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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
What is the 3 etiologies of an adrenal cyst?
Hemorrhage, trauma, idiopathic
26
What are the adrenal hemorrhage etiologies?
Birth trauma (baby going through a lot), anoxia in newborns, systemic disease, anticoagulant therapy
27
Adrenal hemorrhage most commonly affects the ____ adrenal gland (due to venous drainage directly off IVC).
Right
28
What diminishes steroid output?
Addison disease! (hypoadrenalism/hypocorticism)
29
Addison Disease does what to steroid output?
Diminishes it!
30
What disorders increase steroid production?
Cushing syndrome (hyperadrenalism/hypercorticism) and Conn syndrome (hyperaldosteronism)
31
What is the etiology of hypoadrenalism (Addison disease)?
Primary disorders of the cortex or secondary failure in the elaboration of ACTH. Increased production of ACTH.
32
What is the most common form of hypoadrenalism?
Addison Disease
33
What is the most common etiology for Addison Disease?
No one knows! (Idiopathic)
34
Men more commonly have Idiopathic Addison disease. True or false?
False as fuck! Women more commonly are idiopathic. Men commonly have TB.
35
Addison disease changes the colour of what?
Skin
36
Name the top 4 signs and symptoms of Addison disease.
Changes to skin colour, fever, weight loss, diarrhea
37
What are the three sonographic findings of chronic primary hypoadrenalism (also known as Addison disease)?
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
Chronic Secondary Hypoadrenalism (etiology, SF)
Etiology: Abrupt cessation of exogenous steroid therapy SF: shrunken glands with LEAF-LIKE shape ACTH is diminished and NO change in skin
39
Cushing Syndrome is hypoadrenalism or hyperadrenalism?
Hyperadrenalism
40
Cushing Syndrome (etiology, SS, complications)
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
What are the 3 types of Cushing Syndrome?
1. Hypersecretion of ACTH by anterior pituitary (most common). 2. Ectopic ACTH syndrome from adenocarcinoma 3. Adrenocortical neoplasms that are ACTH-independent
42
For Cushing Syndrome, ACTH-dependent forms mostly result in ______ glands.
Enlarged
43
Primary hyperaldosteronism is also known as?
Conn Syndrome
44
Conn Syndrome (Primary Hyperaldosteronism) - Etiology, SS, SF
Benign aldosterone-producing adrenal adenoma SS: Hypernatremia, hypokalemia, arterial hypertension SF: dark little round masses, hard to see
45
Secondary Hyperaldosteronism can be caused by any factor decreasing the _______ _______ to the ________, which raises _________ ________ level and increasing subsequent aldosterone secretion.
Blood supply, kidneys, plasma renin
46
Adenoma of the adrenal gland cortex is associated with ____ syndrome.
MEN
47
MEN syndrome is associated with what kind of cortical tumour?
Adenoma
48
If an Adenoma is greater than ___cm, they are more likely to be ________ and may cause Cushing syndrome.
2cm, functional
49
What is a rare, benign, non functioning cortical tumour?
Myelolipomas
50
When do Myelolipomas make themselves known? (Which decade?)
4th and 6th
51
Adenocarcinomas often produce _______.
Steroids
52
Where are the common met spots for adenocarcinomas?
Lymph nodes, lungs, liver, bones and others
53
What is the sonographic appearance for a hyperfunctioning tumour? (Size, texture)
3-6cm and uniformly hypoechoic
54
What is the sonographic appearance for a non functioning tumour? (Size, texture)
Greater than 6cm, more complex and hyperechoic (bright)
55
What is a pathology associated with the adrenal medulla?
Pheochromocytoma
56
What is the rule of 10 for pheochromocytoma?
10% are malignant, 10% are bilateral or multiple, 10% hereditary syndromes, 10% pediatric, 10% extra-adrenal locations, 10% are normotensive nonfunctioning tumours
57
What are the risk factors for Pheochromocytoma?
Hypertension, hereditary endocrine tumour syndromes (MEN), von Hippel-Lindau, tuberous sclerosis
58
What are the signs and symptoms of Pheochromocytoma?
Hypertension, headache, sweating, tachycardia
59
What are the complications associated with Pheochromocytoma?
Enlarged heart, heart failure, rupture and hemorrhage of tumour
60
What is the sonographic appearance of Pheochromocytoma?
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
What are the typical primaries that cause adrenal mets?
Squamous cell carcinoma of lung, breast.

MIDS 127 - abdo (14 decks)

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