Adrenal glands

Question 1

What are adrenals surrounded by

Answer 1

greets fascia

Question 2

What structures are contained in the retroperitoneum

Answer 2

Kidney
ureters
adrenals
rectum
aorta

Question 3

Where do the adrenals get blood supply from

Answer 3

Suprarenal and phrenic artery

Question 4

What does the left venous system attach to

Answer 4

Renal vein

Question 5

What does the right side venous system attach to

Answer 5

IVC

Question 6

What innervates the adrenal glands

Answer 6

Celiac plexus and splanchnic nerve

*come off lateral spinal horn

Question 7

What does the medulla secrete

Answer 7

Catecholamines

Question 8

What does the adrenal cortex secrete

Answer 8

Aldosterone
cortisol
androgens

Question 9

What is the primary driver of aldosterone

Answer 9

RAAS

Question 10

What are the layers of the adrenal cortex

Answer 10

Zona glomerulosa
Zona fasciculata
Zona reticularis

Question 11

What is cortisol important for

Answer 11

suppress inflammation and regulate glucose

Question 12

What do mineral corticoids effect

Answer 12

Electrolytes

Question 13

How does ACTH effect LDL

Answer 13

It up regulates the intake of LDL and breakdown into usable cholesterol

Question 14

Where is cholesterol broken down

Answer 14

liver

Question 15

What causes aldosterone to be secreted

Answer 15

Angiotensin 2

Question 16

What is the most potent mineralocorticoid

Answer 16

aldosterone

Question 17

How fast would someone die without any mineralocorticoids

Answer 17

3-14 days

Question 18

What is refractory HTN

Answer 18

Unable to control HTN with 3+ meds

Question 19

What is responsible for inhibiting RAAS when blood pressure is too high

Answer 19

Atrial natriuretic peptide

Question 20

What is the most potent steroid hormone

Answer 20

Glucocorticoids

Question 21

How do glucocorticoids effect carbohydrate metabolism

Answer 21

Inhibits insulin acting on the liver

reduces overall insulin sensitivity

Overall it increases glucose levels

Question 22

How do glucocorticoids help with inflammation

Answer 22

they block the release of the inflammatory markers

if inflammation has already started = reduction in effects and increase healing

decrease capillary permeability

Question 23

How do glucocorticoids effect fat metabolism

Answer 23

it mobilizes our fat for energy and ends up having fat deposits in the face and torso

Question 24

what is the most potent glucocorticoid in the body

Answer 24

cortisol

Question 25

What does cortisol do

Answer 25

during stress it increases BP and CO, increases lypolysis in extremities, lipogenesis of trunk/face and atrophy of lymphoid tissue (immunosuppression)

Question 26

What does DHEA stimulate

Answer 26

testosterone in men

Question 27

What is DHEA important for

Answer 27

development of male sex organs and sexual characteristics

Question 28

When are catecholamines released

Answer 28

In response to stress

Question 29

what is psychologic stress driven by

Answer 29

limbic system

Question 30

What is cushings syndrome

Answer 30

excess cortisol levels and clinical presentation of this

Question 31

What is Cushing disease

Answer 31

excess ACTH leading to hypercortisolism

Question 32

What are the causes of cushings syndrome

Answer 32

pituitary adenoma hypothalamic dysfunction paraneoplastic syndrome

Question 33

What causes Cushing like syndrome

Answer 33

we did it! steroids

Question 34

What occurs when there are increased androgens associated with increased ACTH stimulation

Answer 34

increased acne hirsutism

Question 35

What is Addisons disease

Answer 35

adrenal insufficiency

Question 36

How can invasion of extra pulmonary TB effect the adrenals

Answer 36

Cause Addisons disease

Question 37

What are some effects of mineralocorticoid deficiency

Answer 37

Hyperkalemia hyponatremia

Question 38

What occurs with glucocorticoid deficiency

Answer 38

Person will not respond appropriately to stress

Question 39

How does Addisons disease effect the skin

Answer 39

will cause an increase in melanin secretion

Question 40

What is Addisonian crisis

Answer 40

pt. w/ Addisons have increased metabolic demand during disease/stress

Question 41

What is occurring in the body with Adrenal crisis

Answer 41

body is not able to compensate for demands *need for glucocorticoid increases

Question 42

What will occur with hypoaldosteronism

Answer 42

pt. will become hypovolemic, hyponatremia, and hyperkalemic

Question 43

What is Conn's syndrome

Answer 43

primary hyperaldosteronism and is associated with zone glomerulosa tumor

Question 44

How will hyperaldosteronism present

Answer 44

hypertension hypokalemia

Question 45

What is a pheochromocytoma

Answer 45

Tumor of chromatin cells of the adrenal medulla = increased catecholamine secretion

Question 46

What is the genetic predisposition for pheochromocytoma

Answer 46

MEN 2

Question 47

What is the presentation triad with a pheochromocytoma

Answer 47

Headache sweating tachycardia