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247 Cards in this Set
- Front
- Back
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Where are the 2 adrenal glands,
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on top of each kidney, and NO direct connection between them
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What are 2 endocrine glands of adrenal
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adrenal cortex and adrenal medulla
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Cells of adrenal cortex produce
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steriod hormone--corisol and aldosterol
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Cell of adrenal medulla secretes
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CCAs Epi and norepinerhpine--
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Adrenal cortex has 3 zones that produces specfic STEROID hormones
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Zona glomerulosa
Zona fasiculata Zona reticularis |
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What does Zona glomerulosa (outmost) produce
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aldosterone-mineralocorticoids
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What does Zona fasciculata produce
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cortisol/glucocoticoids
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What does Zona reticularis produce (innermost)
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androgens such as dehyroepianrosterone
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Numerous lipid droplets -that represent stored cholestrol with what zone
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zona fasiculata
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What does Adrenal medulla produce
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CCAs
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What are 3 main STERIODS of Adrenal CORTEX
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aldosterone
cortisol dehydroepindrosterone (DHEA) |
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What steriod is produced in greatest amount
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cortisol
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Androgens are produced in small amounts, and only soure of androgen is in
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females
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If androgens are only in females, they are converted in other tissue cells to
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testorsterole in males---and estrogen in females
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May adrogens be linked to onset of puberty in males and females and menopause
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YES
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All adrenal steriod hormones are dervaties of cholesterol, how do cells acquire and store cholesterol
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cells take up LDL (lioproteins)
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The first step in converting chosterol to specifc steriods is
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conversion of cholestrol to pregenolone
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What is rate-limiting step in steriod hormone biosynthesis
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conversion of cholesterol to pregnenolone
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Are steriod hormones stored, if not why
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NOT stored but synthetsieze and secreted on demand
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Does increased amount of cholesterol inside cells enchane steriod synthesis
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YES
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What are 2 types of stimui for secretion of cortisol (ANTERIOR PITUTIARY
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Circaidm rhythms
OTHER--Stress stimuli |
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What drives the noraml dialy pattern of glucocortidcoid secretion
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ciccadiam rhythm--related to sleep wake cycles RATHER than LIGHT-DARK cycles
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When do cortisol levels reach a peak
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shortly after you awake from sleep
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When do cortisol levels reach a low
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just after you fall asleep
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What can override circadiam rhythm? Which does what
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stress stimuli--can increase cortisol synthetsis and secretion
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Physical and Psych, stress increase cortisol release--what are types of physical stress
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Hypoglycemia--
Trauma Heavy exercise |
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What are types of psyh stress that increase cortisol
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acute anxiety
chronic anxiety |
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Short-term stress response activates
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adrenal medulla--CCAs
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Long-term stress resonse activates
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adrenal cortex (minneral corticoids and glucocorticoids)
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What are effects of ACTH on extraadrenal
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melanocyte stimulation--skin pigmentation
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What can cause skin pigmentation
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excessively high ACTH levels
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What are negative feedback loops of cortisol
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Cortisol feeback inhibition on hypothalmus and anterior pituitary and ACTH does feedback inhibition on HYPOTHALMAUS
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How does cortisol transported in bloodsteam
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boudn to Cortisol Binding globulin
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IS only free coritsol molecules able to interact with receptors 5%
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YES
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Cortisol is steriod hormones so what is MOA
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binds to interacellualr receptors stimulates gene expression and alters protien synsthsis (long DOA_
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What are tissues that Cortisol has an effect on
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Liver, SM, and Adipose Tissue
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What else beside cortisol has an effect on LIVER, SKM< and adipose tissue
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GH
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What are cortisol effect on liver
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Increases gluconeogenesis
Increase glycogen synthesis Increase urea cycle activity |
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How does liver increase glyconeogenesis via
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increase A.A uptake and metabolism
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Why does liver increase area cycle activity
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to remove excess nitrogen from aa metabolism
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Cotisol has an ANABOLIC effect on liver, what effect does it have on SKM and Adipose
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CATABOLIC
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What effect does cortisol have on SM and Adipose
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inhibit glucose uptake,a nd icnrease metabolism of proteins and lipids for gluconeogensis
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Cortisol has addional effect on adipose wihci is altered fat moblization,WHERE
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extemremeites fats depleted
Trunk-fat increases |
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Cortisol is important for what developmental effects
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normal fetal development
contributes to differentiation of cells cortisol to mother--gives infant surfactant |
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Cortisol is important for what type of pschic effect
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emtional stability, and euphoria with high levels
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Permissve effects of thryroid hormone are upregulates beta-adrenegic receptor an enchanes action of epi and norep, what are permissive aciton of cortisol
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increase BV vasoconstriction
cortisol enchances acction of epi on lipid metabolism |
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Does cortisol cause inhibitiron of non-essentail functions such as reproductiona nd growth
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YES
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How is cortisol anti-inflammatory//immunosuppression
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inhibtion of PGs, stabilizae lysoomal membrane preventing release of proteolytic enzymes--immuno suppres growth and immune cells
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What effect do glucorticoids have in high doses (cortisol)
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inhibit inflammaotry resonse
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What are benefits of immunosuppressive actions
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suppress rejection resonse to transplanted organs
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What happens result of chornic use of glucocorticod therapy
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supression of ACTH, results in loss of tropic action on adrenal cortex, so adrenal cortex atrophies
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Can abrupt withdrawl fo glucocorticoid theraphy be life treatening
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YES
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What is benfit of slow withdrawl of glucocorticoid therapy
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allows CRH-ACTH adrenal system to become operational agin, allowing ACTH levels to rise and sumualte adrenal cortex to prodce cortisol
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What is the primary mineralcortoid prodcue by zona glomerulosa
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aldosterone
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What are 2 primary regulators of aldosterone
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K+
Angiotensin II, which is controlled both by kidney |
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What are physiogical actions of aldosterone
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Increase sodium renetion,and water rentention, and increases K+ excretion
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What happens to urinary output from aldosterone
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Urinary sodium decreases, and K+ urinary increases
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Aldosterone is a steriod-bases hormone how does it increase Na+ transport into cell
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increases Na+ channels, and increase Na+K+ ATPase activity
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What is a direct simulatory effect to release aldosterone
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increase K+ or decreased Na+
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What is a indirect effect to release aldosterone
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decreased Blood volume--leads to angiotensive II production with sitmulates aldosterone release
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Decrease blood volume/blood pressure triggers kidney
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to release rein, which converts angiotensionoge from liver to angiotnesin I
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Angiotnesiv I is converted to Angio II by
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AcE in ling
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Angiotensin II stimulates
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the zona glomerulosea to produce aldosterone
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Factors that regulate renin rlease from kidneys are
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dedecrease BP and BV
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What are 3 effects of angiotensin II
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vasoconstrtion of BV, stimulates Adernal cortex to increase aldosterone, increases sodium reabsrotion, stiumates brian to increase ADH and increases H20 reabsorption
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What is primary regulator of aldosterone release
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Plassma K+
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Small changes in K+ directly affect what cells
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zona glomeruosa cells, which increase aldosterone secretion
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An increase in plama K+ does what
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depolaries excitable membrane results in cardiac arrhythmias
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A decrease in plama K+ does what
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hyperpolarizes cell membrane--leads to cardia arrhytmias and possible death
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Is tight control of plsam K+ critical to homoestatis and lfie
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YES
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What is a main disease of primary hypofunction of adrenal cortex
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Addison Diesases
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What is cause of Addison Disease or hypofunction
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desturction of adrenal cortical cells--need replacment therapy
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What are clinical mamifestation of Addison's disease of hypofunction
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Hyperpigmentation
Mineralcorticoid deficiency Glucorticoid deficiney |
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What causes hyperpigmentation
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High ACTH levels, b/c cortisol levels lover, and less NEAGIVTE feedback
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What causes mineralcortiocoid defineicy
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increase renal loss of Na+ and increase K+ retention, and decreases ECF/plasma volume and decrease CO
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What is result of glucocorticoid deficinecy
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Hypoglycemia, Ffatigue, weakness,
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What is Andernocrotical hyperfunction disease
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Cushing disease primary or secondy
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What are symptoms of Cushing syndrome
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abnormal fat depoistion, protein metabolism, muscle wasting, and hyperglycemia,
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What are Hypo and Hyper of Throid
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Hypo-Hasimoto's
Hyper--Graves |
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What is hypo /hyper of adernal cortex
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Hypo-addisons
Hyper-Cushing |
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What is site where fetus develops
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uterus
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What is inferios aspect of uterus that extends into vagina
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cervix
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What are 3 layers of uterus
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Perimterium
Myomterium Endoemtrium |
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What wall layers thickness varies during menstual cycle, paritally removed during period, and site for implantation of ovum at start of pregnancy
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endometirum
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What extends laterally from uterus to each ovary, but do NOT contact overay
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Uterine tubes or follopain tubes
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Mature ovulated egg (oocyte) travels from
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ovaeries to fallopain tubes to uterus
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What is distal end of uterine tubues wehre fertilization of oocyte occurs
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ampulla
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What are fimbria
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ends of enterine tubes , that have beating cillia that caputes the ovulated oocyte to carry into uterine tubes
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What is function of ovary
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produces are release mature oocytes
2. produces aer secretes large amount of hormones |
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What is oogenesis
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production of eggs
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What are states of oogensis
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1. Oogogina
2. Primary ooctyes 2. Secondary oocytes |
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When does oogonia occur
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all oogonia are formed within the 1st 3 months of gestation
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What happens during oogonia
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germ cell undero many mitoric divsion, and produce about 4 million ooogonia
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What happens after 3rd month of development
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MITOSSI stops and no new oogniona are ever produced again
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After MITOSIS stops, what happens
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oogonia b/c primary oocyte , then suppround by a single layer of granulosa cells--forming primordial follicule
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What do the primary ooytes do
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BEGIN but do NOT complete a 1st mitotic division
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At birth, what happen
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born with 2 million primoridal follicles
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What is benefit of follocies
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respond to hormonal singals--the oocyte does not
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Orrgoina and Pimary oocytes and primordial follices occur during, where does secondary ooctyes occur
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1st 2 fetus---Secondary occutes is puberty
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By the time puberty is reach, how many primary oocytes remain
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400,000 remain
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Each month what happens
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several follicles or primary oocytes are activate and continue matruation
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What is the dominant follicle
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ONLY one follicle will complete the 1st MEIOTIC division
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THe one folicle that completes the 1st MEIOTIC division will form
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secondary oocyte and a polar body
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What does a secondary oocyte contain
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23 chromosomes and almost all of cytoplasm
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What does polar body contain, and what happen
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nearly devoid of cytoplasm--goes a 2nd meiotic divsions which degenerate
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What happens to secondary oocyte
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START a second meiotic dvision but stops in metaphase II
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When the secondary oocyte is then matrue and ovulated when will it complete 2nd meiotic divsion
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after it is fertilized by a sperm cell--otherwhise deterioes
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Each month only ONE mature oocyte is ovulated, over a normal reproductive life that amounts to how many oocytes
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500
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What are 3 phases of ovarian cycle
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Follicular phase
ovulation luteal phase |
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What cell type does the follicular phase begin with
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primordial follicle
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Several primordial follicles are actived and what happens
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folliclar cells proliferate in number around primary oocyte, adn secrete a glycoprotein rich substance
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The follicular cells secrte a glycoprotein rich substance that forms
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the zona pellucia which is bettwen the oocyte and granulosa cell
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Then another outer layer forms around the follice, is
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Theca
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The granulose cel then secrte a fluid which forms
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into an antrum
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Are a number of perantal/early antral follicules always pressent,
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YES
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What marks the REAL begging of the follicular phase
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Dominant follile
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One one of the growing follicles becomes dominant,and continues to grow into a mature follicule, what happens to all other follicules
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atresia
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What happens to dominant follicule
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The primary oocyte inside the follicle completes its 1st meotici division, and b/comes a secondary oocyte, which begins its secondary meotitic division but does not complete it
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What triggers ovulation
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hormonal signals trigger the follicle to secrete enzmes to break down ovrain memrane, and release seoncdary oocyte
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The FOlluclar phase is what
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Development of mature follicle and secondary ooctye
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The luteral phase begins with
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Corpus Luteum
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What composes the corpus luteum
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consits of the granulosa and tecal cells left over after the 2nd oocyte is released from ovary
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The corpus lutem is yellowish in color and increases in size and secretes 3 hormones
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1. Progesterone
2. Estrogen 3. Inhibin |
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What happens if ovum is not fertilized
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corpus luteum degrades in 12-14 days
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What happens if ovum is fertillized
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corpus lutem continues to secrete estrogen and progesteron until placenta can take over (3months
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What is the princiap estrogen secrted
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estradiol
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The ovarian cycle is completely dependent upon
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hypothalamus, anterior pittuairy and ovary interactions
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What are 5 principals hormones of ovarian cycle
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GnRH FSH, LH estrogen and progesterone
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Before puberty, what prevents Follicular phase
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small amounts of estrogen provide negative feedback to hypothalmus to inhibit GnRH secretion
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What happens in puberty that starts folliuclar growth
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hypothalamus less senstiive to estrogen, GnRH is rlease an stimulates release of FSH and LH, which start follicle growth
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After a few years of low level actiivty GnRH, FSH adn LH secretion b/c high enough to trigger
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dominant follicle grwoth and ovulation to start adult ovarian menstural cycle
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What days are early folluclar phase
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days 1-6
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What happens in early follicular phase
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GnRH secretes FSH and LH stimulate preantral and antral follcile to growth and devlopment, and estrogen and progesterone very low
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What does FSH do
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stimulates granulosa cell to increase in size, and number,and stimulates graulos cells to produce and secrete estrogen
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What does LH do
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sitmulates thecal cells to proliferate and to produce and secrete androgens, which are used by granulosa cells to produce estrogen
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LH stimulates Theca cells to
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thecal cells to grow and make androgens, which diffuse to granulosa cells
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What do granulosa cells do with androgens
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covert andogens to estrogen, and FSH helps granulosa cells secrete estrogen
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What days mark middle foicilar phase
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6-12
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What happens once follicles cells secrete estrogen
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estrogen rises, and exerts a negative feeback on hypothalmus and anterior pituatiary to decrease GnRH and FSH and LH
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How does estrogen act as a postive feeback autocrine mediator
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it simulates proliferation of granulosa cels and increases stregoen produces
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Then one follicle becomes dominant, and other undero atresia, what does dominanst follcile do
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estrogen levels rise SHARPLY
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Does dominant follicle respond to FSH and LH even though their plasam levels are decreasing
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YES
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Increasing inbhibin levels have what effect on anterior pitituary
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has a negative effect on FSH
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What is the late follicular phase
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days 12-14
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What happens around days 12-14,
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estrogen plsama levels peak around days 12-14 due to high output of dominant follicle
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What do high estrogen levels stimulate
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postive feedback effect
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What is the postive feedback effect of estrogen
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estrogen simulates hypothalamus to and anterio pitutary resulting in a LH and FSH surge
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When does LH surge occur
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apporx 18 hours before ovulation
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What does the LH surge trigger
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the primary oocyte to complete its first meiotic division and b/c a secondasry oocyte--dominat follicle is fully matured
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What is day 14
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ovulation
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After LH surge causes the development of the matutre follicule (secondary oocyte), what happens
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mature follicle decrease estrogen production, and begin an increase in progesterone secretion
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When does progesteron secretion occur
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just before ovulation
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May one see a rise in body temp during ovulation
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YES
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What is luteal phase
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days 14-28
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What is 1st thing that happens after ovulation
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formation of corpus luteum
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Does LH surge trigger lueinzation
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YES
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What does corpus luteum produce
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produces and secretes large amount of progestone and estrogen, and inhbin
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Even as LH levels drip does corpus lutem continue to respond to LH for
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10-12 days
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What does progesterone is the presence of estrogen do
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inhibits the hypothalmus and reduces GnRH secretion leading to decreased LH and FSH secretion
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During the luteal phase estrogen concentrations are high gain, what prevents another LH surge
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progesterone inbhits
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Low FSH and LH levels prevent
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follicle growth
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What does birth control durgs mimic
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the luteal phase
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How do birth control drugs mimic the luteal phase
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use elveated progesterone and estrogen to suppres LH and FSH and prevent LH surges and ovulation
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Corpus lutem if not fertilized degenerates after 10-12 days, and loss of corpus lutem leads to
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sharp decrease in progesterone and estrogen
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If progesterone and estrogen levels concentrations drop, what happen
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GnRH and FSH and LH begin to rishe b/c negative feedback inhibhition is gone
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What contracts during menstration and during childbirth
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myometrium
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What is the permanant endometrium layer
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startum basalis
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What layer of endometrium undergoes dramituc changes during ovarian/menstural cycle, and site for fertilzied ovum
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stratum functionalis
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What are phases of UTERINE cycle
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mentstural phase, proliferative phase, and secretory phase
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What is proliferative phase dependent on
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estrogen
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The estrogen produced by the maturing follicles sitmulates
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proliferation of endometerial cell,
growth of myometrium, increases endometrial receptors, and prodcues clear thin mucus in cervix |
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What is benefit of estrogen producing a clear, thin, mucus in cervix
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allows easy passage of sperm from vagina into uterus
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What is main hormone of secretory phase
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progesterone
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What happens in secretory phase
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progesterone from corpus luteum acts on estrogen primed endometium to prepare for uterus implantation
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What does progesterone do n the estrogen primed endometrium
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futher proliferation of blood vessels and glands
secretion of glycogen and glycoproteins into uterus |
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Progesterone also stimulates secretion of glycogen and glycoproteins and
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thick visouc mucus in cervix
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What is the benfit of thick mucus
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forms a cervical plug to prevent bacterial contamination of uterus
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Does progesteron inhbit smooth muscle activity
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YES--keeps myometrium from contract and expelling embryo
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If ovum is not fertilized, what happens
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corpus letuem dengerates and progesterone and estrogen produciton strops
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Without progesteron eand estrogen the straum functionalis is not maintained and degenerates, this is
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the menstrual phase
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What do events occur in menstural phase, which is mediated by prostaglandins
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blood vessels constrction depriving endometrium of blood supply leading to degeneration and uterine smooth muscle contracts---expel endometrium
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Can excessive production of prostaglands cause menstrual cramps
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YES--treat with ibuprofen
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Does blood vessel dialtion occur after intial constrition, what is benefit
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washes out endometrial debris
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What are sugars, stored as
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glucose, fructose, stored as carbs
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What are Triglycerids, broken down
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consists fo fatty acids attached to glycerol, broken down to ketone bodies
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A.A are funciton enzymes, and ca be used as enegy stored as
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proteins
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Why should we regulate blood glucose
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is a perferred fuel some for tissue, and at high levels can damage tissues
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Does glucose at high levels cause all problems of diabetes
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YES
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What are normal fasting levels
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75-115 mg/100ml
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What are tyical plasma glucose values after a high carb meal
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>200, and qucily return to fasting level
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Does energy needs conincide with meal times, so what do we need
|
NO--we need more energy when exercise-that why we need storage adn rlease
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How is glucose uptaked inot he cell in presence of high glucose
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Glucose transports are upregulated, and all passive diffusion of glucose into cell
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What allow passive glucose diffusion into cell
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conversion of glucose to glycogen once enters cells, allows celluar glucose concentrations below plasma glucose
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How does insulin function to decrease blood glucose
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by increasing glucose storage
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What is function of glucoagon
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functions to mobilize glucose from storage
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What are main glucose transporters
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GLUT2 and GLUT 4
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What is function of GLUT-4
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reulation by insulin-important drug target for diabetes patients
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What is function of GLUT-2
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is exresspress in pancretic cells, part of glucose sensing appartatus
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What are 2 functions o f pancrease
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endocrine--hormone
exocrine-digestive enzymes |
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What is function of islets of Langerhands
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secrtes hormones into a portal vein, and transported directly into liver
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What organ sees 2X more insulin, and why
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LIVER--insulin is released into portal system goes directly to liver
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If 2X of insulin is in liver, is this a main problem of therapetic insulin
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YES--cant get 2X of drug insulin into liver by injection
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What do alpha cells of islet release
What do beta cells of islet release |
Alpha-glucagon
Beta-insulin |
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Proinsulin cleaved forms
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Insulin and C-peptide
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What does C-pepdie levels measure
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how much insulin your patients is making
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What is most important signal triggering insulin release
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increase blood glucose
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What are other MAIN factors that trigger insulin rlease
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Gastric hormones, and parasympathetic nervous
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What are MINOR factors that reulgate insulin secretion
|
GAGE
Glucagon, Amino acid/fatty ction/ Glucocorticoids, and epi |
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What does epinehirne do to insulin secretion
|
DECREASES
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The insulin is a protein kinase receptor, how does it work
|
phosphorlation leads to activation of enzymes used to store fuel, and inhbit enzymes used to mobilize mobilized fuel
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What is a major symptoms of type 2 diabetes
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Insulin resistance
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Resistance to insulin effects are coupled to
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increased insulin production
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Does act of exercise lower blood glucose
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YES
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What does Foxa2 do
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activates expression of genes involved in fatty-acid oxidation
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What does Foxo1
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acctives expres of genes involved in gluconegensis
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Which is more senstive to insulin
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Foxa2
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Chronic high psla insulin leads to
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down regulation of receptor number
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What is insulin effect on carbohydrate metabolism
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glycogen synthesis is simulated in liver and muscle and glucoeneogenesis is inhbitied in liver
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What is major source of glucose for diabetic pts
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gluconeogensis
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What is insulin effects on lipid metabolism
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trigylerid storge is activated in adipose tissue
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Direary cholesterol and Triglycerides are transported by chylomicrones, how do triglyceride eneter cell
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Lipoprotein lipases cleave, and allow enter to enter cell
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What are insulin effects on protein metabolism
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active protein synthetis especially in muscle
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AA comes from muscle, and is transported to
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liver
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WHen is muscle tissue senstied to uptake glucose by
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parasympathetic signal to liver and HISS to muscle
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What are inducers fo glucagon secretion
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decrease blood glucose and amino acid
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What is most potenet amino acid that induce glucagon secretion
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arginine
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What happens in high protein diets
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both insulin and glucagon are secretion
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WHat is benefit of insulin and glucagon BOTH being secreted in high proten diets
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Glucogaon keeps blood glcucose up, while insulin promotes storage of aa
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Are parasymthpatetic and sympathetic simtuaate inducers of insulin secretion and glucagon secretion
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YES
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What are inhibitors of glucoagon
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high blood glucose, and fatty acids
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What effect does glucogon have on carbohydrate metabolism
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glyocogen breakdown, and stimulates gluconeogenesiss
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What is glucagon effects of lipid metabolism
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stimulates hormone lipase, which caues breakdown of tryglycerides--fatty acids
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Fatty acids can be used by muscle for energy, ketones boides and then made in liver, and is a source of energy for
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heart adn SKM---
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What is glucagon effect on protein metabolism
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cuases protein degrateion into amino acids used for gluconegensisi
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A product of protein degradion is nitrogen, which builds up as ammonia what happens with glucagon
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stimulates ammonia conversion to urea
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What is function of somatostsin
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inhibts both insulin and glucagon
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Somatostatin may be useful as a therapy to inhibit glucagon secretio in diabetes, why
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need to stop gluconegensis
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IF I/G levels are high what predominates
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insulin predominates--ledags to storgae of fuel
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If I/G levels are low what predominates
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GLUCONG--catabolic state leads to mobilization of fuel
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What role does glucagon play in diabetes (TYPE 1)
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lack of insulin leads to lack of glucose sensing by aplah cells of the islet
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Is insulin require for alpha cell to sense glucose
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YES
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Type 1 Diabetes is caused by combination off TOO little insulin, and too much glucagon
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YES
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Leptin is an adipose tissue secretion that serves to
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inhibit eatin
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Does leptin function as main homeostatic regulator of body weight
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YES
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Leptin levels are quire high in obese people suggseting that obesity may reflect
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leptin resistance
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Increased levels of ciruclating TNF
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insulin resisance
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IS PAl-1 expression a hallmark of obesity
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YES
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