Chapter 8: The Adrenal Glands Flashcards by Valerie Snyder

What is adrenal adenoma?

benign solid mass located within the adrenal glands

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What are adrenal cysts?

benign simple cysts located within the adrenal glands

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What is adrenocorticotropic hormone?

hormone secreted by the anterior pituitary gland, which controls the release of hormones by the adrenal gland

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What is Conn Syndrome?

a syndrome caused by a functioning tumor within the adrenal cortex that produces excess amounts of aldosterone; patients will have hypertension, excessive thirst, excessive urination, and low levels of potassium in the blood

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Cushing syndrome

a syndrome that results from a pituitary or adrenal tumor that causes overproduction of cortisol by the adrenal glands; patients may present with obesity, thinning arms and legs, hypertension, hyperglycemia, and severe fatigue

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What are endocrine glands?

glands that release their hormones directly into the blood stream

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What is Gerota fascia?

the fibrous envelope of tissue that surrounds the kidney and adrenal gland

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What is hirsutism?

excessive hair growth in women in areas where hair growth normally is negligible

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What is hypernatremia?

high levels of sodium in the blood

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What is hypokalemia?

low levels of potassium in the blood

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What is a neuroblastoma?

malignant tumor that can occur within the adrenal gland and anywhere within the sympathetic nervous system

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What is pheochromocytoma?

benign, solid adrenal tumor associated with uncontrollable hypertension

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What are suprarenal glands?

AKA adrenal glands

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What is tachycardia?

abnormally rapid heart rate

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The adrenal glands are controlled by what?

the hypothalamus (and therefore anterior pituitary)

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Are the adrenal glands peritoneal or retroperitoneal?

retroperitoneal

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What controls the release of hormones from the adrenal glands?

adrenocorticotropic hormone secreted by the ant. pit. gland

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The adrenal glands are enclosed by the

Gerota Fascia

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Each gland is composed of what two things?

medulla and cortex

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What are the three zones of the cortex of the adrenal gland?

zona glomerulosa, zona fasiculata, and zona reticularis

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Aldosterone is secreted by what?

the cortex of the adrenal gland

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Aldosterone is responsible for what?

regulating blood pressure by controlling the amounts of sodium and water in the body

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What do androgenic hormones do?

They play a part in the development of male characteristics

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What is cortisol?

A hormone that controls the body’s use of fat, carbs, and protein

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The cortex of the adrenal glands produces what

aldosterone androgenic hormones cortisol

What does the medulla of the adrenal gland produce?

epi and norepi

Describe the location of the right adrenal gland?

- posterior and right lateral to the IVC - medial to RL of liver - lateral to the crus of the diaphragm

Describe the location of the left adrenal gland?

- medial to the upper pole of the left kidney - superior segment is located posterior to the lesser sac - inferior segment is located posterior and lateral to the pancreas

What does epinephrine do?

AKA adrenaline, accelerates heart rate, increases BP, opens airways to lungs, narrows blood vessels in the skin and intestine to increase blood flow to major muscle groups

What does norepinephrine do?

accelerates HR, increases BP, contracts blood vessls

What three arteries supply blood to adrenal glands?

- suprarenal branches of the inferior phrenic arteries - the suprarenal branches of the aorta - the suprarenal branches of the renal arteries

Venous drainage of the adrenal glands is performed by what?

suprarenal veins

The right suprarenal vein drains into

the IVC

The left suprarenal vein drains into

the left renal vein

Where are adrenal glands seen sonographically?

anterior, medial, and superior to kidneys

Cushing syndrome results from what?

high levels of cortisol secretion by the adrenal cortex

Cortisol plays an important role in

glucose metabolism, bp regulation, immune fx, inflammatory response

Cushing syndrome can be associate with what?

a benign tumor that leads to overproduction of cortisol by the adrenal glands..this tumor is often located within the adrenal gland (adrenal adenoma), or in the pituitary gland

What do patients with Cushings present with?

- obesity - thinning arms and legs - hypertension - hirsutism - hyperglycemia - severe fatigue

What does Conn syndrome result from?

high levels of aldosterone secretion by the adrenal cortex

Conn syndrome can be caused by what?

a functioning tumor within the adrenal cortex that causes the adrenal gland to produce excess amounts of aldosterone

Patients with Conn syndrome typically present with what?

- hypertension - excessive thirst - excessive urination - high levels of sodium in the blood (hypernatremia) - low levels of potassium in the blood (hypokalemia)

Adrenal adenomas can be either

hyperfunctioning | nonhyperfunctioning

Hyperfunctioning adenomas are often seen in patients with

either Cushings or Conn's syndromes

How do adrenal adenomas appear sonographically?

solid, hypoechoic mass in area of adrenal gland

T/F: adrenal adenomas may be asymptomatic?

TRUE

What do pheochromocytomas cause?

uncontrollable hypertension

Where does a pheochomocytoma arise from?

medulla of adrenal gland

List the clinical findings of pheochromocytomas?

- uncontrollable hypertension - headaches - tachycardia - tremors - anxiety - excessive sweating

Son findings of pheochromocytomas?

large hyperechoic mass in the area of the adrenal gland

Adrenal cysts are often difficult to distinguish from the

- liver - spleen - upper pole of kidneys

What kinds of adrenal cysts may cause pain?

large or hemorrhagic cysts or infected cysts

T/F: primary adrenal carcinoma is rare?

TRUE

Malignant adrenal tumors will produce symptoms associated with

Cushing syndrome, as they may be functional tumors that produce hormones

Metastisis to the adrenal glands originates most often in what 5 places?

- lungs - breast - colon - kidneys - melanoma

The most common extracranial solid, malignant tumor in children is what?

neuroblastoma

Clinical findings of neuroblastoma

- palp abdominal mass - abdominal pain - bone pain

T/F: metastasis is often found at time of discovery of neuroblastoma?

true

Neuroblastomas typically present before what age?

5 years of age

Son findings of Neuroblastoma

- large heterogenous mass containing areas of calcification and hemorrhage located in the area of the adrenal gland - metastasis often is present at the time of discovery

When do adrenal glands typically spontaneously hemorrhage?

in stressed neonates

How does adrenal gland hemorrhage appear sonographically?

heterogenous appearing mass in the area of the adrenal gland

Clinical findings of adrenal hemorrhage?

- abdominal mass | - acute drop in hematocrit and BP

``` All of the following are associated with Conn syndrome except? A. Adrenal adenoma B. Hypertension C. Excessive Thirst D. Thinning arms and legs ```

D. Thinning arms and legs

When internal bleeding is suspected, what lab value is useful?

hematocrit

The syndrome associated with hypertension, hyperglycemia, obesity, and an adrenal mass is

Cushings

``` All of the following are true statements about adrenal glands except: A. easily seen in fetus B. they are exocrine glands C. composed of cortex and medulla D. AKA suprarenal glands ```

B they are exocrine glands

What kind of gland releases hormones directly into the blood stream

endocrine

The arterial blood supply to the adrenal glands is accomplished by means of what?

Suprarenal arteries

Hyperfunctioning adrenal adenomas are associated with all of the following except: A. Cushing syndrome B.Conn Syndrome C. Hypoechoic mass in the area of the adrenal gland D. Acute drop in hematocrit

D. Acute drop in hematocrit

``` The adrenal cortex produces all of the following except: A. cortisol B. androgens C. aldosterone D. adrenaline ```

D. adrenaline

``` Which of the following is produced by the adrenal medulla? A. cortisol B. aldosterone C. Norepinephrine D. androgens ```

C. norepi

What best describes the location of the right adrenal gland?

posterior and lateral to the IVC

The right suprarenal vein drains directly into the

IVC

A 45 year old woman with thin arms and legs, htn, and severe fatigue presents to the US department for an abd. US. You should thus evaluate the adrenal glands for signs of

- primary adrenal carcinoma | - adrenal adenoma

The most common son. appearance of neuroblastoma is

heterogenous mass with calcifications

The neuroblastoma typically presents before the age of

5 years

Which hormone secreted by the anterior pituitary controls the release of hormones by the adrenal glands?

adrenocorticotropic hormone

``` All of the following are benign adrenal masses except: A. adrenal adenoma B. neuroblastoma C. pheochromocytoma D. adrenal hematoma ```

B. neuroblastoma

The adrenal glands receive blood supply from all of the following except: A. suprarenal branches of inferior phrenic arteries B. suprarenal branches of aorta C. suprarenal branches of renal arteries D. suprarenal branches of the celiac trunk

D. Suprarenal branches of celiac trunk

All of the following are true about the adrenal glands except: A. the adrenal glands play an important role in BP regulation B. the adrenal glands are easily ID'd in the fetus C. the left adrenal gland is located lateral to the upper pole of the left kidney D. the right adrenal gland is located medial to the right lobe of the liver

C. the left adrenal gland is located lateral to the upper pole of the left kidney