Adrenal Cortex Phys- Trachte Flashcards

(34 cards)

1
Q

What are the three zones of the adrenal cortex?

A

Zona Glomerulosa
Zona Fasiculata
Zone Reticularis

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2
Q

Which zone of the adrenal cortex secretes aldosterone?

A

Zona glomerulosa

Aldosterone = mineralcorticoid

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3
Q

Which zone makes cortisol (glucocorticoid)

A

Zone fasiculata

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4
Q

Which zone makes sex hormones (androgens)?

A

Zone Reticularis

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5
Q

Describe the glucocortiocoid endocrine axis

A

Hypothalamus secretes CRH

Anterior pituitary secretes ACTH

Adrenal cortex secretes cortisol

Cortisol acts on immune system, liver, muscle, and adipose tissue

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6
Q

What kind of receptor does CRH bind on corticotrophs in anterior pituitary?

A
Gs-protein coupled receptor
Stimulates adenylate cyclase
Increases cAMP
Increased synthesis of POMC
POMC is cleaved to produce:
MSH
ACTH
Liptropin
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7
Q

What 3 things are proudced during cleavage of POMC in corticotrophs of the anterior pituitary?

A

ACTH
MSH
Lipotropin

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8
Q

What does MSH do?

A

Stimulates melanocyte proliferation and pigmentation

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9
Q

What receptor does ACTH bind?

A

Melanocortin-2-receptor in adrenal cortical cells

Gs coupled receptor
Elevates cAMP
Starts signal transduction cascade involving PKA

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10
Q

What cancer usually causes ectopic production of ACTH?

A

Small Cell lung cancer

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11
Q

What is the rate-limiting step in adrenal steroid synthesis?

A

Production of “side chain cleavage enzyme” in the adrenal cortex

*This enzyme is required for cholesterol conversion to pregnenolone

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12
Q

What enzyme is required for cholesterol conversion to pregnenolone?

A

Side-chain cleavage enzyme (CYP11A = P450scc)

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13
Q

Where would you find glucocorticoid receptors? What is the sequence of events?

A

Cytosol! Belong to the nuclear receptor super family

Hormone bound receptor moves to nucleus and forms homodimers

Homodimers act as transcription factors - bind to Glucocorticoid Response elements

Initiate OR inhibit transcription

Regulates development, metabolism, and immune repsonse

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14
Q

The mineral corticoid receptor has equal affinity for aldosterone and cortisol…. cortisol is much more abundant than aldosterone…… how does aldosterone responsive tissue prevent cortisol from binding to the MR?

A

In aldosterone-responsive cells cortisol is enzymatically converted to cortisone = a metabolically inactive steroid so has no affect (and can’t bind receptor)

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15
Q

What is the primary active glucocorticoid?

A

Cortisol!

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16
Q

What is 90% of cortisol bound to in circulation?

A

60% = CBG = corticotropin binding globulin = transcortin

30% = albumin

17
Q

What happens to bone at sustained elevation of glucorticoids?

A

Decreased osteoblast activity - decreased bone mass - osteoporosis

18
Q

What is Cushing Syndrome?

A

Excessive secretion of cortisol

May be due to a variety of causes

19
Q

If Cushing syndrome is due to excess ACTH secretion (thus increased cortisol) what is normally the cause?

A

Pituitary Adenoma

20
Q

Why do you see hyperpigmentation in pituitary adenomas?

A

Increased POMC!! Remember it produces ACTH, Lipotropin, and MELANOCYTE-STIMULATING HORMONE!

Those melanocytes are working like craaaaaazy!

21
Q

If Cushing syndrome is due to primary glandular excess production of cortisol (like an adrenal tumor) what would the blood profile look like?

A

Increased cortisol

BUT DECREASED ACTH (from negative feedback)

22
Q

What would the blood profile look like in a pituitary adenoma?

A
Increased ACTH (due to the adenoma)
Increased Cortisol
Low CRH (negative feedback)
23
Q

Effect on CRH, ACTH, and cortisol:

Hypothalamic damage resulting in no CRH secretion

A
  • Low CRH
  • Low ACTH
  • Low Cortisol
24
Q

Effect on CRH, ACTH, and cortisol:

Pituitary damage resulting in no ACTH secretion

A
  • Low ACTH
  • Low Cortisol
  • High CRH
25
Effect on CRH, ACTH, and cortisol: | Adrenal damage resulting in no cortisol secretion (Addison’s disease)
* Low cortisol * High CRH * High ACTH
26
Effect on CRH, ACTH, and cortisol: | Receptor damage resulting in no efficacy of cortisol
* High cortisol * High ACTH * High CRH
27
Effect on CRH, ACTH, and cortisol: | Tumor secreting excess CRH
* High CRH * High ACTH * High Cortisol
28
Effect on CRH, ACTH, and cortisol: | Tumor secreting excess ACTH (Cushing’s)
* High ACTH * High Cortisol * Low CRH
29
Effect on CRH, ACTH, and cortisol: | Tumor secreting excess cortisol
* High Cortisol * Low ACTH * Low CRH
30
What 3 enzymes can causes congenital adrenal hyperplasia?
17 a-hydroxylase 21-hydroxylase 11B-hydroxylase
31
What causes congenital adrenal hyperplasia?
Adrenal enzyme deficiency characterized by enlargement of both adrenal glands due to increased ACTH stimulation (due to decreased cortisol production)
32
What are all steroids made from?
Cholesterol!
33
What is Addison's disease?
Immune mediated destruction of adrenal cortex decreased production of cortisol and aldosterone Compensatory increase in POMC (increased ACTH and MSH) Thus you get hyperpigmentation!
34
Does aldosterone exhibited negative feedback on ACTH secretion?
NO!!!!!!