Adrenal Gland Flashcards
adrenal glands are made up of
adrenal cortex
adrenal medulla
(two separate glands)
what does the adrenal gland respond to
stress
- infection
- heat/cold
- dehydration
- exercise
adrenal cortex secretes
mineralocorticoids
glucocorticoids
sex steroids
adrenal medulla secretes
epinephrine
norepinephrine
mineralocorticoids
fluid and ion balance
-promote retention of sodium and loss of potassium
glucocorticoids
play role in overall response to stress
- preserve carbohydrates
- mobilize amino acid
- promote gluconeogenesis
- anti-inflammatory
sex steroids secreted by adrenal cortex
androgens
estrogens
progestins
epinephrine
promotes glycolysis
stimulates release of ACTH
effects heart and vasculature
norepinephrine
acts upon heart and vasculature
pheochromocytoma
tumor that affects adrenal medulla
results in increased production and release of catecholamines
sx of pheochromocytoma
excessive BP tachycardia headache inappropriate sweating GI disorders
hypofunction of adrenal cortex
“adrenal insufficiency”
decrease in hormones produced
primary (problem is in adrenal cortex) and secondary (problem is elsewhere; pituitary) types
hyperfunction of adrenal cortex
increase in hormones produced
primary adrenal insufficiency AKA
Addison’s Disease
incidence of Addison’s Disease
affects both genders equally over lifespan
rare
why was Addison’s Disease more common in the past
tuberculosis
what typically causes Addison’s Disease
autoimmune disease
more than 1/2 of patients with Addison’s Disease seem to have an autoimmune disorder
what are causes of Addison’s Disease other than autoimmune
bilateral adrenalectomy radiation to the adrenals adrenal hemorrhage or infarct infections (histoplasmosis or CMV) malignancies
what can acute adrenal insufficiency occur after?
surgery
pregnancy
trauma
salt loss with excessive sweating
Addisonian crisis
acute adrenal insufficiency in a patient previously diagnosed with Addison’s Disease
what is the primary cause of problems encountered by patients with Addisons
decreases in cortisol and aldosterone output
what does cortisol do
promotes gluconeogenesis (stimulates output of blood glucose)
what does a cortisol deficiency cause
- decrease in gluconeogenesis
- hypoglycemia
- deficiency of liver glycogen
- increased production of adrenocorticotropic horomone (ACTH)
- increased release of melanocyte stimulating hormone (causes darkening of skin pigmentation)
sx of cortisol deficiency
weakness exhaustion hypotension anorexia, weight loss nausea, vomiting mild neuroses to profound depresssion diminished resistance to stress
what does aldosterone do
causes retention of sodium and water
excretion of potassium
sx of aldosterone deficiency
hypotension dehydration craving for salt elevated potassium -most dangerous; can lead to arrhythmias
“other” sx of Addisons
decreased tolerance for even minor stress
poor coordination
decreased libido
amenorrhea (due to change in sex steroids)
poor tolerance for temp change
tx of Addison’s Disease
synthetic corticosteroids and mineralocorticoids
side effects of synthetic corticosteroids and mineralocorticoids
more likely to develop osteoporosis, hypertension, and Type II diabetes
why is type II diabetes a side effect of hormone replacement therapy
cortisol decreases insulin sensitivity
what causes secondary adrenal insufficiency
hypothalamic or pituitary tumor
removal of pituitary or hypopituitarism
sudden withdrawal of corticosteroid drug therapy
what can happen with an Addisonian crisis
patient can quickly go into shock and die
need immediate hospitalization
how is secondary adrenal insufficiency different from primary
sx that occur are related to cortisol deficiency because the mineralocortocoids are not dependent upon pituitary control (if insufficiency is due to pituitary dysfunction)
does hyperpigmentation occur in secondary
no; ACTH output is low
tx of secondary adrenal insufficiency
hormone replacement therapy
