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Abdomin And Superficial Structures > Adrenal Glands > Flashcards

Adrenal Glands Flashcards

1
Q

What are the 2 parts of the adrenal gland?

A
  1. Cortex

2. Medulla

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2
Q

What does the cortex develop from?

A

Mesoderm

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3
Q

What does the medulla develop from?

A

Develops in the neural crest cells (neuroectoderm)

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4
Q

Which develops first, cortex or medulla?

A

Cortex

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5
Q

What occurs at 6 weeks gestation of the cortex?

A
  • Proliferation of the mesoderm from the posterior abdominal wall
  • Mesoderm penetrates the retroperitoneum and becomes the primitive adrenal cortex
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6
Q

What occurs at 8 weeks gestation of the cortex?

A

Structure separates from the posterior peritoneal surface and is surrounded by retroperitoneal connective tissue

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7
Q

After birth, what happens to the primitive cortex?

A

Involutes and disappears by 1 year of age

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8
Q

At what age does the permanent adrenal cortex differentiates into 3 zones?

A

Age 3

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9
Q

What are the 3 zones of the permanent adrenal cortex?

A
  1. Glomerulosa
  2. Fasciculata
  3. Reticularis
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10
Q

When does the medulla form?

A

7th week gestation

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11
Q

What occurs at the 7th week gestation of the medulla?

A
  • Neural crest cells migrate and invade the medial side of the cortex
  • The cells differentiate into the CHROMAFFIN CELLS
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12
Q

Where are the paired adrenal glands located?

A

Retroperitoneal cavity

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13
Q

What is another name for the adrenal glands?

A

Suprarenal glands

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14
Q

Where are the adrenal glands positioned in comparison to the kidneys?

A

Anterior, medial and superior

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15
Q

What tissue surrounds the adrenal glands?

A

Perinephric fat and Gerota’s fascia

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16
Q

Do the adrenal glands have a capsule?

A

Yes

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17
Q

Do the adrenal glands move with the kidneys?

A

No, they are surrounded by their own fascial supports

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18
Q

What phase of breathing do the kidneys separate from the adrenals?

A

Inspiration

Or in upright position

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19
Q

What word can be used to describe the adrenals surface?

A

Nodular

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20
Q

What are the adrenals composed of?

A

Anteromedial ridge and a medial and lateral wing

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21
Q

What is the size of adults adrenal glands?

A

L 4-6cm
W 2-3cm
AP .3-.6cm

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22
Q

What is the size of an adrenal gland compared to an adult kidney?

A

1/13th the size

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23
Q

What is the size of a newborns adrenal gland?

A

L .9-3.6

W .2-.5

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24
Q

What is the size of newborns adrenals compared to the kidneys?

A

Proportionately larger

1/3 the size of the kidney

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25
Q

What is the shape of the adrenals?

A

Pyramid, semi-lunar, V, Y, Z configuration

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26
Q

What is the common shape of the RT adrenal?

A

Pyramidal shaped

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27
Q

What is the common shape of the LT adrenal?

A

Semilunar or crescent shaped and usually slightly larger then the RT

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28
Q

What is the RT gland posterior and lateral to?

A

IVC

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29
Q

What is the RT gland superior to?

A

Right kidney

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30
Q

What is the RT gland posterior and medial to?

A

Liver

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31
Q

What is the RT gland lateral to?

A

Crus of the diaphragm

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32
Q

What is the RT gland posterior to?

A

Duodenum

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33
Q

What is the relation of the LT gland to the LT kidney?

A

Superoprmedial- lower border can reach the renal hilum

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34
Q

How is the LT adrenal positioned in relation to the stomach and lesser sac?

A

Posterior

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35
Q

Is the LT gland posterior or anterior to the crus of the diaphragm?

A

Posterior

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36
Q

What structures is the inferior portion of the LT gland posterior to?

A

Pancreas and splenic vessels

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37
Q

How is the LT adrenal positioned compared to the aorta?

A

Posterolateral to the aorta

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38
Q

Are the adrenal glands vascular organs?

A

Yes

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39
Q

How many arteries are there in each gland?

A

3

40
Q

Describe the 3 arteries that supply blood to the adrenal glands

A
  1. Superior suprarenal arteries from the inferior phrenic arteries
  2. Middle suprarenal arteries from the aorta
  3. Inferior suprarenal arteries from the renal artery
41
Q

What vein drains the adrenal gland?

A

Suprarenal veins

42
Q

What does the right adrenal gland drain into?

A

IVC

43
Q

What does the left adrenal gland drain into?

A

Left renal vein

44
Q

How does the adrenal gland maintain homeostasis?

A

Through hormone secretion

45
Q

Are the adrenal glands double endocrine or exocrine glands?

A

Double endocrine glands

46
Q

What % of the gland is made of the cortex?

A

90% cortex

47
Q

What steroid hormones does the cortex secrete? (3)

A
  1. Mineral corticoids
  2. Glucocorticoids
  3. Gonadal hormones
48
Q

Is the cortex of the adrenal essential?

A

Essential for life

49
Q

What is the release of hormones form the cortex controlled by?

A

Negative feedback system b/w the hypothalamus, anterior pituitary and adrenal gland

50
Q

What does the hypothalamus secrete?

A

ACTHRF- adrenocorticotropic hormone releasing factor

51
Q

What does the secretion of ACTHRF cause the anterior pituitary to secrete?

A

ACTH- adrenocorticotropic hormone

52
Q

What does the release of ACTH from the anterior pituitary cause the adrenal gland to do?

A

Secrete hormones

53
Q

What are the 3 layers of the cortex? What is the volume of each layer?

A
  1. Zone glomerulosa- 15%
  2. Zona fasciculate- 75%
  3. Zona reticulate- 10%
54
Q

What is the most outer layer of the cortex?

A

Zona glomerulosa

55
Q

What does the zona glomerulosa secrete?

A

Mineralocorticoids- Aldosterone

56
Q

What does aldosterone act on?

A

Renal-tubules- sodium retension

57
Q

What is the middle layer of the cortex?

A

Zona fasciculate

58
Q

What does the zona fasciculate secrete?

A

Glucocorticoids- Cortisone and hydrocortisone

59
Q

What are the releases of cortisone and hydrocortisone cause? (3)

A
  1. Fat, protein and carbohydrate metabolism
  2. Suppresses immune response (anti-inflammatory)
  3. Helps resist mental and physical stress
60
Q

What is the inner most zone of the cortex?

A

Zona reticularis

61
Q

What does the zona reticular secrete?

A

Sex hormones- estrogen and progesterone

62
Q

What does the secretion of estrogen and progesterone cause?

A

Promote normal development of the reproductive organs and bones

63
Q

When is the release of sex hormones present?

A

4th year of life

64
Q

What is the medulla?

A

Center portion of adrenal gland

65
Q

What system is related to the medulla?

A

sympathetic nervous system

66
Q

What is the medulla derived from?

A

Ectoderm

67
Q

Is the medulla essential for life?

A

No

68
Q

What portion of the adrenal gland is responsible for the fight or flight response?

A

Medulla

69
Q

What hormones does the medulla secrete?

A

Catecholamine hormones- epinephrine (adrenalin) and norepinephrine

70
Q

What is epinephrine responsible for?

A

Dilating coronary vessels

Constricts skin and renal vessels

71
Q

What is norepinephrine responsible for?

A

Constricts all arteries except coronary vessels

72
Q

What is the body’s response to accelerated HR?

A

Vessels constrict and theres increased BP

73
Q

What is the body’s response to accelerated respiration?

A

Dilation of respiratory passage

74
Q

What does a decreased rate of digestion allow for?

A

Allows for more blood to the muscles

75
Q

What are blood tests used to measure?

A

Cortical function

76
Q

What are urine tests used to measure?

A

Medulla function

77
Q

What are the 4 lab tests used to monitor adrenal gland function?

A
  1. ACTH
  2. Aldosterone
  3. Cortisol
  4. Catecholamines
78
Q

How is ACTH measured?

A

Through blood test

79
Q

What does ACTH stimulate the cortex to secrete?

A

Cortisol, androgens and aldosterone

80
Q

What can cause elevated levels of ACTH?

A

Cushing’s dx and primary adrenal hypofunction

81
Q

How is aldosterone measured?

A

Serum and urine tests

82
Q

When are levels of aldosterone increased?

A

Adenoma, adrenal carcinoma and adrenocorticohyperplasia

83
Q

When are levels of aldosterone decreased?

A

Hypo-functioning adrenal

84
Q

How is cortisol measured?

A

Serum and urine tests

85
Q

When are levels of cortisol increased?

A

Hyperthyroidism, stress, obesity and hyperfunction

86
Q

When are levels of cortisol decreased?

A

Adrenal hypofunction and hypothyroidism

87
Q

How are levels of catecholamines measures?

A

Urine test more reliable then blood test

88
Q

What can cause increased levels of catecholamines?

A

Strenuous activity, malignant neuroblastoma and pheochromocytoma

89
Q

What is the pt prep?

A

Overnight fast

90
Q

What are the factors that affect visualization of the adrenal gland? (7)

A 
Age
Size
Amount of perirenal fat
Presence of bowel gas
Ability to change pt position
Sonographers experience
Equipment
91
Q

What is the appearance of the adrenal gland in an adult?

A 
Rarely visualized (visualized to rule out pathology) 
Homogeneous, hypoechoic structure
92
Q

What is the adult adrenal gland surrounded by?

A

Perirenal fat

93
Q

What is the appearance of the adrenal gland in newborns?

A

Easily identified- very little perirenal fat to obscure
Medulla- echogenic
Cortex- less echogenic rim

94
Q

What structures can mimic the adrenal structure?

A

Crus, pancreatic tail, lymphadenopathy and gastric fundus

95
Q

How is the right adrenal best visualized?

A

Intercostally using liver or kidney as a window
Supine or LLD
Scan beam directed towards the IVC
Scanned from level of the renal hilum to liver

96
Q

How is the left adrenal best visualized?

A

Intercostally using liver or kidney as a window
Supine or LLD
Scan from the epigastrium
Difficult to visualize
Alternate- LPO and scan through IVC and aorta

Abdomin And Superficial Structures (12 decks)

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