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DMST 254 ABD 1 > The Adrenal Glands > Flashcards

The Adrenal Glands Flashcards

1
Q

What does the adrenal glands comprise of? 2

A
  1. Cortex
  2. Medulla
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2
Q

What does the cortex develop from?

A

Mesoderm

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3
Q

What does the medulla develop from?

A

Develops from the neural crest cells

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4
Q

What is the development of the cortex of the adrenals during the 6th week of gestation? 2

A
  1. Proliferation of mesoderm from posterior abdominal wall
  2. Penetrates the retroperitoneum, becomes primitive adrenal cortex
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5
Q

What is the development of the cortex of the adrenals during the 8th week of gestation?

A

Separates from posterior peritoneal surface and is surrounded by connective tissue (capsule)

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6
Q

After birth, the development of the adrenals cortex do what?

A

The primitive cortex involutes and disappears by 1 year of age

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7
Q

At three years of age what happens to the cortex of the adrenals?

A

differentiates into three zones

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8
Q

What happens during the 7th week of development of the medulla? 2

A
  1. Neural cells migrate and invade the medial side of the cortex
  2. Cells differentiate into the chromaffin cells of the adrenal medulla
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9
Q

Where is the adrenals located?

A
  1. Retroperitoneal cavity
  2. Anterior, medial and superior to the kidneys
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10
Q

What are the adrenals surround by?

A

Perinephric fat and gerota’s fascia

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11
Q

What are some physical descriptions of the adrenals? 3

A
  1. Paired
  2. Capsular
  3. Fixed position
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12
Q

What is the size of the adrenals for adults?

A
  1. Length: 4-6 cm
  2. Width: 2-3 cm
  3. AP 3-6 cm
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13
Q

What is the size of the spleen in newborns?

A

proportionately larger, compared to kidneys, usually 1/3 of the size of the kidneys

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14
Q

What is the shape of the adrenals? 3

A
  1. Pyramidal
  2. Semilunar (Crescent)
  3. V,Y, or Z configuration
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15
Q

Which adrenal is usually bigger?

A

Left

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16
Q

What is the position of the right adrenal in relation to the IVC?

A

Posterior and lateral

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17
Q

What is the position of the right adrenal in relation to the Kidney?

A

Superior

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18
Q

What is the position of the right adrenal in relation to the Liver?

A

Posterior and medial

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19
Q

What is the position of the right adrenal in relation to the crus?

A

Lateral

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20
Q

What is the position of the right adrenal in relation to the duodenum?

A

Posterior

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21
Q

What is the position of the left adrenal in relation to the left kidney?

A

Superomedial

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22
Q

What is the position of the left adrenal in relation to the stomach and lesser sac?

A

Posterior

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23
Q

What is the position of the left adrenal in relation to the crus?

A

Lateral

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24
Q

What is the position of the left adrenal in relation tp the pancreas and splenic vessels?

A

Inferior portion posterior

25
Q

What is the position of the left adrenal in relation to the aorta?

A

Posterolateral

26
Q

The adrenal is what kind of organ?

A

Vascular organ

27
Q

What arteries supply the adrenals? 3

A
  1. Superior suprarenal arteries from inferior phrenic arteries
  2. Middle suprarenal artery off the aorta
  3. Inferior suprarenal artery off the renal artery
28
Q

What drains the adrenals?

A
  1. Right suprarenal vein drains into the IVC
  2. Left Suprarenal drains into LRV
29
Q

What is another name for the adrenals?

A

Suprarenal

30
Q

What is the structure of the adrenals? 2

A
  1. Double endocrine gland
  2. cortex and medulla
31
Q

What are the functions of the endocrine part of the adrenals?

A

Maintains homeostasis through hormone secretion

32
Q

What is cortex of the adrenals? How much of the gland does it take up?

A
  1. Thicker outer layer of the adrenals
  2. 90% of the gland
33
Q

What does the cortex of the adrenals secrete? 3

A

steroid hormones such as
1. Corticoids
2. Glucocorticoids
3. Gonadal hormones

34
Q

Is the adrenals essential to life?

35
Q

What is the release mechanism for the hormones of the adrenals?

A

Negative feedback system
ACTHRF»ACTH»adrenal hormones

36
Q

What are the three layers of the cortex?

A
  1. Zona glomerulosa (outer)
  2. Zona Fasciculata (middle)
  3. Zona reticularis (inner)
37
Q

What doers the zona glomerulosa do?

A
  1. Mineralocorticoids - aldosterone secretion
  2. increase aldosterone = sodium and water retention of the body
38
Q

What does the zona fasciculata do?

A
  1. Glococorticoids- cortisone, hydrocortisone secretion
  2. Metabolism, immune response suppression, helps resist mental and physical stress
39
Q

What does the zona reticularis do?

A

Sex hormones- androgens and estrogen secretion

40
Q

What portion of the adrenal is the medulla? What does it do? What does it secrete?

A
  1. Central portion
  2. Fight or Flight
  3. Secretes catecholamines (epinephrine/ norepeinephrine)
41
Q

What are 4 things that happen with fight or flight response?

A
  1. HR increases, constricting vessesls
  2. Increase respiration, dilation of respiratory passages
  3. Decreased digestion
  4. Increase blood sugar levels
42
Q

What are some lab tests for the adrenals? 4

A
  1. ACTH
  2. Aldosterone
  3. Cortisol
  4. Catecholamines
43
Q

What is ACTH released by?

A

Anterior pituitary

44
Q

What does ACTH stimulates the adrenals to release? 3

A
  1. Cortisol
  2. Androgens
  3. Aldosterone
45
Q

What conditions does elevated levels of ACTH mean?

A

Cushings disease and primary adrenal hypofunction

46
Q

What does aldosterone stimulate? What happens if it’s increased? When is it decreased?

A
  1. Mineralocorticoid secretion’s by adrenal cortex
  2. Increased adenoma, adrenal carcinoma and adrenocorticohyperplasia
  3. Decreased in hypofunctioning adrenal
47
Q

How is ACTH measured?

48
Q

How is Aldosterone measured?

A

Urine and serum

49
Q

How is Cortisol measured?

A

blood and urine

50
Q

What does Cortisol do? 2 (what does it increase and what does it decrease in?)

A
  1. Increase hyperthyrodiusm, stress, some types of obestiy and adrenal hyperfunction
  2. Decreased in adrenal hypofunction, hypothyroidism
51
Q

How does catecholamines increase?

A

Increase in strenuous activity, malignant neuroblastoma and pheochromocytoma

52
Q

What secretes catecholamines?

A

Adrenal medulla

53
Q

How do we test for catecholamines?

A

Urine test and serum test. Urine more accurate

54
Q

What is the patient prep for adrenal scans?

A

Overnight fast

55
Q

What is visualization of the adrenals dependent on? 5

A
  1. Age
  2. Size
  3. Amount of perirenal fat
  4. Presence of bowel gas
  5. Ability to change patient position
56
Q

What is the sonographic appearance of the adrenals in adults?

A
  1. Rarely visualized
  2. homogenous, hypoechoic structure
  3. surrounded by more echogenic perirenal fat
57
Q

What is the sonographic appearance of newborns?

A
  1. Easily identified
  2. large in proportion to the kidney and very little perirenal fat to obscure
  3. V, Y or Z shaped configuration
  4. Thin echogenic core (medulla) and a less echogenic rim (cortex)
58
Q

What is the best evaluated scanning technique for getting a right kidney scan? 2

A
  1. Best done using the liver or right kidney as window
  2. Patient should be in the supine position but the LLD position may be utilized
59
Q

What is the scanning technique for getting the left adrenal? 4

A
  1. Decubitus
  2. intercostal scan
  3. use the spleen/ left kidney as a window
  4. Alternative: place patient in left posterior oblique position and scan through the IVC and aorta

DMST 254 ABD 1 (26 decks)

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