Endocrinology- adrenal gland

Question 1

Which main artery and vein are close to Adrenal Gland?

Answer 1

Inferior vena cava

Abdonminal aorta

Question 2

Which artery and vien supplies each adrenal gland?

Answer 2

left- supplied by abdonminal artery

drains into IVC

right- supplied by abdonminal artery

drains into RENAL VIEN

Both have many arteries only one vien into the gland

Question 3

Label this histology of adrenal gland (each layer)

Answer 3

Question 4

What hormones does each layer of adrenal gland produce?

Answer 4

Cortiocsterioids (cortisol)- adrenal cortex (zona golmerulosa, fasciculata, reticularis)

catecholamines (adrenaline)- medulla

Question 5

Give examples of each catecholamine AND coricoesteriods

Answer 5

catecholamines - noradrenaline and adrenaline

corticosteriod - mineralocoricoids (aldosterone), glucocorticoids (corticol),

_sex steriods only in kids (_androgens and oestrogens)

Question 6

What does each layer of cortex produce?

Answer 6

zona glomerulosa- aldosterone

(increase Na + reabsorption in blood and k+ excretion in urine and increase blood pressure as increased water retention)

zona fasiculata and reticularis- cortisol + sex hormones

Question 7

What molecule do all corticosteriods come from?

Answer 7

cholesterol

steriod ( based on cholesterol)

Question 8

How is progesterone (precursor) synthesized from cholesterol?

Answer 8

Question 9

Progesterone to aldosterone?

Answer 9

Question 10

Progesterone to cortisol?

Answer 10

FORGET aldesterone pathway on this

and enzyme is (numbers) HYDROXYLASE

Question 11

Where do sex steriod come of on the pathway?

Answer 11

Question 12

How does aldesterone increase blood pressure? (mechanism of action)

Answer 12

activate ATPase and Na+ channel from urine to cell.

so Na+ reabsoprted in tubules in kidney into blood so increase water retention

also K+ and H+ from cell to urine increased

Question 13

How is it aldosterone regulated?

Answer 13

3 ways

-juxtagolermular appartus measues renal perfusion pressure (blood flow that passes through renal tissue)

• Increase renal sympathetic activity
• decrease Na+ load to top of loop of Henle

ALL release renin into blood

Question 14

What does renin do?

Answer 14

Switch on cascade to convert to AT to AT 1

eventually to Angiotensin ii that regulates release of aldosterone

Question 15

How exactly does AT 11 regulate aldosterone release?

Answer 15

Affects all enzyme in pathway to produce aldesterone from cholsterol:

side chain cleavage

3 hydoxysteriod deydro

21, 11, 18 hydroxylase IN golumerulosa

Question 16

How is cortisol regulated?

Answer 16

By ACTH released by pit gland

Question 17

What are effects of cortisol

Answer 17

(some similar to glucagon)

stress response, increase blood glucose, lysis of protiens and fat, glucogenosis, enhances effect of glucagon and catechloamines,

excretion of water load and increase vessel permeablity

Question 18

How is there a negative feedback?

Answer 18

cortisol feedback negatively to pit gland and hypo

Question 19

How does ACTH stimulate cortisol?

Answer 19

Goes to fasiculata and reticulartis

activates enzymes in pathway from cholesterol to cortisol:

side chain cleavage, 3 hydroxysteriod dehydro

21,11,17 dehydrolase

Question 20

What is special about fluctations in cortisol levels in body?

Answer 20

diurnal rthym- tells tissues what time of day it is, important waking up

low at midnight

high at 8.30am

tells body what time of day it is

(ACTH slightly ahead)

Question 21

What is Addison’s disease?

Answer 21

Primary adrenal failure (not enough hormones).

autoimmune disease, destroys cortex.

OR

Tuberclosis-disease

Question 22

What levels in body give indication?

Answer 22

A lot of ACTH and MSH excreted

low BP

low cortisol and aldesterone

Question 23

Symptoms of addisons disease?

Answer 23

increase pigmentation, tanned looking

weakness

weight loss

low BP

diarheea

vomitting

Vitiligo (patches of white) might be autommune co-existing as well

Question 24

Why do addisons have good tan?

Answer 24

POMC is precurosr to produce ACTH, MSH and endorphonines

so when produce a lot of ACTH simulatnously produce a lot of MSH

Question 25

How can addisons lead to death?

Answer 25

Cortisol and Aldosterone deficiency Salt loss (Na+) low BP death

Question 26

Treatement of addisons disease?

Answer 26

rehydrate with normal saline (as low blood volume) Dextrose (glucose) prevent hypoglycaemia due to low glucocorticoid defi as well as give hydrocortisone (corisol as a medication)

Question 27

What is name of condition of too much cortisol?

Answer 27

Crushing's disease

Question 28

What chemical level changes causes crushing disease?

Answer 28

tumour in adrenal too much cortisol tumour in pit gland too much ACTH

Question 29

Symptoms of Crushing disease

Answer 29

increase weight gain depression red cheeks moon face thin skin myopathy thin arms and legs red striae- stretch marks poor wound healing

Question 30

What other condition is commonly associated with Cushing's syndrome? Why?

Answer 30

Diabities due to insuline resistance as body becomes resistant to hormones

Question 31

Possible causes of crushing syndrome?

Answer 31

steriod by mouth- long term do function of cortisol pituitary adenoma ectopic (too much) ACTH produced by lung cancer adrenal adenoma

Question 32

Clincal signs of crushing disease

Answer 32

thin skin proximal myopathy- weakness of muscles centripetal obesity- lemon on stick hypertension diabites immunsupression moon face striae- stretch marks

Question 33

What cells of adrenal medulla derived from?

Answer 33

**Ectodermal neural crest** temporary group of cells unique to vertebrates that arise from the embryonic ectoderm germ layer,

Question 34

What is precusor for catecholamines (noradrenanline and adrenal )?

Answer 34

Tyrosine - amino acid

Question 35

What trigger release of catecholamines?

Answer 35

Stored in cytoplasmic granules + released in response to ACTH from preganglionic symp neurones

Question 36

How are they synthesized from tyrosine? (pathway)

Answer 36

(dont need to know enzymes)

Question 37

What effects do catecholamines have on body?

Answer 37

**Fight or flight response** tachycardia, sweating, increase blood glucose, alertness, vasocontriction

Question 38

How do they travel in blood? Do they travel freely or bound to molecule? And which one?

Answer 38

NA and Adr circulate bound to **albumin**

Question 39

How are the NorA and Adr degraded?

Answer 39

**monoamine oxidsase** and **catechol-O-methyl transferase**