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Endocrine Physiology > Adrenal Physiology > Flashcards

Adrenal Physiology Flashcards

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1
Q

What are the 4 layers of the adrenal gland?

A

Glomerulosa
Fasciculata
Reticularis
Medulla

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2
Q

What does the zona glomerulosa mainly secrete?

A

Mineralocorticoids primarily aldosterone for the kidneys

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3
Q

What does the zona fasciculata mainly secrete?

A

Glucocorticoids - cortisol and corticosterone to most cells for glucose and glycogen formation

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4
Q

What does the zona reticularis mainly secrete?

A

Androgens to skin, bones and other tissues

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5
Q

What does the adrenal medulla secrete?

A

Epinephrine and Norepinephrine to most cells

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6
Q

What is the adrenarche?

A

Maturation of zona reticularis in late childhood associated with increased adrenal androgen (DHEA/DHEAS) secretion

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7
Q

What is adrenopause?

A

Decline in DHEA production with age

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8
Q

Where does adrenocorticoid synthesis take place?

A

ER and mitochondria

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9
Q

What does enzyme deficiency alter?

A

Production of ALL adrenocorticoids

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10
Q

What does the zone glomerulosa secrete?

A

Aldosterone

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11
Q

What increases aldosterone secretion?

A

Angiotensin II and K+

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12
Q

What are the zona glomerulosa actions mediated by?

A

Mineralocorticoid receptor

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13
Q

What is the role of aldosterone?

A

Maintenance of electrolyte balance and ECF/plasma volume
Regulates naturesis in renal distal tubule and collecting ducts
Role in acid/base balance

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14
Q

What are the causes of Conn’s Syndrome?

A

Aldosterone secreting adrenal tumour
Adrenal hyperplasia

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15
Q

How does Conn’s Syndrome affect the renal electrolyte and H2O absorption?

A

Electrolyte imbalances (hypernatremia and hypokalemia)
metabolic alkalosis
water retention
low plasma free calcium level

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16
Q

What does hypernatremia and hypokalemia cause in Conn’s Syndrome?

A

Hypern - muscle cramps (neuronal hyperexcitability)
Hypok - muscle weakness (muscle hypo excitability)

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17
Q

What is the treatment for Conn’s SYndrome?

A

Surgery
Spironolactone (aldosterone receptor antagonists)

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18
Q

What is Addison’s Disease?

A

Autoimmune destruction of adrenal cortex

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19
Q

What does Addison’s disease cause?

A

Glucocorticoid (mineralcorticoid) deficiency
Hypoaldosteronism
cardiac arrythmias and low ECF volume

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20
Q

What are two characteristics of the Zona Fasiculata?

A

Pale cells - numerous lipid droplets
Well developed ER and plentiful mitochondria

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21
Q

What does the Zona Fasiculata synthesize?

A

Cortisol
ACTH
Lesser amounts of androgen/estrogen synthesis

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22
Q

What are the Zona Fasiculata actions mediated by?

A

Glucocorticoid receptor

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23
Q

What are the 4 metabolic actions of the glucocorticoids (cortisol and ACTH)?

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A

Increase muscle protein catabolism
Increase triglyceride breakdown
Increase hepatic gluconeogenesis
Decrease muscle insulin sensitivity

24
Q

What is cortisol’s effect on immunity and inflammation?

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A

Suppress immune and inflammatory response
Inhibit T and B cell function
Inhibit cytokine production

25
What is cortisol's effect on vasculature?
Maintains normal BP and CO
26
What is cortisol's effect on water and electrolyte balance?
Antidiuretic actions (promotes H2O reabsorption) Increases Na+ reabsorption and K+ excretion
27
What is cortisol's effect to stress?
Metabolic and vascular actions considered beneficial
28
What is the circadian rhythm?
Suprachiasmatic nucleus in hypothalamus that is entrained by visual and light/dark cues Cortisol and ACTH levels increase at night
29
What are 4 causes of Cushing's Syndrome (hypercortisolism)?
Cortisol secreting tumours Ectoptic tumours secreting ACTH Pituitary ACTH excess (Cushings Disease) Prolonged glucocorticoid therapy
30
What are 3 symptoms relating to metabolic actions of cortisol?
Hyperglycemia/glucosuria Insulin resistance Obesity purple stripes females (amenorrhea and hirstusim)
31
What is Addison's Disease (hypocortisolism)?
Autoimmune destruction of adrenal cortex
32
What are the symptoms of Addison's Disease?
Glucocorticoid (and mineralcorticoid) deficiency Hypocortisolism
33
What does hypocortisolism cause?
Hypoglycemia ACTH excess MSH excess (hyperpigmentation)
34
What is the difference between cortisol and aldosterone binding?
Cortsiol has equal affinity for glucocorticoid and mineralcorticoid receptors Aldosterone only binds to mineralcorticoids
35
What is the role of HSD11b2 in mineralcorticoid receptors?
Minimizes illicit activation of mineralocorticoid receptor by cortisol
36
Where is HSD11b1 highly active?
Most metabolically active tissues
37
When is the zona reticularis fully differentiated?
At early childhood (6-8 years old)
38
What does the zona reticularis secrete?
Adrenal androgen/estrogen synthesis DHEA Estrone and estradiol
39
What regulates secretion from the Zona Reticularis?
ACTH (not pituitary gonadotrophins)
40
What is the role of DHEA?
Development of secondary sexual characteristics in females Development of male genitalia in pre-pubertal boys
41
What is congenital Adrenal Hyperplasia?
Defective adrenal steroidogenesis 21-beta-hydroxylase deficiency
42
What 4 endocrine disturbances does congenital Adrenal Hyperplasia cause?
Lowers cortisol production Lowers mineralocorticoid production increases male sex steroids increases ACTH
43
What are 3 other symptoms of congenital Adrenal Hyperplasia?
Adrenal hyperplasia Mineralocorticoid deficiency (salt-wasting form) Aberrant development of primary/secondary sex characteristics
44
What is the adrenal medulla derived from?
Neural crest of embryonic ectoderm
45
What is a nerve ganglion?
Cluster of neural bodies outside CNS
46
What are chromaffin cells?
Neuroendocrine cells that are modified postganglionic sympathetic neurons
47
What do chromaffin cells release?
Epinephrine that acts as a hormone Norepinephrine (20%) Adrenergic receptors
48
What are chromaffin cells innervated by?
Preganglionic sympathetic neurons
49
What triggers chromaffin cells?
Increases sympathetic nervous sytem activity
50
How does endocrine epinephrine differ to sympathetic effects?
Lasts 5-10x longer Affects a wider range of cell types
51
What receptors do E and NE act via?
Plasma membrane adrenoreceptors - G protein coupled adrenergic receptors
52
What allows for tissue specificity and multiplicity of action for E and NE?
Multiple receptor subtypes differential ligand binding affinities different tissue distribution
53
What do the alpha receptors prefer?
NE (more involved in neural pathways)
54
What do beta receptors prefer?
Epinephrine and increases cyclic AMP
55
What are 4 effects of epinephrine?
Increases HR and CO Increases breakdown of Glycogen and fat Increases O2 consumption Increases skeletal muscle flow
56
What is the role of epinephrine in the stress response?
Blood flow diverted to vital organs Increase in HR, peripheral resistance and strength Increase gluconeogenesis and glycogenolysis
57
What does a tumour of the chromaffin cells cause?
Severe hypertension Hyperglycemia Increased metabolic rate arrhythmias anxiety

Endocrine Physiology (12 decks)

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