Adrenal Gland Flashcards
Adrenal Gland
Produce 4 principal hormones
u___
u___
u____(adrenaline)
u____(noradrenaline)
Composed of an inner medulla and outer cortex
uCortex derived from ____
uMedulla derived from ___ __ ___
Cortisol: Gluccocorticoid; increases glucose levels in the blood
Aldosterone: Mineralcorticoid: Increase excretion of _ and reabsorption of __
Epi/NE: Catecholamines. Released from medulla
Adrenal Gland
Produce 4 principal hormones
uCortisol
uAldosterone
uEpinephrine (adrenaline)
uNorepinephrine (noradrenaline)
Composed of an inner medulla and outer cortex
uCortex derived from mesoderm
uMedulla derived from neural crest cells
Cortisol: Gluccocorticoid; increases glucose levels in the blood
Aldosterone: Mineralcorticoid: Increase excretion of K and reabsorption of Na
Epi/NE: Catecholamines. Released from medulla
Adrenal gland sits above the kidney
It is surr by a __ __
Cortex has 3 layers
Glomerulosa (outer): releases aldosterone (mineralcorticoid)
Zona fasiculata secretes gluccocorticoid along with zona reticularis
Reticularis mostly but some of fasiculata secrete adrogens (DHEA and androstenedione)
Medulla: Sympathetic neurons synapse directly onto medulla. Medulla will behave like a postganglionic neuron
Adrenal gland sits above the kidney
It is surr by a fibrous capsule
Cortex has 3 layers
Glomerulosa (outer): releases aldosterone (mineralcorticoid)
Zona fasiculata secretes gluccocorticoid along with zona reticularis
Reticularis mostly but some of fasiculata secrete adrogens (DHEA and androstenedione)
Medulla: Sympathetic neurons synapse directly onto medulla. Medulla will behave like a postganglionic neuron
Adrenal Gland
Cortex
uCortisol (made in _____)
uAldosterone (made in _____)
u)____ steroids
Medulla
uEpinephrine
uNorepinephrine
u
Adrenal Gland
Cortex
uCortisol (made in fasiculata and reticularis layers)
uAldosterone (made in glomerulosa layer)
uAndrogenic steroids
Medulla
uEpinephrine
uNorepinephrine
u
Adrenal Medulla
Modified part of ___ nervous system
Primary stimulus for increased adrenomedullary secretion activation of sympathetic nervous system by___
Releases epinephrine and norepinephrine
uSecreted into blood by___ of __ __
uVary in their ____s for the different ___ receptor types
Epinephrine
uReinforces ____system in mounting general systemic “fight-or-flight” responses
uMaintenance of ___ __ __
____ blood glucose and blood fatty acids
If you have a patient who you administer pennicillin to
Problem: people can get an allergic reaction to this…most serious one is called anaphylaxis which can lead to shock
Give epi for anaphylaxis to maintain the arterial BP
If BP falls too low they get into shock and that’s it, kidneys will shut down and so forth
Adrenal Medulla
Modified part of sympathetic nervous system
Primary stimulus for increased adrenomedullary secretion activation of sympathetic nervous system by stress
Releases epinephrine and norepinephrine
uSecreted into blood by exocytosis of chromaffin granules
uVary in their affinities for the different adrenergic receptor types
Epinephrine
uReinforces sympathetic system in mounting general systemic “fight-or-flight” responses
uMaintenance of arterial blood pressure
uIncreases blood glucose and blood fatty acids
If you have a patient who you administer pennicillin to
Problem: people can get an allergic reaction to this…most serious one is called anaphylaxis which can lead to shock
Give epi for anaphylaxis to maintain the arterial BP
If BP falls too low they get into shock and that’s it, kidneys will shut down and so forth
Cells taken from a tumor of the adrenal medulla.-> _____
Chromaffin cells look round
If you add ___ ___ (required for nerves to be viable) they start to send out projections that form network as if they were neurons.
Cells taken from a tumor of the adrenal medulla.-> Pheochromocytoma
Chromaffin cells look round
If you add nerve GF (required for nerves to be viable) they start to send out projections that form network as if they were neurons.
Adrenal Gland
Cortisol
uCalled ____ as it ___ plasma glucose levels. Deficiency cause ____
Aldosterone
uCalled ____d as it promotes salt and water ___ in the kidneys
Adrenal Androgens
u—— and ——–(DHEA) are —–k male sex hormones
u
u
If you retain salt and water, that will ____ blood pressure
For people on steroids, High levels of steroid (glucocorticoids). These can bind to receptor for ____ too! Increase salt and water uptake and ___ BP. People who take these longterm… Make sure you monitor their BP
Adrenal Androgens
Don’t do much in males
Needed for puberty growth spurt in females
Adrenal Gland
Cortisol
uCalled glucocorticoid as it ↑ plasma glucose levels. Deficiency cause hypoglycemia
Aldosterone
uCalled mineralocorticoid as it promotes salt and water retention in the kidneys
Adrenal Androgens
uandrostenedione and dehydroepiandrosterone (DHEA) are weak male sex hormones
u
u
If you retain salt and water, that will increase blood pressure
For people on steroids, High levels of steroid (glucocorticoids). These can bind to receptor for aldosterone too! Increase salt and water uptake and raise BP. People who take these longterm… Make sure you monitor their BP
Adrenal Androgens
Don’t do much in males
Needed for puberty growth spurt in females
The adrenal cortex secretes steroid hormones (corticosteroids).
Glucocorticoids are ___ ____to insulin
Cortisol is the major glucocorticoid.
___ needed for function
____=Cortisol
Ones without 11-OH are inactive
The adrenal cortex secretes steroid hormones (corticosteroids).
Glucocorticoids are counter-regulatory to insulin
Cortisol is the major glucocorticoid.
11-OH needed for function
Hydrocortisone=Cortisol
Ones without 11-OH are inactive
Glucocorticoids
Cortisol is counter-regulatory to insulin
uCortisol ____ blood glucose and ____ gluconeogenesis
uCortisol inhibits peripheral __ ___ and stimulates the ____ of muscle protein. The amino acids are then available for liver ____
uCortisol induces the synthesis of ___ ___ in liver
uCortisol increases ___ ___ and __ ___ by the liver
u
Bc you aren’t making proteins from aa, those aa are exported to the liver and they enter gluconeogenesis
Just like GH stimulates gluconeogenesis, cortisol does the same thing. Upregulates the synthesis of the enzymes
Long term use of these ___ people to ____
Not everyone will get diabetes
Some people have a reserve in their kidney to produce sufficient insulin so they wont get diabetes
These are high pharmalogical doses that we are talking about
Glucocorticoids
Cortisol is counter-regulatory to insulin
uCortisol elevates blood glucose and promotes gluconeogenesis
uCortisol inhibits peripheral protein synthesis and stimulates the breakdown of muscle protein. The amino acids are then available for liver gluconeogenesis
uCortisol induces the synthesis of gluconeogenic enzymes in liver
uCortisol increases glycogen deposition and glucose release by the liver
u
Bc you aren’t making proteins from aa, those aa are exported to the liver and they enter gluconeogenesis
Just like GH stimulates gluconeogenesis, cortisol does the same thing. Upregulates the synthesis of the enzymes
Long term use of these predisposes people to diabetes
Not everyone will get diabetes
Some people have a reserve in their kidney to produce sufficient insulin so they wont get diabetes
These are high pharmalogical doses that we are talking about
Glucocorticoids
Cortisol is pleiotropic: it acts on __ ___
Increase Total __ __ __ count
Increase Resistance to ___
Increase Total body ___
Increase water ___
Increease___ activity
Decrease__ __ function
Decrease___
uHas ___ effects so allow other factors to __ __
u
For ___ to work optimally, cortisol needs to be present.
Cortisol is the main stress hormone that protects us from stress.
Epi is released in response to stress in the fight or flight reaction
They work together
It redistributes body fat.
Belly fat: due to cortisol
Fat gets deposited in the face.
That’s why people who take steroids get rounded, moon face
Depressive functions is why it is used for ___ ___
Knowing immune system is depressed, you should examine mouth carefully for candida (thrush) opportunistic infection.
Glucocorticoids
Cortisol is pleiotropic: it acts on many systems
ué Total white blood cell count
ué Resistance to stress
ué Total body fat
ué water excretion
ué brain activity
uê Immune system function
uê Inflammation
uHas permissive effects so allow other factors to work better
u
For epi to work optimally, cortisol needs to be present.
Cortisol is the main stress hormone that protects us from stress.
Epi is released in response to stress in the fight or flight reaction
They work together
It redistributes body fat.
Belly fat: due to cortisol
Fat gets deposited in the face.
That’s why people who take steroids get rounded, moon face
Depressive functions is why it is used for therapeutic effects
Knowing immune system is depressed, you should examine mouth carefully for candida (thrush) opportunistic infection.
Steroids inhibit enzyme: ____
Phospholipase A2 breaks down __ ___to ____ acids which can produce your ___
Prostaglandins protect the ____. Increase mucous, decrease acid secretion and they maintain blood flow.
High levels of cortisol and PLA2 is inhibited. Stomach: may develop ___
Steroids inhibit enzyme: PLA2
Phospholipase A2 breaks down membrane phospholipds to arachidonate acids which can produce your prostaglandin
Prostaglandins protect the stomach. Increase mucous, decrease acid secretion and they maintain blood flow.
High levels of cortisol and PLA2 is inhibited. Stomach: may develop ulcers
Physiologic Effects of Glucocorticoids
Antiinflammatory effects
u↓ ___and so ↓ ___ ___ from immune cells
uSuppress genes that code for ___ ___, ____ leading to ↓ __ ___proliferation
uStimulate production of___ (Annexin A1) which inhibits ___
FInhibit the two main products of inflammation, ___ and ____
•inhibits various leukocyte ___ ___ (epithelial adhesion, emigration, chemotaxis, phagocytosis, respiratory burst, etc.). Suppress ____ expression
u
u
NFKB is important in cytokine release
Physiologic Effects of Glucocorticoids
Antiinflammatory effects
u↓ NF-κB and so ↓ cytokine release from immune cells
uSuppress genes that code for IL1-6, 8, IFN-γ, leading to ↓ T-cell proliferation
uStimulate production of Lipocortin (Annexin A1) which inhibits PLA2
FInhibit the two main products of inflammation, prostaglandins and leukotrienes
•inhibits various leukocyte inflammatory events (epithelial adhesion, emigration, chemotaxis, phagocytosis, respiratory burst, etc.). Suppress cyclooxygenase expression
u
u
NFKB is important in cytokine release
Physiologic Effects of Glucocorticoids
Metabolic Effects
uInduce expression of enzymes involved in ____
uStimulation of gluconeogenesis from__ __ and ___
uInhibition of glucose uptake in ___ and ___ ___
uStimulation of lipolysis and proteolysis in __ ___tissue. ___ used for energy in muscle also induce insulin____
u
u
Physiologic Effects of Glucocorticoids
Metabolic Effects
uInduce expression of enzymes involved in gluconeogenesis
uStimulation of gluconeogenesis from amino acids and glycerol
uInhibition of glucose uptake in muscle and adipose tissue
uStimulation of lipolysis and proteolysis in extra-hepatic tissue. FA used for energy in muscle also induce insulin resistance
u
u
Physiologic Effects of Glucocorticoids
Development
uGC are required for promoting___ of the ___and production of ____ necessary for __ ___ lung function
Brain function
uGC important for formation of ___ associated with ___
uNeeded for___ and ___
mothers can be given glucocorticoids to treat the babies bc if babies don’t produce enough surfactant, they can’t breath properly
Excess can cause psychosis
Physiologic Effects of Glucocorticoids
Development
uGC are required for promoting maturation of the lung and production of surfactant necessary for extra-uterine lung function
Brain function
uGC important for formation of memories associated with emotion.
uNeeded for arousal and alertness
mothers can be given glucocorticoids to treat the babies bc if babies don’t produce enough surfactant, they can’t breath properly
Excess can cause psychosis
Adverse Effects of Glucocorticoids
nEndocrine
↓___secretion
↓___ ___ ___ release
nGI tract
n__ __
nBrain
nCNS ___, ___
nBone
n___bone formation ___bone mass, ____
nSkeletal muscle/CT
nProtein ____, muscle atrophy
nCollagen ____n, skin thinning
nImmune system
n___
n___
nGrowth
n)___ Linear growth
nCardiovascular/renal
n___ blood pressure
nSalt and water ___
nFat
nPromote ___ fat
nCarbohydrate
n___Gluconeogenesis
___ Free FA production
___ Insulin resistance
___ Hepatic glycogen deposition
Eye
n___, ___
These are alll physiological effects of glucocorticoids
GI inhibit prostaglandins
Cause osteoporosis
Collagen breakdown: Be very careful handling their gingiva. Gingiva is very thin
Increase BP bc of their action at mineralcorticoid receptor
Know this slide
Adverse Effects of Glucocorticoids
nEndocrine
↓GH secretion
↓TSH,LH,FSH release
nGI tract
nPeptic ulcers
nBrain
nCNS depression, psychosis
nBone
n↓bone formation ↓bone mass, osteoporosis
nSkeletal muscle/CT
nProtein catabolism, muscle atrophy
nCollagen breakdown, skin thinning
nImmune system
nImmunosuppression
nAntiinflammatory
nGrowth
n↓ Linear growth
nCardiovascular/renal
n↑blood pressure
nSalt and water retention
nFat
nPromote visceral fat
nCarbohydrate
n↑ Gluconeogenesis
n↑ Free FA production
n↑ Insulin resistance
n↑ Hepatic glycogen deposition
nEye
nCataract, glaucoma
These are alll physiological effects of glucocorticoids
GI inhibit prostaglandins
Cause osteoporosis
Collagen breakdown: Be very careful handling their gingiva. Gingiva is very thin
Increase BP bc of their action at mineralcorticoid receptor
Know this slide
Genomic action of glucocorticoids
Glucocorticoid has_____ receptors
Cortisol diffuses across them membrane
Binds receptor
Receptor dimerizes
Dimer complex undergoes Translocation to nucleus
Binds to dna GRE (___ __ __t)
Increases tx of certain genes
Some of these genes are those for enzymes of glucconeogenesis
Has genomic effects
There are some cell surface receptors but we haven’t really figured them out yet. Not important for exam.
Genomic action of glucocorticoids
Glucocorticoid has Intracellular receptors
Cortisol diffuses across them membrane
Binds receptor
Receptor dimerizes
Dimer complex undergoes Translocation to nucleus
Binds to dna GRE (Gluccocorticoid response element)
Increases tx of certain genes
Some of these genes are those for enzymes of glucconeogenesis
Has genomic effects
There are some cell surface receptors but we haven’t really figured them out yet. Not important for exam.
néBlood glucose
n Gluconeogenesis
n Brain activity
n Stress resistance
nêInflammation
n Immune response
n
