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CABS3: endocrine > Adrenal gland A&P, Pathophysiology > Flashcards

Adrenal gland A&P, Pathophysiology Flashcards

1
Q

what surrounds the kidney

A

Gerota’s fascia (with the kidney)

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2
Q

where are the adrenal glands located

A

superiorly on the kidneys

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3
Q

what is within the retroperitoneal cavity

A

kidneys
ureters
suprarenal gland
rectum
aorta
duodenum

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4
Q

where does the adrenal gland receive its blood supply from

A

suprarenal artery, phrenic artery

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5
Q

where does the left adrenal gland release blood into

A

renal vein

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6
Q

where does the right adrenal gland release blood into

A

direct connect to IVC

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7
Q

how is the adrenal gland innervated

A

celiac plexus and splanchnic nerves
come off the lateral horn of the spinal cord

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8
Q

what are the layers of the adrenal gland

A

outer cortex and inner medualla layers
Zona Glomerulosa
zona fasciculata
zona reticularis

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9
Q

what does the medulla of the adrenal gland secrete

A

catecholamines

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10
Q

what does the cortex of the adrenal gland create/secrete

A

hormones from cholesterol
androgens and corticosteroids

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11
Q

what is proeduced in the zona glomerulosa

A

aldosterone (mineralocorticoid)
causes sodium retention, potassium and hydrogen excretion
regulates BP

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12
Q

what is produced by the zona fasciculata

A

cortisol, cortisone, corticosteroids (glucocorticoids)
helps with stress response to suppress inflammatory response
regulate glucose through gluconeogenesis

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13
Q

what does the zona reticularis produce

A

aldosterone, androgens and estrogens, glucocorticoids - sexual characteristics

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14
Q

what are corticosteroids all derived from

A

cholesterol

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15
Q

what do lipid soluble hormones require

A

binding protein fro transport in circulation

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16
Q

where are corticosteroids broken down

A

in the liver

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17
Q

what is a diurnal rhythm

A

guaranteed shifts of hormone levels

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18
Q

what is the major mineralocorticoid

A

aldosterone
regulated by renin-angiotensin system (RAS)

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19
Q

what do mineralocorticoids affect

A

minerals in particular Na+ and K+

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20
Q

where is aldosterone prodcued

A

within the zona glomerulosa within adrenals

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21
Q

what stimulates the secretion of Aldosterone

A

ACTH - hyponatremia/hyperkalemia, and the RAS

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22
Q

what are the effects of glucocorticoids

A

anti-inflammatory
metabolic suppression
neurologic suppression
growth suppression
increase in glucose
protein break down
increase effect of catecholamines

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23
Q

how do glucocorticoids affect carbohydrate metabolism

A

increase gluconeogenesis within the liver
inhibits insulin acting on the liver
reduces overall insulin sensitivity
increase glucose levels

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24
Q

how do glucocorticoids affect protein metabolism

A

induce protein catabolism and inhibit protein synthesis
decrease stores of proteins from amino acid mobilization

25
Q

what are glucocorticoid affect on fat metabolism

A

promotes mobilization of fatty acids- increase free fatty acids within circulation
- increased fat deposits in torso and face (moon faces and buffalo hump)

26
Q

what are glucocorticoids affect on stress

A

during times of Physical or emotional stress, increase ACTH secretion from pituitary - allows for immediate mobilization of resources, will try to increase energy availability

27
Q

what are glucocorticoid affects on inflammation

A

blocks release of inflammatory markers - decreases capillary permeability

28
Q

what are glucocortiocoid affects on the immune system

A

suppression
decreases lymphocytes
decreased immunity

29
Q

what is the most potent glucocortiocid in the body

A

cortisol

30
Q

what does the zona reticularis secrete

A

adrenal gonadocorticoids (androgens and estrogens)

31
Q

what is cholesterol synthesized into

A

DHEA and androstenedione

32
Q

what is the adrenal medulla

A

collection of neural tissue

33
Q

what produce and store catecholamines

A

pheochromocytes (chromaffin cells)

34
Q

what secretes the catecholamines

A

medulla - are considered hormones not neurotransmitters

35
Q

what is your bodies stress response to trigger fight or flight

A

catecholamine release

36
Q

what do stressful events trigger

A

sympathetic-adrenal-medullary axis
increased production of ACTH - increase cortisol

37
Q

what occurs with psychological stress

A

excitation of limbic system (amygdala, hippocampus) which then stimulate hypothalamus

38
Q

what occurs with physical stress

A

pain stimuli go up through brain stem to affect paraventricular nucleus

39
Q

what is cushing syndrome

A

the excess CORTISOL levels and clinical presentation of this

40
Q

what is cushing disease

A

excess ACTH leading to hypercortisolim
m/c type of hypercotisolism
associated with pituitary adenoma

41
Q

What causes hypercortisolism

A

increased ACTH d/t pituitary adenoma
hypothalamic dysfunction with increased corticotropin releaseing hormone secretion
paraneoplastic syndrome secreting excess ACTH
ACTH-independent hypercortisolism from adrenal adenoma

42
Q

what is cushing like syndrome

A

we did it from drug use

43
Q

what happens with increase cortisol

A

increased gluconeogenesis and hyperglycermia
increased catabolsim of proteins- decreased muscle mass, easy tissue damage (leads to purple striae) and osteoporosis
fat mobilized from LE to thorax

44
Q

what is addisons disease

A

insufficient adrenocortical hormones (cortisol and aldosterone)

45
Q

what is primary adrenal insufficiency caused by

A

associated with autoimmune disorders - atrophy of cortices
less commonly: cancer, invasion of extrapulmonary TB

46
Q

what is the presentation of the skin with addisons disease

A

melanin pigementation - increase in ACTH production there will be an increase in MSH productivity

47
Q

what is adrenal crisis

A

(addisonian crisis)
pt with addisons disease has increased metabolic demand during disease or stress state
body unable to compensate for demands

48
Q

what is hypoaldosteronism

A

if deficit - pt will become hypovolemic, hyponatremic and hyperkalemic

49
Q

what can hyperkalemia cause

A

cardiac toxicity - weakness of contraction and arrhythmia

50
Q

what is hyperaldosteronism

A

associated with zona glomerulosa tumor - increase aldosterone secretion

51
Q

what is primary hyperaldosteronism also known as

A

conn’s syndrome

52
Q

what are other causes of hyperaldosteronism

A

familial
adrenocortical carcinomas
paraneoplastic secretion

53
Q

what can occur with a patients pH with hyperaldosteronism

A

metabolic alkalosis

54
Q

what is a tumor of the chromaffin cells of the adrenal medulla

A

pheochromocytoma

55
Q

what does pheochromocytoma increase

A

secretion of catecholamines

56
Q

what is the definitive treatment of pheochromocytomas

A

surgical resection of the tumor

57
Q

what is the triad for pheo presentation

A

HA, sweating, tachycardia

58
Q

what is the most common symptom of pheo

A

HTN (sustained or paroxysmal)

59
Q

what is a pheochromocytoma multisystem crisis

A

blood pressure dysregulation, hyperthermia, AMS, end organ dysfunction - may see Takotsubo

CABS3: endocrine (5 decks)

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