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Year 2- Endocrine System > The Adrenal Gland > Flashcards

The Adrenal Gland Flashcards

1
Q

Where are the adrenal glands?

A

On the superior pole of each kidney- therefore, we have two adrenal glands

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2
Q

The adrenal glands are composed of two separate endocrine glands which have been rolled into one structure. What are the two glands which make up the adrenal gland?

A

Adrenal medulla
Adrenal cortex

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3
Q

Which type of gland is the adrenal medulla?

A

Neuroendocrine gland

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4
Q

What doe the adrenal medulla secrete?

A

Catecholamines- mostly epinephrine but also norepinephrine and dopamine

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5
Q

Which type of gland is the adrenal cortex?

A

True endocrine gland

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6
Q

Name the three classes of hormone secreted by the adrenal cortex.

A

Mineralocorticoids
Glucocorticoids
Sex steroids

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7
Q

Give an example of a mineralocorticoid secreted from the adrenal cortex.

A

Aldosterone

->involved in he regulation of sodium and potassium

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8
Q

Give an example of a glucocorticoid secreted from the adrenal cortex.

A

Cortisol

->involved in maintaining plasma glucose

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9
Q

Give an example of a sex steroid secreted from the adrenal cortex.

A

Testosterone

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10
Q

Which part of the adrenal gland is in the core?

A

Adrenal medulla

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11
Q

What is the body’s stress hormone?

A

Cortisol

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12
Q

What are epinephrine and norepinephrine associated with?

A

Stimulation of the sympathetic NS

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13
Q

RECAP- to make sure you are paying attention hehe

Which part of the adrenal gland is neuroendocrine?

A

Adrenal medulla

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14
Q

How many layers does the adrenal cortex have?

A

3

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15
Q

Name the three levels of the adrenal cortex from most superficial to deep.

A

Zona glomerulosa
Zona fasciculata
Zona reticularis

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16
Q

What does the zona glomerulosa secrete?

A

Aldosterone and other mineralocorticoids

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17
Q

What does the zona fasciculata secrete?

A

Glucocorticoids e.g. cortisol

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18
Q

What does the zona reticularis secrete?

A

Sex steroids

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19
Q

RECAP- what are steroid hormones derived from?

A

Cholesterol

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20
Q

All steroid hormones come from cholesterol but what differentiates them into different end products?

A

Different enzymes

->for example, enzymes needed to make aldosterone are only found in the zona glomerulosa

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21
Q

Which enzyme is required for the production of cortisol and aldosterone but not sex steroids?

A

21- hydroxylase

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22
Q

Defective 21-hydroxylase is a common cause of which congenital problem?

A

Congenital adrenal hyperplasia

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23
Q

In those with congenital adrenal hyperplasia due to 21-hydroxylase deficiency, what does this result in?

A

Deficiency of aldosterone and cortisol.
Disrupted control of salt and glucose homeostasis

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24
Q

Why may those with congenital adrenal hyperplasia have malformed genitalia?

A

All the cholesterol in the adrenal cortex gets channelled into making sex steroids as cannot be made into aldosterone or cortisol.
Therefore, there is a lot higher conc. of sex steroids which deforms genetalis and can make it hard to distinguish between male and female.

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25
Q

A deficit in 21-hydroxylase results in adrenal hyperplasia. Why?

A

Cortisol cannot be synthesised so we lose that negative feedback loop. There will be hypersecretion of CRH and ACTH and there will be overstimulation of the adrenal gland leading to hyperplasia.

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26
Q

What type of hormone is cortisol?

A

Glucocorticoid hormone

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27
Q

95% of plasma cortisol is bound to which carrier protein?

A

Cortisol binding globulin

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28
Q

Is cortisol hydrophilic or lipophilic?

A

Lipophilic

->this is why they are bound to proteins in order to be transported in plasma

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29
Q

Glucocorticoids are well known clinically for their anti-inflammatory effects. How do these effects come about?

A

The glucocorticoids switch off transcription and translation of proteins that make up enzymes in inflammatory pathways

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30
Q

Therefore, glucocorticoids can be used in the treatment of many conditions. List some of them.

A

Asthma, rheumatoid arthritis, ulcerative colitis, organ transplants.

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31
Q

At what point of the day is the peak of cortisol release?

A

Early morning

->cortisol is our stress hormone and if you think about getting out of a warm bed in January, it’s stressful :)

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32
Q

Which type of enzymes does cortisol stimulate the formation of?

A

Gluconeogenic enzymes in the liver

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33
Q

How does cortisol aid with the production of glucose?

A

Stimulates the formation of gluconeogenic enzymes which enhance gluconeogenesis and therefore the production of glucose

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34
Q

How does cortisol provide gluconeogenic substrates for the liver?

A

Via proteolysis- cortisol stimulates the breakdown of muscle protein to provide these substrates.

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35
Q

As well as assisting in the breakdown of muscle protein, what else can cortisol assist in the breakdown of?

A

Adipose tissue via lipiolysis

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36
Q

What does cortisol do to insulin sensitive tissue?

A

Reduces their insuin sensitivity

37
Q

What happens if there is excess cortisol?

A

Diabetogenic effects as cortisol acts to oppose insulin and create more glucose

->look at the previous examples, cortisol promotes gluconeogenesis, proteolysis, lipolysis and decreases insulin sensitivity

38
Q

Previously, the questions have been on how cortisol effects blood glucose levels. However, it can also have effects on other physiological things.
How does cortisol impact calcium balance?

A

Negative effect on calcium balance as decreases absorption from gut and increases the excretion from kidneys.

39
Q

Cortisol can also increase bone resorption. Which condition can this lead to?

A

Osteoporosis

40
Q

How can cortisol effect mood?

A

Depression and impaired cognitive function are strongly associated with hypercortisolaemia.

41
Q

Which disease can occur when the body makes too much cortisol?

A

Cushing’s disease

42
Q

How does cortisol levels reflect blood pressure?

A

Hypertension- high levels of cortisol
Hypotension- low levels of cortisol

43
Q

How does cortisol help when we go from lying or sitting to standing?

A

Brings about vasoconstriction which pushes blood away from the feet and up to the head

->this is why there is a peak in cortisol levels when we get up in the morning as helps us get out of bed without feeling dizzy

44
Q

How can cortisol be used in suppression of the immune system?

A

Reduces circulating lymphocyte count and reduces antibody formation.
Inhibits inflammatory response.

45
Q

What are some of the side effects of glucocorticoid therapy?

A

Skin becomes thinner and more fragile du to loss of fat via lipolysis.
More prone to infection due to suppression of immune function.
Muscle weakness

46
Q

What is aldosterone?

A

A mineralocorticoid which acts on the kidneys to determine the levels of minerals absorbed/excreted.

47
Q

Where is aldosterone released from?

A

Zona glomerulus in the adrenal cortex

48
Q

In terms of specific minerals, how does aldosterone control the absorption./excretion?

A

Increases reabsorption of sodium ions.
Promotes excretion of potassium ions.

49
Q

Which reflex pathway controls the secretion of aldosterone?

A

RAAS
Renin-angiotensin-aldosterone system

50
Q

What is the main function of aldosterone?

A

To regulate blood pressure

51
Q

What does increased aldosterone lead to?

A

Sodium retention and potassium depletion leading to increased blood pressure.

52
Q

What does decreased aldosterone lead to?

A

Sodium loss and increased potassium in the plasma leading to decreased blood pressure

53
Q

What condition is caused by hypersecretion of cortisol?

A

Cushing’s syndrome/disease

54
Q

What is the usual cause of hypersecretion of cortisol?

A

Tumour, either in the adrenal cortex or pituitary gland

55
Q

What type of hypercortisolism would there be if the tumour was in the adrenal cortex?

A

Primary hypercortisolism

56
Q

What type of hypercortisolism would there be if the tumour was in the pituitary gland?

A

Secondary hypercortisolism

57
Q

Which is more common- a tumour in the adrenal cortex (primary hypercortisolism) or one in the pituitary gland (secondary hypercortisolism)?

A

A tumour in the pituitary gland leading to secondary hypercortisolism and Cushing’s disease

58
Q

There is a difference between Cushing’s disease and Cushing’s syndrome. What is it?

A

Cushing’s disease in a specific type of Cushing’s syndrome due to a tumour in the PITUITARY GLAND

59
Q

Therefore, which out of Cushing’s disease/syndrome is primary and which is secondary?

A

Primary- Cushing’s syndrome
Secondary- Cushing’s disease

60
Q

Sometimes hypersecretion of cortisol is iatrogenic is origin. What does this mean?

A

Too much cortisol has been administered theraputically

61
Q

What are some of the characteristic signs of Cushing’s disease?

A

Differing fat deposition, around the neck and the face
More fat distribution around trunk
Muscle wasting

->often known as moon face (faraway tree iykyk)

62
Q

What is more common- hypersecretion of cortisol or hyposecretion?

A

Hypersecretion

63
Q

Which disease is hyposecretion of cortisol associated with?

A

Addison’s disease

64
Q

In Addison’s disease, there is not just hyposecretion of cortisol but what else?

A

All adrenal steroid hormones

65
Q

What causes Addison’s disease?

A

Autoimmune destruction of adrenal cortex

66
Q

What are some of the symptoms/signs of Addison’s disease?

A

Hyperpigmentation
Hypotension

67
Q

Why is there hyperpigmentation in Addison’s disease?

A

Excess MSH (melanocyte stimulating hormone)

68
Q

Why is there hypotension in Addison’s disease?

A

Loss of permissive effects of cortisol on adrenoceptors and loss of ability to retain sodium.

69
Q

The excess production of MSH (melanocyte stimulating hormone) accompanies the excess production of which other hormone?

A

ACTH (adrenocorticotropic hormone)

70
Q

What is Addisonian Crisis/Adrenal Crisis?

A

Life threatening hypotension and hypoglycaemia

->medical emergency

71
Q

What promotes the release of CRH and ACTH?

A

Stress :)

72
Q

There are things that can disinhibit the Hypothalamo-Pituitary-Adrenal axis. This means they inhibit the normal inhibition that cortisol has on ACTH and CRH.
What thigs can bring about this disinhibition?

A

Lack of sleep
Alcohol
Caffeine

->increase cortisol levels basically

73
Q

What effect does elevated levels of cortisol have on the immune system?

A

Reduces effectiveness of immune system hence increasing vulnerability to infection

->IS THIS WHY WE GET ILL DURING EXAM SEASON

do we get ill during exam season?

I usually get ill after exams

Idk

74
Q

As previously mentioned, the adrenal medulla has a neuroendocrine role, similar to which part of the pituitary gland?

A

Posterior pituitary

75
Q

As the adrenal medulla has a neuroendocrine role, how does it release hormones?

A

Directly into bloodstream

76
Q

Describe the process by which the adrenal sympathetic pathway releases hormones into the blood.

A

Long preganglionic fibre coming from sympathetic chain in vertebral column to the adrenal medulla.
Here, there is a shorter postganglionic fibre.
The postganglionic cell releases epinephrine, and some norepinephrine and dopamine into the blood.

->as it’s releasing chemicals into the blood and having a distal effect, it’s a hormone rather than a neurotransmitter

77
Q

What is a phechromocytoma?

A

Rare neuroendocrine tumour found in the adrenal medulla

78
Q

What does a pheochromocytoma result in?

A

Excess catecholamines
This causes increased HR, leading to greater cardiac output and a great increase in BP

79
Q

What is pheochromocytoma associated with?

A

Hypoglycaemia

80
Q

How is pheochromocytoma managed?

A

Surgery- responds well

81
Q

RECAP- if there is pathology impacting the hypothalamus, is this a primary, secondary or tertiary problem?

A

Tertiary

82
Q

If there is hypersecretion of corticotropin releasing hormone, what does this result in the hypersecretion of too?

A

ACTH

83
Q

If there is hypersecretion of ACTH, what else is there hypersecretion of?

A

Cortisol

Basically- hypersecretion of CRH leads to hs of ACTH leads to hs of cortisol

84
Q

Usually hypersecretion of cortisol switches off the secretion of CRH due to negative feedback. When will this not happen?

A

If there is pathology relating to the hypothalamus- a tertiary problem

85
Q

RECAP- if there is pathology impacting the pituitary gland, is this a primary, secondary or tertiary problem?

A

Secondary

86
Q

What happens if there is a secondary problem e.g. tumour in the pituitary gland in the case of the adrenal cortex?

A

Excess amounts of ACTH leading to excess cortisol.
Low levels of CRH however because the excess cortisol feeds back and switches off the hypothalamus, which is functioning, but the pituitary gland doesn’t receive the message as is dysfunctional.

->this may be confusing but if so, go to Lecture 6.2, approx 20mins

87
Q

RECAP- if there is pathology impacting the end endocrine tissue, is this a primary, secondary or tertiary problem?

A

Primary

88
Q

What happens if there is a primary problem in the end endocrine tissue in the case of the adrenal cortex?

A

Hypersecretion of cortisol

This hypersecretion switches off the releases from the hypothalamus and then the ACTH release from the anterior pituitary.
Therefore, only cortisol levels are high

89
Q
A

Year 2- Endocrine System (27 decks)

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