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Name the 3 layers of the cortex of the adrenal medulla from outside to inside

1. zona glomerulosa
2. zona fasciculata
3. zona reticularis


what type (chemical category) of hormones does the cortex and medulla of the adrenal cortex secrete?

The cortex releases steroid hormones and the medulla releases catecholamines


what are the three categories of corticosteroids that the adrenal cortex secrete?

1. mineralcorticoids
2. glucocorticoids
3. sex hormones


aside from the inner layers of the adrenal cortex, what other place produces sex hormones?

in the gonads in much higher abundance.


what stimulated the release of cortisol from the adrenal medulla?

ACTH from the anterior pituitary


Why can't steroid hormones move freely in the blood? What are they bound to?

steroid hormones are hydrophobic and so must be transported by proteins. Cortisol is transported by transcortin and the others by albumin


TRUE or FALSE: Cortisol is essential for life. Why or why not?

TRUE; important direct effects on intermediary metabolism of carbohydrate, protein and lipid


what are the effects of cortisol?

1. hepatic gluconeogenesis (amino acids into carbohydrates)
2. increases breakdown of lipids
3. increases protein breakdown (muscles)
4. increases the amount of glucose available to the brain by inhibiting utilization by other tissues


What does the 'permissive action of cortisol' mean?

This means that there is an amount of cortisol that is required to allow for other processes to occur such as its effect on catecholamines


what effects does cortisol have at pharmacological concentrations that it doesn't have at normal concentrations?

1. immunosuppresion
2. anti-inflammatory


using glucocorticoids for long term use can have several consequences. What are they?

1. loss of bone mass
2. impaired body's defence against infections
3. atrophy of the adrenal (negative feedback on pituitary-adrenal axis)
4. hyperglycemia


what negative consequences can occur when taking synthetic glucocorticoids?

1. cause negative feedback on anterior pituitary which causes atrophy of corticotropes because no ACTH is required
2. atrophy of adrenal cortex because of lack of stimulation by ACTH
3. low levels of cortisol, aldosterone and DHEA production


what does aldosterone do?

controls body fluid volume by increasing sodium reabsorption by the kidneys


What stimulates aldosterone secretion?

1. activation of renin-angiotensin system in response to decreased blood pressure , low Na and high plasma K
2. ACTH has only a minor role


What does DHEA stand for?



the adrenal androgens are in what major form?



What role does DHEA (androgen) have in female development?

1. enhancement of pubertal growth spurt
2. maintains secondary sex characteristics
3. libido (sex drive)
4. some conversion by aromatase to estrogen


Why is DHEA not as prominent in males?

testosterone androgen produced by the testes overpowers DHEA which is why in females, it's actions are much more significant


primary hyperaldosteronism

caused by a hyper secreting adrenal tumour made up of aldosterone secreting cells (Conn's syndrome); causes increased Na, decreased K, and hypertension


secondary hyperaldosteronism

inappropriately high activity of the renin-angiotensin system


What is cushing's syndrome?

an excessive cortisol secretion


what causes Cushing's syndrome?

1. Excessive CRH and ACTH release (hypoth disorder; pituitary tumor)
2. adrenal tumors secreting cortisol independent of ACTH
3. Ectopic tumors (usually lungs) that secrete ACTH


what are the symptoms of Cushing's syndrome?

1. hyperglycemia
2. excess protein breakdown
3. abnormal fat distribution
4. insulin resistance (adrenal diabetes)
5. decreased immune response
6. decreased inflammatory response


what does an excess of androgens do in males and females?

- in adult females, causes male pattern body hair, small breast size, inappropriate masculinization
- in newborn females, pseudohermaphroditism
- prepubertal males --> pseudopuberty
- nothing in adult male because of testosterone



congenital adrenal hyperplasia - genetic deficiency in cortisol synthetic enzymes


TRUE or FALSE: Excess DHEA causes negative feedback on GnRH and LH/FSH release from hypothalamus and anterior pituitary

TRUE; no gametes, pseudohermaphroditism, pseudo puberty


if one adrenal medulla is broken down can this cause adrenocortical insufficiency?

no because there is still another one that can compensate. both must be affected


What is primary adrenocortical insufficiency?

- also knows as addison's disease
- an autoimmune disorder where antibodies attack adrenal cortex and so aldosterone and cortisol are deficient
- cortisol and aldosterone defiency


secondary adrenal insufficiency

hypothalamic or pituitary abnormality resulting in deficient ACTH secretion; only cortisol is deficient because aldosterone secretion does not depend on ACTH stimulation


is aldosterone essential for life?