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nuero > adrenal gland > Flashcards

adrenal gland Flashcards

1
Q

Adrenal glands: where are they?

A

Above the kidney, Ad RENAL- protected by the ribs

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2
Q

how many arteries do they have- right and left

A

lots

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3
Q

how many veins for the left and right adrenal glands

A

1

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4
Q

where does the left adrenal vein drain into

A

renal vien

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5
Q

right adrenal vein

A

into inferior vena cava

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6
Q

draw the adrenal gland and the adjacent structure

A

draw

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7
Q

name the 2 main regions of the adrenal glands

A

adrenl cortex

adrenal medulla

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8
Q

what does the adrenal cortex relese

A

Secretes Corticosteroids

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9
Q

adrenal medulla

A

Secretes catecholamines

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10
Q

name the 3 regions of teh adrenal cortex

A

Zona glomerulosa
Zona fasciculata
Zona reticularis

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11
Q

draw it

A

draw it

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12
Q

what regions makes Catecholamines

A 
Adrenal medulla
(neuroendocrine/chromaffin cells)
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13
Q

Adrenal cortex

A

Corticosteroids

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14
Q

what is the origine of adrlaline and noradrelaline

A

dpoamine

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15
Q

nora

A

no meythl group

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16
Q

examples of Catecholamines

A

Adrenaline/epinephrine (80%)
Noradrenaline/norepinephrine (20%)
[Dopamine]

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17
Q

examples of Corticosteroids

A 
Mineralocorticoids (Aldosterone)  
Glucocorticoids (Cortisol
Sex steroids (Androgens, oestrogens)
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18
Q

what does the Zona glomerulosa make

A

Aldosterone

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19
Q

what do teh Zona fasciculata

Zona reticularis

A

cortisol

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20
Q

what is a significance of one vein

A

all hormones released will travel through same vein

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21
Q

what are steriods

A

Steriod is an hormone based on a cholesterol/ comes from cholestrol

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22
Q

Adrenal gland secretions precursor

A

cholesterol

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23
Q

how many carbons in cholestrol

A

27

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24
Q

What is an enzyme?

A

Protein that catalyses a specific reaction
Protein that catalyses a specific reaction
1

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25
Q

what precourous do all steriods make

A

pregnenolone- basic steriod

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26
Q

first step to form aldestron (mineralocorticoid)

A

Side chain cleavage

–> Pregnenolone

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27
Q

next

A

3 beta Hydroxy Steroid Dehydrogenase

–> Progesterone

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28
Q

what positions are oxidised by hrdoxylases (OH group added)

name the enzymes

A

21 Hydroxylase
11 Hydroxylase
18 hydroxylase

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29
Q

how to form glucocorticoid

A

same until forming Progesterone

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30
Q

what are hydroxled (OH group added)

A

17 hydoxylase
21 hydoxylase
11 hydoxylase

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31
Q

final product

A

CORTISOL

32
Q

cholesterol to aldosterone with all intermediates

A 
cholesterol
progesterone
11-deoxy corticosterone
corticosterone
aldosterone
33
Q

to make cortisol

A 
cholesterol
progesterone
17-OH prog
11-deoxy deoxycortisol
cortisol
34
Q

to make S steroids

A 
cholesterol
progesterone
17-OH prog
Sex steroids
(androgens)
(oestrogen)
35
Q

What does aldosterone do?

A

Major net effect is to conserve body sodium by stimulating its reabsorption
Increased sodium reabsorption water reabsorption,
raising blood volume, regulating blood pressure

36
Q

how does it work

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

switches on ATPase

37
Q

what is released when blood pressure fails

A

Renin release when blood pressure falls

38
Q

what releases renins

A

Juxtaglomerular apparatus

39
Q

when bp is high

A

Blood pressure high suppress renin

40
Q

when bp is low

A

Blood pressure low suppresses renin secreated

41
Q

How is aldosterone regulated?

A

low bp

renin relased

42
Q

what do the renins do

A

convert angiotensinogen (from liver) to Angiotensin I

43
Q

next

A

A1 concerted by ACE to angiotensin 2

44
Q

affects of a2

A

vasoconstriction

acts on adrenals

45
Q

what happens in the adrenal glands

A 
Activation of the following enzymes
Side Chain Cleavage
3 Hydroxysteroid dehydrogenase
21 hydroxylase
11 hydroxylase
18 hydroxylase
to make aldetsrone
46
Q

summary of Aldosterone

A

Summary of aldosterone action:

Controls blood pressure, sodium and lowers potassium

47
Q

How is cortisol secretion regulated?

A

ACTH

48
Q

Physiological effects of cortisol

A 
Normal stress response
Metabolic effects
peripheral protein catabolism
hepatic gluconeogenesis
increased blood glucose concentration
fat metabolism (lipolysis in adipose tissue)
enhanced effects of glucagon and catecholamines
Weak mineralocorticoid effects
Renal and cardiovascular effects
excretion of water load
increased vascular permeability
49
Q

how is increased cortisol suprresed

A

Cortisol feedbacks negatively

50
Q

how is it released

A

CRH –> ACTH –> cortisol

51
Q

draw a HPA axis

A

Remember to add backwards arrow wwhen cortisol negatively effects pit and hyp

52
Q

Effects of ACTH on the adrenals

A 
Activation of the following enzymes
Side Chain Cleavage
3 Hydroxysteroid dehydrogenase
21 hydroxylase
11 hydroxylase
17 hydroxylase
cortisol
53
Q

what sort of variation does cortisol

A

Cortisol has diurnal rhythm
Tells youre tissue/hormone what time of day it is
Peaks at 8 30
Low at midnight

54
Q

This is cortisol, and the only difference between prednisolone and cortisol is this double bond here. What this does is it gives prednisolone a longer half life, more potency, and a binding affinity of over twice that of cortisol

A

This is cortisol, and the only difference between prednisolone and cortisol is this double bond here. What this does is it gives prednisolone a longer half life, more potency, and a binding affinity of over twice that of cortisol

55
Q

what is Addison’s disease

A

Primary adrenal failure

Autoimmune disease where the immune system decides to destroy the adrenal cortex (UK)

56
Q

most common cause

A

Tuberculosis of the adrenal glands (commonest cause worldwide)

57
Q

sympotoms/sign

A 
hyperpigmentation 
low bp 
weakness 
weight loss 
diahorrea 
vomitting 
vitilago
58
Q

adrenal crisis signs/sypm

A 
fever 
syncope 
convulsion 
hypoglecemia 
hyponatremia 
severe vomiting and diarrhea
59
Q

what affect does it have on other hormones

A

Pituitary starts secreting lots of ACTH and hence MSH

60
Q

why low blood pressure

A

No cortisol or aldosterone

61
Q

Why do patients with Addison’s disease have a good tan?

A

POMC is a large precursor protein that is cleaved to form a number of smaller peptides, including ACTH, MSH and endorphins
Thus people who have pathologically high levels of ACTH may become tanned

62
Q

main dangers of addisons

A 
Cortisol deficiency
Aldosterone deficiency
Salt loss
Low blood pressure
Eventual death
63
Q

how to prevent death

A

Rehydrate with normal saline
Give dextrose to prevent hypoglycaemia which could be due to the glucocorticoid deficiency
Give hydrocortisone or another glucocorticoid

64
Q

What happens if you have too much cortisol?

A

Your metabolism changes and you put on weight…

65
Q

What can cause too much cortisol?

A

A tumour of the adrenal
-Excess cortisol
A tumour of the pituitary
-Excess ACTH

66
Q

what is Cushing’s syndrome

A

Cushing’s syndrome is a condition caused by having too much of a hormone called cortisol in your body. It can be serious if it’s not treated.

67
Q

signs/symptoms

A 
big torso/fat but skinny arms and legs 
Red cheeks
Easy bruising
Thin skin
Red Striae (stretch marks)
Poor wound healing
Adrenal gland gets bigger 
Interscapular fat  
Diabetes, hypertension and osteoporosis
Immunosuppression (reactivation of TB 
Proximal myopathy weak muscle
68
Q

hormone cause

A

Occurs due to an excess of cortisol or other glucocorticoid

69
Q

List four possible causes of Cushing’s syndrome

A

Taking steroids by mouth (common) (glucocorticoid)
pituitary dependent Cushing’s disease (pituitary adenoma)
Ectopic ACTH (lung cancer)
adrenal adenoma or carcinoma
§

70
Q

examples of Catecholamines

A

Adrenaline/epinephrine (80%)

Noradrenaline/norepinephrine (20%)

71
Q

what is the precoursor for adr and na sythesis

A

tyrosine

72
Q

where is it stored

A

in cytoplasmic granules & released in response to ACh from preganglionic sympathetic neuronesq

73
Q

Role of catecholamines

A

Fight or flight response’ e.g. tachycardia, sweating, increased blood glucose, alertness, vasoconstriction

74
Q

how do adr and na circulate the blood

A

NA & Adr circulate bound to albumin

75
Q

how do they get degraded

A

Degraded by two hepatic enzymes: monoamine oxidase & catechol-O-methyl transferase

nuero (36 decks)

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