Suprarenal Gland histology

Question 1

What is the embryonic origin of he cortex of the adrenal gland?

Answer 1

mesodermal in origin; develops from the celomic epithelium of the posterior abdominal wall

Question 2

What is the embryonic origin of the medulla of the adrenal gland?

Answer 2

Ectodermal in origin; develops from the neural crest cells.

Question 3

By what week of embryonic development have the cortical elements have differentiated into a thin outer definitive cortex and a thick inner fetal cortex.

Answer 3

Week 8

Question 4

Does the fetus produce steroids during gestation?

Answer 4

Yes.

Question 5

HOw does the fetal adrena cortex change after birth?

Answer 5

It involutes rapidly after birth

Question 6

By birth, what two layers of the cortex is definitive?

Answer 6

ZOna glomerulosa, and fasciulata.

Question 7

By when does the zona reticularis fully devleop by?

Answer 7

First year of life.

Question 8

By what week are both the cortical and medullary elements appear?

Answer 8

Between 5-6 weeks

Question 9

Development of the adrenal medulla is in concert with the development of what other system?

Answer 9

sympathetic nervous system

Question 10

After the adrenal medulla elements develop, what is the path of their migration to go where it is normally.

Answer 10

The medulla is derived from neural crest, migrate forward to the para-aortic and paravertebral regions and along the adrenal vein toward the medial aspect of the developing adrenal fetal cortex.

Question 11

During early stage of gestation, the adrenal cortex synthesizes _ which is a precursor of the synthesis of estrogen by the placenta.

Answer 11

dehydroepiandrosterone (DHEA)

Question 12

A lack of synthesis of progesterone, glucocorticoids, and androstenedione is attributed to lack of what enzyme?

Answer 12

3beta-hydroxysteroid dehydrogenase (3B-HSD).

Question 13

What is the fetoplacental unit?

Answer 13

It’s the interaction between the fetal adrenal cortex and the placenta.

Question 14

A mutation in the gene for 3B-HSD type II leads to this uncommon congenital disorder.

Answer 14

3beta-hydroxyteroid dehydrogenase II deficiency congential adrenal hyperplasia (3B-HSD CAH)

Question 15

How do infants with milder form of 3B-HSD type II present?

Answer 15

Female = virilization 
Male = undervirilization

Question 16

Which type of congenital adrenal hyperplasia can cause ambiguous genitalia in both sexes?

Answer 16

3B-HSD CAH type II

Question 17

Glucocorticoids, either from the mother, or synthesized from placental progesterone by the fetus are absolutely essential for what three developmental events?

Answer 17

1. The production of surfactant by type II alvoelar cells after 8th month
2. Development of functional hypothalamopituitary axis
3. induction of the thymic involution

Question 18

Which adrenal cortex hormones is the zona glomerulosa NOT able to produce.

Answer 18

cortisol or sex steroids because zona glomerulosa lacks 17a-hydroxylase (CYP17).

Question 19

Which layer of the adrenal cortex makes up the majority of the cortex

Answer 19

Zona Fasiculata (75%).

Question 20

In what layer of the adrenal cortex are you llikely to find spongiocytes?

Answer 20

Zona Fasciculata

Question 21

Cortisol can be converted to cotisone in what cell types?

Answer 21

Hepatocytes

Question 22

What are the two main general function of cortisol?

Answer 22

1. metabolic effects: stimulates gluconeogenesis to increase the concentration of glucose in blood
2. An anti-inflammatory effect: supresses tissue responses to injury and decreases cellular and humoral immunity

Question 23

True or False, both the Zona fasiculata and reticularis contain ACTH receptors

Answer 23

True

Question 24

Which two androgens are the predominantly produced in Zona reticularis?

Answer 24

DHEA and androstenedione.

Question 25

Adrenal gland is the major source of androgens for women; what do they do in woman?

Answer 25

stimulates the growth of pubic and axillary hair during puberty

Question 26

Where are chromaffin cells found?

Answer 26

Adrenal medulla

Question 27

What cell types are regarded as the modifie sympathetic postganglionic neurons without postganglionic axons?

Answer 27

Chromaffin cells

Question 28

Why are chromaffin cells regarded as modified sympathetic post ganglion neurons without postganglion axons?

Answer 28

They are derived from neural crest cells and during embyonic development they lost their axons and dendrites.

Question 29

What innervates the adrenal medulla?

Answer 29

sympathetic preganglionic fibers that release Ach

Question 30

Explain the blood supply to the adrenal gland.

Answer 30

Superior, middle and inferior adrenal arteries enter the cortex capsule and form arterial plexus and give rise to three sets of branches: 1. subcapsular (suppies the capsule), 2. short cortical enters cortex forming straight fenestrated capillariessinusoids, percolating between the zona glomerulosa nd fasciulata and forming a capillary network int he zona reticularis
3. Long cortical aa - medullary arteries which travel without branching and supply the medulla

Question 31

What is conn’s syndrome and where is found?

Answer 31

aka. Primary aldosteronism. Its caused by a tumor in zona glomerusa and cause excessive release of aldosterone

Question 32

What is secondary hyperaldosteronism caused by?

Answer 32

increase in renin secretion

Question 33

In Cushing’s disease, what layers of the adrenal cortex does it mainly affect?

Answer 33

Zona Fasiculata

Question 34

Why is ACTH levels elevated in Addison’s disease?

Answer 34

Addisons disease is the chronic destruction of the adrenal cortex by an autoimmune process or tuberculosis, and so there is a lack of cortisol in the body. This feeds back to the hypothalamus to secreted more ACTH

Question 35

A pt appears with fatigue, malaise, muscle weakness, anorexia, postural dizziness, syncope and GI symptoms like nausea, vomiting, abd pain, diarrhea, and constipation. Pt also notes decreased libido, and amenorrhea, and changes in her skin color. Upon examaining you also notice the pt is hypotensive, has thinning of axillary and pubic hair and pt shows signs of vitiligo. What is the likely diagnosis?

Answer 35

Addison’s disease

Question 36

What causes pheochromocytoma?

Answer 36

Benign tumor of the chromaffin cells

Question 37

What is released in excess in pheochromocytoma?

Answer 37

Epi and Nor-Epi

Question 38

What are the signs and symptoms of pheochromocytoma

Answer 38

They resemble signs and symptoms of sympathetic nervous system like elevated HR, BP, palpitation, diaphoresis, axniety, HA, nausea, and pallor. It can also preciptate life-threatening hypertensionor cardiac arrhthmias.