endocrine gland which secretes 3 classes of steroid hormones:

Mineralocorticoids e.g aldosterone - regulation of sodium and potassium

Glucocorticoids e.g cortisol - maintaining plasma glucose

Sex steroids e.g testosterone

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4
Q

What are the 3 zones of the adrenal cortex

A

Zona reticularis
Zona fasiculata
Zona glomerulosa

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5
Q

What does the zona glomerulosa secrete

A

mineralocorticoids - aldosterone

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6
Q

What does the zona fasciculata secrete

A

glucocorticoids - cortisol

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7
Q

What does the zona reticularis secrete

A

sex hormones

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8
Q

What does a defect in 21-hydroxylase cause

A

Congenital adrenal hyperplasia resulting in aldosterone and cortisol deficiency - this disrupts salt, potassium and glucose balance
The androgen synthesis is unaffected so there is an excessive production resulting in hyperplasia

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9
Q

What causes release of adrenocorticotropic hormone from the anterior pituitary gland

A

Corticotropin releasing hormone from the hypothalamus

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10
Q

What is the negative feedback for the hypothalamic-pituitary-adrenal pathway

A

Cortisol or ACTH

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11
Q

What is cortisol

A

Glucocorticoid hormone which influences glucose metabolism - 95% of it is bound to a carrier protein

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12
Q

which carrier protein does cortisol bind to

A

Cortisol binding globulin

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13
Q

Which cells have cytoplasmic glucocorticoid receptors

A

All cells with a nucleus

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14
Q

Why are glucocorticoids potent anti-inflammatories

A

They switch off the coding for enzymes which bring about the inflammatory response

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15
Q

What drives the peak in cortisol during the day

A

Peak in ACTH which occurs at 6-9am

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16
Q

What is the effect of cortisol on gluconeogenesis

A

Stimulates production of gluconeogenic enzymes in the liver which enhances production of glucose

17
Q

What is the effect cortisol on proteolysis

A

Stimulates the breakdown of muscle protein to provide gluconeogenic substrates for the liver

18
Q

What is the effect of cortisol
on lipolysis

A

Cortisol stimulates lipolysis which increases free fatty acid concentration in the plasma - allows for an alternative supply of fuel

19
Q

What is the effect of cortisol on insulin sensitivity

A

Decreases insulin sensitivity of muscle and adipose tissue

20
Q

What is the correlation between cortisol and insulin

A

Cortisol opposes the effects of insulin and is diabetogenic

21
Q

What is the effect of cortisol on calcium

A

Decreases absorption from the gut and increases excretion of the calcium - also increases bone resorption which results in osteoporosis

22
Q

What is the effect of cortisol on mood and cognition

A

It depresses mood and impairs cognitive function

23
Q

Why is cushings disease (hypercortisolaemia) associated with hypertension

A

Because cortisol has a permissive effect on norepinephrine - particularly in smooth muscle which causes constriction

24
Q

What is the effect of cortisol on the immune system

A

Suppression of the immune system - cortisol reduces lymphocyte count and inhibits the inflammatory reaction

25
Q

What is the function of the mineralocorticoid, aldosterone

A

Acts on the kidney to determine the levels of minerals reabsorbed or excreted
It increases sodium reabsorption and potassium excretionat the distal tubule

26
Q

What is the effect of increased aldosterone on blood pressure

A

Increased blood volume and therefore pressure

27
Q

What is cushings syndrome

A

Hyper-secretion of cortisol due to tumour in the adrenal cortex

28
Q

What is cushings disease

A

Hypercortisolism caused by a tumour in the pituitary gland

29
Q

What are the characteristic features of cushings disease

A

Wastings of the exremeties due to the catabolic action of cortisol

Fat is distributed to the face and trunk

Striations are commonly seen on the abdomen in cushin

moon face

Buffalo hump

30
Q

What is addisonian crisis

A

Life threatening hypotension and hypoglycaemia

31
Q

What is addison’s disease

A

Autoimmune destruction of the adrenal cortex so no steroid hormones are produced

32
Q

What does stress promote in relation to cortisol

A

Increases CRH and ACTH release so cortisol increases

33
Q

What is the effect of alcohol and caffeine on the hypothalamo-pituitary-adrenal axis

A

depress the neurons involved in negative feedback and increasing levels of CRH and ACTH

34
Q

What is the effect of high cortisol on the immune system

A

Leaves patient more prone to infection

35
Q

What is pheochromocytoma

A

Rare neuroendocrine tumour qwhich is found in the adrenal medulla which causes excess catecholamins

endocrine (30 decks)

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