Adrenal Glands (Penny)

4 CLINICAL FINDINGS OF ADRENAL HEMORRHAGE

1. Abdominal mass 2. Jaundice 3. Anemia 4. Acute drop in hematocrit and blood pressure

2 SONOGRAPHIC FINDINGS OF NEUROBLASTOMA

1. Large, heterogeneous mass containing areas of calcification and hemorrhage located in the area of the adrenal gland 2. Metastasis

What is the cause of Cushing disease?

Anterior pituitary gland tumor

anoxia

-lack of oxygen supply to the body, organ, or tissue

neuroblastoma

-malignant tumor that can occur within the adrenal gland and anywhere within the sympathetic nervous system

6 CLINICAL FINDINGS OF CONN SYNDROME

1. Hypertension 2. Excessive thirst 3. Excessive urination 4. (hypernatremia) 5. (hypokalemia) 6. Muscle cramps and weakness

_____ _____also referred to as primary adrenocortical insufficiency or chronic primary hypoadrenalism,

Addison disease,

What is the term for low levels of sodium in the blood?

Hyponatremia

SONOGRAPHIC FINDINGS OF ADRENAL ADENOMAS

Solid, hypoechoic mass in the area of the adrenal gland

The adrenal glands are surrounded by a connective tissue capsule called:

Gerota fascia

The syndrome associated with hypertension, hyperglycemia, obesity, and an adrenal mass is:

Cushing syndrome

Hyperfunctioning adenomas are often seen in patients suffering from

Cushing syndrome or Conn syndrome.

With active internal hemorrhage, the patient's hematocrit will:

Decrease

Which types of glands release their hormones directly into the bloodstream? a. Endocrine glands b. Exocrine glands

Endocrine glands

______ Is the primary hormone produced by the medulla.

Epinephrine

The ______ ______ is the most common benign solid mass of the adrenal gland.

adrenal adenoma

adrenal adenoma

benign solid mass located within the adrenal glands

Aldosterone is responsible for regulating ______ ______ by controlling the amount of ____ & _____ in the body.

blood pressure sodium and water

hyperpigmentation

darkening of the skin

hypernatremia

high levels of sodium in the blood

Metastasis to the adrenal glands can originate in the ______, ______, or ______ in many patients.

lung, breast, or lymphoma

striae

stretch marks

Venous drainage is performed by means of the

suprarenal veins.

When internal bleeding is suspected, what laboratory value is most useful for a sonographer to evaluate? a. Hematocrit b. Blood urea nitrogen C. Androgenic hormone d. Alkaline phosphatase

a. Hematocrit

Epinephrine may also be referred to as

adrenaline,

3 SONOGRAPHIC FINDINGS OF ADRENAL CYSTS

1. Anechoic 2. Round 3. Acoustic enhancement

2 CLINICAL FINDINGS OF ADRENAL CYSTS

1. Asymptomatic 2. Large, infected, or hemorrhagic cysts can cause pain

2 SONOGRAPHIC FINDINGS OF ADDISON DISEASE

1. Enlarged appearance of the adrenal glands in the acute stages of the disease 2. Atrophic or calcified gland in the chronic stage

8 CLINICAL FINDINGS OF ADDISON DISEASE

1. Hypotension 2. Weakness and fatigue 3. Loss of appetite and weight loss 4. Bronzing of the skin (hyperpigmentation) 5. Elevated liver enzymes 6. Hyperkalemia (high levels of potassium) 7. Hyponatremia (low levels of sodium) 8. Increased ACTH

adrenal cysts

benign simple cysts located within the adrenal glands

Addison disease, is an ____ disorder that results from the hypofunction of the adrenal cortex.

endocrine

Gerota fascia-

fibrous envelope of tissue that surrounds the kidney and adrenal gland

adrenocorticotropic hormone

hormone secreted by the anterior pituitary gland, which controls the release of hormones by the adrenal glands

The right suprarenal vein drains directly into the

inferior vena cava (IVC),

The adrenal glands may also be referred to as the

suprarenal glands.

10 CLINICAL FINDINGS OF CUSHING SYNDROME

1. Obesity 2. Thinning arms and legs 3. Hypertension 4. Hirsutism 5. Hyperglycemia 6. Severe fatigue 7. Poor wound healing 8. Buffalo hump 9. Moon-shaped face 10. Red or purple striae over the abdomen and thighs

3 CLINICAL FINDINGS OF NEUROBLASTOMA

1. Palpable abdominal mass 2. Abdominal pain 3. Bone pain

SONOGRAPHIC FINDINGS OF ADRENAL HEMORRHAGE

1. Round or triangular-shaped mass in the area of the adrenal gland 2. Echogenic during the acute stage 3. With time it will become heterogeneous, hy- poechoic, and possibly cystic

3 CLINICAL FINDINGS OF ADRENAL ADENOMAS

1. Signs and symptoms of Cushing Syndrome 2. Signs and symptoms of Conn syndrome 3. May be asymptomatic

Which of the following has a clinical finding of bronzing of the skin? a. Addison disease b. Cushing disease c. Cushing syndrome d. Conn syndrome

Addison disease

Which of the following is also referred to as primary adrenocortical insufficiency? a. Conn syndrome b. Addison disease c. Cushing disease d. Congenital adrenal hyperplasia

Addison disease

1. An abdominal sonogram is requested for a now born in the intensive care unit. The new born is suffered from brief anoxia at birth and is now suffering from jaundice. Superior to the right kidney, you visualize a triangular-shaped, heterogeneous mass. What is the most likely diagnosis?

Adrenal hemorrhage

Which of the following mass-like lesions may be associated with congenital adrenal hyperplasia and found within the testes? a. Adrenal adenomas b. Adrenal rests c. Pheochromocytomas d. Neuroblastomas

Adrenal rests

The adrenal cortex produces all of the following except: a. Cortisol b. Androgens c. Aldosterone d. Adrenaline

Adrenaline

Location of Left Adrenal Gland 1. ____ to the upper pole of the left kidney 2. Superior segment is located ____ to the lesser sac 3. Inferior segment is located _____ and _____ to the pancreas

1.Medial 2.posterior 3.posterior and lateral

Location of Right Adrenal Gland 1. ____ and ____ to the inferior vena cava 2. ____ to the right lobe of the liver 3.____ to the crus of the diaphragm

1.Posterior and lateral 2.Medial 3.Lateral

What are the two hormones of the adrenal cortex? What are the two hormones of the adrenal medulla?

Aldosterone, androgens, and cortisol Epinephrine and norepinephrine

Which of the following is produced by the adrenal medulla? a. Cortisol b. Aldosterone c. Norepinephrine d. Androgens

Norepinephrine

The arterial blood supply to the adrenal glands is accomplished by means of the:

Suprarenal arteries

All of the following are true statements about the adrenal glands except: a. The adrenal glands are easily identified in the fetus b. The adrenal glands are exocrine glands. c. The adrenal glands are composed of a medulla and cortex. d. The adrenal glands may also be referred to as the suprarenal glands.

The adrenal glands are exocrine glands.

The left suprarenal vein drains directly into the:

Left renal vein

tachycardia

abnormally rapid heart rate

adrenal rests

accessory adrenal gland tissue

Neuroblastomas, which arise from the ______ ______, typically present before 5 years of age, with the median age of diagnosis being 22 months.

adrenal medulla

Accessory adrenal gland tissue, commonly referred to as _____ _____, can be found within the _______. ______, ______, and _______ ______

adrenal rests testes, epididymis, ovaries, and inguinal canal

Adrenal Cortical cancers tend to be large and have the tendency to invade the ______ _____ & _____

adrenal vein and IVC

The hypothalamus controls the release of _____ hormone by the _____ _____ _____, which in turn controls the release of hormones by the adrenal glands.

adrenocorticotropic (ACTH) anterior pituitary gland

Conn syndrome results from: High levels of ______

aldosterone

The cortex is the outer part of the adrenal gland. Among the hormones produced by the cortex is

aldosterone

The adrenal cortex also produces _____ hormones, which play a part in the development of male characteristics, and cortisol, which controls the body's use of _____, ______, and ______

androgenic fat, carbohydrates, and protein.

suprarenal glands

another name for the adrenal glands

Cushing syndrome can result from a tumor in the ______ _______ _______ or an adrenal tumor that cause an increase in ____ secretion by the adrenal cortex-termed ______.

anterior pituitary gland cortisol hypercortisolism

The chronic form of Addisons disease typically leads to an

atrophic and calcified gland.

Aldosterone is responsible for regulating ______ ______ by controlling the amounts of ____ and ____ in the body.

blood pressure sodium amd water

With Addison disease, the cortex inadequately secretes _______ resulting from partial or complete destruction of the adrenal glands.

corticosteroids

Hyperfunctioning adrenal adenomas are associated with all of the following except: a. Cushing syndrome b. Conn syndrome c. Hypoechoic mass in the area of the adrenal gland d. Acute drop in hematocrit

d. Acute drop in hematocrit

Addison disease

endocrine disorder that results from hypofunction of the adrenal cortex

Both ______ and ______ are responsible for the fight-or-fight" response.

epinephrine and norepinephrine

The inner part of the adrenal glands, the medulla, produces _____ and ____

epinephrine and norepinephrine.

buffalo hump

excessive amount of fat on the back between the shoulders

hirsutism

excessive hair growth in women in areas where hair growth is normally negligible

. The adrenal glands are the _____ most common site of metastasis.

fourth

endocrine glands

glands that release their hormones directly into the bloodstream

Cortisol plays an important role in what 4 functions

glucose metabolism, blood pressure regulation, immune function, and inflammatory response.

congenital adrenal hyperplasia

group of disorders in which there is a deficiency of cortisol production by the adrenal glands, although other hormones produced by the adrenal may be deficient as well

hypertension

high blood pressure

Conn syndrome, also referred to as primary hyperaldosteronism, results from

high levels of aldosterone secretion by the adrenal cortex.

hypercortisolism

high levels of cortisol in the blood

hyperkalemia

high levels of potassium in the blood

pheochromocytoma

hyperfunctioning, benign adrenal mass that causes the adrenal gland to release excessive amounts of epinephrine and norepinephrine into the blood stream leading to uncontrollable hypertension

the normal adrenal glands are often easily visualized in the fetus and in the pediatric patient as _____ structures ______, _____, ______ to the upper pole of each kidney

hypoechoic anterior, medial, and superior

The paired adrenal glands, which are controlled by hormones produced by the ______, and subsequently the ______ _____ ______

hypothalamus, anterior pituitary gland,

the left suprarenal vein drains into the

left renal vein

Addison disease can also cause elevated _______ ______, ________, and _______

liver enzymes, hyperkalemia, and hyponatremia.

hypokalemia

low levels of potassium in the blood

hyponatremia

low levels of sodium in the blood

The most common extracranial solid, malignant tumor in children is the

neuroblastoma.

Cushing syndrome associated with a benign tumor often located within the

or adrenal gland within the pituitary gland.

Cushing syndrome can be associated with a benign tumor that leads to the

overproduction of cortisol by the adrenal glands.

Cushing disease

presence of a brain tumor in the pituitary gland that increases the release of adrenocorticotropic hormone resulting in Cushing syndrome

Conn syndrome, also referred to as

primary hyperaldosteronism,

Conn syndrome

syndrome caused by a functioning tumor within the adrenal cortex that produces excessive amounts of aldosterone

Cushing syndrome

syndrome that results from an anterior pituitary gland or adrenal tumor that causes over production of cortisol by the adrenal glands

crus of the diaphragm

tendinous structure that extends from the diaphragm to the vertebral column; there are two crura (plural for crus), a right crus and a left crus

Adrenal Glands receive their blood supply by means of what 3 arteries

the suprarenal branches of the inferior phrenic arteries, the suprarenal branches of the aorta, and the suprarenal branches of the renal arteries.

Conn syndrome, can be caused by a functioning _____ within the _____ _____most likely a benign, aldosterone producing _____ _____ that causes the adrenal gland to produce excessive amounts of _____.

tumor adrenal cortex adrenal adenoma aldosterone

Each gland is composed of a medulla and a cortex. The cortex is the outer part of the adrenal gland. It is composed of three zones:

zona glomerulosa, zona fasciculata, and zona reticularis.

Which of the following would result in buffalo hump and moon-shaped face clinical findings? a. Conn syndrome b. Addison disease c. Adrogenism d. Hypercortisolism

Hypercortisolism

the adrenal glands are enclosed in the

Gerota fascia.

A localized collection of blood describes a:

Hematoma