Adrenals

Question 0

Lt adrenal tumor will displace the left kidney ___

Answer 0

Inferiorly

Question 1

Rt adrenal tumor will displace the IVC __

Answer 1

Anteriorly

Question 2

A rt adrenal tumor will displace the rt kidney

Answer 2

Inferiorly

Question 3

A lt adrenal tumor will displace the splenic vein ___

Answer 3

Anteriorly

Question 4

A rt adrenal tumor will displace the rt renal vein ____

Answer 4

Anterior

Question 5

Panc tail will displace the left adrenal ___

Answer 5

Posterior

Question 6

What 3 arteries perfuse the adrenal glands

Answer 6

supra renal branch of inferior phrenic artery, supra renal branch of the aorta, and supra renal branch of the renal artery

Question 7

The rt supra renal vein drains into

Answer 7

IVC

Question 8

Lt supra renal vein drains into

Answer 8

left renal vein and then the IVC

Question 9

Phenochromocytoma

Answer 9

In the adrenal medulla, organ of Zuckerkandl (near aortic bif), paravertebral sympathetic ganglia

Cause hypersecretions of catecholamines; dopamine, norepinephrine, and epinephrine.

Symptoms: headaches, palpitations, excessive perspiration.

Question 10

Medulla secretes

Answer 10

Catecholamines which secrete epinephrine and norepinephrine

Question 11

What 4 criteria define a non functioning cortical Adenoma

Answer 11

1. A unilateral mass
2. No history of malignancy elsewhere
3. No biochemical evidence of adrenal hyperfunctioning
4. Adrenal mass < 3 cm in diam

Question 12

3 most common primary mets to adrenal

Answer 12

Lung, breast, and melanoma

Question 13

Adrenal myelolipoma

Answer 13

Echogenic mass with propagation speed artifact

Question 14

2 tumors that arise from medulla

Answer 14

Phenochromocytoma and neuroblastoma

Question 15

Adrenals located in the

Answer 15

Anterior pararenal space

Question 16

Adrenal gland

Answer 16

2 endocrine glands

Cortex and Medulla

Question 17

Right adrenal pyramid lies ____ to IVC, ____ to rt liver lobe, ____ to diaphragm, and _____ to kidney

Answer 17

Post/lat to IVC
Medial to right liver lobe
Lateral to diaphragm
Sup to ant kidney

Question 18

Right adrenal shape

Answer 18

Upside down Y or V shape

Question 19

Left adrenal shape

Answer 19

Crescent shape or triangular

Question 20

Left adrenal lies ____ to lesser sac, ____ to pancreas, ____ to kidney, ____ to diaphragm

Answer 20

Posterior to lesser sac
Post/lat to panc
Ant/medial to kid
Post on diaphragm

Question 21

Blood supply

Answer 21

Suprarenal branch of inferior phrenic art
Suprarenal branch of Aorta
Suprarenal branch of Renal artery

Right supra renal vein empties into IVC
Left suprarenal vein empties into left renal vein

Question 22

Cortex

Answer 22

Secretes steroids
medullocorticoid, menurolocorticoid: regulates electrolytes and secretes aldosterone)
Glutocorticoids
Cortizone
Hydrocortizone
Androgen
Estrogen

Question 23

Medulla

Answer 23

Secretes catecholamines

Epinephrine, norepinephrine

Fight or flight response

Question 24

Addisons Disease (adrenocortical hypo functioning)

Answer 24

Chronic primary hypoadrenalism, atrophic gland

Dec cortisol

Skin color changes, sodium & potassium retention, Renal impairment, dec blood volume, sugar, lipids, fatigue, weak, hypotension, GI distress

Enlg adrenal with possible necrosis

Steroid therapy treatment

Question 25

Adrenogenital syndrome

Adrenal hyperplasia

Answer 25

Inc sex hormones, develop male characteristics muscle hair

Excess androgen production, ambiguous genitalia,

Question 26

Conn’s Syndrome (hyperaldosteronism)

Answer 26

Primary hyperaldosteronism, excessive secretion of aldosterone

Hypernatremia (inc sodium), hypokalemia (dec potassium), 
Water retention
HTN***
Muscle weak, cramps 
Altered renal function 

Hyper aldosterone

Question 27

Cushing’s Syndrome (adrenocortical hyperfunctioning)

Answer 27

Hyperadrenalism
Hypercorticolism
Inc glucose production

Protruding abdomen, poor wound healing, prone to infection, thin skin bruise easy, moon face, buffalo hump

Upper body obesity, round moonface, inc fat around neck = buffalo bump, thinning of arms & legs

Osteoporosis, hyper pigmentation, htn, virilization

Question 28

Waterhouse Friderichsen Syndrome / acute hypoadrenalism

Answer 28

Massive destruction of gland

Question 29

Hemorrhage

Answer 29

MC in newborns bc large adrenal and inc vascularity
From hypoxia

Hemorrhage and liquefaction
Anechoic(older) to Echogenic, ca+

Question 30

Adenoma

Answer 30

Common, associate with MENs Syndrome. Don’t secrete hormones.

Question 31

Myelolipoma

Answer 31

Rare benign. Don’t secret hormones. Hyperechoic, propagation speed error

Question 32

Cortical carcinoma

Answer 32

Rare
Usually steroid producing
Nonsteroid producing is highly malignant

Encapsulated, variable echotexture, ca+

Invasion to adrenal vein, ivc, lymph nodes

Question 33

Mets

Answer 33

4th mc site for mets
Lung, breast, kidney, bronchial, lymphoma, melanoma, GI, thyroid, pancreas

More than half bilateral

Question 34

Pheochromocytoma

Answer 34

Arises from medulla

Highly vascular, HTN patients, usually benign, solitary right sided. Assoc with MENs Syndrome

HTN, headache, sweat, pallor, tachycardia, inc metabolism, palpitations, excessive perspiration

Inc catecholamine, and metabolites. Secretes catecholamine, dopamine, norepinephrine, epinephrine

Question 35

Rule of 10 pheochromocytoma

Answer 35

10% extra adrenal 
10% malignant
10% bilateral 
10% familial
10% not assoc with HTN

Question 36

Neuroblastoma

Answer 36

MC adrenal tumor in pediatrics
Neural crest origin
1/2 occur in 1st year of life
Rare after 8 years

Arises from medulla

Palp mass, abd protrusion, fever, wt loss, pallor, loss of energy, HTN, inc catecholamine
75% with mets

Highly echogenic, poorly defined borders, ca+, necrosis, hemorrhage

Mass presses down on kidney

Question 37

Adrenal size

Answer 37

Length 3-5 cm
Width 2-3 cm
Thick 1 cm