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Endocrine Physiology > The Adrenal Gland > Flashcards

The Adrenal Gland Flashcards

1
Q

What kind of hormone is cortisol?

A

Glucocorticoid hormone

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2
Q

What does a glucocorticoid hormone do?

A

Influences glucose metabolism

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3
Q

Binding of plasma cortisol

A

95% is bound to carrier protein - cortisol binding globulin (CBG)

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4
Q

What cells have cytoplasmic glucocorticoid receptors?

A

All nucleated cells

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5
Q

What kind of hormone is aldosterone?

A

Mineralcorticoid

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6
Q

Function of increased aldosterone

A

Increases reabsorption of Na+ ions and therefore H20 retention
Promotes the secretion of K+
Resulting in increased blood volume and increased BP

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7
Q

Function of a mineralocorticoid hormone

A

Acts on distal tubule of the kidney to determine the levels of minerals reabsorbed/excreted

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8
Q

Where is aldosterone secreted from?

A

Adrenal cortex

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9
Q

What is the secretion of aldosterone from the adrenal cortex primarily controlled by?

A

Renin-angiotensin-aldosterone (RAAS) system

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10
Q

Function of decreased aldosterone

A

Leads to Na+ (and H20) loss and increased [K+] plasma

Resulting in diminished blood volume and decreased BP

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11
Q

Where are the adrenal glands found?

A

Superior pole of the kidney

Retroperitoneal space

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12
Q

Where does the left adrenal vein drain into?

A

Left renal vein

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13
Q

Where does the right adrenal vein drain into?

A

IVC

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14
Q

What is found on the outside and the inside of the adrenal gland?

A

Outside - cortex

Inside - Medulla

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15
Q

How much of the adrenal gland is the medulla?

A

25%

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16
Q

How much of the adrenal gland is the cortex?

A

75%

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17
Q

Tissue of adrenal medulla

A

Modified sympathetic ganglion derived from neural crest tissue

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18
Q

Tissue of adrenal cortex

A

True endocrine derived from mesoderm

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19
Q

What type of hormones does the adrenal medulla secrete?

A

Catecholamines

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20
Q

What are the main catecholamines that the adrenal medulla secretes?

A

Epinephrine / Adrenaline
Norepinephrine
Dopamine

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21
Q

What 3 classes of steroid hormones does the adrenal cortex secrete and give an example of each?

A

Mineralcorticoids e.g. aldosterone
Glucocorticoids e.g. cortisol
Sex steroids e.g. testosterone

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22
Q

What two hormones produced by the adrenal gland are ESSENTIAL for survival?

A

Aldosterone

Cortisol

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23
Q

3 zones of the cortex

A

Zona reticularis
Zona fasciculata
Zona glomerulosa

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24
Q

What does the zona reticularis secrete?

A

Sex hormones

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25
Q

What does the zona fasciulata secrete?

A

Glucocorticoids

26
Q

What does the zona glomerulosa secrete?

A

Aldosterone

27
Q

Is the adrenal medulla true endocrine tissue?

A

No

28
Q

Features of post ganglionic fibres in the adrenal medulla

A

Do not have axons

Instead release their neurohormones (Adrenaline) directly into the blood

29
Q

How are different steroid hormones found in different zones of the adrenal cortex?

A

Different enzymes are found in different adrenal zones

30
Q

What is the pre-hormone of testosterone and oestrogen called?

A

DHEA

31
Q

What does DHEA decline with?

A

Age

32
Q

What does ACTH stand for?

A

Adrenocorticotrophic hormone

33
Q

What stimulates ACTH to be released from the anterior pituitary?

A

Corticotrophin releasing hormone (CRH)

34
Q

What is used for negative feedback in the hypothalamic pituitary adrenal pathway?

A

ACTH on CRH

35
Q

What is found in the pattern of cortisol release?

A

A marked circadian rhythm

36
Q

What is the circadian rhythm of release of cortisol preceded by?

A

A similar pattern of release of ACTH

37
Q

Half life in cortisol vs ACTH

A

Cortisol burst persists longer but half life is much longer

38
Q

Peak of cortisol release is when?

A

approx. 6-9am

39
Q

Nadir of cortisol release is when?

A

Midnight

40
Q

What does nadir mean?

A

Lowest level

41
Q

Other fluctuations of cortisol during the day are due to what?

A

Effects of other stimuli which are related to stress

42
Q

What does cortisol have a permissive action to?

A

Glucagon

43
Q

Actions of cortisol on glucose metabolism

A

Gluconeogenesis
Proteolysis in muscle
Lipolysis in adipose tissue
Decreases insulin sensitivity of muscles and adipose tissue

44
Q

Why would lipolysis be an glucocorticoid action of cortisol?

A

Because lipolysis in adipose tissue increases [FFA] in the plasma creating an alternative fuel supply that allows [BG] to be protected while also creating a substrate (glycerol) for gluconeogenesis

45
Q

Actions of cortisol which are non-glucocorticoid

A

Negative effect on Ca2+ balance (decrease absorption from gut, increases excretion at kidneys, increase bone resorption)
Impairment of mood (depression) and cognition
Permissive effects of norepinephrine (vasoconstrictive)
Suppression of immune system

46
Q

How does cortisol suppress the immune system?

A

Reduces the circulating lymphocyte count
Reduces antibody formation
Inhibits the inflammatory response

47
Q

Side effects of glucorticoid therapy

A

Increased severity and frequency of infection

Muscle wastage

48
Q

What is a pheochromocytoma?

A

Rare neuroendocrine tumour found in the adrenal medulla

49
Q

Pathology of pheochromocytoma

A

Results in excess catecholamines leading to increased HR -> increased CO and very increased BP
Diabetogenic

50
Q

Pathology of cushings disease/syndrome

A

Hypersecretion of cortisol

51
Q

Causes of cushings syndrome and what does this result in?

A

Tumour in the adrenal cortex

PRIMARY hypercortisolism

52
Q

Causes of cushings disease and what does this result in?

A

Tumour in the pituitary gland

SECONDARY hypercortisolism

53
Q

What is there an excess of in cushings disease?

A

ACTH

54
Q

What is Addison’s disease?

A

Hyposecretion of all adrenal steroid hormones due to the autoimmune destruction of the adrenal cortex

55
Q

What are CRH and ACTH release promoted by?

A

Stress

56
Q

What are CRH and ACTH aggravated by and what does this do to the hypothalamo-pituitary axis (HPA)?

A

Alcohol
Caffeine
Lack of sleep
“Disinhibits” the HPA

57
Q

Why is care required when withdrawing glucorticoid treatment?

A

Due to enhanced negative feedback effects of exogenous control

58
Q

Therapeutic cortisol effects on negative feedback

A

Enhances negative feedback on hypothalamus and pituitary, reducing release of CRH and ACTH

59
Q

What does loss of trophic action of ACTH on the adrenal gland cause?

A

Atrophy of the gland

60
Q

What type of hormone is aldosterone?

A

Mineralocorticoids

61
Q

What is another name for sex steroids?

A

Androgens

62
Q

What is noradrenaline also produced by?

A

Sympathetic chain

Endocrine Physiology (8 decks)

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