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GOATED BRS > Adrenal gland > Flashcards

Adrenal gland Flashcards

1
Q

Where are the adrenal glands located?

A

Situated superiorly over the medial and superior aspect of the kidney

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2
Q

Which hormones are secreted by the adrenal glands?

A

Secretes steroids and catecholamine hormones into systemic circulation
(Sex-steroids, epinephrine, norepinephrine, adrenaline, noradrenaline, mineralcorticoids, glucocorticoids)

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3
Q

what shape is the right adrenal gland?

A

Pyramidal shape, contracting with the semi-lunar shape of the left gland

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4
Q

Which type of fascia encloses the adrenal glands?

A

Perinephric fascia

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5
Q

What is the anatomical relationship between the spleen and adrenal glands?

A

The left adrenal gland resides inferior to the spleen

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6
Q

Where does the left adrenal vein drain into?

A

Traverses into the renal vein

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7
Q

Where does the right adrenal vein drain into?

A

inferior vena cava

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8
Q

How many arteriole branches supply each adrenal gland?

A

57 arteriole branches

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9
Q

What is the outer adrenal gland called?

A

Cortex

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10
Q

What is the inner adrenal gland?

A

Medulla

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11
Q

What are the three layers of the adrenal cortex?

A

Zona glomerulosa, zona fasciata, zona reticularis

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12
Q

Which hormones are secreted from the Zona glomerulsosa?

A

Aldosterone (mineralcorticoids)

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13
Q

Which hormone is secreted from the zone fasciulata?

A

Cortisol

Small proportions of androgens

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14
Q

Which hormone is secreted by the zone reticularis?

A

Androgens and oestrogens

Smaller proportions of corticosteroids

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15
Q

Which cells are located within the adrenal medulla?

A

Chromaffin/neuroendocrine cells

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16
Q

Which hormones are secreted by the adrenal medulla?

A

Adrenaline and noradrenaline(+dopamine)

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17
Q

Which molecule are steroids derived from?

A

Cholesterol

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18
Q

How many carbon atoms are present in cholesterol?

A

27

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19
Q

What is the structure of cholesterol?

A

Cyclic rings

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20
Q

How is cholesterol converted into pregnenolone?

A

Side chain cleavage (p450scc)

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21
Q

How is pregenenlone converted into progesterone?

A

3-beta-hydroxy steroid dehydrogenase(3BHSD)

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22
Q

Step 1 for progesterone>aldosterone synthesis?

A

21-hydroxylase converts progesterone into 11-dexoycorticosterone

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23
Q

Step 2 for progesterone>aldosterone synthesis?

A

11-hydroxylase converts 11-deoxycorticosterone into corticosterone

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24
Q

Step 3 for progesterone>aldosterone synthesis?

A

18-hydroxylase converts corticosterone into aldosterone

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25
Q

Describe the pathway of molecules for cholesterol to cortisol synthesis?

A

Cholesterol –> Pregnenolone –>Progesterone –> 17-hydroxy-progesterone –> 11-deoxycortisol –> cortisol

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26
Q

Which enzymes are involved with cortisol synthesis?

A

17-hydroxylase
21-hydroxylase
11-hydroxylase

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27
Q

Which hormone influences the synthesis of cortisol?

A

ACTH

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28
Q

How is cortisol predominantly transported within the body?

A

Corticosteroid binding globulin

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29
Q

Which transport protein transports 15% of cortisol?

A

Albumin

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30
Q

Which form of cortisol is active?

A

Unbound form (10%)

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31
Q

What is the function of aldosterone?

A

Stimulates Na+ reabsorption in the distal convoluted tubule and cortical collecting duct. Essential for kidneys, sweat glands, gastric glands and colon.

Stimulates K+ and H+ secretion in the distal convoluted tubule and cortical collecting duct; alternating pH regulation of the blood.

32
Q

What effect does aldosterone have on potassium and hydrogen ions?

A

Stimulates potassium and hydrogen ion secretion in the distal convoluted tubule and cortical collecting duct

33
Q

What is the mechanism of action for aldosterone?

A

Stimulates Na+ reabsorption in distal convoluted tubule and cortical collecting duct in kidney (and in sweat glands, gastric glands, colon)

Stimulates K+ and H+ secretion, also in distal convoluted tubule and cortical collecting duct

34
Q

How does the glomerulus receive blood?

A

Afferent arteriole within the nephron

35
Q

Which arteriole carries blood away from the glomerulus?

A

Efferent arteriole

36
Q

Where are the juxtaglomerular cells located?

A

Lining the ascending limb of the loop of Henle, and the distal convoluted tubule, exposed to the afferent arteriole

37
Q

What is the function of the juxta-glomerular cells?

A

Secretes renin

38
Q

Which region of cells lies adjacent to the JG cells?

A

Macula densa

39
Q

What is the function of the macula densa?

A

Responds to changes in sodium ion concentration.

40
Q

Which receptors are located on JG cells and afferent arteriole?

A

beta-1 adrenergic, responds to sympathetic stimulation

41
Q

Which three factors contribute to renin release?

A

Decreased renal perfusion pressure
Increased renal sympathetic activity
Decreased sodium load

42
Q

Which hormone is secreted by the liver, which influences aldosterone synthesis?

A

Angiotensin II increases aldosterone synthesis

43
Q

What effect does renin have on the renin-angiotensin system?

A

Renin converts angiotensinogen into angiotensin I

44
Q

How is angiotensin-1 converted into angiotensin-2?

A

Angiotensin converting enzymes (ACE)

45
Q

What effect does angiotensin II have on the zone glomerulosa?

A

Stimulates the production of aldosterone

46
Q

What effect does an increase potassium concentration have on angiotensin?

A

Increases angiotensin concentration

47
Q

What effect does angiotensin -II have on vasculature?

A

Vasoconstrictor

48
Q

Which hormone has a permissive effect (enhancing) On the renin-angiotensin system?

A

Corticotrophin

49
Q

What is cortisol typically associated with?

A

Stress hormone

50
Q

Where is cortisol made?

A

Zone fasciculate of the adrenal cortex

51
Q

What metabolic effects are exerted by cortisol?

A

Stimulates peripheral protein catabolism,
Hepatic gluconeogenesis
Enhances effects of glucagon and catecholamines
Stimulates glycogenolysis
Fat lipolysis of adipose tissue

Overall effect: Increases blood glucose concentration

52
Q

What effect does cortisol have on mineralcorticoid receptors?

A

Behaves like aldosterone, increases water and sodium ion retention

53
Q

How and why is cortisol converted into cortisone?

A

-IIB-Hydroxysteroid dehydrogenase 2
-Removes cortisol to reduce interference with mineralcorticoid receptors

54
Q

What is the pattern of secretion of cortisol?

A

Diurnal rhythms(Circadian)

55
Q

What is inadequately secreted in Addison’s disease?

A

Cortisol from adrenal cortex(Fasciculata)

56
Q

What is the main causes of Addison’s disease in the UK?

A

Autoimmune disease

57
Q

What are the main two main causes of Addison’s disease?

A

TB and autoimmune disease

58
Q

How does TB cause Addison’s disease?

A

TB in the adrenal gland, reduces the cells that consist the zona fasciculata, therefore reducing secretion of cortisol, according to negative feedback system, this would elevate levels of ACTH from the anterior pituitary gland

59
Q

Which hormonal levels increase in Addison’s?

A

CRH
ACTH
MSH

60
Q

What are the clinical effects of Addison’s disease?

A 
Hypoglycaemia
Low blood pressure
weakness
Bronze discolouration 
Hyponatremia
Hyperkalaemia
Metabolic acidosis
Autoimmune vitillog
Infertility
61
Q

Why is there bronze pallor and increase pigmentation in Addisons?

A

Pro-opiomelanocortin precursor protein that is cleaved to form small peptides, including ACTH and MSH

62
Q

What is MSH?

A

Melanin stimulating hormone

63
Q

What are the treatments of Addison’s disease?

A

Glucose/dextrose intravenous solution
Steroid IV replacement therapy (Hydroxycortisone)

64
Q

What tests are conducted in regards to the management of Addison’s?

A

Measure urea electrolytes
Measure blood pressure
ACTH, cortisol levels afterwards

65
Q

When should cortisol level measurements take place?

A

8am, when cortisol levels are highest

66
Q

What is Cushing’s syndrome and what is its most common causation?

A

Concerned with elevated levels of cortisol, primarily caused by an adrenal adenoma

67
Q

What are the main effects of Cushing’s?

A 
Impaired glucose tolerance
Hypertension
Hyperglycaemia
Proximal myopathy (muscle weakness)
Mental changes
Skin changes
Centripetal obesity
68
Q

What are the common causations of Cushing’s(Apart from adrenal adenoma)?

A

Oral consumption of steroids

Ectopic ACTH secretion (Lung cancer)

69
Q

Where does the adrenal medulla derive from embryologically?

A

Ectodermal neural crest

70
Q

Which amino acid is the precursor for adrenaline and noradrenaline

A

Tyrosine

71
Q

How are catecholamines stored and what molecule releases them?

A

Catecholamines are stored in cytoplasmic granules and released by Acetylcholine

72
Q

What molecules are bound to noradrenaline and adrenaline in circulation?

A

Albumin

73
Q

Which hepatic enzymes degrade catecholamines?

A

Monoamine oxidase
Catechol-o-methyl transferase

74
Q

What is the proportion of hormones produced by the adrenal medulla and what are they?

A

Catecholamines
80% Adrenaline/Epinephrine
20% Noradrenaline/Norepinephrine

75
Q

Which hormones are formed in the adrenal cortex?

A

Corticosteroids
Mineralcorticoids(Aldosterone)
Glucocorticoids(Cortisol)
Sex-steroids(Androgens, oestrogens)

76
Q

What are the major effects of aldosterone and what stimulates its secretion?

A

Increases Na+, H2O
Decreases K+
-Produced by Z.G, stimulated by ATII on adrenals

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