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Endocrine > The Adrenal Gland > Flashcards

The Adrenal Gland Flashcards

1
Q

Peritonisation of adrenal glands

A

Retroperitoneal

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2
Q

Other organs that are retroperitoneal

A

SAD PUCKER

Suprarenal glands
Abdominal Aorta
Duodenum (2nd to 4th part)
Pancreas
Ureters
Colon (ascending and descending)
Kidneys
Esophagus
Rectum
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3
Q

2 components of adrenal gland

A

Medulla

Cortex

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4
Q

What percentage of the adrenal gland is made up by adrenal medulla?

A

25%

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5
Q

What is secreted by the adrenal medulla?

A

Catecholamines

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6
Q

Name the catecholamines secreted by the adrenal medulla

A

Epinephrine
Norepinephrine
Dopamine

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7
Q

What tissue is the adrenal medulla derived from?

A

Neural crest - modified sympathetic ganglion

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8
Q

What tissue is the adrenal cortex derived from?

A

Mesoderm - true endocrine gland

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9
Q

What is secreted by the adrenal cortex?

A

Steroid hormones

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10
Q

Name the types of steroid hormones secreted by the adrenal cortex

A

Mineralocorticoids
Glucocorticoids
Sex hormones

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11
Q

What type of steroid hormone is aldosterone?

A

Mineralocorticoid

Secreted by adrenal cortex

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12
Q

Cortisol is which type of hormone?

A

Glucocorticoid - secreted by adrenal cortex

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13
Q

Name the 3 zones of the cortex and what they secrete

A

Zona glomerulosa - aldosterone
Zona fasciculata - glucocorticoids
Zona reticularis - sex hormones

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14
Q

What is secreted in the zona fasciculata?

A

glucocorticoids

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15
Q

What is secreted in the zona glomerulosa?

A

aldosterone

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16
Q

What is secreted in the zona reticularis?

A

sex hormones

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17
Q

What are all products of the adrenal cortex derived from?

A

Cholesterol

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18
Q

Why are different products produced in the cortex if derived from the same?

A

Different enzymes

All derived from cholesterol

19
Q

Common cause of congenital adrenal hyperplasia

A

Defects in 21 hydroxylase

20
Q

Effects of 21 hydroxylase deficiency

A

Adrenal Hyperplasia
No cortisol produced, no negative feedback on CRH from hypothalamus
ACTH produced in excess
Glands enlarge

21
Q

Describe the hypothalamic-pituitary-adrenal axis

A

Hypothalamus- CRH
CRH promotes Anterior pituitary - ACTH
ACTH promotes Adrenal Cortex - Cortisol
Negative feedback from cortisol and ACTH on CRH secretion

22
Q

Which products of the adrenal cortex are unaffected/driven to excess with 21 hydroxylase defect/deficiency?

A

Androgens

Produced in excess as precursors driven to this pathway

23
Q

95% of cortisol is bound to which carrier protein?

A

Cortisol Binding Globulin

24
Q

What pattern does cortisol release follow?

A

Circadian rhythm
Peak in morning, lowest at midnight
Preceded by ACTH release

25
Q

What can lead to fluctuations in cortisol release?

A

Stress-related stimuli

26
Q

What is cortisols role in survival?

A

Protect brain from hypoglycaemia

27
Q

What is cortisols role during hypoglycaemic challenge?

A

Permissive to glucagon

28
Q

What is the effect of cortisol on muscle and adipose tissues?

A

Increases proteolysis
Increases lipolysis
Decreases insulin sensitivity of both tissues

29
Q

Effects of cortisol on glucose metabolism (4)?

A
  1. Gluconeogenesis – cortisol stimulates production of enzymes in liver
  2. Proteolysis – stimulated to give gluconeogenic substrates for liver
  3. Lipolysis – stimulates within adipose tissue  increased FFA alternative fuel – glycerol for gluconeogenesis
  4. Decreases insulin sensitivity of muscles and adipose tissues
30
Q

4 non-glucocorticoid actions of cortisol

A

Negative effect on Ca2+ balance
Impairment of mood and cognition
Permissive effects on norepinephrine
Suppression of the Immune System

31
Q

Side effects of glucocorticoid therapy

A

Thinning skin
Muscle wasting
Increased frequency and severity of infection

32
Q

Which type of hormone is aldosterone?

A

Mineralocorticoid

33
Q

Where in the kidney does aldosterone act?

A

Distal tubule

34
Q

Action of aldosterone

A

Increase Na+ Resorption

Promote K+ excretion

35
Q

Effects of increased aldosterone levels

A

Increased circulatory volume

Increased BP

36
Q

Hypersecretion of Cortisol leads to what conditions

A

Cushings syndrome
Cushings disease
Both due to tumour within HPA axis

37
Q

A tumour in which location leads to Cushings syndrome

A

Adrenal cortex

Primary hypercortisolism

38
Q

A tumour in which location leads to Cushings disease?

A

Pituitary

Secondary hypercortisolism

39
Q

Causes of hypercortisolism

A

Cushings syndrome/disease

Iatrogenic

40
Q

Which condition leads to hyposecretion of cortisol?

A

Addison’s

41
Q

How does addison’s disease occur and what is the effect?

A

Autoimmune destruction of adrenal cortex

No steroid hormones secreted

42
Q

Name given to tumour of adrenal medulla

A

Phaeochromocytoma - neuroendocrine tumour

43
Q

Effects of phaeochromocytoma

A

Excess catecholamines
Raised HR, CO, BP
Diabetogenic

44
Q

Risk of withdrawing glucocorticoid therapy

A

Adrenal insufficiency

Endocrine (3 decks)

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