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AB&SS 1 > C9: Adrenal Glands > Flashcards

C9: Adrenal Glands Flashcards

1
Q

the adrenals are composed of what 2 parts?

these 2 parts develop from which cells?

A
  1. Cortex
    - develop from mesoderm
  2. Medulla
    - from neural crest cells/neuro-ectoderm
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2
Q

which part of the adrenal develops first

A

cortex

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3
Q

during cortical development, what occurs at 6 wks gestation

A
  • proliferation of the mesoderm from the post abdo wall

- the proliferated mesoderm penetrates the retroperitoneum and becomes the primitive adrenal cortex

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4
Q

during cortical development, what occurs at 8 wks gestation

A

-structure separates from the post peritoneal surface and is surrounded by retroperitoneal c-tissue which forms the adrenal capsule

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5
Q

whats happening in terms of cortical development shortly after birth

A

-primitive adrenal cortex disappears by age 1

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6
Q

whats happening in terms of cortical development at age 3

A

permanent adrenal cortex differentiates into 3 zones/layers

  1. glomerulosa
  2. fasciculata
  3. reticularis
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7
Q

during medullary development, what occurs at 7 wks gestation

A

-neural crest cells migrate and invade the medial side of the cortex and then differentiate into chromaffin cells of the medulla

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8
Q

where do the neural crest cells develop?

A

outside the cortex, then migrate in

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9
Q

another name for adrenals

A

suprarenals

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10
Q

whats the relationship of the adrenals to the kidneys

A

anterior, medial and superior

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11
Q

what fascia and fat surround the adrenals

A
  • gerotas fascia

- perinephric fat

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12
Q

do the adrenals have there own fascicle supports?

do they move with the kidney

A

yes… they move independent of the kidney

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13
Q

what the norm size of the adrenals in adults

A

L: 4-6 cm
W: 2-3 cm
AP: 0.3-0.6 cm

1/13 of the kidney size

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14
Q

what the norm size of the adrenals in kids

A

L: 0.9-3.6 cm
W: 0.2-0.5 cm

1/3 of kidney size

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15
Q

which adrenal is usually largest

A

L

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16
Q

whats the relationship of the R adrenal to the liver and curs of the diaphragm

A
  • post to L lobe liver and medial to R lobe of liver

- lateral (for R and L adrenal)

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17
Q

can the inferior border of the L adrenal extend to the renal hilum

A

yes

18
Q

whats the relationship of the L adrenal to the stomach and lesser sac

A

posterior

19
Q

whats the relationship of the inferior part of the L adrenal to the pan tail and splenic vessels

A

posterior

20
Q

if there was a mass on the L adrenal, how would that effect the pan tail

A

would push it anterior

21
Q

name the 3 arteries the supple each adrenal gland and where do they branch from

A
  1. superior suprarenal artery (from inferior phrenic arteries)
  2. middle suprarenal artery (from AO)
  3. inferior suprarenal artery (from renal artery)
22
Q

how is blood drained from the adrenals and where does it drain into

A

suprarenal veins

R (short): drains into IVC
L (long) : drains into LRV

23
Q

what kind of gland is the adrenal often described as?

whats its general function and how does it accomplish it

A

double endocrine gland

-maintains homeostasis through hormone secretion

24
Q

what %. of the gland does the cortex make up?

is the adrenal cortex (AC) essential to life

A

90%

yes

25
Q

in general, what type of hormones does the cortex release? what type of system regulates the release of these hormones?

list the specific hormones it releases

A

steroid hormones

+ regulated by - feedback system b/w the hypothalamus, anterior pituitary and adrenal gland

  • mineral corticoids
  • glucocorticoids
  • gonadal hormones
26
Q

describe how the - feedback system work to control the release of AC hormones

A

-blood level of adrenal cortex hormones are detected which causes the hypothalamus to secrete ACTHRF… ACTHRF stimulates the anterior pituitary to release ACTH which causes the cortex to produce hormones

27
Q

describe the the zona glomerulosa of the cortex.

what does it secrete

A
  • makes up 15 % of the cortex
  • outer layer

+ secretes mineralocorticoids… specifically aldosterone which acts on the renal tubule to increase sodium retention and increase BP

28
Q

describe the the zona fasciculate of the cortex.

what does it secrete

A
  • makes up 75 % of the cortex
  • middle layer

+ secretes glucocorticoids…. specifically cortisone and hydrocortisone which are for metabolism, suppress the immune response (anti-inflammatories) and helps resist mental and physical stress

29
Q

describe the the zona reticularis of the cortex.

what does it secrete

when does this zone become present

A
  • makes up 10 % of the cortex
  • inner layer

+ secretes sex hormones.. specifically estrogen and androgens which promote development of reproductive organs and bones

  • @ 4 yrs
30
Q

the medulla is related to what nervous system in the body

is it essential for life?

A

sympathetic nervous system… responsible for flight or fight

not essential

31
Q

in general, what type of hormones does the medulla release?

list the specific hormones it releases and there effect on the body

A

catecholamines

-epinephrine/adrenaline
+ dilutes coronary vessels
+ constricts skin and renal vessels

-norepinephrine
+ constricts all arteries except coronary vessels

32
Q

whats the body’s response to catecholamines

A
  • increases heart rate, BP (due to constriction), blood sugar, blood flow to muscles, respiration
  • dilates respiratory passages
  • slows digestions
33
Q

whats the purpose of performing a blood test for adrenal function

A

measures cortical function

34
Q

whats the purpose of performing a urine test for adrenal function

A

measures medulla function

35
Q

describe the echogenicity and echo texture of the adrenals in adults

A

homogenous and hypoechoic

36
Q

describe the echogenicity of the adrenals in kids

when should child adrenals show and adult appearance

A

thin echogenic core (medulla) and less echogenic rim (cortex)

-age 1

37
Q

why is it more difficult to see the adrenals in adults then children

A

they have more perirenal fat surrounding them

38
Q

which 4 structures can commonly mimic the adrenal glad on US

A
  • crus of the diaphragm
  • panc tail
  • lymphadenopathy
  • gastric fundus
39
Q

whats the best way to interrogate the R adrenal

where should the sound beam be directed if scanning the adrenal transversely

A

intercostally using liver of R kidney as a window… patient usually in supine

+ towards the IVC and should be scanning from the renal hilum to the liver

40
Q

whats the best way to interrogate the L adrenal

whats an alternate way to scan the L adrenal

A

intercostal scanning using spleen or L kidney as a window… patient in decube or RAO

  • patient in LPO and scan through the liver, IVC and AO

AB&SS 1 (13 decks)

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