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DEMS Unit 4 > Adrenal Gland Physiology > Flashcards

Adrenal Gland Physiology Flashcards

1
Q

Zones of adrenal cortex

A

anatomically in 3 zones but functionally as 2

  • Zona Glomerulosa
  • Zona fasciculata
  • Zona reticularis
  • latter two function more as a unit
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2
Q

what does zona glomerulosa produce

A

mineralcorticoids –aldosterone

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3
Q

hormone produced by zona fasciculata

A

glucocorticoids– most importantly cortisol

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4
Q

hormone produced by zona reticularis

A

sex steroids– androgens (DHEA-S)

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5
Q

Is the adrenal gland proportionally larger in fetus or adult

A

fetus

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6
Q

what is different about fetal adrenal gland

A

larger and has additional region/fetal zone– large inner zone

  • important source of precursor for estrogen synthesis by placenta
  • 3 zones (glomerulosa, fasciculata, reticularis) found in subcapsular area
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7
Q

precursor of adrenal hormones

A

cholesterol

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8
Q

from what is adrenal hormone precursor mostly

A

circulating LDL that bind plasma membrane receptors – internalized

  • once in cell, cholesterol is removed, esterified, and stored in lipid droplets
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9
Q

How does cortex get cholesterol

A

endocytosis of circulating LDL; also can make it from acetyl Co-A (not major source)

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10
Q

In women what is main source of female androgens

A

adrenal gland vs testis in men

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11
Q

synthetic path of closterol

A

cholesterol—-pregenolone– 17 hydroxypregenolone- dihydroepiandosterone

  • pregnenolone – mineralcorticoids (aldosterone)
  • 17-hydroxypregenolone – glucocorticoids (cortisol)
  • Dihydroepiandosterone (DHEA)– Sex steroids (Androgens)
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12
Q

how are cortex zones functionally specialized

A

each make different hormones by controlling levels of various enzymes

-i.e. glomerulosa doesn’t contain 17hydrozylase

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13
Q

immediate stress response due to what hormones

A

norepinephrine/epi

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14
Q

longer stress response due to what hormone

A

cortisol

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15
Q

metabolic fxns of cortisol

A
  • glucose - increase in glucose via gluconeogenesis; antagonizes nsulin action (counterregulatory hormone)
  • Proteins: proteolysis of skeletal muscle
  • Lipids- increases FFA; mobilizes fat to central areas – centripetal distribution of fat (Mood facies; Buffalo Hump)
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16
Q

Actions of cortisol on heart/blood

A

polycythemia and increased beta adrenergic effects due to increased adrenergic receptors and release of adrenaline(aka permissive effects)

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17
Q

permissive effects

A

when facilitating action of another hormone

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18
Q

action of cortisol on bone

A

vitamin D antagonist– leads to decreased calcium and mobilization from bone to cause osteoporosis

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19
Q

action of cortisol on fibroblasts

A

decreases fibroblast number and decreased collagen synthesis– leads to easy bruisability and skin thinning

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20
Q

cortisol effects on inflammation

A
  • anti-inflammatory
  • inhibits phospholipase A2 – decreasing arachidonic acid and thus production of proxaglandins, thromboxanes, and leukotrienes
  • inhibits vascular permeability changes and inhibiting fibroblast proliferation and thus sealing of wound
21
Q

phospholipase A2 action

A

enzyme that breaks down membrane phospholipids to provide second messenger arachidonic acid, which is precursor for prostaglandins, thromboxanes, leukotrienes

22
Q

is cortisol helpful in internal inflammation or external injury

A

internal inflammation–external injury would prevent wound healing

23
Q

cortisol action on immune system

A

immunosuppression

  • decrease T cell proliferation and activation
  • inhibits IL-2 (T cell growth factor)
  • inhibits histamine release
24
Q

when might you use cortisol for its immune system effects

A

transplant of organs to decrease rejection

25
Q

is cortisol good or bad

A

can help with brief source of cortisol for period of stress but not good long term
- need it for life

26
Q

What is ACTH produced from

A

propiomelanocortin

  • this large hormone is cleaved into smaller proteins
  • also bet beta-LPH
27
Q

what kind of hormone is ACTH

A

peptide

28
Q

actions of ACTH on adrenal gland

A

increases cell number and enzymes

- mainly regulates cortisol

29
Q

what regulates ACTH production

A

mainly cortisol levels

30
Q

what regulates aldosterone

A

renin-angiotensin system

31
Q

Regulation of cortisol

A

hypothalamus secretes CRH– acts on pituitary to release ACTH– acts on adrenal gland

32
Q

Causes of hypocortisolism

A

adrenal insufficiency (commonly Addison’s) or pituitary insufficiency (not enough ACTH)

33
Q

labs in Addison’s

A

decreased Cortisol, decreased mineralcorticoids, increased ACTH

34
Q

labs in pituitary insufficiency

A

low ACTH, low cortisol, nl aldosterone for a time

35
Q

how does cortisol travel in blood

A

> 90% bound to cortisol binding globulin

36
Q

where are cortisol receptors

A

in cytosol tethered to proteins

37
Q

Causes of hypercortisolism

A

aka Cushing’s syndrome

  • Pituitary hyperfunction
  • adrenal hyperfunction
  • Exogenous Cushing’s
38
Q

labs in pituitary hyperfunction

A

high ACTH, high cortisol, aldosterone can be nl

39
Q

adrenal hyperfunction

A

low ACTH, high cortisol, depending on tumor, aldosterone can be high as well

40
Q

Exogenous

A

increased cortisol due to overprescription of corticosteroids (i.e. prednisone)

41
Q

what converts pregenolone to 17-hydroxy pregenolone

A

17-hydroxylase

42
Q

is 17-hydroxylase in zona glomerulosa

A

no

43
Q

where is 17-hydroxylase

A

since making 17-hydroxy pregenolone, mainly in zona fasciculata?

44
Q

why is cortisol essential for life

A

maintains vascular tone

45
Q

most common cause of Cushing’s

A

exogenous corticosteroids

46
Q

diagnose Cushings

A

24 hour urine

47
Q

High dose dexamethosone

A

helps determine if ATCH elevated from pituitary adenoma or paraneoplastic

48
Q

hyperaldosterone

A

excess aldosterone; grab sodium/dump K

  • met metabolic alkalosis due to dumping of H ions
  • HTN
  • hyponatremia, hyerkalemia, hypovolemia

DEMS Unit 4 (16 decks)

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