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endocrine > adrenal gland physiology > Flashcards

adrenal gland physiology Flashcards

1
Q

how many adrenal glands are there

A

2

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2
Q

where are the adrenal glands

A

one above each kidney

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3
Q

what are the adrenal glands composed of

A

two endocrine organs one surrounding the other

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4
Q

what does the outer layer of adrenal gland compose

A

adrenal cortex

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5
Q

what does the adrenal cortex secrete

A

steroid hormones

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6
Q

what are the inner parts of the adrenal glands

A

adrenal medulla

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7
Q

what does the adrenal medulla secrete

A

catecholamines

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8
Q

what are the 3 layers of the adrenal cortex

A
  • zona glomerulosa - zona fasciculata - zona reticularis
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9
Q

what is the outer layer of the adrenal cortex

A

zona glomerulosa

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10
Q

what is the middle layer of the adrenal cortex

A

zona fasciculata

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11
Q

what is the inner most layer of the adrenal cortex

A

zona reticularis

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12
Q

what does the adrenal cortex produce

A

a number of different adrenocortical hormones

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13
Q

what are all steroids derived from

A

cholesterol

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14
Q

what is the main mineralocorticoid

A

aldosterone

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15
Q

what is the main glucocorticoid

A

cortisol

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16
Q

what does cortisol play a major role in

A

glucose metabolism

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17
Q

what are sex hormones similar to

A

similar to those produced by the gonads (testes in males, ovaries in females)

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18
Q

what part of the adrenal cortex produces aldosterone

A

zona glomerulosa

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19
Q

where is cortisol synthesised

A

limited to the two inner layers of the adrenal cortex

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20
Q

where is the major source of glucocorticoid

A

zona fasciculata

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21
Q

are the adrenocortical hormones lipophilic

A

yes

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22
Q

how are the adrenocortical hormones carried

A

in the blood bound to plasma proteins

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23
Q

what is cortisol bound to mostly

A

plasma protein corticosteroid-binding-globulin

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24
Q

what is aldosterone mostly bound to

A

albumin

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25
Q

does each adrenocorticol steroid hormone bind to its own specific hormone

A

yes

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26
Q

where is the principle site of aldosterone action

A

distal and collecting tubules of the kidney

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27
Q

what is the effect of aldosterone

A

promotes sodium retention and enhances potassium elimination during the formation of urine

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28
Q

what does cortisol play an important role in

A
  • carbohydrate, protein and fat metabolism - hormonal activities - helps resist stress
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29
Q

what is the overall effect of cortisol metabolically

A

increase the concentration of blood glucose at the expense of protein and fat stores

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30
Q

cortisol and gluconeogenesis

A

stimulates it

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31
Q

cortisol and glucose uptake

A

inhibits glucose uptake - but not in the brain

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32
Q

cortisol and lipolysis

A

facilitates it - releasing fatty acids

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33
Q

what is cortisol important for

A

permit the catecholamines to induce vasoconstriction - if lacking cortisol a patient may go into shock in a stressful situation that demands vasoconstriction

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34
Q

what does cortisol play a key role in

A

stress

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35
Q

cortisol and the immune system

A
  • anti-inflammatory - immunosuppressive
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36
Q

what inflammatory mediators does cortisol partially block

A
  • prostaglandin - leukotrienes
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37
Q

how does cortisol affect the neutrophils

A

suppresses migration of neutrophils to the site of inflammation

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38
Q

what can lymphocytes secrete

A

ACTH

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39
Q

cortisol and the immune system

A

dampens its affects

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40
Q

what can be administered to inhibit the inflammatory response

A

glucocorticoids

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41
Q

what are glucocorticoids good at treating

A

rheumatoid arthritis

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42
Q

how should glucocorticoids be administered

A

sparingly

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43
Q

why should glucocorticoids be given sparingly

A
  • patient has limited ability to resist infection - troublesome side effects - suppresses the hypothalamus
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44
Q

side effects of glucocorticoids

A
  • GI ulcers - high blood pressure - atherosclerosis - menstrual irregularities - bone thinning
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45
Q

REGULATION OF CORTISOL

A

REGULATION OF CORTISOL

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46
Q

what secreted cortisol

A

adrenal cortex

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47
Q

how is secretion of cortisol regulated

A

negative feedback

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48
Q

what tare the steps of cortisol secretion

A
  1. ACTH from anterior pituitary corticotropes 2. acts through cAMP 3. stimulates the adrenal cortex to secrete cortisol
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49
Q

what happens when ACTH is reduced

A

the zona fasciculata and zona reticualris shrink considerably and cortisol secretion is reduced

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50
Q

what maintains the size of the zona glomerulosa

A

angiotensin

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51
Q

what enhances the synthesis of cortisol

A

ACTH

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52
Q

specific influences of ACTH on cortisol production

A
  1. ACTH mobilises cholesterol from the lipid droplets in the zona fasciulata and reticularis 2. increases the production of pregneneolone from cholesterol 3. increases production of enzymes needed to convert pregneolone into cortisol
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53
Q

what causes ACTH release

A

corticotropin-releasing hormone (CRH) from the hypothalamus

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54
Q

how does CRH stimulate corticotropes

A

via cAMP

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55
Q

what 2 factors influence cortisol concentration

A
  • diurnal rhythm - stress
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56
Q

what kind of rhythm does cortisol display

A

diurnal rhythm

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57
Q

when is the highest level of cortisol

A

morning

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58
Q

when is the lowest level of cortisol

A

night

59
Q

what increases cortisol level

A

stress

60
Q

HORMONES

A

HORMONES

61
Q

what does adrenal cortex produce in females

A

estrogens

62
Q

what does adrenal cortex produce in males

A

androgens

63
Q

where is the main site of production of sex hormones

A

gonads - testes males - ovaries females

64
Q

does each sex only produce their specific hormones

A

no they both have a small amount of the other

65
Q

what converts testosterone into oestrogen

A

aromatase

66
Q

where is aromatase found

A

adipose tissue

67
Q

what is the only adrenal sex hormone that has biological importance

A

androgen dehydroepiandrosterone (DHEA)

68
Q

does ACTH control adrenal gland androgen secretion

A

yes

69
Q

ADRENAL CONDITIONS

A

ADRENAL CONDITIONS

70
Q

what hormones can be overstimulated

A
  • aldosterone - cortisol - adrenal
71
Q

what can cause excessive mineralocorticoid secretion

A
  • hyper-secreting adrenal tumour - inappropriately high activity of renin angiotensin aldosterone system
72
Q

example. of excess mineralocorticoid secretion diseases

A
  • atherosclerotic narrowing of renal arteries
73
Q

symptoms of hyperaldosteronism

A
  • hypernatremia (Na+ retention) - hypokalaemia (K+ depletion) - hypertension
74
Q

what is cortisol hypersecretion call

A

Cushings syndrome

75
Q

what can cause Cushings syndrome

A
  • overstimulation of adrenal cortex by excessive amounts of ACTH - adrenal tumours that secrete cortisol - ACTH secreting tumours located in places other than the pituitary
76
Q

what are the symptoms of Cushings caused by

A

exaggerated effects of glucocorticoids

77
Q

what happens when too many amino acids are converted into glucose

A

high blood glucose (mimics diabetes mellitus)

78
Q

where is the extra glucose deposited

A
  • as body fat - abdomen - above shoulder blades - face
79
Q

what are the excess glucose depositions called

A
  • buffalo hump - moon face
80
Q

what does loss of muscle protein lead to

A

muscle weakness and fatigue

81
Q

what does loss of structural protein in blood vessels lead to

A

easy bruisability

82
Q

what is adrenal androgen secretion condition

A

masculinising condition

83
Q

what do androgen exert

A

masculinising effects

84
Q

what happen when a women has androgen secretion

A

develop male pattern of body hair

85
Q

what is it called when a women has a male pattern body hair

A

hirtuism

86
Q

what are other symptoms of androgen secretion

A
  • deepening of the voice - muscular arms and legs - smaller breast - menstruation may cease
87
Q

what happens if a newborn female has adrenogenital syndrome

A

they have male type external genitalia

88
Q

why do newborn females get male genitalia

A

as the clitoris enlarges under androgen influence and takes on a penile appearance

89
Q

what is it called when the female ovaries are present but the external genitalia resemble those of a male.

A

female psueodhermaphroditism

90
Q

what is it when pre pubertal males have excessive androgen secretion

A
  • deep voice - beard - enlarged penis - sex drive
91
Q

what is it called when a pre pubertal male has excessive androgen

A

precocious pseudopuberty

92
Q

in pseudopuberty do the males develop sperm

A

no as the testes are still in their non-functional prepubertal state

93
Q

does excess androgen stimulation in males have an effect

A

not really

94
Q

what is adrenogenital syndrome most commonly caused by

A

inherited enzymatic defect in the cortisol steroidogenic pathway

95
Q

how to treat cortisol deficit with ACTH increase

A

glucocorticoids - replaces cortisol deficit - inhibits hypothalamus and pituitary so that ACTH secretion is suppressed

96
Q

ADRENOCORTICAL INSUFFICIENCY

A

ADRENOCORTICAL INSUFFICIENCY

97
Q

what happens if one adrenal gland is non-functional or removed

A

the other healthy organ takes over the function of both

98
Q

if one gland is affected then the patient has adrenocortical insufficiency true or false

A

false both glands must be affected as if one gland is non-functional then the other hypertrophies

99
Q

what is another name for primary adrynocortical insufficiency

A

Addison disease

100
Q

what is the problem in Addison disease

A

all layer of the adrenal cortex are under secreting

101
Q

what is the common cause of Addison

A

autoimmune destruction of the cortex

102
Q

why may secondary adrenocortical insufficiency occur

A

because of a pituitary or hypothalamic abnormality - results in insufficient ACTH secretion

103
Q

is Addison disease fatal

A

yes

104
Q

is aldosterone essential for life

A

yes

105
Q

what do patients with aldosterone deficiency present with

A
  • K+ retention (hyperkalaemia) - Na+ depletion (hyonatremia)
106
Q

what does K+ retention cause

A

cardiac abnormality

107
Q

symptoms of Addison

A
  • poor response to stress - hypoglycaemia - lack of permissive action for metabolic activities - hyperpigmentation
108
Q

why does hyperpigmentation occur in Addison

A

high levels of ACTH can bind with alpha-melanocyte stimulating hormone causing darkening of the skin

109
Q

ADRENAL MEDULLA

A

ADRENAL MEDULLA

110
Q

what does sympathetic pathway consist of

A

two neurons in sequence

111
Q

what is the neurotransmitter released by the sympathetic post ganglionic fibre

A

norepinephrine

112
Q

what receptors do norepinephrine bind to

A

adrenergic receptors

113
Q

what does the adrenal medulla consist of

A

modified postganglionic sympathetic neurons called chromaffin cells

114
Q

what happens when chromaffin cells stimulated

A

they release their chemical transmitter directly into circulation

115
Q

what is the norepinephrine called that is released from the adrenal medulla

A

epinephrine

116
Q

what class do epinephrine and norepineprhine belong to

A

catecholamines

117
Q

what are catecholamines derived from

A

amino acid tyrosine

118
Q

where is catecholamines synthesised

A

entirely within the cytosol of the adrenomedullary secretory cells

119
Q

once produced where are catecholamines stored

A

in chromaffin granules

120
Q

how are catecholamines secreted into the blood

A

by exocytosis of chromaffin granules

121
Q

what’s most abundant epinephrine or norepinephrine

A

epinephrine

122
Q

where is epinephrine produced

A

adrenal medulla

123
Q

what are the 4 receptors for epinephrine and norepinephrine

A
  • alpha 1 - alpha 2 - beta 1 - beta 2
124
Q

what does norepinephrine bind predominantly with

A

alpha and beta 1

125
Q

what does epinephrine activate

A

beta 2 receptors

126
Q

where are beta 2 receptors

A
  • skeletal muscles
127
Q

what is the overall function of epinephrine

A

reinforce the sympathetic nervous system

128
Q

what support peak physical exertion and stress

A

sympathetic nervous system and epinephrine

129
Q

does epinephrine have a role in blood pressure

A

yes

130
Q

does norepinephrine dilate the airways

A

nope

131
Q

does epinephrine and norepinephrine stimulate bladder emptying

A

no they inhibit bladder emptying

132
Q

epinephrine effect on blood glucose

A

increase it

133
Q

epinephrine and insulin

A

inhibits insulin

134
Q

epinephrine is responsible for rest and digest

A

no fight or flight

135
Q

can the brain use fatty acids for energy

A

no

136
Q

epinephrine increase heart rate true or false

A

true

137
Q

epinephrine causes swathing true or false

A

true

138
Q

epinephrine constricts the pupils true or false

A

false dilate pupils

139
Q

what is catecholamine secretion by the adrenal medulla controlled by

A

sympathetic input into the gland

140
Q

how much can epinephrine be increased during stress

A

300 times

141
Q

diagram

A
142
Q

diagram

A
143
Q

diagram

A

endocrine (6 decks)

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