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Endocrine Pathophys > Adrenal Glands > Flashcards

Adrenal Glands Flashcards

1
Q

What are the two regions of the adrenal gland?

A

Cortex (outer) and Medulla (inner)

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2
Q

What is the function of the cortex?

A

Responds to long-term stress

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3
Q

What hormones does the cortex secrete?

A

Cortisol
Aldosterone
Androgens

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4
Q

What is the function of the medulla?

A

Responds to short-term stress

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5
Q

What hormones does the medulla secrete?

A

Catecholamines (epi/nor)
Enkephalins and other peptides

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6
Q

What are examples of long term stress responses?

A

Retention of water/salt by the kidneys
Increased BP/blood volume
Increased blood glucose/proteolysis/lipolysis
Suppress immune response
Maintain/promote anabolic growth

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7
Q

What are examples of short term stress responses?

A

Increase HR/BP
Bronchodilation
Glycogenolysis + increase in plasma glucose
Blood diverted from GI to heart, CNS, + muscles
Increase metabolism

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8
Q

The adrenal medulla is a functional “____________” of the _____________ nervous system

A

“extension” ; sympathetic

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9
Q

Short term stress signaling starts in the _____________, which then signals the ______________, which sends action potentials to the adrenal _____________ via the sympathetic division of the _______________ nervous system

A

Hypothalamus
Brainstem/Spinal Cord
Medulla
Autonomic

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10
Q

What are catecholamines?

A

Epinephrine (adrenaline)
Norepinephrine (noradrenaline)

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11
Q

What are the percentages of catecholamines released by the adrenal medulla?

A

80% Epinephrine
20% Norepinephrine

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12
Q

What responses do enkephalins stimulate?

A

Analgesic

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13
Q

What stimulates the adrenal medulla and what is the response?

A

Stressor or threats to survival
(think adrenaline related)
Fight or flight response

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14
Q

What happens in a fight or flight response?

A

HR/BP/TPR increase
Ventilation increases
Metabolism increases
Glycogenolysis/lipolysis
CNS “alertness” increases
GI function decreases

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15
Q

What tissues does the adrenal medulla target?

A

Heart
Blood vessels
Bronchioles
Liver
Adipose
Intestines
Kidneys
CNS

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16
Q

How do sympathetic stimuli affect the kidneys?

A

Decrease GFR and RBF (think long term stress response)

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17
Q

How are catecholamines removed from circulation?

A

Metabolized by enzymes in the kidneys and excreted via kidneys

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18
Q

What are the layers of the adrenal cortex?

A

Zona Glomerulosa (outer)
Zona Fasiculata (middle)
Zona Reticularis (inner)

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19
Q

What does the zona glomerulosa contain?

A

Enzymes that synthesize aldosterone

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20
Q

What does the zona fasiculata contain?

A

Enzymes that synthesize cortisol

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21
Q

What does the zona reticularis contain?

A

Enzymes that synthesize adrenal androgens

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22
Q

What is the precursor/stimuli to adrenal cortex hormones?

A

Cholesterol

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23
Q

______ binds to receptors and delivers cholesterol into the adrenal ___________

A

LDL
Cortex

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24
Q

_______ stimulates the adrenal cortex to convert cholesterol into ______________

A

ACTH
Pregnenolone

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25
Q

What is pregnenolone used for?

A

To synthesize aldosterone, cortisol, and adrenal androgens

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26
Q

What can cause adrenal pathologies?

A

Enzyme deficiencies

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27
Q

What does cortisol do?

A

Enhances enzyme activity to allow metabolism to occur more efficiently
“Gas pedal, not the ignition”

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28
Q

What can excess cortisol cause?

A

Suppressive effects
(Think negative feedback loop)

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29
Q

What does cortisol influence?

A

Plasma glucose
Immune response
CV function
Kidney function
CNS function
Fetal growth and surfactant

30
Q

What is the target tissue of cortisol?

A

Heart
Blood vessels
Kidneys
Liver
Adipose
Muscles
Immune system
CNS
CT (bone, ligaments, tendons)

31
Q

Cortisol effect on heart and blood vessels

A

Vasoconstriction
Increase HR and stroke volume

32
Q

Cortisol effect on kidneys

A

Increase GFR and RBF
Increase salt/water retention
Increase potassium excretion

33
Q

How does cortisol affect the immune system?

A

Enhance anti-inflammatory response

34
Q

How does excess cortisol affect the immune system?

A

Impairs immune system
Reduces both cellular and humoral immunity
(Poor wound healing/immune defenses)

35
Q

How does cortisol affect the CNS?

A

Increases excitability
Increases attention and memory formation but may impair recall
Alters mood and perception

36
Q

How does excess cortisol affect the CNS?

A

Can cause neuronal death and impair CNS function (depression/dementia)

37
Q

How does cortisol effect bone? What can excess cortisol cause?

A

Stimulates osteoclasts/calcium resorption
Excess can cause osteoporosis

38
Q

How does cortisol affect muscle? What can excess cortisol cause?

A

Stimulate proteolysis
Excess can cause muscle wasting/weakness and loss of lean body mass

39
Q

How does cortisol affect tendons/ligaments/CT? What can excess cortisol cause?

A

Inhibits fibroblasts/collagen production (weakens CT)
Excess can cause ligament/tendon failure

40
Q

What stimulates cortisol?

A

Circadian rhythm
Stress

41
Q

When is most cortisol released and when does it peak?

A

Released between midnight and 8am, peaks right before waking

42
Q

What inhibits cortisol?

A

Negative feedback loops
Elevated levels of cortisol inhibit ACTH and CRH (which stimulate cortisol)

43
Q

What is the function of aldosterone?

A

Influence renal regulation of salt, water, and potassium

44
Q

What tissues does aldosterone target?

A

Kidneys and blood vessels

45
Q

How does aldosterone affect the kidneys?

A

Increases Na reabsorption promoting water resorption
Increases potassium excretion

46
Q

What is the function result of aldosterone’s affect on the kidneys?

A

Increase BP/BV
Decrease plasma potassium
Increase pH

47
Q

How does potassium affect pH?

A

Potassium excretion is coupled with hydrogen excretion in the kidneys
The loss of hydrogen promotes alkalosis in the plasma

48
Q

What stimulates aldosterone?

A

Angiotensin II
Hyperkalemia

49
Q

What inhibits aldosterone?

A

Negative feedback loops
Atrial natriuretic peptide (ANP)
Beta Blockers

50
Q

What are androgens responsible for?

A

Development and maintenance of male characteristics
Role in reproductive activity
Precursor to estrogen

51
Q

What are examples of active androgens and what is their MOA?

A

Dihydrotestosterone (DHT)
Testosterone (precursor to DHT)
MOA: bind to androgen receptors and exert androgenic effects on target tissue

52
Q

What are examples of inactive androgens and what is their MOA?

A

DHEAS/DHEA
Androstenedione
MOA: Converted to active androgen (testosterone) which does on to exert androgenic effects

53
Q

The adrenal glands release which androgens?

A

Inactive
(DHEAs/DHEA and androstenedione)

54
Q

What other organs secrete androgens?

A

Gonads (testes and ovaries)

55
Q

What is the most abundant androgen?

A

DHEAS/DHEA

56
Q

Testosterone is synthesized in which organs?

A

Mostly in gonads but small amount in peripheral tissues

57
Q

What is the difference between males and females regarding testosterone production and release?

A

Males’ testes release testosterone into bloodstream/circulation
Females’ ovaries convert most testosterone into estrogen w/ small amount of testosterone released into circulation

58
Q

Where are inactive androgens converted into testosterone?

A

Peripheral tissues

59
Q

The conversion of testosterone into DHT requires?

A

5 alpha reductase

60
Q

DHT is the most __________ androgen

A

Potent

61
Q

What is the approximate ratio of DHT:Testosterone in the body?

A

1:10

62
Q

What is the difference between females and males in regards to DHT synthesis?

A

Females have less 5 alpha reductase than males which results in less DHT synthesis

63
Q

Androgens and pre-puberty

A

Play important role in development of axillary hair, pubic hair, muscle mass, sebaceous glands (acne)

64
Q

Adrenal excess during pre-puberty in males causes?

A

Significant androgenic effects
Isosexual precocious puberty

65
Q

What is isosexual precocious puberty?

A

Early development of male secondary sexual characteristics before the age of 9

66
Q

Adrenal excess during pre-puberty in females causes?

A

Significant androgenic effects
Heterosexual precocious puberty

67
Q

What is heterosexual precocious puberty?

A

Early development of male secondary sexual characteristics before the age of 8

68
Q

Androgens and post-puberty in males

A

Limited role in maintenance of male sex characteristics
Testosterone plays the dominant role instead

69
Q

Androgens and post-puberty in females

A

Significant role in maintenance of axillary/pubic hair growth, muscle mass, libido
Since ovaries produce such a small amount of testosterone

70
Q

What is the difference in having adrenal excess post-puberty in males vs. females?

A

Adrenal excess will have no/minimal androgenic effect in males but a significant androgenic effect in females

71
Q

Excess androgens post-puberty in females

A

Development of male sexual characteristics
cystic acne, male type baldness, infertility

Endocrine Pathophys (12 decks)

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