Physiology Of Adrenal Gland

Front 1

What are the layers of the adrenal cortex (four) and what is produced in each?

Back 1

Front 2

What is the main action of mineral corticoids (aldosterone)?

Back 2

Increase Na reabsorption and K secretion to maintain body fluid volume.

Front 3

What are the main actions of glucocorticoids (cortisol)?

Energy, glucose where, increased what for energy, immune and inflammation efffects

Back 3

Front 4

What are the two functions of adrenal sex hormones?

Back 4

Growth, and developmental control

Front 5

What are the main functions of catecholamines? Increase what where? What type of response for fuel availability?

Back 5

Front 6

How are adrenocortical hormones transported?

What is the transport globulins for each (corticosteroid, aldosterone, sex, progesterone)?

Which protein has low affinity reversible binding?

What two things is cortisol bound to?

What proteins is aldosterone bound to? How much is free?

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Front 7

What are the purposes of transport binding proteins?

Activity, protection, life-time, delivery

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Front 8

What is the source of all steroid hormones?

What is the main provider of cholesterol for adrenocortical steroid synthesis?

What is the pathway of cholesterol to aldosterone, androgens , and progesterone?

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Front 9

LDL particles bind to LDL receptors in ________ on plasma membranes of adrenal cortical cells.

LDL-receptor complex is transported intracellularly by ________________.

Formation of ________ and lysosomes.

In lysosomes, __________ is release from the receptors.

LDL receptors are ________ to the plasma membrane.

Cholesterol is ________ and stored in __________ until it is needed for the synthesis of _________ hormones.

Back 9

Front 10

What is the rate limiting step (and where does it occur) in adrenal corticosteroid synthesis?

What is the key enzyme?

What controls this (which axis and which hormones)?

What are the two functions of ACTH?

Back 10

Front 11

Draw out the adrenal steroid synthesis pathway, label the enzymes, label the zones of the adrenal cortex, and indicate the activators and inhibitor sod the pathway.

Back 11

Front 12

What are the target tissues for aldosterone (express MRs)?

What are two non-specific activation of MRs by glucocorticoids?

What is the enzyme that converts cortisol metabolite to cortisone?

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Front 13

I. Genomic effects: Upregulation of Gene Expression (3-24 h, Delayed effects) = MINERALCORTICOIDS

Step 1: _________ penetrates the target cell, binds to MRs in the cytoplasm

Forms a __________ complex;

Step 2: The hormone-receptor complex translocates to the __________;

(transformation of the hormone-receptor complex)

Step 3: Binding to a _;

Step 4. Upregulation of gene expression

(____________, _______________)

2. Non-Genomic Effects (<1h, _________ Effects)

cAMP –, IP3 –, Ca2+– mediated signaling;
Protein phosphorylation-mediated cell signaling pathways (SGK-1, ERK1/2, JNK) => MEDIATED VIA _________

Back 13

Non-genomic effects mediated via second messenger

Front 14

What are the effects of mineral corticoids on Na+, K+, and H+?

1. What pumps are affected?

2. What sodium channels?

3. What K channel in the kidney?

4. What kinase? What does this kinase activate resulting in what sodium and K levels?

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Front 15

What is the main site of synthesis of glucocorticoids? Which GC is the most potent? Which has modest potency? What is the low active cortisol metabolite by 11-B-HSD2?

What are some synthetic glucocorticoids (in order of potency)?

Back 15

Front 16

What re the key enzymes in cortisol biosynthesis? What are some drugs that can act on each?

Back 16

Front 17

What type of rhythm is cortisol secretion? What two components is it regulated by?

When is cortisol production at its peak? Gradually declines by? When are the lowest levels?

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Front 18

1. Glucocorticoids are _________.
2. Binding to glucocorticoid receptors in the __________.
3. The Hormone–Receptor complex translocates into the _________.
4. Binding to the promoter regions of target genes (________% of genome)

5. Stimulation or _________ of gene expression (transactivation)

6. Suppression of genes via ___________factors (NFκB) (transrepression).

Back 18

1. Glucocorticoids are cell-permeable
2. Binding to glucocorticoid receptors in the cytoplasm
3. The Hormone–Receptor complex translocates into the nucleus
4. Binding to the promoter regions of target genes (5-25% of genome) 5. Stimulation or repression of gene expression (transactivation)

6. Suppression of genes via transcriptional factors (NFκB) (transrepression).

Front 19

What is the overall effect of glucocorticoids?

Back 19

Increase glucose production via gluconeogenesis

Front 20

What are the target organs?

What happens in liver (promotes what from amino acids, up or down regulation of key enzymes, mobilization of what uptake from blood, enhanced ______ formation)?

What are the two effects in the pancreas (effects on insulin)?

Back 20

Front 21

What do many organs develop against in response to glucocorticoids?

What is the effect of glucose uptake and utilization by most cells? (increased or decreased)? How?

Does the blood glucose level go up or down?

Is glucose supply to the brain enhanced?

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Front 22

What is the effect of glucocorticoids on protein metabolism?

1. Various Organs (Except the liver): __________ protein catabolism; __________ Protein Synthesis.

– Increases _________ (catabolic effects)
– Amino acids in the blood _________
– Amino acid transport to tissues _______
– _______protein synthesis (muscle, lymphoid tissue)

– Body weight __________

– Muscle __________

2. Liver:

– __________ protein synthesis (upregulation of key enzymes);

– __________ gluconeogenesis (convert amino acids to glucose)

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Front 23

What is the overall effect of glucocorticoids on protein metabolism?

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Front 24

Glucocorticoids and Fat Metabolism

1. Adipose tissue: _________ lipolysis,
__________ mobilization and oxidation of fatty acids

as an ___________ in the time of starvation:

– Fat degradation to fatty acids ________
– Fatty acids in the blood ________
– Oxidation of fatty acids in the cells ______

Result: ________ in gluconeogenesis, lipolysis and proteolysis

2. Food uptake _______ , Redistribution of body fat, paradoxical fat ________ in the body

3. High doses of oral cortisol can lead to _________ (deposition of fat in the chest and head, fat lump between the shoulders, rounded face);
________ blood pressure, diabetes and bone loss.

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Front 25

What is the effect of cortisol on immunity and inflammation?

__________ inflammatory and immune responses, ____________ susceptibility to infections

Macrophages and _______ - main targets;

– Production of inflammatory cytokines ______

– Function of inflammatory cells ______
– Apoptosis ______
– Release of histamine and serotonin ______

- ______ of the lymphoid tissue (Thymus)

Suppression of inflammation and immune function (hours – days):

• Inhibits Phospholipase ______
•_________ initial stages of inflammation (lysosomal disruption);

• Prevents ________ (_______ permeability of blood capillaries);

• _________ leukocyte migration to the inflamed area;

• _________ the immune system (T lymphocyte);
• Attenuates fever (_______ release);
• __________ immunological rejection of transplanted organs and tissues.

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Front 26

Actions of GC in other tissues:

Skin: ________synthesis

Intestine: Ca2+ absorption ____

Kidney: Ca2+ reabsorption _______

Blood: Ca2+ level ______

Bones: Ca2+ mobilization leads to ______;

________ bone formation by
________ Type I collagen formation

Growth suppression

• Blood vessels:___________; Promote hypertension;

• Blood clotting _______, resulting in bruising;

• Gastrointestinal effects:
__________ GI function, gastric acid and enzyme production;

• Nervous system: _______ hypothalamic-pituitary-adrenal axis Increase appetite, influence ________ and mood.

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Front 27

What are the male sex hormones?

What are the key enzymes?

What are two key enzyme deficiencies?

What are the female sex hormones?

The adrenal sex hormones have more of an effect for which sex?

Back 27

17-alpha-hydroxylase = decrease production of sex hormones???

11-alpha-hydorylase= increased production sex hormones???

Front 28

What are the hormones of the adrenal medulla?

What is the pathway of epinephrine synthesis starting with tyrosine?

It is increased by a high concentration of what?

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Front 29

Adrenal medulla: Fight or Fligh

Targets: What are the four?

• Functions: Immediate response to _________:

– Heart rate __
– Breathing rate __
– Blood Pressure __
– Glucose release from the liver _
– Blood Glucose level __
– Metabolic rate __
– Changes in blood vessel ______

– Blood flow to skeletal muscles __
– Lipolysis, free fatty acids __
– Digestive processes __
– Urine production __

Neural Control
(______ nervous system)

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Front 30

What is the hypothalamic-pituitary-adrenal axis? Draw it.

Regulates ______ response, ______ usage, _______ response, and _________.

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Front 31

Cortisol effect on CRH release?

What three areas of brain does cortisol inhibit?

• _______ of the inhibitory input of hippocampus

• Suppression of _____ by hypothalamus

• Suppression of ACTH production by _____

Long-term Rx dexamethasone:

– Cortisol production ___
– Functional _____ of the

hypothalamic-pituitary-

adrenal axis

Metabolic Effects ___

Immune Effects ___

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Front 32

What is stress?

What are some causes?

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Front 33

What does moderate stress activate?

Acute Stress effects:
– Heart rate ___
– Breathing rate __
– Blood glucose __
– Glucose utilization ___

– Energy production ___

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Front 34

Effects of chronic stress:

– Excessive _____ and _____ of hypothalamic- pituitary – adrenal axis (overriding negative feedback);

– Induces secrtion of
of adrenal ________;

– ________ of adrenal glands, adrenocortical hyperfunction;

Major Health Problems:

–Heart disease; –Immunosuppression; –Digestive problems; –Sleep disorders; –Anxiety, depression

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