Adrenals Flashcards

0
Q

Lt adrenal tumor will displace the left kidney ___

A

Inferiorly

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1
Q

Rt adrenal tumor will displace the IVC __

A

Anteriorly

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2
Q

A rt adrenal tumor will displace the rt kidney

A

Inferiorly

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3
Q

A lt adrenal tumor will displace the splenic vein ___

A

Anteriorly

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4
Q

A rt adrenal tumor will displace the rt renal vein ____

A

Anterior

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5
Q

Panc tail will displace the left adrenal ___

A

Posterior

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6
Q

What 3 arteries perfuse the adrenal glands

A

supra renal branch of inferior phrenic artery, supra renal branch of the aorta, and supra renal branch of the renal artery

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7
Q

The rt supra renal vein drains into

A

IVC

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8
Q

Lt supra renal vein drains into

A

left renal vein and then the IVC

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9
Q

Phenochromocytoma

A

In the adrenal medulla, organ of Zuckerkandl (near aortic bif), paravertebral sympathetic ganglia

Cause hypersecretions of catecholamines; dopamine, norepinephrine, and epinephrine.

Symptoms: headaches, palpitations, excessive perspiration.

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10
Q

Medulla secretes

A

Catecholamines which secrete epinephrine and norepinephrine

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11
Q

What 4 criteria define a non functioning cortical Adenoma

A
  1. A unilateral mass
  2. No history of malignancy elsewhere
  3. No biochemical evidence of adrenal hyperfunctioning
  4. Adrenal mass < 3 cm in diam
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12
Q

3 most common primary mets to adrenal

A

Lung, breast, and melanoma

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13
Q

Adrenal myelolipoma

A

Echogenic mass with propagation speed artifact

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14
Q

2 tumors that arise from medulla

A

Phenochromocytoma and neuroblastoma

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15
Q

Adrenals located in the

A

Anterior pararenal space

16
Q

Adrenal gland

A

2 endocrine glands

Cortex and Medulla

17
Q

Right adrenal pyramid lies ____ to IVC, ____ to rt liver lobe, ____ to diaphragm, and _____ to kidney

A

Post/lat to IVC
Medial to right liver lobe
Lateral to diaphragm
Sup to ant kidney

18
Q

Right adrenal shape

A

Upside down Y or V shape

19
Q

Left adrenal shape

A

Crescent shape or triangular

20
Q

Left adrenal lies ____ to lesser sac, ____ to pancreas, ____ to kidney, ____ to diaphragm

A

Posterior to lesser sac
Post/lat to panc
Ant/medial to kid
Post on diaphragm

21
Q

Blood supply

A

Suprarenal branch of inferior phrenic art
Suprarenal branch of Aorta
Suprarenal branch of Renal artery

Right supra renal vein empties into IVC
Left suprarenal vein empties into left renal vein

22
Q

Cortex

A
Secretes steroids
medullocorticoid, menurolocorticoid: regulates electrolytes and secretes aldosterone)
Glutocorticoids
Cortizone
Hydrocortizone
Androgen
Estrogen
23
Q

Medulla

A

Secretes catecholamines

Epinephrine, norepinephrine

Fight or flight response

24
Q

Addisons Disease (adrenocortical hypo functioning)

A

Chronic primary hypoadrenalism, atrophic gland

Dec cortisol

Skin color changes, sodium & potassium retention, Renal impairment, dec blood volume, sugar, lipids, fatigue, weak, hypotension, GI distress

Enlg adrenal with possible necrosis

Steroid therapy treatment

25
Q

Adrenogenital syndrome

Adrenal hyperplasia

A

Inc sex hormones, develop male characteristics muscle hair

Excess androgen production, ambiguous genitalia,

26
Q

Conn’s Syndrome (hyperaldosteronism)

A

Primary hyperaldosteronism, excessive secretion of aldosterone

Hypernatremia (inc sodium), hypokalemia (dec potassium), 
Water retention
HTN***
Muscle weak, cramps 
Altered renal function 

Hyper aldosterone

27
Q

Cushing’s Syndrome (adrenocortical hyperfunctioning)

A

Hyperadrenalism
Hypercorticolism
Inc glucose production

Protruding abdomen, poor wound healing, prone to infection, thin skin bruise easy, moon face, buffalo hump

Upper body obesity, round moonface, inc fat around neck = buffalo bump, thinning of arms & legs

Osteoporosis, hyper pigmentation, htn, virilization

28
Q

Waterhouse Friderichsen Syndrome / acute hypoadrenalism

A

Massive destruction of gland

29
Q

Hemorrhage

A

MC in newborns bc large adrenal and inc vascularity
From hypoxia

Hemorrhage and liquefaction
Anechoic(older) to Echogenic, ca+

30
Q

Adenoma

A

Common, associate with MENs Syndrome. Don’t secrete hormones.

31
Q

Myelolipoma

A

Rare benign. Don’t secret hormones. Hyperechoic, propagation speed error

32
Q

Cortical carcinoma

A

Rare
Usually steroid producing
Nonsteroid producing is highly malignant

Encapsulated, variable echotexture, ca+

Invasion to adrenal vein, ivc, lymph nodes

33
Q

Mets

A

4th mc site for mets
Lung, breast, kidney, bronchial, lymphoma, melanoma, GI, thyroid, pancreas

More than half bilateral

34
Q

Pheochromocytoma

A

Arises from medulla

Highly vascular, HTN patients, usually benign, solitary right sided. Assoc with MENs Syndrome

HTN, headache, sweat, pallor, tachycardia, inc metabolism, palpitations, excessive perspiration

Inc catecholamine, and metabolites. Secretes catecholamine, dopamine, norepinephrine, epinephrine

35
Q

Rule of 10 pheochromocytoma

A
10% extra adrenal 
10% malignant
10% bilateral 
10% familial
10% not assoc with HTN
36
Q

Neuroblastoma

A

MC adrenal tumor in pediatrics
Neural crest origin
1/2 occur in 1st year of life
Rare after 8 years

Arises from medulla

Palp mass, abd protrusion, fever, wt loss, pallor, loss of energy, HTN, inc catecholamine
75% with mets

Highly echogenic, poorly defined borders, ca+, necrosis, hemorrhage

Mass presses down on kidney

37
Q

Adrenal size

A

Length 3-5 cm
Width 2-3 cm
Thick 1 cm