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physio fall midterm > endocrionology lecture 3 > Flashcards

endocrionology lecture 3 Flashcards

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1
Q

adrenal medulla develops from

A

neural crest cells

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2
Q

what part of the ANS is the adrenal medulla

A

sympathetic

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3
Q

what 2 hormones does the adrenal medulla secrete

A

epinephrine and norepinephrine

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4
Q

preganglionic symp neurons come from the spinal cord and synapse where

A

in the adrenal medulla on postganglionic cells called CHROMAFFIN CELLS

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5
Q

what do chromaffin cells release (into the blood)

A

epinephrine and norepinephrine (epinephrine mostly)

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6
Q

what is the phenyl-N-methyltransferase and where is it located

A

an enzyme located in high quantities in the adrenal medulla that converts NE to E (which is why the medulla mainly secretes E)

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7
Q

which receptors have a higher affinity for Epinephrine

A

beta adrenergic

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8
Q

which receptors have a higher affinity for NE

A

alpha adrenergic

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9
Q

epinephrine from the medulla to target tissues (via blood to the liver/muscle/fat) and causes what…

A

increase fuel availability/increase glucose by stimulating lipolysis, glycogenolysis, gluconeogenesis

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10
Q

where does the adrenal cortex develop from

A

mesothelial cells in the intermediate mesoderm (similar to the gonads)

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11
Q

is the adrenal cortex part of the nervous system

A

no!

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12
Q

what stimulates the adrenal cortex

A

blood borne signals (aka hormones)

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13
Q

what does the adrenal cortex secrete

A

steroid hormones

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14
Q

what are the 3 different zones of the adrenal cortex

A
  1. zona glomerulosa (outer)
  2. zona fasiculata
  3. zona reticularis (inner)
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15
Q

what causes different steroids to be produced by the zones

A

there are different steroidogenic enzymes in each zone

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16
Q

what is steroid synthesis in the adrenal cortex stimulated by

A

ACTH (adrenocorticotrophic homone)

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17
Q

what is the major target of aldosterone

A

the kidney when there is a drop in blood volume (decrease in b.p) or a decrease in Na in the blood

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18
Q

what is the major effect of aldosterone

A

stimulate Na and H20 retention in the kidney (to maintain blood volume and b.p)

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19
Q

what happens with K and H as a result of aldosterone secretion

A

increase in urinary excretion of K and H

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20
Q

where does aldosterone bind

A

remember that aldosterone is a steroid hormone so it binds to an intracellular receptor which then acts as a transcription factor to bind to DNA and increase the synthesis of specific proteins

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21
Q

what proteins (3) does aldosterone stimulate the synthesis of

A
  1. Na channels (sodium permeases) at the apical membrane (towards the tubular fluid)
  2. Na/K ATPase in the basolateral membrane (towards the blood)
  3. etc enzymes in the mitochondria
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22
Q

what are plasma angiotensin II and renin and how are they related

A

renin is a hormone (released by the kidney) in response to decreased Na levels and decreased b.p. RENIN STIMULATES PLASMA ANGIOTENSIN II to be released. PAT-II stimulates aldosterone to be released to ultimately increase Na in the blood and increase b.p.

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23
Q

how are plasma K [ ]s related to aldosterone secretion

A

increase in K plasma levels–> increases aldosterone secretion

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24
Q

aldosterone secretion is stimulated by a ____ in plasma pH and a ____ in plasma H

A

stimulated by a DECREASE in pH and INCREASE in [H]

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25
how is b.p related to aldosterone secretion
when b.p drops stretch receptors are stimulated in the arteries and there is input to the cortex to increase aldosterone secretion
26
increase in Na intake (via diet) causes what
inhibition of aldosterone
27
what is secreted from the zona fasiculata
the glucocorticoids (cortisol and corticosterone)
28
what is the major affect of cortisol
increase fuel/glucose availability
29
cortisol increases ____ in the liver
gluconeogenesis
30
cortisol increases ____ in the muscle
proteolysis
31
cortisol increases ____ in the fat tissue
lipolysis
32
cortisol decreases ____ in muscle and in fat
glucose uptake
33
what does cortisol do to the immune and inflammatory responses
decreases it (aka why you get a cortisol shot)
34
what does cortisol do to growth and reproductive functions
decreases them
35
what receptor does cortisol work on and what is the purpose
'permissive action' on beta-adrenergic receptors in smooth muscle to regulate b.p
36
cortisol is an antagonist of
insulin
37
how does cortisol work to decrease the glc uptake in muscle and fat
by blocking the GLUT4 transporter that insulin works on
38
secretion/synthesis of cortisol is stimulated by
ACTH
39
cortisol has a ________ on CRH and ACTH
negative feedback action
40
what is secreted from the zona reticularis
androgens (sex steroids)....including DHEA and androstenedione
41
what is DHEAs role
it acts as a precursor of other sex steroids (circulating reservoir). it has weak androgenic action.
42
peripheral concentrations of DHEA reflect the activity of the ____
adrenal cortex
43
peripheral concentrations of DHEA reflect the activity of the ____
adrenal cortex ....bc DHEA has constant levels in the body so a decrease would reflect a problem
44
what is androstenedione synthesized from
DHEA
45
androstenedione provides a non-gonadal source of
testosterone and estradiol (it can be converted to these 2 things)
46
why is androstenedione important to women
provides reproductive steroids prior to puberty and in postmenopausal women (when ovary isnt able to produce them)
47
what are sex steroids regulators of
mood, libido, hair growth, erythropoesis (rbc production), and acne
48
synthesis of androgens is stimulated by
ACTH
49
what is the stress axis
hypothalamus, anterior pituitary, adrenal cortex
50
what is the response of the SNS to stress activation
specific organ responses and increased epinephrine (from the adrenal medulla)
51
what is the specific organ response via the SNS when triggered by stress
smooth muscle stimulation and inhibition
52
activation of the stress axis by stress causes
increase cortisol secretion (which ultimately increases the availability of fuel)
53
when activated by stress, the SNS response is ____
rapid
54
when activated by stress, the stress axis response is _____
delayed (bc cortisol can't be stored and needs to be made)
55
what are the goals of the stress response
1. maintain b.p 2. mobilize/increase availability of metabolic fuel 3. inhibit the non-essential fns
56
how is the stress response shut off
1. removal of stressor | 2. negative feedback of cortisol on ACTH and CRH
57
what is the SNS response to glycogenolysis (stress response)
increases it in hepatic and muscle cells
58
what does the SNS response do to adipose tissue (stress response)
increase its breakdown and a source of glycerol for gluconeogenesis
59
what does the SNS response do for fatigue (stress response)
decreases muscle fatigue
60
what does the SNS response do for heart rate (stress response)
increases it
61
what does the SNS do to blood vessels (stress response)
vasoconstriction to smooth muscle, vasodilation in skeletal muscle
62
what does the SNS do to breathing (stress response)
increase ventilation
63
what does the SNS do to breathing (stress response)
increase ventilation
64
why is cortisol damaging after long periods of chronic stress
- highly catabolic - anti inflammatory/immune - increase mobilization of lipids in blood--->atherosclerosis and hypertension
65
what is Addison's disease
adrenal insufficiency
66
what are the causes of primary adrenal insufficiency (problem with the gland)
disease, congenital, autoimmune
67
what are the causes of primary adrenal insufficiency (problem with the gland)
disease, congenital, autoimmune
68
what are the causes of secondary adrenal insufficiency
- pituitary problem (glucocorticoid defect only bc ACTH secreted by the ant pituitary doesn't effect aldosterone/mineralocorticoid) - glucocorticoid therapy (feedback effects on CRH and ACTH)
69
why is there hyperpigmentation due to adrenal insufficiency
there is lots of ACTH and its prohormone, POMC. POMC is also the prohormone for MSH (melanocyte stimulating hormone)--->pigmentation
70
what is hypercortisolinemia/cushings disease
due to a pituitary tumor (or exogenous glucocorticoid)--> increased ACTH-->elevated bassal [ ]s of cortisol
71
in dental patients, what is the primary concern of cushings disease
impairment of the immune system after a procedure
72
in dental patients what is the concern of glucocorticoid therapy/secondary adrenal insufficiency
maintaining b.p during anesthesia and diminished immune/inflammatory responses
73
what are the symptoms of adrenal insufficiency
- low cortisol/high ACTH - weakness/lethargy/decreased appetite ( bc glucocorticoids not acting as fuel mobilizers) - low b.p (low aldosterone) - low glc when fasting (low cortisol) - hyperpigmentation
74
what are the symptoms of cushings disease
- excessive tissue catabolism (high cortisol) - diabetes like symptoms (cortisol blocking insulin)...increased appetite, circulating glc,etc - impaired immune - hypertension threat

physio fall midterm (12 decks)

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