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Adrenal Glands: STRESS pt.1
Dr. Romito 2-11-09
19
Health Care
Professional
02/15/2009

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Cards

Term
What are the two regions of the adrenal gland?
Definition
Cortex and Medulla
Term
What are the three layers of the adrenal cortex (superficial to deep)?
Definition

Zona glomerulosa

 mineralcorticoids: primarily aldosterone

 

Zona fasciculata

glucocorticoids:  primarily cortisol

 

Zona reticularis

androgens:  primarily DHEA

Term
What is the most secreted hormone from the adrenal cortex, its subgroup, and its zone of the cortex.
Definition

Cortisol

 

Glucocorticoids

 

Zona Fasciculata

Term
What are the three components of the HPA axis?
Definition

Hypothalamus

Anterior Pituitary

Adrenal Cortex

Term
What are the effects of ACTH on the adrenal cortex?
Definition

Adrenocorticotrophic Hormone 

 

-Promotes growth and function of all 3 cortical zones.

 

-Effects secretion of glucocorticoids (much more than mineralcorticoid secretion)

 

FYI: Adreno (Adrenal Gland)--Cortico (Cortex)--Tropic (Growth)

Term
In the synthesis of steroid hormones from cholesterol, what is the first and rate limiting step?
Definition
The conversion of cholesterol to pregnanolone.
Term

Glucocorticoids

 

1. anabolic or catabolic?

 

2.  Where are they produced and secreted?

 

3.  What are their main targets?

 

4.  What are they derived from?

Definition

1.  Catabolic

2.  Zona fasiculata of the adrenal cortex

3.  Liver, skeletal muscle, fat

4.  Derived from pregnenolone, which is from cholesterol.

Term
What are the major effects  of cortisol?
Definition

Catabolism

Energy metabolism

sympathoadenal effects

Anti-inflammatory and immunosupressive

Term

What is the primary glucocorticoid in humans?

 

Is it bound in circulation?

Definition

Cortisol

 

Yes, it is bound to CBG (Transcortin)

-Blunts fluctuations in cortisol blood levels

 

High on the half-life continuum

Term
Describe glucocorticoid receptor activation pathway?
Definition

1.  The bound hormone comes to the membrane dissociates from its carrier and enters the cell.

2.  Hormone binds to its intracellular receptor, activates it and causes dissociation of heat shock proteins.

3.  Dimerization occurs and it binds to the hormone response element on the DNA target (glucocorticoid response element)

Term
What types of stress stimulate cortisol secretion.
Definition

Physical stress

hypoglycemia

trauma

exercise

 

Mental Stress

acute anxiety and chronic anxiety

Term

Compare and contrast glucagon and cortisol

Definition

Compare

Both are catabolic

both focus on increasing blood glucose

Breaks down proteins, this generates urea

 

Contrast 

Cortisol, unlike glucagon, promotes the synthesis of glycogen.

Cortisol is from the fasiculata layer of the adrenal cortex while glucagon is from alpha cells of the islets of langerhans in the pancreas.

Term

What is cortisol's effect on inflammation and immune response?

 

How can this be beneficial and also harmful?

Definition

It supresses both the immune and inflammatory response.

 

It can beneficial at stopping transplant rejection, stopping rashes, or for sore joints.  Its bad because it supresses your immune system's ability to fend off infections.

Term

Mineralcorticoids

 

1. What are their protein carriers?

 

2.  Where are they produced and secreted?

 

3.  What are their main targets?

-what's their function

Definition

Example:  Aldosterone

1.  Albumin, CBP carrier

2.  Zona glomerulosa of the adrenal cortex

3.  Kidneys

-Sodium Retention

-Water Retention

-Potassium Excretion

Term
Summarize control of aldosterone
Definition

1.  juxtaglomerular cells sense decrease in blood pressure or volume.

2.  Rennin is secreted

3. Angiotensinogen is converted to angiotensin I

4.  Angiotensin I is converted to angiotensin II, which targets Zona glomerulosa cells to produce aldosterone.

Term

Since cortisol has limited mineralcorticoid activity similar to that of aldosterone and considering cortisol is produced in much larger quantities...

 

Why doesn't cortisol take over for aldosterone?

Definition

The Enzyme Protective Effect!

 

In aldosterone responsive cells, cortisol becomes inactivated to cortisone.

Term
What conditions occur from an adrenal cortex pathology?
Definition

Addison's Disease (Destruction of Adrenal Cortex, lack of gluco- and mineral- corticoids)

Cushing's Disease (excess cortisol)

 

These can be cause by primary causes (autoimmune destruction or infection) or by secondary causes (Hypothalamic/pituitary failure)

Term
What are some signs and symptoms of Addison's Disease?
Definition

Basically no mineral- or gluco- corticoids 

Can see pigmentation of Mucosa

 

Low Aldosterone causes 

Hypotension (not retaining water)

Hyponatremia (not retaining sodium)

Hyperkalemia (not excreting potassium)

 

Low Cortisol Causes

hypoglycemia

weight loss

apetite loss

Term
What are some causes of Cushing's Syndrome
Definition

Cushing's aka hypercortisolism can happen from:

 

Secondary:  Tumor on the anterior pituitary, secretes excess ACTH (Adrenocorticotropic Hormone)

 

Or more commonly, exposure to exogenous sources of cortisol

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