The Adrenal Gland Flashcards

1
Q

how many arteries does the right adrenal gland have? how many veins does it have?

A

57 1 adrenal vein

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2
Q

Where in the right adrenal gland does the right adrenal vein exit?

A

central of the adrenal gland on the left hand side (towards the middle)

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3
Q

where does the right adrenal vein drain into directly?

A

inferior vena cava

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4
Q

where does the left adrenal vein drain into?

A

renal vein

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5
Q

where in the left adrenal gland does the left adrenal vein exit?

A

right at the bottom (inferior section)

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6
Q

draw the anatomy of the circulatory system of adrenal glands.

A
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7
Q

which part of the adrenal gland secrets corticosteroids (eg. cortisol)?

A

adrenal cortex

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8
Q

what are the three parts of the adrenal cortex? Name from outside to inside.

A

zona glomerulosa

zona fascisculata

zona reticularis

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9
Q

what does the adrenal medulla secrete?

A

catecholamines (eg. adrenaline)

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10
Q

what does the zona glomerulosa (outer zone of adrenal gland) make?

A

aldosterone

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11
Q

give 2 examples of catecholamines

A

adrenaline and noradrenaline

[plus dopamine]

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12
Q

give three examples of corticosteroids

A

mineralocorticoids (aldosterone)

glucocorticoids (cortisol)

sex steroids (androgen, eostrogen)

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13
Q

draw a cross section of the adrenal gland

A
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14
Q

what is the precursor to all steroid hormones?

A

cholesterol

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15
Q

what is a steroid?

A

any molecule that comes from cholesterol

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16
Q

is adrenaline a steroid? why?

A

no because it does not come from cholesterol

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17
Q

name the enzymes used and intermediates formed during the conversion of cholesterol to aldosterone

A
  • cleave sidechain
  • form pregnenolone
  • 3 beta hydroxy steroid dehydrogenase
  • oxidise(form ketone group) and form progesterone
  • 21 hydroxylase (add hydroxyl group)
  • 11 deoxycorticosterone
  • 11 hydroxylase (add hydroxyl group)
  • corticosterone
  • 18 hydroxylase (add hydroxyl group)
  • aldosterone
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18
Q

name the enzymes used and intermediates formed during the conversion of cholesterol to cortisol

A
  • cleave sidechain
  • form pregnenolone
  • 3 beta hydroxy steroid dehydrogenase
  • oxidise(form ketone group) and form progesterone
  • 17 hydroxylase
  • form 17-hydroxyprogesterone
  • 21 hydroxylase
  • form 11 deoxy-cortisol
  • 11 hydroxylase
  • CORTISOL
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19
Q

What does aldosterone do?

A

controls blood pressure

20
Q

draw synthesis pathways (from cholesterol) of aldosterone, cortisol and sex hormones

A
21
Q

which cation drives blood pressure?

A

sodium

22
Q

what does aldosterone do to increase blood pressure?

A
  • stimulates Na+ reabsorption in distal convoluted tubule and cortical collecting duct in kidney (and in sweat glands, gastric glands, colon)
  • it does this by turning on the synthesis of proteins that make sodium pumps on collecting duct side and sodium-potassium pumps on the blood vessel side
  • stimulates K+ and H+ secretion
  • increased sodium reabsorption leads to water reabsorption, raising blood volume
23
Q

how is aldosterone regulated?

A
  • renin is secreted from the juxtaglomerular kidney cells when a fall in blood pressure is detected. High pressure suppresses renin.
24
Q

what 3 things stimulate renin?

A
  1. decreased renal perfusion pressure
  2. increased renal sympathetic activity
  3. decreased Na+ load to top of loop of henle (macula densa cells)
25
Q

what does renin do?

A

converts angiotensinogen to angiotensin I

26
Q

Which enzyme converts angiotensin I to angiotensin II in the circulation

A

angiotensin converting enzyme (ACE)

27
Q

what effects does angiotensin 2 have on tha adrenals?

A

stimulates enzymes:

  • side chain cleavage
  • 3 hydroxysteroid dehydrogenase
  • 21 hydroxylase
  • 11 hydroxylase
  • 18 hydroxylase

in the adrenal gland, forming aldosterone

28
Q

summarise what aldosterone does

A

controls blood pressure, sodium and lowers potassium

29
Q

how is cortisol secretion regulated?

A

Adrenocorticotropic hormone (ACTH)

30
Q

what are the metabolic effects of cortisol?

A

peripheral protein catabolism

hepatic gluconeogenesis

increased blood glucose concentration

fat metabolism (lipolysis in adipose tissue)

enhanced effects of glucagon and catecholamines

31
Q

draw the hypothalamo pituitary adrenal system

A
32
Q

what causes primary adrenal failure?

A

Addison’s disease

  • autoimmune disease where immune system destroys adrenal cortex
  • tuberculosis of adrenal glands
33
Q

why do patients with Addison’s disease tan so well?

A

pro-opio-melanocortin(POMC) is a large precursor protein

–>

cleaved to form smaller peptides inc. ACTH, MSH (melanocyte stimulating hormone), endorphins

ie. whenever you make ACTH, you also make MSH

if you have adrenal failure, and no cortisol, you make more ACTH and therefore more MSH which goes to you skin, stimulating melanin.

34
Q

what effects does addison’s disease have?

A
  • cortisol deficiency
  • aldosterone deficiency
  • salt loss
  • low blood pressure
  • eventual death
35
Q

what treatment is given to someone with Addison’s disease

A
  • rehydrate w/ saline
  • dextrose: prevents hypoglycaemia (could be due to glucocorticoid deficiency)
  • give hydrocorticisone (or other corticoid)
36
Q

what happens if you have too much cortisol?

A

Cushing’s syndrome:

metabolism changes and you put on weight

37
Q

what causes Cushing’s syndrome?

A
  • tumour of adrenal (adrenal adenoma or carcinoma) - too much cortisol
  • tumour of pituitary (pituitary adenoma) - too much ACTH
  • ectopic ACTH (lung cancer)
  • taking steroids eg. cortisol, glucocorticoids, by mouth (common)
38
Q

What are the clinical signs of Cushing’s Syndrome?

A
  • thin skin
  • proximal myopathy
  • centripetal obesity (lemon on sticks)
  • diabetes, hypertension and osteporosis
  • Immunosuppression (reactivation of TB)
  • Moon face
  • Striae (stretch marks)
39
Q

what is the precursor for adrenaline and noradrenaline synthesis?

A

tyrosine

40
Q

where are catchetolamines stored? When are they released?

A
  • cytoplasmic granules
  • released in response to ACh from preganglionic sympathetic neurones
41
Q

where in the medulla are catchetolamines derived from?

A

ectodermal neural crest

42
Q

how is adrenaline made from tyrosine?

A
  • tyrosine hydroxylated to form dopamine
  • dopamine hydroxylysed further to noradrenaline
  • Noradrenaline methylated to form adrenaline
43
Q
A
44
Q

which protein are noradrenaline and adrenalin bound to in the bloodstream?

A

albumin

45
Q

which two enzymes break down and removed adrenaline?

A
  • monoamine oxidase
  • catchetol-O-methyl transferase