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Endocrinology > The Adrenals and their hormones > Flashcards

The Adrenals and their hormones Flashcards

1
Q

Where are the adrenal glands located

A

Above the kidneys

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2
Q

How many arteries and veins serve the adrenal glands

A

Many arteries by only one vein : inferior vena cava

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3
Q

Name the layers of the adrenal glands from outside in

A

Zona glomerulosa
Zona Fasciculata
Zona reticularis
Medulla

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4
Q

What does the medulla produce

A

Catecholamines e.g. adrenaline (80%) and noradrenaline

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5
Q

What does the zona glomerulosa produce

A

Mineralocorticoids e.g. aldosterone

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6
Q

What does the zona fasciculata produce

A

Glucocorticoids e.g. cortisol, androgens and oestrogen

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7
Q

What does the zona reticularis produce

A

Glucocorticoids, androgens and oestrogen

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8
Q

Describe the synthesis of steroid hormones form cholesterol

A
  1. liberation of the cholesterol from the ester by esterase
  2. stAR transports it to the inner mitochondrial membrane
  3. Pathway to form the mature hormone
  4. Hormone may freely diffuse through the membrane
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9
Q

Where does synthesis of steroid hormones occur

A

Gonads OR adrenals

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10
Q

What is the majority of steroid hormones bound to

A

Corticosteroid binding protein (CBG) and albumin

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11
Q

What does cortisol mainly bind to as it travels in the blood

A

CBG

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12
Q

What does aldosterone bind to as it travels in the blood

A

Albumin

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13
Q

When are cortisol levels highest and lowest

A

Highest in the morning, lowest in the afternoon

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14
Q

Which receptors does cortisol bind to

A

Glucocorticoid receptors and aldosterone receptors

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15
Q

Which receptors do aldosterone bind to

A

Aldosterone receptors

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16
Q

How do organs ensure aldosterone is taken up when needed

A

11b-HSB2 breaks it down into an inactive form so it cannot leave

17
Q

Which tissues require aldosterone specifically

A

Kidney and placenta

18
Q

What is the purpose of the renin-angiotensin system

A

Increase blood pressure

19
Q

Where is renin produced

A

Granular cells of the kidney in the afferent arteriole

20
Q

Which factors influence renin release

A

Renal perfusion pressure (Afferent arteriole pressure)
Renal sympathetic activity
Macular densa cells (low sodium recognised)

21
Q

Describe the renin-angiotensin system

A
  1. Renin release is stimulated by low blood pressure or low sodium
  2. renin released and activates angiotensinogen from the liver
  3. angiotensin I formed and circulates
  4. Angiotensin converting enzyme (ACE) converts to angiotensin II
  5. angiotensin II activates the aldosterone producing cells in the zone glomerulosa of the adrenal glands
22
Q

What is the feedback system for the hypothalami-pituitary-adrenocortical axis

A

ACTH stimulates the release of cortisol

Cortisol has a direct negative effect on the Adenohypophysis (-CRH) and an indirect negative effect on the hypothalamus

23
Q

What are the principal physiological actions of adrenal hormones

A

Increase in sodium, bicarbonate and water resorption

24
Q

What does aldosterone do

A

Movement of sodium from tubules in the kidney to the blood

25
Q

How does aldosterone work

A

Increases the number of sodium channels and sodium-potassium ATPase

26
Q

What does cortisol do

A

Increase glucose concentration

27
Q

How does cortisol work

A

Affects DNA transcription and therefore translation
increased gluconeogenesis and glycolysis
Decrease blood flow to skeletal muscle and fat to prevent glucose storage

28
Q

How does cortisol affect memory

A

Increases the capacity to respond to serotonin

29
Q

What are some immunosuppressor and anti-inflammatory effects of cortisol

A

Decrease in lymphocyte and monocyte functions, complement

decrease in leukocyte function, complement and histamine reactions

30
Q

How may the adrenal glands assist in a gonad dysfunction

A

Release of adrenal androgens for the zone reticularis

31
Q

Give an example of an adrenal androgen

A

DHEA, Androstenedione

32
Q

Where do the left and right adrenal veins drain into

A

Left drains into the renal vein and then the IVC

Right drains straight into the IVC

33
Q

What is an important thing to consider before left adrenalectomy

A

Damage to the spleen so immunise with HIB and pneumovax

34
Q

What are the physiological responses to cortisol during a stress event

A

Peripheral protein catabolism
Hepatic gluconeogenesis
Increases blood glucose concentration
Fat metabolism (lipolysis in adipose tissue)
Enhanced effects of catecholamines and glucagon

Endocrinology (9 decks)

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