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AU 15 - Human Phys > Endocrinology - Lecture 3 > Flashcards

Endocrinology - Lecture 3 Flashcards

1
Q

What are the two divisions of the adrenal gland?

A

Medulla

Cortex

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2
Q

Adrenal Medulla

A

Inner portion of the gland
Part of the sympathetic nervous system…it’s a modified sympathetic ganglion
Autonomic nervous system that controls fight or flight
Derived from neural crest cells

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3
Q

Adrenal Cortex

A

Outer portion of the gland
Responds to hormones
Derived from mesothelial cells of the intermediate mesoderm

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4
Q

What types of hormones are secreted by the adrenal medulla?

A

Catecholamines: epinephrine and norepinephrine

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5
Q

T/F - The adrenal medulla is a gland in the sympathetic ganglion with no postsynaptic neurons with axons

A

True

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6
Q

Why does the adrenal medulla secrete more epinephrine than norepinephrine?

A

It contains significant amounts of the enzyme phenyl-N-methyltransferase, which converts NE to E

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7
Q

What are the divisions of the adrenal cortex?

A

Zona glomerulosa
Zona fasciculata
Zona reticularis

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8
Q

Zona glomerulosa

A

Outermost layer of the adrenal cortex
Cells are arranged in clumps
Secretes Aldosterone

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9
Q

Zona fasciculata

A 
Middle layer of the adrenal cortex
Cells are arranged in long, parallel lines 
Secretes glucocorticoids (cortisol and corticosterone)
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10
Q

Zona reticularis

A

Innermost layer of the adrenal cortex
Cells are arranged in a net-like or web orientation
Secretes sex steroids (DHEA, androstendione)

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11
Q

Aldosterone

A

Mineralcorticoid produced by cells in the zona glomerulosa

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12
Q

Aldosterone action

A

Stimulate Na and H2O retention in order to maintain blood volume and blood pressure

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13
Q

What is the largest target tissue of aldosterone

A

Kidneys

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14
Q

What regulates the secretion of aldosterone?

A
  • The kidney secretes a hormone (renin) when blood pressure or Na blood levels are too low
  • Stimulated by an increase in plasma K
  • Stimulated by a decrease in plasma pH or an increase in plasma H+
  • Stimulated by a drop in systemic blood pressure
  • Inhibited by an increase in Na intake
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15
Q

Glucocorticoids

A

Cortisol and corticosterone

Secreted by the cells of the zona fasciculata

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16
Q

What is the major function of glucocorticoids

A

Increase metabolic fuel availability and use in tissues

17
Q

What effect does cortisol have on the body?

A

Increase gluconeogenesis in the liver
Increase proteolysis in muscles
Increase lipolysis
Decrease glucose uptake in muscle and fat
Decrease immune and inflammatory responses
Decrease growth and reproductive energy
Regulate blood pressure

18
Q

Androgens

A

Sex steroids secreted by the zona reticularis

Dehydroepiandrosterone (DHEA) and Androstenedione

19
Q

Dehydroepiandrosterone (DHEA)

A

A precursor of other sex steroids - so it can serve as a circulating reservoir in peripheral tissues containing steroidogenic enzymes
Relatively weak androgenic action

20
Q

Androstenediione

A

Synthesized by enzymatic conversion of DHEA
Stronger than DHEA
Provides a non-gonadal source of testosterone and estradiol - an important source of reproductive steroids prior to puberty and in postmenopausal women

21
Q

What do adrenal sex steroids do?

A

Regulate mood, libido, hair growth, erythropoiesis, and acne

22
Q

Why is the stress response important?

A

It is critical for maintenance of homeostasis and essential for survival
It allows the body to respond to things that are deviations from the “norm”

23
Q

What happens if a stress response persists after the stress is gone?

A

Adverse effects that can become damaging

24
Q

What adverse conditions can occur to chronic stress responses?

A

Cortisol will catabolize tissue, which can be rebuilt when stress is over. But if stress prolongs, it won’t rebuild and the body can be damaged
Cortisol has high anti-inflammatory and anti-immune effects. This conserves energy in the long term, but we want these things to work at some point.
Mobilization of metabolic fuels increases lipids in the blood, and along with increased blood pressure can lead to atherosclerosis, hypertension, and blood clots

25
Q

What evidence is there for an interaction between immune function and activation of the stress response?

A
  • HSV + psychiatric illness –> increased recurrences and duration of outbreak
  • Influenze + family dysfunction –> increased frequency and severity of illness
  • Hep B + exams –> delayed antibody response to vaccine
26
Q

What is the CNS connection to the stress response?

A

A stress response is a response of the stress axis (Hypothalamus - ant pituitary - adrenal cortex) to a stressor that stimulates hypothalamic CRH neurons and inputs to the SNS

27
Q

What are the causes of a primary insufficiency leading to Addison’s Disease

A

Disease
A congenital disorder
Autoimmune disorder

28
Q

What are the causes of a secondary insufficiency leading to Addinson’s Disease?

A

Pituitary problem
Glucocorticoid therapy - can use exogenous corticosteroids, which has feedback effects on CRH and ACTH which can impair a normal stress response

29
Q

What are symptoms of adrenal insufficiency (Addison’s disease)

A

Low cortisol
High ACTH
Weakness, lethargy, and decreased appetite
Low blood pressure
Low glucose when fasting
Hyperpigmentation due to lack of negative feedback control of POMC

30
Q

How do you treat adrenal insufficiency? (Addison’s disease)

A

Exogenous glucocorticoids and/or dietary controls

31
Q

What causes Hypercortisolinemia (Cushing’s disease)

A

Typically due to a pituitary tumor or administering too much exogenous glucocorticoid

32
Q

How do you treat Hypercortisolinemia?

A

Remove the tumor that’s causing it

33
Q

What are symptoms of Hypercortisolinemia?

A

Excessive tissue catabolism (especially bone, skin, and muscle)
Type II Diabetes-like symptoms (increased appetite and circulating glucose)
Impaired immune functions
Threat of hypertension

34
Q

What is the primary concern for dentists seeing patients with Hypercortisolinemia?

A

Impaired immune function after a procedure
Hypertension
Osteoperosis
Increased bleeding

AU 15 - Human Phys (7 decks)

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