Final Exam Review Flashcards
___ glands are organs that secrete hormones
Endocrine
What are (4) types of hormones?
- Peptide/protein hormones
- Catecholamines
- Steroid hormones
- Thyroid hormones
What is the most common type of hormone in the body? Examples of this type of hormone include insulin, growth hormone, and antidiuretic hormone
Peptide/protein hormones
___ hormone > 100 amino acids
Protein
___ hormone < 100 amino acids
Peptide
This type of hormone is produced by the adrenal medulla; examples = adrenaline, norepinephrine
Catecholamines
This type of hormone is secreted by the adrenal cortex; examples = cortisol, aldosterone, ovaries/testes
Steroid hormones
This type of hormone is anything derived from tyrosine; examples = T3, T4
Thyroid hormones
Peptide/protein hormones and catecholamines are ___ soluble
Water soluble
Steroid and thyroid hormones are ___ soluble
Fat soluble
___ feedback loop = the hormone itself sends the signal to STOP production/release of hormone when there is enough
Negative feedback loop
Example of a positive feedback loop = ___ hormone
Lutenizing hormone
LH and positive feedback—LH acts on the ovaries to cause secretion of ___; ___ (more/less) LH is secreted to secrete more estrogen
Secretion of estrogen; more LH is secreted to secrete more estrogen
___ = all of the chemical reactions in the body
Metabolism
___ = energy during resting conditions
Basal metabolic rate
Basal metabolic rate accounts for ___-___% of daily energy expenditure
50-70%
Basal metabolic rate ___ (increases/decreases) with age
Decreases
___ is the end product of almost all the energy released in the body
Heat
Metabolic rate is quantitatively measured in ___
Calories
The following factors ___ (increase/decrease) metabolic rate: thyroxine, testosterone, growth hormone, fever
Increase
The following factors ___ (increase/decrease) metabolic rate: inadequate thyroxine (hypothyroidism), sleep, malnutrition
Decrease
___ is responsible for temperature regulation
Hypothalamus
What specific part of the hypothalamus controls temperature regulation?* KNOW FOR BOARDS
Anterior hypothalamus—preoptic nuclei
Shivering increases O2 consumption up to ___%
Up to 300%
Hypothermia—PVR ___ (increases/decreases)
Increases
Hypothermia—renal effects = ___ = ___ (increased/decreased) plasma volume
Diuresis = decreased plasma volume
Hypothermia—cerebral O2 consumption ___ (increases/decreases); MAC ___ (increases/decreases)
Decreases; decreases
Hypothermia causes MAC to decrease ___-___% per degree C
5-7%
Hypothermia results in delayed ___
Emergence
Hypothermia ___ (increases/decreases) clotting factors/platelets
Decreases
Hypothermia ___ (increases/decreases) metabolism; ___ NMB; ___ emergence
Decreases metabolism; prolongs NMB; delays emergence
Hypothermia ___ healing; risk for infection is ___ (increased/decreased)
Delays healing; risk for infection is increased
What are the two body compartments?
Peripheral compartment and core compartment
___ compartment = limbs, skin, subcutaneous tissue; ___ of body’s heat content
Peripheral compartment; 1/3 of body’s heat content
___ compartment = major thoracic and abdominal organs + brain; ___ of body’s heat content
Core compartment; 2/3 of body’s heat content
Vasoconstriction during anesthesia will cause periphery to go down to 30-32 C to maintain core temp at 37 C—T/F?
True
___ = principle byproduct of metabolism
Heat
Shivering can increase heat production by ___%
300%
Body heat is preserved by peripheral vaso___
Vasoconstriction
What are (4) mechanisms of heat loss? (in order from greatest amount of heat loss to least)
- Radiation (40%…ppt says 60%)
- Convection (30%)
- Conduction (20%)
- Evaporation (10%)
What type of heat loss is this?—greatest amount of heat loss; amount of heat loss is determined by the difference in temperature between body/surroundings
Radiation
What type of heat loss is this?—heat loss via air currents; degree of heat loss depends on amount of body surface area exposed/airflow
Convection
What type of heat loss is this?—heat loss via direct contact (i.e.: OR table)
Conduction
What type of heat loss is this?—skin prep, open abdominal cavities, respiration
Evaporation
Anesthesia (both general and regional) inhibits peripheral vasoconstriction—T/F?
True
Biggest drop in body temperature is during the first hour after induction; there is a 1-2 degree C decrease in core temperature because of peripheral vasodilation—T/F?
True
Most heat loss occurs in proportion to exposed ___
Exposed body surface area
General anesthesia promotes vaso___, ___ (increases/decreases) metabolic rate/heat production, and ___ (increases/decreases) hypothalamic responsiveness to hypothermia
Vasodilation, decreases metabolic rate/heat production, and decreases hypothalamic responsiveness to hypothermia
NMBs prevent shivering—T/F?
True
Heat loss is more pronounced with ___ and ___ patients (think age extremes)
Elderly and neonatal
Neonatal patients have a ___ (lower/higher) body surface area based on their weight, which causes ___ (more/less) heat loss
Higher body surface area, causes more heat loss
Sweating leads to heat loss/cooling and must be prevented—T/F?
True
What is the most commonly used drug to treat post-op shivering?
Demerol
What disorder is this?—rare, usually inherited disorder of skeletal muscle; results in a hypercatabolic state…tachycardia, hypercapnia, muscle rigidity, tachyarrhythmias, metabolic acidosis
Malignant hyperthermia
Drug/dose to treat malignant hyperthermia = ___
Dantrolene 2.5 mg/kg every 5 minutes until symptoms subside
Max dose of dantrolene = ___
10 mg/kg
Even if patient had a previous uneventful surgery, they can still develop MH in the future—T/F?
True
MH triggers = ___
All inhalation agents + succs
Nitrous oxide can cause MH—T/F?
False! Nitrous is safe
Locals, propofol, non-depolarizing NMBs, benzos, and barbituates are all safe to use in patients with a history of MH—T/F?
True
___ gland = the “master gland”
Pituitary
___ = the coordinating center of the endocrine system
Hypothalamus
This organ delivers signals to the pituitary gland, and the pituitary gland releases hormones that influence other endocrine systems
Hypothalamus
Hypothalamus + pituitary gland = ___ axis
Hypothalamic-pituitary adrenal (HPA) axis
The HPA axis lives inside the BBB—T/F?
False—HPA axis lives OUTSIDE the BBB
What are the (6) main hormones secreted from the anterior pituitary gland? (FLAT PIG)
- Follicle stimulating hormone
- Lutenizing hormone
- Adrenocorticotropic hormone
- Thyroid stimulating hormone
- Prolactin
- I—ignore
- Growth hormone
Pituitary gland rests in the ___ bone in area called the ___
Sphenoid bone in area called the sella turcica
What are (4) divisions of the pituitary gland?
- Adenohypophysis
- Pars intermedius
- Pars tubularis
- Neurohypophysis
Adenohypophysis = ___ pituitary; ___ (smallest/largest) part of the pituitary gland
Anterior pituitary; largest part of the pituitary gland
Pars intermedius = gone after ___
Fetal development
Pars tubularis = highly ___, no known hormones secreted
Vascular
Neurohypophysis = ___ pituitary
Posterior
Anterior vs. posterior pituitary—anterior pituitary is more of a ___ connection
Vascular/glandular connection
Anterior vs. posterior pituitary—posterior pituitary is more of a ___ system connection
Nervous system/glial connection
Posterior pituitary only secretes ___ and ___ ONLY
Oxytocin and antidiuretic hormone ONLY
Hormones secreted by the posterior pituitary are produced by the ___, transfer down nerve fibers, and are stored/released from the ___
Produced by the hypothalamus and stored/released from the posterior pituitary
Anterior pituitary is also called the ___
Adenohypophysis
Anterior pituitary is connected to the hypothalamus via a ___ network
Portal venous network
___ = capillary beds connected; this is how signals are transferred from the hypothalamus down to the anterior pituitary gland
Portal venous network
(5) anterior pituitary cell types (in order of percentage in the body):
- Somatotropes (30-40%)
- Corticotropes (20%)
- Thyrotropes (3-5%)
- Gonadotropes (3-5%)
- Lactotropes (3-5%)
Somatotropes—___-___%; secrete ___
30-40% MOST ABUNDANT***; secrete growth hormone
Corticotropes—___%; secrete ___
20%; secrete ACTH
Thyrotropes—___-___%; secrete ___
3-5%; secrete TSH
Gonadotropes—___-___%; secrete ___ and ___
3-5%; secrete LH and FSH
Lactotropes—___-___%; secrete ___
3-5%; secrete prolactin
Posterior pituitary is AKA ___
Neurohypophysis
Posterior pituitary produces only ___ hormones
2
Posterior pituitary produces ___ and ___
Oxytocin and vasopressin (AKA ADH—antidiuretic hormone)…regulate uterine contractions/water balance
Blood supply of hypothalamus/pituitary gland—___ is supplied by the superior hypophyseal artery
Hypothalamus
Blood supply of hypothalamus/pituitary gland—___ is venous by the way of long portal vessels
Anterior pituitary
Blood supply of hypothalamus/pituitary gland—___ is supplied by the inferior hypophyseal artery
Posterior pituitary
What are two nuclei in the posterior pituitary?
- Paraventricular nucleus
- Supraoptic nucleus
What nucleus is this?—lies above the third ventricle of the brain; produces and transports oxytocin via nerve fibers to the posterior pituitary
Paraventricular nucleus
What nucleus is this?—lies above the optic chiasm/nucleus; produces and transports ADH (vasopressin) via nerve fibers to the posterior pituitary
Supraoptic nucleus
This hormone is synthesized in the supraoptic nucleus; increases permeability of collecting ducts, increasing free water absorption
Vasopressin (ADH)
Vasopressin (ADH)—___ (increases/decreases) urine osmolality; ___ (increases/decreases) plasma osmolality; ___ (increases/decreases) ECF volume
Increases urine osmolality; decreases plasma osmolality; increases ECF volume
Vasopressin (ADH) causes contraction of vascular smooth muscle, producing a vasoconstrictive pressor effect (more prevalent in large doses)—T/F?
True
Vasopressin (ADH) acts on what (2) receptors?
- V1 receptor
- V2 receptor
___ receptor = pressor effect; vasoconstriction; direct effect on increasing arterial BP; prevalent with extreme increases in circulating levels, i.e.: hemorrhage
V1
___ receptor = ADH effect (reabsorption of water); indirect way of increasing BP by increasing blood volume
V2
Would see an increase in vasopressin/ADH from: ___ II; ___ stimulation; ___osmolarity; ___volemia; ___tension
Angiotensin II (RAAS system); sympathetic stimulation; hyperosmolarity; hypovolemia; hypotension
Stimulus for vasopressin/ADH release: osmoreceptor in hypothalamus is activated by plasma osmolality > ___ mosm/L
> 290 mosm/L
Normal plasma osmolality = ___-___
285-290
Once plasma osmolality > 290, hypothalamus sends signals of ___
Thirst
Vasopressin release—___ (increased/decreased) ECF volume
Decreased
Vasopressin release—___ (increased/decreased) Na
Increased
Vasopressin release—___ (increased/decreased) BP
Decreased
Nicotine stimulates vasopressin release—T/F?
True—sympathetic stimulation
Nausea, pain, and stress can cause vasopressin release—T/F?
True
Positive pressure ventilation can cause vasopressin release—T/F?
True
Without ADH, urine output is ___
Excessive
Diabetes insipidus (DI)—___ thirst, ___ urine
Excessive thirst, dilute urine
___ deficiency causes DI
ADH deficiency
Two types of DI:
- Central/neurogenic DI
- Nephrogenic DI
What type of DI is most common?
Central/neurogenic DI
___ DI is common post head injury or pituitary surgery
Central/neurogenic DI
___ DI results from the inability of the kidney to respond to ADH (i.e.: chronic renal disease, lithium toxicity, hypercalcemia, hypokalemia)
Nephrogenic DI
DI results in excretion of large amounts of ___osmotic urine with ___osmotic plasma and ___dipsia, ___uria, without hyperglycemia
Large amounts of hypoosmotic urine with hyperosmotic plasma and polydipsia, polyuria without hyperglycemia
Treatment of DI = limit ___ intake and give ___
Limit sodium intake and give synthetic ADH (DDAVP)
DI can cause ___natremia d/t excessive water loss
Hypernatremia
Hypernatremia from DI ___ (increases/decreases) MAC
Increases
Hypovolemia from DI requires ___ (increased/decreased) doses of IV agents
Decreased
Postpone elective surgery for Na > ___
150
Symptoms of ___natremia = restlessness, lethargy, hyperreflexia; can proceed to seizures, coma, death
Hypernatremia
Rapid correction of hypernatremia results in seizures, brain edema, permanent neurologic damage, and death—T/F?
True
SIADH =
Syndrome of inappropriate antidiuretic hormone…ADH overload
SIADH—autonomous release from pituitary (or tumor) causes water ___, ___natremia, ___ urine, ___osmolar plasma
Water retention, hyponatremia, concentrated urine, hypoosmolar (dilute) plasma
Causes of SIADH = CNS disorders/head trauma, SCC of lung, pulmonary infection, pituitary surgery—T/F?
True
Signs of SIADH = water ___, ___ hyponatremia, ___ edema causing CNS effects—lethargy, seizures, coma
Water intoxication, dilutional hyponatremia, brain edema
Treatment of SIADH = treat ___, fluid ___
The underlying cause, fluid restriction
What tetracycline antibiotic can be used to treat SIADH?
Demeclocycline—decreases the body’s responsiveness to ADH
Hyponatremia—usually asymptomatic until at a sodium level of ___ meq/L
125
Serious symptoms of hyponatremia result at levels below ___ meq/L
Below 120
Na > ___ safe for elective procedures
> 130
Na < ___ may lead to cerebral edema
< 130
Intraoperatively, hyponatremia causes a ___ (increase/decrease) in MAC
Decrease
Postoperatively, hyponatremia can cause ___, ___, ___ (think neuro symptoms)
Agitation, confusion, somnolence
Treatment of hyponatremia = ___% saline, ___ (sometimes used)
Hypertonic 3% saline, lasix sometimes used
Hyponatremia must be corrected slowly—recommended correction is 1-2 meq/L/hr or < 12 meq/L in 24 hours—T/F?
True
Rapid correction of hyponatremia can result in central ___
Central pontine myelinolysis
Monitor serum Na+ every ___ hours during treatment of hyponatremia
1-2 hours
Oxytocin (pitocin) is secreted from the ___ nucleus of the posterior pituitary
Paraventricular
Oxytocin (pitocin) causes ___ of the uterus during labor (and can be used to contract uterus to decrease blood loss after birth)
Contraction
Oxytocin also causes contraction of the myoepithelial cells of the ___
Lactating breast
Oxytocin/milk release is an example of a ___ loop
Positive-feedback
Pituitary tumors are often found as a result of compression on adjacent structures, such as visual changes with impingement of the optic chiasm—T/F?
True
Compression of optic chiasm from pituitary tumor can result in bitemoral hemianopsia, which is loss of ___ in both eyes
Peripheral vision
Patients undergoing pituitary resection should undergo evaluation of their hormonal function to detect either ___ or ___
Hypersecretion or panhypopituitarism
Pituitary tumors = hypersecretion of ___, ___, ___
GH, TSH, ACTH
Panhypopituitarism = ___ (high/low) levels of hormones, have to provide ___
Low levels of hormones, have to provide hormone replacement
Acromegaly = too much ___; difficult ___, ___
Too much GH; difficult mask, intubation
Hyperthyroid = too much ___; ___cardia, ___ loss
Too much TSH; tachycardia, weight loss
Cushing’s disease = too much ___; difficult ___ and ___
Too much ACTH; difficult airway and access
Panhypopituitarism = need hormone replacement with ___, ___, ___
Cortisol, levothyroxine, DDAVP
Most pituitary resection are done with ___ approach
Trans phenomenal
Patients may develop ___ d/t loss of ADH from pituitary tumor surgery; may be temporary or permanent; may be evident intraop or postop
DI
Suspect DI in patients after pituitary tumor resection with ___ urine output; confirm with urine specific gravity < ___
High urine output; confirm with urine specific gravity < 1.005
Treat DI with ___ and ___ replacement
DDAVP and volume replacement
Acromegaly = ___ hypersecretion after adolescence
Somatotropin/growth hormone
Patients with acromegaly will be difficult ___/___, have ___ (small/large) tongue and epiglottis, ___ mandible, ___ facial features
Difficult mask/intubation, have large tongue and epiglottis, enlarged mandible, distorted facial features
Patients with acromegaly will have ___ narrowing and vocal cord ___
Sub glottic narrowing and vocal cord enlargement
Patients with acromegaly, may consider downsizing ETT by ___
0.5
___ is common in patients with acromegaly
OSA
REVIEW posterior pituitary—___ secretes hormones that are transferred and stored in ___ and released when needed; only 2 hormones secreted by posterior pituitary = ___ and ___
Hypothalamus secretes hormones that are transferred and stored in posterior pituitary and released when needed
Only 2 hormones secreted by posterior pituitary = oxytocin and ADH (vasopressin)
REVIEW anterior pituitary—___ sends either releasing or inhibitor signals to anterior pituitary; AP has ___ different cell types that can release ___ different hormones in response to signals sent from hypothalamus
Hypothalamus; 5 different cell types; release 6 different hormones
Adrenal glands are located on top of the ___
kidneys
Adrenal glands are AKA the ___ glands
suprarenal
Two parts of the adrenal glands = ___ and ___
cortex and medulla
Adrenal cortex = ___ layer; makes up ___-___% of the adrenal gland; synthesizes more than ___ different types of ___ hormones
outer layer; makes up 80-90% of the adrenal gland; synthesizes more than 30 different types of steroid hormones (corticosteroids)
Adrenal medulla = ___ or ___ region; makes up ___-___% of the adrenal gland
core or inner region; makes up 10-20% of the adrenal gland
What are the (3) layers of the adrenal cortex?
- Zona glomerulosa
- Zona fasciculata
- Zona reticularis
Zona glomerulosa = ___ layer
outermost
Zona fasciculata = ___ layer
middle layer
Zona reticularis = ___ layer
inner layer
Zona glomerulosa produces ___
mineralocorticoids, i.e.: aldosterone
Zona fasciculata produces ___
glucocorticoids, i.e.: cortisol
Zona reticularis produces ___
androgens, i.e.: DHEAS (dehydroepiandrosterone)–has similar effects to testosterone
Adrenal medulla lies underneath the adrenal ___; secretes ___–___% epinephrine, ___% norepinephrine
underneath the adrenal cortex; secretes catecholamines; secretes 80% epinephrine, 20% norepinephrine
Adrenal cortex mediates the stress response via the production of substances known as ___ and ___
mineralocorticoids and glucocorticoids
This zone of the adrenal cortex produces mineralocorticoids like aldosterone
zona glomerulosa
This zone of the adrenal cortex produces glucocorticoids like cortisol
zona fasciculata
This zone of the adrenal cortex produces androgens like DHEAS; it is a secondary site of androgen synthesis
zona reticularis
Aldosterone, cortisone, and testosterone are all ___ hormones; all are synthesized from ___
steroid hormones; all are synthesized from cholesterol
Mineralocorticoids = ___
aldosterone
Mineralocorticoids control minerals, AKA ___
electrolytes–sodium and potassium
Primary mineralocorticoid is ___
aldosterone–90%
Aldosterone affects ___ balance, which regulates blood pressure
salt/water balance
RAAS review–kidneys release ___ in response to hypovolemia»_space; ___ is released by the liver and converts renin into ___»_space; ___ is converted to ___ by ACE (which is released from the lungs)»_space; ___ [potent vasoconstrictor] stimulates release of ___ from the adrenal gland»_space; ___ causes retention of sodium and water, excretion of potassium, and increases BP
kidneys release renin in response to hypovolemia»_space; angiotensinogen is released by the liver and converts renin into angiotensin I»_space; angiotensin I is converted to angiotensin II by ACE (which is released from the lungs)»_space; angiotensin II [potent vasoconstrictor] stimulates release of aldosterone from the adrenal gland»_space; aldosterone causes retention of sodium and water, excretion of potassium, and increases BP
Anything that causes a drop in ECF (i.e.: hemorrhage) will cause release of ___ from the kidneys and thus kick off the ___ system
release of renin from the kidneys and thus kick off the RAAS system
Aldosterone primarily affects the principle cells of the ___ and collecting ducts of the kidneys
distal convoluted tubule
Aldosterone causes the retention of ___ and ___; excretion of ___ and ___
retention of sodium and water; excretion of K+ and H+
When aldosterone is unopposed, it leads to ___tension, extracellular fluid ___, ___kalemia, ___osis
hypertension (d/t sodium and water retention), extracellular fluid expansion (d/t sodium and water retention), hypokalemia (d/t K+ excretion), alkalosis (d/t H+ excretion)
What are two potent controllers of aldosterone secretion?–serum ___ and ___
serum potassium and angiotensin II
Primary hyperaldosteronism is AKA ___ syndrome
Conn’s syndrome
Conn’s syndrome is caused by ___ secreting tumors or hyperplasias
aldosterone secreting tumors or hyperplasias
Treatment of Conn’s syndrome is successful for tumors because they are usually unilateral–once you remove the tumor, patient is cured–T/F?
True
Patients with adrenal hyperplasia usually require pharmacological intervention with medications such as spironolactone–K+ sparing diuretic–T/F?
True because the excess aldosterone causes K+ excretion
Conn’s syndrome effects [think too much aldosterone]–___ (increased/decreased) ECF volume; ___tension; K+ ___; metabolic ___osis
increased ECF volume; hypertension; K+ depletion; metabolic alkalosis
Diagnosis of conn’s syndrome = ___ (high/low) renin from negative feedback
low renin–kidneys stop secreting renin in response to high levels of aldosterone
Treatment of conn’s syndrome = ___ or ___ management
surgical or medical management
Secondary hyperaldosteronism = excess of aldosterone ___ of the adrenal gland
OUTSIDE of the adrenal gland (i.e.: abdominal tumor outside of the adrenal gland)
In secondary hyperaldosteronism, ECF is lost to the ___; intravascularly, patients are ___ despite total volume ___; this triggers release of ___ by kidneys; release of ___ exacerbates fluid/sodium retention
ECF is lost to the extravascular space; intravascularly, patients are volume depleted despite total volume overload; this triggers release of renin by kidneys; release of renin exacerbates fluid/sodium retention
In primary and secondary hyperaldosteronism, want to restrict ___ and ___
fluids and sodium
___ (low/high) potassium levels in primary and secondary hyperaldosteronism can cause muscle weakness and ___ (increase/decrease) sensitivity to NMBs
low potassium levels in primary and secondary hyperaldosteronism can cause muscle weakness and increase sensitivity to NMBs
Hypoaldosteronism = adrenal ___
insufficiency
Hypoaldosteronism–___ lost in the urine, ___ retained; plasma volume ___ (increases/decreases); ___tension and ___kalemia may lead to circulatory collapse
Na+ lost in the urine, K+ retained; plasma volume decreases; hypotension and hyperkalemia may lead to circulatory collapse
Glucocorticoids = ___
cortisol
Cortisol is also called ___
hydrocortisone
___ is the principle glucocorticoid (95%) and is produced in the zona ___
cortisol is the principle glucocorticoid and is produced in the zona fasciculata
HPA axis and release of cortisol–hypothalamus sends ___ releasing hormone to the ___; ___ pituitary releases ___ to stimulate the adrenal glands to release ___ during stress; when levels are high, the negative feedback loop sends signals back to the hypothalamus to suppress its release
hypothalamus sends corticotropin-releasing hormone to the anterior pituitary; anterior pituitary releases ACTH to stimulate the adrenal glands to release cortisol during stress
___ hormone stimulates cortisol secretion almost entirely
adrenocorticotropic hormone (ACTH)
ACTH release is controlled by ___ releasing hormone from the ___
corticotropin releasing hormone from the hypothalamus
Physiologic stress causes release of both ___ and ___
ACTH and CRH
High cortisol levels cause ___ of ACTH and CRH release (negative feedback)
inhibition
CRH, ACTH, and cortisol are released in relation to circadian rhythms, with highest levels in the morning to change from a sleep to waking period–T/F?
True
Effects of glucocorticoids [cortisol]–stimulate ___neogenesis; ___ (increases/decreases) glucose utilization by cells; ___ (increases/decreases) blood glucose concentration
stimulate gluconeogenesis; decreases glucose utilization by cells; increases blood glucose concentration
High levels of cortisol have ___ effects
anti-inflammatory
Cortisol ___ healing and is useful in ___ processes, ___ reactions, ___, and organ ___
cortisol enhances healing and is useful in autoimmune processes (i.e.: lupus, RA, inflammatory bowel diseases like Crohn’s), allergic reactions, asthma, and organ transplant
Very high doses of cortisol are often used to assist in preventing organ rejection–T/F?
True
Almost any stress (physical or neurogenic) can cause an immediate release of ACTH by the anterior pituitary gland, followed by greatly increased secretion of cortisol–T/F?
True
The adrenal medulla is ___ connected to the sympathetic nervous system via ___ nerve fibers
directly connected to the SNS via ventral nerve fibers
Short-term stress response is a very ___ response; adrenal ___ releases catecholamines
very rapid response; adrenal medulla releases catecholamines–epi and norepi
Long-term stress response is a ___ response; adrenal ___ releases ___corticoids and ___corticoids
slower response; adrenal cortex release mineralocorticoids (aldosterone) and glucocorticoids (cortisol)
Short-term stress response–___ (increased/decreased) heart rate; ___ (increased/decreased) BP; liver converts glycogen to ___ and releases it into blood; ___ of bronchioles; ___ (increased/decreased) digestive system activity/urine output; ___ (increased/decreased) metabolic rate
increased heart rate; increased BP; liver converts glycogen to glucose and releases it into blood; dilation of bronchioles; decreased digestive system activity/urine output; increased metabolic rate
Long-term stress response–retention of ___ and ___ by kidneys; ___ (increased/decreased) blood volume and BP; proteins/fats converted to ___ or broken down for energy; ___ (increased/decreased) blood glucose; ___ of immune system
retention of sodium and water by kidneys; increased blood volume and BP; proteins/fats converted to glucose or broken down for energy; increased blood glucose; suppression of immune system
Cushing’s syndrome–caused by excessive ___ secretion
cortisol
Cushing’s syndrome causes can be ___ dependent or ___ dependent
ACTH dependent or non-ACTH dependent
Causes of Cushing’s syndrome–ACTH secreting ectopic tumor (most often located in the ___ as ___); overactive hypothalamic secretion of ___; primary glucocorticoid secreting ___ tumor
- ACTH secreting ectopic tumor (most often located in the lung as SCC)
- overactive hypothalamic secretion of corticotropin-releasing hormone
- primary glucocorticoid secreting adrenal tumor
