Suprarenal Glands - 2/9 Cole

Question 1

Where embryological origin is the medulla from?

Develops from what?

Answer 1

Ectoderm all

Neural crest
MEN

Question 2

What do accessory adrenocortical nodules develop from?

Answer 2

Partly/completely detached rests of the coelom if epithelial primordia

Question 3

What does the definitive cortex develop into?

With what?

Answer 3

Functional adrenal cortex

Zonae glomerulosa and fasciculata present at birth

Question 4

When does the Zona reticularis develop?

Answer 4

1st year of life

Question 5

When do the cortical and medullary elements appear?

Answer 5

5-6 weeks of fetal growth

Question 6

What is the fetoplacental unit?

Answer 6

Interaction between the fetal adrenal cortex and placenta

Question 7

What is the source of glucocorticoids?

Answer 7

Maternal

Placental progesterone by the fetus

Question 8

What are glucocorticoids needed for?

Answer 8

Production of surfactant by type II alveolar cells after 8th month
Development of fx HPA axis
Induction of thymic involution

Question 9

What does the adrenal cortex produce?

Medulla?

Answer 9

Steroid hormones

Catecholamines

Question 10

Describe the organization of the adrenal cortex

Answer 10

Outermost is ZG

Middle is ZF

Inner is ZR

GFR, GO

Question 11

What does the zona glomerulosa make?

In response to what?

Answer 11

Mineralcorticods, mainly aldosterone

Ag II and ACTH

Question 12

What enzyme does the ZG lack?

Meaning it can’t make what?

Answer 12

17alpha-hydroxylase (CYP17)

Sex steroids or cortisol

Question 13

What does the ZF secrete?

What does it contain?

Answer 13

Glucocorticoids and androgens

Lipid droplets containing cholesterol, spongiocytes

Question 14

What does the ZF and ZR have?

What can they make?

Answer 14

17alpha-hydroxylase

Glucocorticoids (Cortisol) and sex hormones

Question 15

Where is cortisol stored?

What stimulates it?

How/where is it converted?

Function?

Answer 15

Not stored in cells, newly synthesized

ACTH

In hepatocytes to cortisone

Anti-inflammatory and anti-allergy

Question 16

What are the 2 major effects of cortisol?

Answer 16

Metabolic -> stimulates gluconeogensis

Anti-inflammatory -> suppress tissue response to injury and Dec cellular humoral immunity

Question 17

What stimulates the ZF and ZR?

Answer 17

ACTH

Question 18

What does the ZR primarily secrete?

What can it also secrete?

Answer 18

Androgens

Glucocorticoids

Question 19

What are the predominant androgens produced by the cortex of the adrenal gland?

Answer 19

DHEA and androstenedione

Question 20

What can DHEA and androstenedione be converted to?

Answer 20

Testosterone and estrogen in peripheral tissues

Question 21

What are chromaffin Cells regarded as?

Derived from what?

Secretory granules of what?

Answer 21

Modified sympathetic postganglionic neurons w/out postganglionic axons

Neural crest

Epi and NE

Question 22

What innervates the adrenal medulla?

Answer 22

Sympathetic Preganglionic fibers that release ACh

Question 23

How are catecholamines secreted?

In response to what?

What kind of response are they?

Answer 23

Into the blood

Stress

Sympathetic response

Question 24

Blood supply to the adrenal glands is supplied via what?

Answer 24

Super adrenal - from inf phrenic a.
Middle - from aorta
Inferior - from renal a.

Question 25

What do the adrenal arteries form?

Answer 25

Arterial plexus

Question 26

What are the branches from the arterial plexus?

Answer 26

Capsule (subcapsular plexus) Short cortical a. Long cortical a.

Question 27

The medulla has a direct blood supply via what? Additional blood supply?

Answer 27

Long cortical a. Sinusoids from the cortex

Question 28

What is primary hyperaldoesteronism?

Answer 28

Conn's syndrome, aldosterone secreting tumor in ZG

Question 29

What is secondary hyperaldoesteronism?

Answer 29

INC in renin secretion

Question 30

What is Cushing's disease?

Answer 30

ACTH producing tumors of anterior pituitary Causes INC in aldosterone, cortisol and androgen

Question 31

What is Cushing's syndrome?

Answer 31

Tumor of adrenal cortex results in overproduction of cortisol, androgen, aldosterone

Question 32

What are the endogenous causes of Cushing's syndrome? Exogenous?

Answer 32

``` Pituitary tumor (Cushing's disease) Adrenal tumor ``` Taking glucocorticoid containing meds (hydrocortisone)

Question 33

What are the classic Sx of Cushing's syndrome?

Answer 33

Moon face, buffalo hump, obesity

Question 34

What is Addison's disease? What is decreased, what is increased?

Answer 34

Chronic destruction of the adrenal cortex by autoimmune process or Tb Cortisol low, ACTH becomes high

Question 35

Sx of Addison's disease?

Answer 35

Inc in skin pigmentation in skin folds and gums Hypotension and circulatory shock Muscle weakness

Question 36

What is a pheochromacytoma? What is secreted? Sx?

Answer 36

Benign tumor of the chromaffin cells Epi and NE Hyperactive Symp NS, INC BP, anxiety, INC HR -> hypertension and cardiac arrhythmias

Question 37

Where embryological origin is the cortex from? Develops from what?

Answer 37

Mesoderm Celomic epithelium of posterior abdominal wall CMC