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Abd / SS > Module 10 : Adrenal Glands > Flashcards

Module 10 : Adrenal Glands Flashcards

1
Q

two parts of adrenal gland

A

cortex and medulla

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2
Q

cortex develops from what in embryo

A
  • mesoderm
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3
Q

medullar develops from what in embryo

A
  • neural crest cells

neuroectoderm

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4
Q

adrenal cortex

A
  • cortex develops first
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5
Q

cortex at 6th week gestation

A
  • proliferation of the mesoderm from the posterior abdominal wall
  • penetrates the retroperitoneum and becomes primitive adrenal cortex
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6
Q

adrenal cortex at 8th week gestation

A
  • separates from the posterior peritoneal surface and is surrounded by retroperitoneal connective tissue
  • becomes capsule
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7
Q

adrenal cortex at 3 years of age

A
  • permanent adrenal cortex differentiates into 3 zones
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8
Q

3 zones of the adrenal cortex

A
  • glomerulosa
  • fasciculata
  • reticualaris
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9
Q

adrenal medulla at 7 weeks gestation

A
  • neural crest cells migrate and invade in the medial side of the cortex
  • these cells differentiate into chromaffian cells of adrenal medulla
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10
Q

anatomy of adrenals

A
  • paired organs
  • retroperionteal
  • SUPRARENAL GLANDS
  • anterior medial and superior to kidneys
  • surrounded by perinephric fat and gerotas fascia
  • have a capsule
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11
Q

adrenal size - adults

A
  • length 4-6cm
  • width 2-3cm
  • AP 0.3 - 0.6 cm
  • 1/13 the kidney size
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12
Q

adrenal size - newborns

A
  • proportionately larger compared to kidner

- 1/3 kidney size

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13
Q

adrenal shape

A
  • pyramid
  • semi lunar
  • V Y or Z configuration
  • left larger than right
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14
Q

right adrenal relationships

A
  • posterior and lateral to IVC
  • superior to right kidney
  • posterior to left lower of liver
  • medial to right lobe of liver
  • lateral to crus of diaphragm
  • posterior to duodenum
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15
Q

left adrenal relationships

A
  • superomedial to left kidney
  • posterior to stomach
  • posterior to lesser sac
  • lateral to crus of diaphragm
  • inferior portion posterior to panc tail and splenic vessels
  • posterolateral to aorta
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16
Q

blood supply

A
  • vascular organ
  • 3 arteries
    + superior suprarenal artery from inferior phrenic arteries
    + middle suprarenal artery off aorta
    + inferior suprarenal artery off renal artery
  • venous drainage
    + suprarenal vein
    = right (short) drains into IVC , left (longer) drains into left renal vein
17
Q

physiology of adrenal

A
  • double endocrine gland
    + 2 glands wrapped in one
  • maintains homeostasis through hormone secretion
18
Q

cortex - physiology

A
  • thicker outer layer
  • 90% of gland
  • secretes steroid hormones
  • essential for life (need at least one)
  • release controlled by negative feedback system
19
Q

steroid hormones

A
  • mineral corticoids
  • glucocorticoids
  • gonadal hormones
20
Q

negative feed back to cortex

A
  • low levels of cortical hormones cause hypothalamus to secrete ACTHRF (adrenocorticotropic hormone releasing factor)
  • this causes anterior pituitary to release ACTH (adrenocorticotropic hormone)
  • this cases adrenal to produce hormones
21
Q

zona glomerulosa

A
  • outer layer
  • secretes mineralocorticoids
    + aldosterone
    = increases sodium and water reabsorption to increase blood volume and pressure
22
Q

sona fasciculata

A
  • middle layer
  • secretes glucocorticoids
    + cortisone and hydrocortisone
    = fat, protein, and carb metabolism
    = suppresses immune respire
    = resist mental and physical stress
23
Q

zona reticularis

A
  • inner zone
  • secretes sex hormones
    + estrogens and androgens
24
Q

medulla physiology

A
  • central portion
  • sympathetic nervous system
  • responsible for fight or flight
  • secretes catecholamines
25
Q

catecholamines

A
  • epinephrine = adrenalin

- norepinephrine

26
Q

body response to epinephrin

A
  • increased heart rate
  • constricting vessels incrasign blood pressure
  • increased breathingrate
  • dilation of respiratory passage
  • dicreased digestion more blood to muscles
  • increase blood sugar for energy
27
Q

lab tests for adrenals - blood

A
  • assess cortical function
28
Q

lab tests for adrenals - urine

A
  • assess medullary function
29
Q

ultrasound of adrenals

A
  • overnight fast
  • visualization depends on
    + age, size, perirenal fat, bowel gas
30
Q

adults adrenal ultrasounds

A
  • rarely seen
  • just see area to rule out phathology
  • homogeneous hypoechoic
31
Q

newborns adrenal ultrasound

A
  • easily identified
  • thin echogenic core
  • less echogenic rim
32
Q

right adrenal windows

A
  • intercostal using liver

- supine or LLD position

33
Q

left adrenal windows

A
  • decubitus or right anterior oblique
  • intercostal use spleen or left kidney as window
  • in LPO use liver and great vessels as window

Abd / SS (14 decks)

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