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Endocrinology yr2 > Adrenal medulla and adrenaline stress axis > Flashcards

Adrenal medulla and adrenaline stress axis Flashcards

1
Q

acute stress

A

rapid
sympathetic
release of adrenaline and noradrenaline

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2
Q

chronic stress

A

HPA axis

release of steroids

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3
Q

adrenal glands

A

just aboe kidneys
adrenal cortext: secretes steroid hormones
adrenal medulla: adrenaline etc

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4
Q

structure of adrenal glands

A 
capsule
zona glomerulosa
zona fasiculartis
zona reticuaris
medulla
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5
Q

ZG

A

zona glomerulosa
small close cells
makes steriods

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6
Q

ZF

A

biggest part
cells arranged radially in cords
makes steriods too

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7
Q

ZR

A

small cells

network of interdigitating capillaries

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8
Q

adrenal medualla

A

chromaffin cells
dense granules
makes opiods and enkephalins

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9
Q

chromaffin cells

A

innervated by preganglia nerves ending in a cholinergic synapse
secrete adrenaline and noradrenaline

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10
Q

synthesis of adrenaline and noreadrenaline

A

synthesized in the medulla in an enzymatic pathway – – converts the amino acid tyrosine into a series of intermediates then epinephrine.

  • Tyrosine is first oxidized to L-DOPA, which is subsequently decarboxylated to give dopamine. - Oxidation gives norepinephrine.
  • methylation of the primary amine of norepinephrine using PNMT
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11
Q

release of adrenaline and noradrenaline

A

Adrenocorticotropic hormone (ACTH) and the sympathetic nervous system stimulate the synthesis of adrenaline precursors
ympathetic nervous system, acting via splanchnic nerves to the adrenal medulla, stimulates the release of adrenaline
NO NEG FEEDBACK

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12
Q

actions of adrenaline

A

increased HR and BP

increased metabolism

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13
Q

three types of adrenaline receptor

A

A1: intestine leading to contractions
A2: decreases insulin
B1: increased HR and skin contraction

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14
Q

example of an effect of adrenaline

A

mobilisation of energy in the form of glucose

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15
Q

define catecholamines

A

dopamine
adrenaline
noreadrenaline

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16
Q

what hormones does the arenal cortext make?

A

cortisol, aldosterone, androgens

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17
Q

whats the roleof cortisol

A

glucocortiocoid

action of carbohydrate metabolism and the response to stress

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18
Q

role of aldosterone

A

regulates salt and water balance

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19
Q

glucocortiocoid

A

cortisol

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20
Q

mineralcoirtiocoid

A

aldosterone

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21
Q

describ the hypothalamopituitary axis

A

organises appropriate hormonal responses by the pituitary to signals made by higher centres in the brain
pit connected to hypothalamus, blood flow in hypophyseal portal transports releasing factors to the pit where its stimulated to make relevant hormones

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22
Q

which cells in the ant pit are we looking at here

A

adrenocortiotrophs

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23
Q

describe the HPA stress axis

A
  • stress related stimuli leads to secretion of corticotrophin releasng hormone from hypothalamus
  • stimulates pituitary to secrete ATCH, adrenlocortioctophic hormone
  • this stimulate the adrenal cortext to make cortisol
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24
Q

describe ATCH

A

a peptide hormone in the family of melanocortins

made as a large precursor and browen down into ATCH and POMC

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25
Q

role of ZG

A

secretes aldosterone

26
Q

role of ZF

A

secretes cortisol

27
Q

role of ZR

A

secretes sex steriods/androgens

28
Q

what does ATCH do when it reaches the adrenal gland

A

stimulates the adrenal cortext

- conversion of cholesterole to prenelalone in ZF and ZR

29
Q

negative feedback on HPA axis

A

cortisol exerts neg feeback to turn off secretion of CRH and ATCH
(pituitary and hypothalamus neg feedback)

30
Q

circardian rhythms and cortisol

A

plasma cortisol low around midnight, ax day time but slowly falls throughout the day

31
Q

transport of cortisol

A

complexed with corticosteroid binding globulin

32
Q

main effects of cortisol

A
  • catabolic homrone modules carb, fat and protein metabolism increasing blood glucose
33
Q

other extra effects of cortisol

A

stimulates appetite

anti-inflmatory

34
Q

dysfunctions of cortisol

A

over production- cushings syndrome

35
Q

cushings syndrome

A

over production of cortisol

can be due to steriod medication

36
Q

cushings disease

A

benign tumour of ptuitary leading to excess cortisol

it is CRH producing

37
Q

symptoms of too much cortisol

A

central obesity due to cortisol stimulating appetite
thinning of skul
bruising
hypertension

38
Q

diangosis of cushings syndrome

A

measurement of cortisol/ATCH in urine or plasma

39
Q

what do normal or low ATCH conc in urine or plasma mean

A

cushings sundrome but adrenal tumour or steriod medication is leading to the disease

40
Q

what do high ATCH level in urine or plasma show

A

ectopic ATCH producting tumour

41
Q

dexametasome text

A

low dose will supress ATCH in normal patients but not in cushings disease

42
Q

treatment of cushings

A

reduce steriod meds
removal of tumor
adrenalecomy

43
Q

under production of cortisol

A

complicated and presents as addinsons disease

44
Q

long term stress response of glucocortiocoids

A

cortisol

fats and proteins broken down into glucose

45
Q

long term stress mineralocoriocoids

A

retention of Na and water by kidneys

increased blood vol and BP

46
Q

short term stress adrenaline and noreadrenaline

A

glygocen broken down, increased blood glucose

incrased BP and breathing rate and metabolic rate

47
Q

where is aldosterone made

A

in the zone glomerulosa

48
Q

what does aldosterone affect?

A

distal tubule and collecting ducts of kidney

increases Na resorption

49
Q

how does aldosterone lead to more Na resorption

A

intracllular binding leads to transcription of gene

NA transporter protein made and moved to kidney

50
Q

low sodium diet

A

higher aldosterone

51
Q

high sodium diet

A

lower adosterone and thinner ZG in adrenal gland

52
Q

what is the rennin-angiotensin system

A

hormone system that regulates blood pressure and fluid balance.

53
Q

describe the renin-angiotensin system

A

renal blood low flow
juztaglomerular cell convert pre-renin to renin and secrete into blood
this then convers antiotensin to angiotensin 1 which then converts angiotensin 1 into 22 by using ACE

54
Q

role of angiotensin 2

A

potent vasoconstrictor peptide that causes blood vessels to narrow inceasing blood pressure
also stimulates aldosterone secretion

55
Q

how do aldosterone and renin-angiotensin work together?

A

renin-angiotensin system work to stimulate aldosteron to be secreted
and then both work togther to increase extracellular fluid volume which will increase the blood pressure.
angiotensin also constricts blood vessels to raise BP

56
Q

excessive mineralcortiocoid

A

adrenal tumour making alodsterone
excessive renin
excess ATCH stimulating steriodogenesis

57
Q

symptoms of excess mineralocortiocoid

A

too much Na retention
leads to hypertention
- raised BP
burry vision

58
Q

conns syndrome

A

aldosterone secreting tumour, adenoma of adrenal cortext

causes hyper-aldosteronism ( high aldosterone)

59
Q

addinsons disease

A

adrenal failure

might be autoimmune or inflamatory or heamahaggic

60
Q

why is addinsons complex

A 
lack of all
- glucocortiocoids
- mineralcoiroiods
- adrenal adrogens
leads to lots of varied symptoms
61
Q

treatment for addinsons

A

hydrocortiosone to replace cortisol

administration of mineralicorticoids to replace loss

Endocrinology yr2 (9 decks)

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