2-9-16-Suprarenal Gland (Cole) Flashcards Preview

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Flashcards in 2-9-16-Suprarenal Gland (Cole) Deck (52):
1

The renal cortex is derived from ___

The renal medulla is derived from ___

Mesoderm --> develops from the celomic epithelium of the posterior abdominal wall

Ectoderm --> develops from the neural crest cells

2

___ occur in up to 50% of newborn infants, but tend to atrophy and disappear in the early postpartum period. They can be detected anywhere along the path of the embryonic migration of adrenal cortex

Adrenocortical rests

3

___ are minor developmental anomalies arising from partly or completely detached rests of the coelomic epithelial primordia from which the adrenal cortex is derived. They are most frequently located in contact with the capsule at 1 pole of the adrenal but can occur completely separated from the adrenal gland in the retroperitoneal fat

Accessory adrenocortical nodules (i.e., ectopic adrenal tissue, accessory cortical tissue, hamartoma)

4

The developmental of adrenal zones occurs slowly after birth, in parallel with regression of the fetal cortex, and is not completed until ___

Late in the 1st year of life

5

The ____ persists and develops into the functional adrenal cortex, with distinct zonae glomerulosa and fasciculata present at birth. The zona reticularis develops during the 1st year of life

Definitive cortex

6

Both cortical and medullary elements appear between the ___ weeks of fetal growth

5th-6th weeks

7

The ___ and sympathetic NS develop in concert

Adrenal medulla

8

During the early stage of gestation, the adrenal cortex synthesizes ___, a precursor of the synthesis of estrogen by the placenta

DHEA

9

A lack of ___ enzyme activity prevents the synthesis of progesterone, glucocorticoids, and androstenedione

3-beta-hydroxysteroid dehydrogenase

10

The interaction between the fetal adrenal cortex and the placenta is known as the __

Fetoplacental unit

11

___ is an uncommon form of congenital adrenal hyperplasia that results from a mutation in the gene for (3beta-HSD) type II

3beta-hydroxysteroid dehydrogenase II deficient congenital hyperplasia (3beta-HSD CAH)

12

Milder forms of 3beta-HSD CAH type II can produce what?

Virilization of genetically female infants and undervirilization of genetically male infants. This form of primary hypoadrenalism is the only form of CAH that can cause ambiguous genitalia in both genetic sexes

13

Glucocorticoids are essential for these 3 main developmental events:

1-Production of surfactant by type 2 alveolar cells after the 8th month of fetal life

2-Development of a functional hypothalamopituitary axis

3-Induction of thymic involution

14

THe adrenal cortex is of mesodermal origin and produces ___

The adrenal medulla is of neuroectodermic origin and produces ___

Steroid hormones

catecholamines

15

What are the 3 zones of the adrenal cortex from the outer-most to inner-most layer?

Zona glomerulosa --> Zona fasciculata --> Zona reticularis

16

What does the zona glomerulosa primarily produce?

Mineralocorticoids, mainly aldosterone

Produced in response to Ang II (also ACTH)

17

__ lies under the capsule and represents 10-15% of the adrenal cortex. THe celles aggregate into a glomerulus-like arrangement and have a moderate amount of lipid droplets in the cytoplasm.

Zona glomerulosa

18

The zona glomerulosa lacks the enzyme ___ and cannot produce cortisol or sex steroids

17alpha-hydroxylase

19

Aldosterone stimulates renal __ reabsorption and renal secretion of ___

Na

K and H

20

___ is 75% of the renal cortex and secretes mainly glucocorticoids and androgens.

Zona fasciculata

21

What cell type is characteristic of the zona fasciculata?

Spongiocytes

Cells appear vacuolated (foamy appearance)

22

___ contains cuboid cells, with the structural features of steroid producing cell arranged in longitudinal cords separated by cortical fenestrated capillaries/sinusoids

Zona fasciculata

23

Which zones of the adrenal cortex contain 17alpha-hydroxylase to produce glucocorticoids?

Fasciculata and Reticularis

Also contain 17,20-hydroxylase --> produce sex hormones

24

Cortisol is converted in hepatocytes to ___

Cortisone

25

List the 2 major effects of cortisol:

-Metabolic --> stimulates gluconeogenesis to increase [glucose] in blood

-Anti-inflammatory --> suppresses tissue responses to injury and decreases cellular and humoral immunity

26

___ is the innermost layer of the adrenal cortex (~5-10% of total volume) and the cells are arranged in irregular cords that form an anastomosing network

Zona reticularis

27

What hormones does the zona reticularis characteristically secrete?

Gluocorticoids and androgens

28

The primary site of adrenal sex hormone production is the ___

Zona reticularis

29

___ are the predominant androgens produced by the cortex of the adrenal gland

DHEA and androstenedione

30

Chromaffin cells are associated with the ___

Adrenal medulla

31

___ are composed of polyhedral cells arranged in cords or clumps and regarded as modified sympathetic postganglionic neurons without postganglionic axons.

Chromaffin cells

32

Chromaffin cells are derived from ___

Neural crest

33

The adrenal medulla is innervated by sympathetic preganglionic fibers that release ____

Ach

34

___ are secreted into the blood instead of being secreted into a synapse, as in postganglionic terminals. They are secreted in response to intense emotional rxns., defensive rxn. To stress, increase HR, dilate BVs supplying cardiac and skeletal muscle, bronchiole dilation, and vasoconstrict BVs supplying GI tract, kidneys, skin

Catecholamines (epi, norepi)

35

List the arterial contributions of the adrenal gland capsule

Inferior phrenic a. --> superior adrenal a.

Aorta--> middle adrenal a.

Renal a. --> inferior adrenal a.

All form an arterial plexus

36

Regarding bloody supply of the adrenal gland, ___ supplies the capsule

The subcapsular plexus

37

Regarding blood supply to the adrenal gland, __ is the second set of arteries that enters the cortex forming straight fenestrated capillaries/sinusoids, percolating between the zona glomerulosa and fasciculata, and forming a capillary network in the zona reticularis before entering the medulla

Short cortical aa.

38

Regarding blood supply of the adrenal gland, ___ is the 3rd set generating medullary arteries that travel without branching and supplying blood ONLY to the medulla

Long cortical aa

39

A tumor that is localized in the zona glomerulosa that causes excessive secretion of aldosterone is known as ____

Conn's syndrome (primary aldosteronism)

40

A more common cause of hyperaldosteronism is an increase in renin secretion and this is known as ___

Secondary hyperaldosteronism

41

An increase in aldosterone, cortisol, and adrenal androgen production-secondary to ACTH production-occurs in ___

Cushing's disease

42

___ is caused by an ACTH-producing tumor of the anterior hypophysis

Cushing's disease

43

___ is when a functional tumor of the adrenal cortex can also result in overproduction of cortisol, as well as of aldosterone and adrenal androgens

Cushing's syndrome

44

Overproduction of cortisol caused by either a pituitary tumor, adrenal tumor, or some other unknown factor is a ___ cause of Cushing's syndrome

Endogenous

45

Taking medications containing glucocorticoids, such as hydrocortisone, may be a ___ cause of Cushing's syndrome

Exogenous

46

___ is a chronic destruction of the adrenal cortex by an autoimmune process or TB.

Addison's disease

47

In Addison's disease, ___ secretion increases because of the cortisol deficiency. It can cause an increase in skin pigmentation, in particular in the skin folds and gums

ACTH

48

In Addison's disease, the loss of ___ leads to hypotension and circulatory shock. Also, a deficiency in ___ causes muscle weakness in Addison's disease

Mineralocorticoids

Cortisol

49

List symptoms of Addison's disease:

Fatigue, lassitude, malaise, weakness, anorexia

Postural dizziness, syncope

GI symptoms

Myalgias, arthralgias, rarely flexion contractures

Decreased libido, amenorrhea

50

What are signs of Addison's disease?

Weight loss, hyperpigmentation, hypotension, thinning of axillary and pubic hair, vitiligo

51

___ is a benign tumor of the chromaffin cells that leads to episodic secretion of epi and norepi. Signs and symtpoms are those of sympathetic NS hyperactivity: elevated HR, BP, palpitations, diaphoresis, anxiety, headaches, nausea, pallor

Pheochromocytoma

52

The superior suprarenal artery arises from ___ artery

The middle suprarenal artery arise from ___

The inferior suprarenal arteries arise from ___ artery

Inferior phrenic

Abdominal aorta

Renal