Adrenal Glands Flashcards

1
Q

Where are the adrenal glands located?

A

Found within renal perinephric fascia (fascia attaches to crura of the diaphragm).

Separated from kidneys by perirenal fat.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Describe the R + L adrenal gland shapes and general location (which organs are they near?)

A

Right: Pyramid shape. Near right lobe of liver.

Left: (Larger): Semilunar shape. Near stomach, pancreas, spleen.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Describe the embryological differences of the adrenal cortex and medulla.

A

Cortex: Mesoderm

Medulla: Neural crest cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Describe the blood supply of the adrenals (arteries)

A

Superior adrenal arteries: From inferior phrenic artery near solar plexus

Middle adrenal artery: From abdominal aorta, adjacent to celiac trunk

Inferior adrenal artery: Branches off renal artery.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Describe the general venous drainage of L vs R adrenal

A

Left: Left adrenal vein > left renal vein > IVC

Right: Right adrenal vein > IVC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Describe the lymph drainage of adrenals

A

Drain to lumbar lymph nodes via adrenal lymphatic vessels; vessels originate from 2 lymphatic plexuses (1 in cortex, 1 in medulla).

Drains to cisterna chyli, thoracic duct to L subclavian vein

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Describe the nerve supply of the adrenal glands

A

Primary innervation via sympathetic nervous system to the chromaffin cells of adrenal medulla.

Sympathetic Supply:

  • Arise from splanchnic nerves and celiac plexus
  • Preganglionic fibers originate from T5-T11 and terminate in medulla
  • No synapses to postganglionic fibers
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Fetal adrenal hormones are needed for prenatal development of organs, especially _______ maturation, as they signal the release of _______.

A

Fetal adrenal hormones are needed for prenatal development of organs, especially LUNG maturation, as they signal the release of SURFACTANT.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is adrenarche?

A
  • Early stage of sexual maturation.
  • Zona reticularis begins to enlarge.
  • Adrenals secrete more androgens.
  • Starts around age 6-8, peaks around 10-14.
  • Results in pubic hair, body odor, skin oiliness, acne.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is adrenopause?

A
  • Decline in secretion of adrenal androgens
  • Peak secretion around 20-25Y, then declines 2%/year
  • Levels at 80Y, only 10-20% remaining
  • Caused by involution of zona reticularis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the function of chromaffin cells?

A

Modified sympathetic ganglion cells, lacking dendrites and axons.

Synthesize and store epinephrine and norepinephrine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Name the 3 adrenal cortex layers and the main steroids they produce.

A
  • Zona Glomerulosa: Mineralocorticoids (Aldosterone)
  • Zona Fasciculata: Glucocorticoids (Cortisol)
  • Zona Reticularis: Androgens (DHEA)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the General Adaptation Syndrome?

A

How organisms respond to stress. 3 stages;

  1. Alarm
  2. Resistance
  3. Recovery/Exhaustion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

General support (non-pharmacologic) for General Adaptation Syndrome phases (3)

A
  1. Alarm: Nervines, GABA
  2. Resistance: Sedating adaptogens (Ashwagandha, bacopa)
  3. Exhaustion: Stimulating adaptogens (Rhodiola, Shisandra)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Stress and disease can lead to ________ dysregulation

A

Stress and disease can lead to HPA-AXIS dysregulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Chronic over-activated HPA-axis leads to:

A

Atrophy of the hippocampus (decreased memory) , depression, mood disorders

17
Q

Chronically under-activated (flattened) HPA-axis conditions:

A

Chronic fatigue syndrome (CFS), PTSD, insomnia, burnout

18
Q

Adrenal Stress Index tests ______ samples (#) times per day

A

Adrenal Stress Index tests SALIVA samples 4 times per day

18
Q

Adrenal Stress Index tests ______ samples (#) times per day

A

Adrenal Stress Index tests SALIVA samples 4 times per day

19
Q

(T or F) Cortisol is hydrophilic, and is mostly carried by plasma proteins

A

True

20
Q

(T or F) Cortisol half-life is 60-90 mins, and is determined by extent of plasma binding and by rate of metabolic inactivation

A

True

21
Q

80% of cortisol is bound by this carrier protein

A

Corticosteroid-binding globulin (CBG) aka “Transcortin”

22
Q

Increased CBG levels in:

A
  • High estrogen states (pregnancy, birth control)
  • Hyperthyroidism
  • T2DM, insulin resistance
  • Genetic disorders
23
Q

Decreased CBG in:

A
  • Hypothyroidism
  • Protein deficiency states (liver disease, nephrotic syndrome)
  • Genetic disorders (familial CGB deficiency)
24
Q

10% of cortisol is bound to what carrier protein

A

Albumin

25
Q

(T or F) Bound steroids are biologically inactive. Only the free fraction is active.

A

True

26
Q

(T or F) There are cortisol binding proteins in saliva

A

False, saliva reflects free cortisol

27
Q

Describe A+P of glucocorticoid receptors

A
  • Found in nearly every cell in body
  • Unbound receptors in cytoplasm
  • Usually bound to heat shock proteins
  • Binding of cortisol to GR releases the hsp
28
Q

Binding of glucocorticoids to GR can induce 2 responses:

A
  • Non-genomic cell signaling: (fast, sec to mins). Via activation of kinases, which phosphorylate enzymes
  • Genomic cell signaling: Regulates gene expression (slower) via binding to transcription factors. mRNA products (proteins) made
29
Q

Glucocorticoid receptor agonists

A

Cortisol, synthetic GCs (prednisolone, dexamethasone), corticosterone, aldosterone

30
Q

Glucocorticoid receptor antagonists

A

Progesterone, testosterone, 17beta-estradiol, 11-deoxycortisol, mifepristone