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physiology :( y2s1 > physiology of adrenal gland > Flashcards

physiology of adrenal gland Flashcards

1
Q

what is the hormone released by zona glomerulosa?

A

aldosterone

Z.G will be 15% of the adrenal cortex

regulated by ANG 2 and potassium level

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2
Q

what is the hormones released by zona fasiculata ?

A

cortisol MAINLY
small amount of estrogen and adrenal androgens

Z.F represents 75% of the adrenal cortex

regulated by ACTH

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3
Q

what are the hormones released by zona reticularis?

A

adrenal androgens
DHEA
Androstenedione
small amount of estrogen and glucocorticoids

Regulated by ACTH

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4
Q

describe the characteristics of aldosterone?

A

primary mineralocorticoid

90% of mineral corticoid activity

essential for survival

40% of it is in the FREE form

60% of it is in BOUND form

short half life 20 minutes

share the same synthetic pathway as cortisol

HAS SOME CORTISOL ACTIVITY AND VICE VERSA

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5
Q

what are the 2 main stimulus of aldosterone ?

A

Renin –> angiotensin 2

High K +

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6
Q

what are stimulus that would lead to increased secretion of renin?

A

sympathetic activity

decreased sodium in tubular fluid

decreased blood pressure

decreased blood flow to the kidney

all of these would lead to increased renin and ang 2 = increased aldosterone

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7
Q

describe how does ang 2 promotes aldosterone release?

A

G protein coupled receptor –> Phospholipase C pathway —> hydrolysis of PIP2 –> IP3 and 1,2 diacylglycerol —> INCREASED CALCIUM CONCENTRATION —-> Aldosterone secretion

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8
Q

what are the minor stimulus of Aldosterone release?

A

increased sodium

slight decrease in aldosterone

ACTH

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9
Q

why is it rare and very hard for someone to develop high sodium level in blood?

A

cuz of ADH hormone , it leads to water retention and increased fluid this will decrease the overall level of water and decrease the ratio of sodium to water

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10
Q

what is the function of aldosterone ?

A

increases Na absorption ( conserves Na )

increases K secretions ( wastes K in urine )

Increases proton ( H ) secretion but it is a minimum effect

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11
Q

what happens when you have excess aldosterone ?

A

Increased ECF volume and arterial pressure

hypokalemia

muscle weakness

metabolic alkalosis

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12
Q

what happens when you have Aldosterone deficiency ?

A

Low blood volume

circulatory shock

hyperkalemia

cardiac toxicity ,arrhythmia

heart failure

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13
Q

what is the MOA of aldosterone that leads to increased Sodium retention?

A

Aldosterone enters the cell and bind to its receptor forming complex then it enters the nucleus and then it increases the transcription of certain proteins that will do its function

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14
Q

what is the basal side ?

A

the side towards the blood

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15
Q

what is the laminar side?

A

the side towards tubular lumen

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16
Q

what are the channels that are found on the laminar membrane ?

A

epithelium sodium channels

potassium channel

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17
Q

what is the channel found on the basal side?

A

sodium potassium pump

3 Na out , 2 K in

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18
Q

describe the usage of these channels by aldosterone to produce its sodium retention effect?

A

1- Laminal side : The sodium channels will BE STIMULATED BY ALDOSTERONE to take SODIUM FROM THE TUBLUES and take them inside the cell

2- Basal side Aldosterone will stimulate the sodium/potassium pump to PUMP THE SODIUM outside the cell to the blood

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19
Q

describe the same thing but for potassium ?

A

1- Basal side : stimulated Na/K pump will be moving K to the inside of the cell

2- Laminal side :stimulated potassium channels will take the potassium out to the tubular lumen –> Excreted

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20
Q

what is aldosterone effect?

A

we have excessive aldosterone and excessive sodium absorption yet no hypernatremia

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21
Q

what are the 3 ways that aldosterone escape happens?

A

1- When sodium is reabsorbed it will bring water with it so this will increase the volume ratio compared to sodium

2- high amount of sodium in the blood due to aldosterone will effect the osmoreceptor leading to thirst and water drinking = high volume ratio compared to sodium

3-Adh will be secreted when theres high Sodium = increased volume = increased volume ratio

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22
Q

What are androgens?

A

dehydroepiandrosterone (DHEA )

androstenedione

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23
Q

what happens to androgens?

A

converted to either testosterone and estrogen in peripheral tissues

though the amount synthesized in adrenal is small compared to gonads is small

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24
Q

compare the activity of gonads androgen and adrenal androgens?

A

Testosterone from testes is the most active androgen

the have adrenal androgen have less than 20% of the adrenal androgens

25
what regulates the androgens?
ACTH regulates the secretion of adrenal androgens
26
what are the glucocorticoids ?
Cortisol ( hydrocortisone ) corticosterone
27
what is the most significant one in regard to activity ?
cortisol is the most active 95% of the whole g.c activity corticosterone 4% of g.c activity
28
what does cortisol bind to in blood?
cortisol binding globulin --> transcortin albumin
29
what is the % of bound cortisol in the blood?
90% to 95% of cortisol in the blood is in the bound form very long half life ( 60-90 minutes )
30
what is the function of bound hormones?
serve as a reservoir whenever the level of the hormone drops the bound one will get released to try and elevate the lvl back up again also increases the half of the hormone
31
what is the relation between mineralocorticoids and glucocorticoids ?
m.c triggers slight g.c activity and g.c triggers slight m.c activity both have activity of the other one but to lesser extent
32
what are the factors that lead to the release of glucocorticoids ?
circadian rhythm ( day and night ) stress they will stimulate CRH from hypothalamus CRH will stimulate ACTH from ant pituitary ACTH will stimulate cortisol
33
what are the effects of glucocorticoids on proteins?
catabolism of proteins and destruction EXCEPT IN LIVER it causes anabolism in liver
34
what is the effect of cortisol on glucose ?
increase glucose level gluconeogenesis inhibit uptake of glucose in tissue leaving it for brain and heart mainly
35
what is the effect of cortisol on fat?
lipolysis followed by lipogenesis it breaks down fat in the limbs and move it to the trunk and face and the back of the neck
36
what is the effect of cortisol on the immune system?
inhibit the immune system by breaking down proteins used by immune system like antibodies, cytokines , etc VERY strong anti inflammatory
37
what would short term stress lead to ?
release of catecholamines
38
what would long term stress lead to?
release of ACTH release of cortisol release of mineralocorticoids
39
what is effect of cortisol in inflammation ?
anti inflammatory and immuno suppressive effects blocks early stages of inflammation process if inflammation has already begun causes rapid results of the inflammation and increase rapidity of healing
40
how will cortisol achieve its anti inflammatory effects?
stabilization of lysosomes --> proteolytic enzymes wont be released decreased permeability of capillaries decreased migration of WBCs and phagocytosis of inflamed cells decreased production of T lymphocytes and antibodies Reduces fever by decreasing the release of IL-1
41
what are the anti allergic effect of cortisol ?
blocks inflammatory response to allergic reaction basic allergic reaction not affected Can be life saving Decreases number of eosinophils , basophils, lymphocytes increase RBCs -----> in cause of deficiency it will lead to anemia large doses of cortisol --atrophy of lymphoid tissues -- decreased production of T cells antibodies -- Decreased immunity
42
what are the regulators of cortisol release?
ACTH --> main regulator ACTH is regulated CRF Cortisol has negative feedback inhbibiton CRF has diurnal rhythm --> highest during the early morning Lowest : near midnight Catechaolamines --> Stimulate CRF and ACTH During stress : very high quantities of CRF and ACTH are released
43
what is the key important stimulus for cortisol ?
hypothalamus by different types of stress
44
what is circadian rhythm?
Glucocorticoid secretion pattern : rate of secretion CRF, ACTH and cortisol high are in early morning and low at late evening
45
what are the diseases of increased adrenal cortex production ?
increased aldosterone ---> primary aldosteronism increased adrenal androgens ----> congenital adrenal hyperplasia increased cortisol ---> cushing syndrome
46
what are disorders associated with decreased adrenal gland ?
Decreased cortisol and aldosterone ---> addison disease
47
What is pheochromocytoma tumor?
tumor that lead to increased catecholamine
48
what are the causes of adrenal insufficiency ?
Atrophy of adrenal cortex autoimmune disorders ( 80% of the patient , AIRE GENE MUTATION ) tuberculosis cancer Secondary : insufficient quantities of ACTH
49
why do we have pigmentation in cases of primary addison disease?
cuz ACTH is associated with MSH melanocyte stimulating hormone
50
how do you stop death due to aldosterone insufficiency ?
extensive salt therapy m.c injections --> aldosterone injections
51
what happens if you keep aldosterone deficiency?
hyperkalemia ( high K ) hyponatremia ( low Na ) Decrease Cl lvl Extra cellular fluid and blood volume drops cuz no water retention Low CO cuz no volume ---> circulatory shock = death hyperkalemia ---> cardiac toxicity ---> weak contractions , arrhythmia, heart failure
52
what happens in cortisol deficiency?
inability to handle stress hypoglycemia fatigue and weakness hypotension decreased appetite and weight loss anemia --> decrease RBC production and inhibit it hyperpigmentation due to excess ACTH secretion GI discomfort , nausea, vomiting Cortisol increases what is already high and inhibit what it is already low
53
what are the causes of cushing syndrome?
it is marked by increased cortisol and to lesser extent androgens Adenoma of anterior pituitary -- Increased ACTH secretion , adrenal hyperplasia , increased cortisol secretion Increased CRH from hypothalamus ----> increased ACTH Ectopic secretion of ACTH from tumor elsewhere adenoma of the adrenal cortex
54
what are the characteristics of cushing syndrome ?
buffalo like torso ---> fat deposition moon face --> fat deposition in face acne and hirsutism due to increased androgenic effect muscle weakness and wasting --> hypokalemia due to aldosterone effect slender extremities hypertension menstrual irregularities purple stria on abdomen --> due to decreased cartilage of B.V = bleeding osteoporosis ---> it decreases Ca lvl so PTH will be secreted to counter this and cause bone resorption glucose intolerance poor wound healing Easy bruising
55
why doesnt plasma protein decrease even though theres protein catabolism?
cuz it increases protein anabolism in liver which is responsible for making plasma proteins
56
what are some causes of conns syndrome ( primary aldosteronism )
small tumor of zona glomerulosa --> large amount of aldosterone secreted
57
what are the characteristics of conns syndrome ?
hypokalemia mild metabolic alkalosis -- due to H secretion ( H is lost ) Slight increase in extracellular fluid volume and blood volume Modest increase in plasma sodium concentration ( not severe due to aldosterone escape ) Hypertension due to increased volume retention occasional periods of muscle paralysis due to hypokalemia Decreased plasma renin concentration ( cuz soo much aldosterone already exist )
58
what is the treatment of conns syndrome ?
surgical removal of tumor

physiology :( y2s1 (15 decks)

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