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63 Cards in this Set

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  • Back
What are the three layers of the adrenal cortex?
zona glomerulosa
zona fasciculata
zona reticularis
This layer of the adrenal _______ produces mineralcorticoids: aldosterone/DOC:
cortex, zona glomerulosa
This layer of the adrenal _______ produces glucocorticoids: cortisol.
cortex, zona fasciculata
This layer of the adrenal _______ produces gonadocorticoids: androgens.
cortex, zona reticularis
Contains chromaffin cells secreting mainly epinephrine & small amounts of norepinephrine.
adrenal medulla
These cells of the adrenal medulla secrete mainly epi and small amounts of norepi:
chromaffin cells
All adrenal hormones are _________, made from __________.
steroids, cholesterol
Synthesis of Adrenal Cortex Hormones

The specific hormone that is ultimately secreted once ______________ is formed is determined by the enzymatic makeup of the particular cells involved.
Adrenal steroid hormones are transported in blood bound to a specific plasma protein called __________ or ___________________ and to a lesser extent to albumin.
transcortin, corticosteroid binding globulin (CBG)
Like albumin, CBG (________________) is synthesized and secreted by the _____, but its concentration is only about 1000th that of albumin.
corticosteroid binding globulin, liver
About ___% of the glucocorticoids and about ___% of the aldosterone in blood are bound to protein. For this reason, adrenal steroids have a relatively long half-life in blood -- about 90 minutes for cortisol and about 30 minutes for aldosterone.
95%, 60%
The adrenal medulla is in effect a _________________ ganglion in which the post-ganglionic neurons have lost thier axons and become secretory cells.
The adrenal medulla cells secrete when stimulated by the pre-ganglionic neurons that reach the adrenal gland via the ___________ nerves.
These hormones are from the adrenal cortex and are essential for the maintenace of sodium balance and ECF volume.
These are adrenal cortex hormones that have widespread effects on the metabolism of carbohydrates and proteins.
Secretion of glucocorticoids and sex steroids are mainly controlled by _____ from the ________.
ACTH, anterior pituitary
Mineralcorticoid secretion is subjected to independent control by substances in the circulation, of which the most important is _______________, a peptide formed in the ____________.
agiontensin II, bloodstream
The adrenal veins drain venous blood, but do so in an asymmetrical fashion. On the right side, the adrenal vein directly enters the ____________, whereas on the left, it usually drains into the _______________.
inferior vena cava, left renal vein
The adrenal medulla accounts for ________% of the mass of the adrenal gland.
The rate-limiting step of steroid hormone biosynthesis is the conversion of the 27-carbon cholesterol molecule to the 21-carbon ___________ molecule.
This is the common precursor of all steroid hormones produces by the adrenals as well as the gonads.
The major glucocorticoid in humans is _______. Its secretion is strongly stimulated by ____ from the ________.
cortisol, ACTH, anterior pituitary
Basal secretion of ACTH follows a ________ rhythm driven by the ____.
diurnal (Activity is defined at certain parts of the day), CRH
Activity is defined at certain parts of the day
Although named for their critical role in maintaining carbohydrate reserves, _____________ produce a number of diverse physiological actions, many of which are still not well understood. Virtually every tissue of the body is affected by an excess or deficiency of _________. If any simple phrase could describe the role of __________, it would be "coping with _______". Even if carbohydrate intake were adequate, individuals suffering from adrenal insufficiency would still teeter on the brink of disaster when faced with a threatening situation.
glucocorticoids, glucocorticoids, glucocorticoids, adversity
Physiological Effects of Glucocorticoids Effects on Metabolism
- 3 things -
-Increased protein catabolism (proteolysis)
-Increased lipolysis
-Increased gluconeogenesis by the liver
The bottom line is that _________ protects against hypoglycemia by increasing glucose production by the liver, increasing protein breakdown and elevating FFA levels.
Many of the effects of cortisol serve to generate high levels of precursors for ________________. This should make sense considering how cortisol is referred to a hormone that protects us in the face of stress. However, this also means that cortisol confers a tendency to hyperglycemia and decreased carbohydrate tolerance, which can cause problems (e.g. -- for patients with diabetes mellitus who are placed on high doses of glucocorticoids).
hepatic gluconeogenesis
__________ is needed to maintain normal vascular integrity and responsiveness. In the absence of ________, abnormal ______________ occurs, so that even without an external loss of fluid, the filling of the vascular bed is reduced and blood pressure falls.
cortisol, cortisol, vasodilation
Normal _____ function requires cortisol. In its absence, glomerular filtration rate _____ and water cannot be excreted as rapidly.
renal, falls
Cortisol also has a ________________ effect that is partly responsible for normal sodium retention and potassium excretion. Although aldosterone is some 300-600 times more potent a ___________ than cortisol, under normal circumstances 200 times more cortisol than aldosterone is secreted. Therefore, a substantial part of overall _____________activity is derived from cortisol.
mineralcorticoid, mineralcorticoid, mineralcorticoid
When blood pressure is reduced, the ___________________ mechanism is activated to stimulate aldosterone secretion and not cortisol. Thus, when extra mineralocorticoids are needed, aldosterone and not cortisol serves that function.
_____________ inhibit the inflammatory response to tissue injury by inhibiting the production of many inflammatory mediators such as histamine, cytokines, leukotrines and prostaglandins. This effect requires high levels of circulating ______________ and cannot be produced by administering steroids without producing the other manifestations of ____________ excess. However, local administration of ________________ -- e.g. by injection into an inflamed joint or near an irritated nerve-- produces a high local concentration of the steroid, often without enough systemic absorption to cause serious side effects.
Glucocorticoids, glucocorticoids, glucocorticoids, glucocorticoids
The actions of _____________ in patients with bacterial infections are dramatic but dangerous. Not only does cortisol decrease the formation of inflammatory mediators, but it also decreases the migration of many ___ to sites of injury. This is also a major mechanism of the anti-inflammatory actions of cortisol, BUT it also increases the susceptibility to infection that can occur following chronic secretion of cortisol or chronic exogenous administration.
glucocorticoids, WBCs
_________ are the hormones that exert masculinizing effects, and they promote protein anabolism and growth.
Testosterone from the testes is the most active androgen, and the adrenal androgens (_______________ and _______________) have less than 20% of its activity.
androstenedione & DHEA- dehydroepiandrosterone
Secretion of the adrenal androgens is controlled by ______, but not by the ________ (FSH & LH). The plasma level of DHEA peaks around age 25 in normal men and women and declines steadily thereafter to low values in old age. The secretion of adrenal androgens is nearly as great in castrated males as it is in normal males, so it is clear that these hormones exert very little masculinizing effects when secreted in normal amounts. However, they can produce appreciable masculinization when secreted in excessive amounts. In adult males, excess adrenal androgens merely accentuate existing characteristics; but in prepubertal boys, they can cause sex characteristics without testicular growth (______________). In females, they cause female _____________ and adrenogenital syndrome.
ACTH, gonadotropins, precocious pseudopuberty, pseudohermaphroditism
The adrenal androgen ________ is converted to testosterone and to estrogens in the circulation. It is an important source of estrogens in men and postmenopausal women.
Aldosterone is the primary _____________. The major function of aldosterone is to control body fluid volume by increasing the reabsorption of ___________ by the kidneys. At the same time, aldosterone also promotes the excretion of _____ via the kidneys.
mineralcorticoid, sodium, potassium
The stimulus for aldosterone secretion originates in the kidneys when cells in the _______________ synthesize and secrete renin into the blood.
juxtaglomerular (JG) apparatus
_____ secretion is stimulated by such things as sodium depletion, hypotension, hemorrhage and dehydration.
What is produced by the juxtaglomerular (JG) apparatus?
The kidneys posses __________________ that sense changes in blood pressure.
intrarenal baroreceptors
In the blood, renin splits off ________________ from its substate ____________, a protein synthesized by the liver. __________ is biologically inactive but is rapidly converted into the active compound _______________ by the action of ___________________________.
angiotensin I, angiotensinogen, angiotensin I, angiotensin II, angiotensin converting enzyme (ACE)
Most of the ACE that forms angiotensin II in circulation is located in __________ cells. Much of the conversion occurs as blood passes through the ________, but there is also conversion in many other parts of the body.
endothelial, lungs
__________ cells line the entire circulatory system, from the heart to the smallest capillary
Angiotensin II exerts two major actions, one as a direct arteriolar ______________ and the other as a stimulus to ___________ secretion.
vasoconstrictor, aldosterone
_____________ are a class of anti-hypertensive drugs that block the conversion of angiotensin I into angiotensin II. Examples of ACE inhibitors include captopril and enalapril. Another class of anti-hypertensives is the angiotensin II receptor blockers, such as losartan.
ACE inhibitors
__________ specifically refers to a tumor in the pituitary gland that stimulates excessive release of cortisol from the adrenal gland by releasing large amounts of ACTH.
Cushing's disease
Symptoms include rapid weight gain, particularly of the trunk and face with sparing of the limbs (central obesity), a round face often referred to as a "moon face", excess sweating, telangiectasia (dilation of capillaries), thinning of the skin (which causes easy bruising) and other mucous membranes, purple or red striae (also caused by thinning of the skin) on the trunk, buttocks, arms, legs or breasts, proximal muscle weakness (hips, shoulders), and hirsutism (facial male-pattern hair growth). A common sign is the growth of fat pads along the collar bone and on the back of the neck (known as a buffalo hump). The excess cortisol may also affect other endocrine systems and cause, for example, reduced libido, impotence, amenorrhoea and infertility. Patients frequently suffer various psychological disturbances, ranging from euphoria to frank psychosis. Depression and anxiety, including panic attacks, are common.

Other signs include persistent hypertension (due to the aldosterone-like effects) and insulin resistance, leading to hyperglycemia (high blood sugars) which can lead to diabetes mellitus. Untreated Cushing's syndrome can lead to heart disease and increased mortality. Cushing's syndrome due to excess ACTH may also result in hyperpigmentation of the skin, due to its ability to stimulate melanocyte receptors.
Cushing's disease
intentional exogenous administration of hormone
A rare endocrine disorder in which the adrenal gland produces insufficient amounts of steroid hormones (glucocorticoids and often mineralocorticoids). It may develop in children as well as adults, and may occur as the result of a large number of underlying causes.
Addison's disease
____ is a 39-amino acid peptide hormone processed from a large precursor molecule, pro-opiomelanocortin (POMC). Within the corticotropes, a single mRNA directs the synthesis and processing of POMC into smaller biological active fragments which include b-LPH, a-MSH and b-endorphin. ACTH is the only product of POMC whose physiological role is clearly established in humans.
Tumor of adrenal medulla: epi and norepi
Interesting tumors: waxing and waning up dumping of epi and norepi – exagerated SNS response. High BP, HR, sweat a lot.
A neuroendocrine tumor of the medulla of the adrenal glands originating in the chromaffin cells, which secretes excessive amounts of catecholamines, usually adrenaline and noradrenaline (epinephrine and norepinephrine in the US
Originally thought to come from the brain. Unique marker in blood, elevations can indicate CHF. Can cause Na loss but main stimulus is volume expansion.
B-type natriuretic peptide (BNP)
Recently, a hormone produced by the ventricles of the heart, ______________ has been shown to increase in response to ventricular volume expansion and pressure overload.
B-type natriuretic peptide (BNP)
______ is a marker of ventricular systolic and diastolic dysfunction. This test is useful in diagnosing congestive heart failure. It is not useful for diagnosing other heart conditions.
B-type natriuretic peptide (BNP)
_____________ is a protein hormone synthesized and secreted by the muscle cells in the atria (and to a much lesser extent in the ventricles) of the heart.
Atrial natriuretic peptide (ANP)
Increases in blood volume and blood pressure as well as increases in plasma sodium stimulate the secretion of ______.
Atrial natriuretic peptide (ANP)
Opposite of aldosterone.
Atrial natriuretic peptide (ANP)
-stimulates urinary excretion of Na+ by inhibiting Na+ reabsorption
Atrial natriuretic peptide (ANP)
-stimulates a diuresis
relaxes smooth muscle of arterioles
-inhibit renin release
inhibits ADH release from the posterior pituitary
Atrial natriuretic peptide (ANP)