Physiology Ch. 77

Front 1

Two parts of the adrenal glands

Back 1

Adrenal medulla and adrenal cortex

Front 2

part of the adrenal gland that is related to sympathetic nervous system and secretes epinephrine and norepinephrine

Back 2

the andrenal medulla

Front 3

what does the adrenal cortex secrete?

Back 3

corticosteroids synthesized from steroid cholesterol

Front 4

where do mineralcorticoids and glucorticoids (adrenocortical hormones) and sex hormones such as androgenic hormones come from

Back 4

the adrenal cortex

Front 5

what affects the electrolyes of extracellular fluids

Back 5

mineralocorticoids

Front 6

what increases blood glucose concentration

Back 6

glucocorticoids

Front 7

the principal mineralocorticoid

Back 7

aldosterone

Front 8

principal glucocorticoid

Back 8

cortisol

Front 9

what is the zona glomerulosa

Back 9

thin outer layer of adrenal cortex that secrete aldosterone because they have aldosterone synthase

Front 10

what controlls secretion of zona glomerulosa

Back 10

angiotensin II and potassium

Front 11

zona fasciculata

Back 11

middle and widest layer that secretes cortisol and corticosterone and some adrenal androgens and estrogens

Front 12

what controls the secretion of the zona fasciculata

Back 12

the hypothalamic pituitary axis via adrenocorticotropic hormone (ACTH)

Front 13

zona reticularis

Back 13

deep layer that secretes the adrenal androgens dehydroepiandrosterone (DHEA) and androstenedione, estrogens, and some glucocorticoids

Front 14

what regulates zona reticularis

Back 14

ACTH

Front 15

what does angiotension II increase do

Back 15

increases output of aldosterone

Front 16

where are steroids from

Back 16

steroids from cholesterol from acetate and LDL

Front 17

how is LDL captured

Back 17

captured in coated pits on adrenocortical cell membranes

Front 18

affect of ACTH

Back 18

acth increases receptors for LDL and stimulates adrenal steroid synthesis

Front 19

cholesterol forms what in the mitochondria

Back 19

forms pregnenolone from being cleaved with cholesterol desmolase

Front 20

cotisol has a keto oxygen on what carbon number and which two are hydroxylated?

Back 20

keto oxygen is on 3 and hydroxylated on 11 and 21

Front 21

What carbon does aldosterone have an oxygen atom bound?

Back 21

bound to carbon 18

Front 22

most of cortisol binds to plasma proteins especially a flobulin called

Back 22

cortisol-binding globulin or transcortin which slows elimination of cortisol from plasma

Front 23

how much of aldosterone combines with plasma proteins

Back 23

only 60% so shorter half life

Front 24

adrenal steroids are degraded in liver to what?

Back 24

glucuronic acid

Front 25

without mineralcorticoids,what happens to potassium, sodium, and chloride as well as blood volume

Back 25

potassium rises and the otehr two are lost and blood volume is reduced. person has diminished cardiac ouput and can be prevented by administration of aldosterone

Front 26

function of 11B-hydroxysteroid dehyrdrogenase type 2

Back 26

converts cortisol to cortisone which does not avidly bind mineralcorticoid receprots

Front 27

what is it called when you have a 11B-hydroxysteroid dehyrdogenase type 2 deficiency

Back 27

an apparent mineralocoricoid excess syndrome

Front 28

ingestine of what can cause AME

Back 28

licorice because it contains glycyrrhetinic acid

Front 29

aldosterone affect on sodium and potassium

Back 29

increases reabsorpition of sodium and increases secretion of potassium in principal cells of the collecting tubules as well as distal tubules and colelcting ducts

Front 30

what does increase in extracellular fluid sodium due to body

Back 30

makes you thirsty so you drink and reabsorb water to decrease the concentration

Front 31

aldosterone increase of extracellular fluid volume more than 1 or 2 days will lead to what and what happens in the kidneys

Back 31

increased arterial pressure which leads to excression of salt and water in the kidney called pressure natiuresis and pressure diuresis

Front 32

return to normal of salt and water secretion as a result of pressure natiuresis and diuresis is called what?

Back 32

aldosterone escape

Front 33

zero aldosterone secretion leads to what

Back 33

decreased extracellular fluid volume, dehydration, leading to circulatory shock and death within a few days

Front 34

too much aldosterone does what with potassium

Back 34

loss of potassium and it goes into most cells of the body. there is a decrease in plasma potassium concentration and there is severe muscle weakness

Front 35

what is a decrease in plasma potassium concentration called

Back 35

hypokalemia

Front 36

what does aldosterone deficient do to potassium

Back 36

increase potassium which leads to cardiac toxicity, weakness of heart, arrhythmia, and heart failure

Front 37

excess aldosterone affect on hydrogen ions

Back 37

exchanged for sodium so secreted in intercalated cells. cause metabolic alkalosis

Front 38

aldosterone effect on salivary and sweat glands

Back 38

to conserve body salt and secrete potassium and bicarbonate ions

Front 39

How does aldosterone become activated

Back 39

it diffuses to ineterior of tubular epithelial cells, combines with cytoplasmic mineralcorticoid receptor protein. The aldosterone receptor complex diffuses into the nculeus and is altereted and forms mRNA which diffuses back into the cytoplasm and causes protein formation which are enzymes and membrane transport proteins for sodium, potassium, and hydrogen transport.

Front 40

enzyme produced by aldosterone-receptor complex that is the principal part of the pump for sodium and potassium echange at the basolateral membranes

Back 40

sodium-potassium adenosine triphosphatase

Front 41

protein inserted into luminal membrane that allows diffusion of sodium ions from tubular lumen into cell

Back 41

epithelial sodium channel (ENaC)

Front 42

function of spironolactone

Back 42

antagnoie activation of the MR by aldosterone

Front 43

Function of amiloride

Back 43

used to block ENaC

Front 44

aldosterone does what to cAMP

Back 44

aldosterone increases formation of cAMP in vascular smooth muscle cells of the renal colelcting tubules

Front 45

aldosterone does what to phosphatidylinositol

Back 45

stimulates this second messenger system

Front 46

four factors that regulate aldosterone

Back 46

increased potassium ion concentration increases aldosterone secretion, increased angiotensin II increases aldosterone, increased sodium concentration slightly decreases aldosterone secretion, and ACTH and little effect but is important

Front 47

What does activation of the renin-angiotension system do

Back 47

responds to diminished blood flow to the kidneys or sodium loss and excretes excess ptoassium and increases blood volume and arterial pressure

Front 48

Absences of ACTH has what effect on aldosterone secretion

Back 48

It reduces aldosterone secretion

Front 49

another name for cortisol

Back 49

hydrocortisone

Front 50

this increases gluconeogenesis (formation of carbs from proteins)

Back 50

cortisol

Front 51

cortisol increases enzymes required to convert what into glucose in the liver cells through activation of DNA and mRNA

Back 51

amino acids

Front 52

what causes mobilization of amino acids from extrahepatic tissues from muscle

Back 52

cortisol

Front 53

increase in gluconeogenesis effect on glycogen storage in liver cells

Back 53

increases storage

Front 54

what does cortisol do to rate of glucose utilization

Back 54

decreases rate of glucose utilization because there is a depression of oxidation of NADH

Front 55

what does blood glucose concentration do with increased gluconeogenesis and reduction of rate of glucose

Back 55

it causes glucose concentration to rise which stimulates secretion of insulin

Front 56

high levels of glucocorticoid reduce sensitivity of many tissues to stimulatory effects of insulin on what?

Back 56

glucose uptake and utiliztion

Front 57

increase in blood glucose concentration is called what?

Back 57

adrenal diabetes

Front 58

cortisol effect on proteins

Back 58

decrease protein synthesis and increase catabolism of proteins in cells as well as depression of formation of RNA. liver and plasma proteins increase

Front 59

corticol effect on muscles

Back 59

they become weak

Front 60

cortisol effect on amino acid transport into muscle cells

Back 60

depresses it but catabolism of proteins releases amino acids into the plasma

Front 61

effects of increased plasma concentration of amino acids

Back 61

increased rate of deamination of amino acids by liver, increased protein synthesis in the liver, increased formation of plasma proteins by the liver, and increased conversion of amino acids to glucose

Front 62

cortisol promotes mobilization of what in muscles

Back 62

amino acid mobilization. also from adipose tissue

Front 63

increased mobilization of fats by cotizol with increased oxidation of fatty acids in absences of a-glycerophsphate allows a shift of glucose for energy to fatty acids when?

Back 63

in times of starvation

Front 64

Ecess cortisol causes what disorder

Back 64

moon face where there is excess deposition of fat in the chest and head regions

Front 65

stress causes increase secretion of what?

Back 65

ACTH followed by secretion of cortisol

Front 66

what are the five main stages of inflammation

Back 66

release of chemicals such as histamine, bradykinin, proteolytic enzymes, prostaglandins, and leukotrienes from damaged tissue cells, increase in blood flow to inflammed area called erythema, leakage of pure plasma into damaged areas from increased permeability causing a nonpitting edema, infiltration of leukocytes, and ingrowth of fibrous tissue

Front 67

two basic anti-inflammatory effects of cortisol

Back 67

block early stages of inflammation before it begins and causes a rapid resolution of inflammation if it has already began

Front 68

five ways cortisol prevents inflammation

Back 68

stabilizes lysosomal membranes, decreases permeability of capillaries, decerases migration of white blood cells into inflamed area and phagocytosis of damaged cells by diminishing prostaglandins and leukotrienes that would increases vasodilation, it suppresses immune system, and attenuates fever by reducing the release of interleukin-1 from the white blood cells.

Front 69

Used to prevent shock or death in anaphylaxis

Back 69

cortisol

Front 70

lymphocytopenia or eosinopenia are seen in what cortisol levesl

Back 70

decreased cortisol

Front 71

why are cortisol drugs useful in transplants?

Back 71

They suppress immunity and prevent rejection

Front 72

cortisol does what to red blood cells

Back 72

increases production. polycythemia

Front 73

mechanism of cortisol action

Back 73

diffuses through membrane, binds with protein receptor in cytoplasm, then the hormone receptor complex interacts with glucocorticoid response elemnts to induce or repress gene transcription

Front 74

two basic anti-inflammatory effects of cortisol

Back 74

block early stages of inflammation before it begins and causes a rapid resolution of inflammation if it has already began

Front 75

other names for ACTH

Back 75

corticotropin or adrenocorticotropin

Front 76

five ways cortisol prevents inflammation

Back 76

stabilizes lysosomal membranes, decreases permeability of capillaries, decerases migration of white blood cells into inflamed area and phagocytosis of damaged cells by diminishing prostaglandins and leukotrienes that would increases vasodilation, it suppresses immune system, and attenuates fever by reducing the release of interleukin-1 from the white blood cells.

Front 77

Used to prevent shock or death in anaphylaxis

Back 77

cortisol

Front 78

what induces release of ACTH

Back 78

corticotropin releasing factor that is secreted into the primary capillary and carried to anterior pituitary gland

Front 79

What is the principle effect of ACTH on adrenocortical cells

Back 79

to activate adenylyl cyclase which induces formation of cAMP which actiates enzymes that cause formation of the adrenocortical hormones

Front 80

lymphocytopenia or eosinopenia are seen in what cortisol levesl

Back 80

decreased cortisol

Front 81

why are cortisol drugs useful in transplants?

Back 81

They suppress immunity and prevent rejection

Front 82

cortisol does what to red blood cells

Back 82

increases production. polycythemia

Front 83

mechanism of cortisol action

Back 83

diffuses through membrane, binds with protein receptor in cytoplasm, then the hormone receptor complex interacts with glucocorticoid response elemnts to induce or repress gene transcription

Front 84

other names for ACTH

Back 84

corticotropin or adrenocorticotropin

Front 85

what induces release of ACTH

Back 85

corticotropin releasing factor that is secreted into the primary capillary and carried to anterior pituitary gland

Front 86

What is the principle effect of ACTH on adrenocortical cells

Back 86

to activate adenylyl cyclase which induces formation of cAMP which actiates enzymes that cause formation of the adrenocortical hormones

Front 87

causes initial conversion of cholesterol to pregnenolone

Back 87

protein kinase A

Front 88

what is the effect of long term stimulation of the adrenal cortex by ACTH

Back 88

increases secretory activity an causes hypertrophy and proliferation of the adrenocortical cells in the zona fasciculata and reticularis

Front 89

negative feedback of cortisol

Back 89

on the hypothalamus to decrease formation of CRF and on anterior pituitary to decrease formation of ACTH

Front 90

circadian rhythm consists of what

Back 90

high levels of CRF, ACTG, and cortisol in the morning and low in the evening

Front 91

Gene that forms the RNA molecule that causes ACTH synthesis causes formation of what?

Back 91

proopiomelanocortin (POMC) which is the precursor of ACTH and melanocyte stimulating hormone (MSH), B-lipotropin, and B-endorphin

Front 92

ACTH level in addison's disease

Back 92

ACTH is high

Front 93

Prohormone convertase 1 is expressed where

Back 93

in the pituitary and results in the production of N terminal peptide, ACTH, and B-lipotropin

Front 94

where is PC2 expressed

Back 94

hypothalamus and produces alpha, beta, and gamma MSH and B-endorphin but not ACTH

Front 95

function of alpha MSH

Back 95

functions in appetite regulation

Front 96

what does MSH stimulate

Back 96

stimulates black pigment melanin in melanocytes between dermis and epidermis

Front 97

what does the pars intermedia secrete

Back 97

large amounts of MSH

Front 98

inability of adrenal corties to produce sufficient adrenocortical hormones

Back 98

Addison's disease or primary adrenal insufficiency

Front 99

Cause of adrenal gland hypofunction

Back 99

tuberculous

Front 100

what may atrophy due to lack of ACTH production inpituitary gland

Back 100

adrenal glands because cortisol and aldosertone are low

Front 101

what develops from lack of aldosterone

Back 101

hyponatremia, hyperkalemia, and mild acidosis because potassium and hydrogen ions arent secreted

Front 102

glucocorticoid deficiency causes what?

Back 102

Causes loss of cortisol secretion which makes it impossible to maintain normal blood glucose concentration between meals. stress can do a person in as well as a respiratory infection

Front 103

what is addisonian crisis

Back 103

the need for extra glucocoricoids and the associated severe debility in times of stress

Front 104

hypersecretion of the adrenal cortex

Back 104

cushing's syndrome. adenoma of anterior pituitary causes large amounts of ACTH. abnormal hypothalamus causes high levels of CRH which stimulates ACTH. cortisol causes reduced feedback on ACTH

Front 105

affect of dexamethasone

Back 105

wont decrease ACTH secrtion for ACTH dependent cushings such as ACTH secreting pituitary adenoma or hypothalamic pituitary dysfunction but will supress in ACTH independent such as primary adrenal overproduction of cortisol

Front 106

Cushings can result from large amounts of what over time?

Back 106

glucorticoids such as in rheumatoid arthritis. leads to moon face

Front 107

glucocorticoids cause decreased tissue proteins except in liver and plasma proteins

Back 107

causes severe weakness, suppressed immune system

Front 108

what develops where tissue tears easily with decreased tissue proteins?

Back 108

purplish striae

Front 109

how do you treat cushings?

Back 109

with drugs that block steriodogenesis, such as metyrapone, ketoconazole, and aminoglutethimide, or ones that inhibit ACTH secretion such as serotonin antagonists and GABA transaminase inhibitors, as well as adrenalectomy

Front 110

what does a tumor of the zona glomerulosa result in?

Back 110

large amounts of aldosterone called primary aldosteronism or conn's syndrome. results in hypokalemia, metabolic alkalosis, increase in extracellular fluid volume and plasma sodium concentration. also includes periods of muscle paralysis caused by hypokalemia

Front 111

how is plasma renin concentration affected by primary aldosteronism

Back 111

it is decreased