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MIDS 127 - abdo > Adrenal Glands > Flashcards

Adrenal Glands Flashcards

1
Q

What are the measurements of a regular adrenal gland?

A

3-6cm long, 2-4cm wide, 0.3-1.0cm thick

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2
Q

Are fetal adrenals smaller than adult adrenals?

A

No, they are bigger

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3
Q

What is posterior and lateral to the IVC, medial to the RLL, and lateral to the diaphragmatic crus?

A

Right adrenal

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4
Q

What is posterolateral to the AO and lateral to the crus of a the diaphragm?

A

Left andreal

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5
Q

Is the right or left adrenal typically bigger?

A

Left andreal

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6
Q

What is the most vascular organ in the body?

A

The adrenals

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7
Q

What are the 3 arteries associated with the adrenal glands?

A

Superior suprarenal branch off inferior phrenic artery
Middle suprarenal artery off AO
Inferior suprarenal artery off renal artery

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8
Q

What are the 3 layers of the adrenal gland, from outermost to inner?

A

Zona glomerulsa, zona fasciculata, zona reticularis

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9
Q

Hormone secretion is controlled by the _____ ______ mechanism.

A

Negative feedback

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10
Q

Zona glomreulosa is responsible for which hormone?

A

Aldosterone

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11
Q

Zona fasciculata is responsible for which hormone?

A

Glucocorticoids including cortisol or hydrocortisone

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12
Q

Zona reticularis is responsible for the male and female ___________ .

A

Gonadocorticoids

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13
Q

What are two principal hormones synthesized in the medulla?

A

Epinephrine and norepinephrine

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14
Q

What causes the hypothalamus to signal neurons to stimulate the chromaffin cells to output epinephrine and norepinephrine?

A

Pain or stress

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15
Q

What is the clinical implication and conditions if adrenocorticotropic hormone (ACTH) is increased?

A

Addison disease, ectopic ACTH syndrome, pituitary adenoma, pituitary Cushing syndrome, primary adrenal insufficiency, and stress

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16
Q

What is the clinical implication and conditions if adrenocorticotropic hormone (ACTH) is decreased?

A

Primary adrenocortical hyperfunction (due to tumor or hyperplasia) and secondary hypoadrenalism.

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17
Q

What is the clinical implication and conditions if aldosterone is increased?

A

Adrenal tumor (adenoma), aldosteronism (primary or secondary), bilateral adrenal gland hyerplasia, cirrhosis

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18
Q

What is the clinical implication and conditions if aldosterone is decreased?

A

Addison disease, primary hpoaldosteronism, salt-wasting syndrome, septicemia, stress

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19
Q

The right adrenal has the shape of…

A

Triangular, or inverted Y or V shape

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20
Q

The left adrenal has the shape of…

A

Triangular or semi-lunar appearance

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21
Q

Do adrenal tumors commonly invade the adjacent kidney?

A

No! It’s rare!

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22
Q

Anterior displacement of the retroperitoneal fat line, IVC, right renal vein, and posterior displacement of the right kidney is from…

A

The right adrenal gland being diseased.

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23
Q

Anterior displacement of splenic vein and posteroinferior displacement of the left kidney occurs from…

A

The left adrenal gland being diseased!

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24
Q

Are adrenal cysts common?

A

No!

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25
Q

What is the 3 etiologies of an adrenal cyst?

A

Hemorrhage, trauma, idiopathic

26
Q

What are the adrenal hemorrhage etiologies?

A

Birth trauma (baby going through a lot), anoxia in newborns, systemic disease, anticoagulant therapy

27
Q

Adrenal hemorrhage most commonly affects the ____ adrenal gland (due to venous drainage directly off IVC).

A

Right

28
Q

What diminishes steroid output?

A

Addison disease! (hypoadrenalism/hypocorticism)

29
Q

Addison Disease does what to steroid output?

A

Diminishes it!

30
Q

What disorders increase steroid production?

A

Cushing syndrome (hyperadrenalism/hypercorticism) and Conn syndrome (hyperaldosteronism)

31
Q

What is the etiology of hypoadrenalism (Addison disease)?

A

Primary disorders of the cortex or secondary failure in the elaboration of ACTH. Increased production of ACTH.

32
Q

What is the most common form of hypoadrenalism?

A

Addison Disease

33
Q

What is the most common etiology for Addison Disease?

A

No one knows! (Idiopathic)

34
Q

Men more commonly have Idiopathic Addison disease. True or false?

A

False as fuck! Women more commonly are idiopathic. Men commonly have TB.

35
Q

Addison disease changes the colour of what?

A

Skin

36
Q

Name the top 4 signs and symptoms of Addison disease.

A

Changes to skin colour, fever, weight loss, diarrhea

37
Q

What are the three sonographic findings of chronic primary hypoadrenalism (also known as Addison disease)?

A

Infections: acute: diffuse enlargement | chronic: atrophy
TB: enlarged hyperechoic and nodular glands with a thickened capsule and area of necrosis
Idiopathic: small irregular contracted glands

38
Q

Chronic Secondary Hypoadrenalism (etiology, SF)

A

Etiology: Abrupt cessation of exogenous steroid therapy
SF: shrunken glands with LEAF-LIKE shape

ACTH is diminished and NO change in skin

39
Q

Cushing Syndrome is hypoadrenalism or hyperadrenalism?

A

Hyperadrenalism

40
Q

Cushing Syndrome (etiology, SS, complications)

A

Etiology: Treatment of nonendocrine disorders with long course of potent glucocorticoid drugs.

SS: protein loss, impaired immunity, bruising, hyperpigmentation, hypertension

Complications: islet cell of panc can’t produce enough insulin therefore diabetes

41
Q

What are the 3 types of Cushing Syndrome?

A
  1. Hypersecretion of ACTH by anterior pituitary (most common).
  2. Ectopic ACTH syndrome from adenocarcinoma
  3. Adrenocortical neoplasms that are ACTH-independent
42
Q

For Cushing Syndrome, ACTH-dependent forms mostly result in ______ glands.

A

Enlarged

43
Q

Primary hyperaldosteronism is also known as?

A

Conn Syndrome

44
Q

Conn Syndrome (Primary Hyperaldosteronism) - Etiology, SS, SF

A

Benign aldosterone-producing adrenal adenoma
SS: Hypernatremia, hypokalemia, arterial hypertension
SF: dark little round masses, hard to see

45
Q

Secondary Hyperaldosteronism can be caused by any factor decreasing the _______ _______ to the ________, which raises _________ ________ level and increasing subsequent aldosterone secretion.

A

Blood supply, kidneys, plasma renin

46
Q

Adenoma of the adrenal gland cortex is associated with ____ syndrome.

A

MEN

47
Q

MEN syndrome is associated with what kind of cortical tumour?

A

Adenoma

48
Q

If an Adenoma is greater than ___cm, they are more likely to be ________ and may cause Cushing syndrome.

A

2cm, functional

49
Q

What is a rare, benign, non functioning cortical tumour?

A

Myelolipomas

50
Q

When do Myelolipomas make themselves known? (Which decade?)

A

4th and 6th

51
Q

Adenocarcinomas often produce _______.

A

Steroids

52
Q

Where are the common met spots for adenocarcinomas?

A

Lymph nodes, lungs, liver, bones and others

53
Q

What is the sonographic appearance for a hyperfunctioning tumour? (Size, texture)

A

3-6cm and uniformly hypoechoic

54
Q

What is the sonographic appearance for a non functioning tumour? (Size, texture)

A

Greater than 6cm, more complex and hyperechoic (bright)

55
Q

What is a pathology associated with the adrenal medulla?

A

Pheochromocytoma

56
Q

What is the rule of 10 for pheochromocytoma?

A

10% are malignant, 10% are bilateral or multiple, 10% hereditary syndromes, 10% pediatric, 10% extra-adrenal locations, 10% are normotensive nonfunctioning tumours

57
Q

What are the risk factors for Pheochromocytoma?

A

Hypertension, hereditary endocrine tumour syndromes (MEN), von Hippel-Lindau, tuberous sclerosis

58
Q

What are the signs and symptoms of Pheochromocytoma?

A

Hypertension, headache, sweating, tachycardia

59
Q

What are the complications associated with Pheochromocytoma?

A

Enlarged heart, heart failure, rupture and hemorrhage of tumour

60
Q

What is the sonographic appearance of Pheochromocytoma?

A

Well encapsulated round hypervascular 2-6cm tumour, echogenicity can vary, or may be solid or have areas of cystic components or necrosis/hemorrhage, eggshell peripheral calcification

61
Q

What are the typical primaries that cause adrenal mets?

A

Squamous cell carcinoma of lung, breast.

MIDS 127 - abdo (14 decks)

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