C5 -- The Adrenal Medulla and Adrenal Cortex

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What cells secrete dopamine in the adrenal medulla?

Unknown

Glucocorticoids bind to ____ receptors.

glucocorticoid

Amino acids mobilized by glucocorticoids are available for _____, to _____, or for ____.

gluconeogenesis; help repair damaged tissue; synthesis of new cellular structures

Body fat is distributed in two characteristic ways: ____ and ___.

moon face; buffalo hump

_____ are poorly developed in individuals with Cushing's syndrome.

muscles

Epinephrine, by circulating in the blood, can reach areas ______, such as ____.

not innervated by the sympathetic nervous system; skeletal muscle cells

Explain the permissive action of glucocorticoids.

small amounts of glucocorticoids must be present for a number of metabolic reactions to occur

___ amounts of cortisol are free in the plasma; with the ___ cortisol being what interacts with the tissues.

small; free

Glucocorticoids are primarily derived from ___ layer(s) of the adrenal cortex.

zona fasciculata

In females, excess _____ can result in some masculinizing.

adrenal androgens

Adrenocorticotropic hormone acts on the ____ to release ____.

adrenal cortex; glucocorticoids

Norepinephrine, epinephrine, and dopamine are all secreted by the ____.

adrenal medulla

While hormones from the ____ are not essential for life, they are very helpful when dealing with emergencies and stress.

adrenal medulla

There are two endocrine organs in the adrenal gland, the ____ and the ___.

adrenal medulla; adrenal cortex

_______ will acutely increase aldosterone production.

adrenocorticotropic hormone (ACTH)

What is the name of the mineralocorticoid secreted by the adrenal cortex?

aldosterone

____ is a mineralocorticoid that is ____.

aldosterone; essential for life

Corticosterone is derived from ____ layer(s) of the adrenal cortex.

all three

Glucocorticoids suppress manifestations of ____ that are due to the release of ____ from tissues.

allergic disease; histamine

Cortison is bound to a(n) ____ called ____, or corticosteroid-binding globulin in the plasma.

alpha globulin; transcortin

Free fatty acids mobilized by glucocorticoids are available as a(n) ____ for tissue that can use this instead of glucose, thus conserving glucose for the ____.

alternative fuel; brain

____ are the hormones that exert masculinizing effects, promoting ____ and ___.

androgens; protein anabolism; growth

The adrenal androgen _____ is converted to testosterone and to estrogens in fat and other peripheral tissues.

androstenedione

____ is an important source of estrogens in men and postmenopausal women.

androstenedione

Aldosterone is regulated by ____ levels and directly stimulated by _____ levels.

angiotensin II; high plasma potassium

Corticotropin-releasing hormone stimulates the ____ to release ____.

anterior pituitary gland; adrenocorticotropic hormone (corticotropin, ACTH)

Define stress.

any change in the environment that changes or threatens to change an existing optimal steady state

Define pressor responses.

blood pressure changes due to vessel constriction/dilation

Glucocorticoid excess can lead to ____ and ____, as well as generate a(n) ____, ____, and ____.

bone dissolution; osteoporosis; increased appetite; insomnia; mental symptoms

Epinephrine promotes _____, such as ____.

breakdown of stored fat and carbohydrate; promoting the breakdown of glycogen in the skeletal muscle and liver

Minor injuries to patients with Cushing's can easily cause ____.

bruising

Glucocorticoids play an important role in ____, ___, and ___ metabolism.

carbohydrate; protein; fat

The secretion of adrenal androgens is nearly as great in ____ and ____ as it is in ____.

castrated males; females; normal males

The adrenal medulla secretes ____.

catecholamines

Permissive action of glucocorticoids is important for _____ to exert their ____ effects.

catecholamines; lipolytic

The hormones of the adrenal cortex are derived from ____.

cholesterol

Preganglionic sympathetic innervation usually has a ____ nerve ending, meaning that _____ is the necessary neurotransmitter for the information to reach the adrenal medulla.

cholinergic; acetylcholine

____ is secreted alongside cortisol by the adrenal cortex, and is approx. ____ as active.

corticosterone; 1/3

____ is the primary glucocorticoid.

cortisol

The adrenal cortex secretes two glucocorticoids, ___ and ___.

cortisol; corticosterone

The five major hormones secreted by the adrenal cortex are ___, ___, ___, ___, and ___.

cortisol; corticosterone; aldosterone; dehydroepiandrosterone (DHEAS); androstenedione

What are the two androgens secreted by the adrenal cortex?

dehydroepiandrosterone (DHEAS); androstenedione

Prolonged increase in plasma glucocorticoids is ____ to the body.

detrimental

The circadian rhythm is also called a ____ rhythm.

diurnal

The concentrations of DHEAS increase until it peaks in the _____.

early 20's

ACTH and plasma cortisol have their most frequent bursts in the ____.

early morning

The main catecholamine secreted by the adrenal medulla is ____.

epinephrine

Two cell types comprise the adrenal medulla: _____ and _____.

epinephrine secreting cells; norepinephrine secreting cells

What three catecholamines are secreted from the adrenal medulla?

epinephrine; norepinephrine; dopamine

____ and ____ reinforce the sympathetic nervous system to prepare the body for ____.

epinephrine; norepinephrine; fight or flight

Describe "moon face" as it pertains to Cushing's syndrome.

fat collects in the abdominal wall and face

Describe "buffalo hump" as it pertains to Cushing's syndrome.

fat collects in the upper back

Both epinephrine and norepinephrine increase the ____ and ___ of the heart via _____ receptors.

force; rate of contraction; beta-1

Permissive action includes the requirement for glucocorticoids to be present for ____ and ____ to exert their ___ effects.

glucagon; catecholamines; calorigenic

The adrenal cortex secretes ____, which have widespread effects on the metabolism of carbohydrates and proteins.

glucocorticoids

The adrenal cortex secretes ____, ____, and ____.

glucocorticoids; mineralocorticoids; sex hormones/androgens

Small amounts of ____ are important for catecholamines to produce ___ and ____.

glucocorticoids; pressor responses; bronchodilation

Glucocorticoids inhibit _____ by many tissues, but not for the ___.

glucose uptake and use; brain

Glucocorticoids keep more ___ available for the ____ to utilize.

glucose; brain

Cushing's syndrome patients are often ____.

hypertensive

Glucocorticoids will inhibit the ____ and ____ gland.

hypothalamus; anterior pituitary

Epinephrine promotes breakdown of stored fat and carbohydrate, resulting in a(n) ____.

increase in blood fatty acids and blood glucose levels

The major function of aldosterone is to ____.

increase the reabsorption of sodium in the collecting ducts of the kidney

Glucocorticoids inhibit the _____ to tissue injury.

inflammatory response

Glucorticoids are said to have anti-_____ and anti-_____ effects when high levels of circulating glucocorticoids are present.

inflammatory; allergic

Prolonged treatment with an anti-inflammatory dose of glucocorticoids will _____, and thus stopping treatments "cold turkey" will mean that the pituitary gland is unable to produce normal amounts of ____ for up to one month. How do we avoid this?

inhibit ACTH release; ACTH; taper the withdrawal of glucocorticoids

ACTH is secreted in ____ throughout the day, and plasma cortisol levels ____.

irregular bursts; follow these bursts

The rate of metabolism of cortisol is decreased with ____ and ____, including ____.

kidney disease; stress; surgery

Dehydroepiandosterone sulfates (DHEAS) have __% of testosterone's activity.

less than 20%

Glucocorticoids facilitate _____ in adipose tissue, which releases ____ into the blood.

lipolysis; free fatty acids

Cortisol is metabolized by the ____.

liver

People with Cushing's can have a ____ effect (retention of sodium) from _____, which also contributes to the moon face.

mineralocorticoid; glucocorticoids

Adrenal androgens play a ____ role in masculinizing.

minimal

When glucocorticoid levels are high for long periods of time, ___ such as ____ can occur.

pathologies; Cushing's syndrome

Together the sympathetic nervous system and the adreno-medullary epinephrine mobilizes the body's resources to support ______, otherwise known as ____.

peak physical exertion; fight or flight

Glucocorticoids exhibit significant _____ for other hormonal activity.

permissive actions

In Cushing's, wounds heal ____.

poorly

Aldosterone is crucial in _____, and will cause secretion of ____ into the urine when the plasma ____ levels are high.

potassium regulation; potassium; potassium

The cells of the adrenal medulla secrete when they are stimulated by ____.

preganglionic nerve fibers

Glucocorticoids stimulate ____ in many tissues, especially in muscle. This increases the blood ____ levels

protein degradation; amino acid

In Cushing's syndrome, the patient is depleted of ____ as a result of ____.

protein; excess protein catabolism

The ____ effects of increased glucocorticoid levels are beneficial when dealing with stress.

short-term

The adrenal cortex secretes ____.

steroid hormones

Glucocorticoids _____ hepatic gluconeogenesis, which typically involves conversion of ____ into ____.

stimulate; amino acids; carbohydrates

Glucocorticoids help a person resist ___.

stress

Physical, chemical, physiological, psychological, emotional, and social are all types of ____.

stress

____ causes the release of glucocorticoids.

stress

____ and ____ stimulate the hypothalamus to release _____.

stress; diurnal/circadian rhythms; corticotropin-releasing hormone (CRH)

Secretion by the adrenal medulla is initiated by the _____ with ____ release by the preganglionic neurons.

sympathetic nervous system; acetylcholine

When a person works night-shift and sleeps during the day, do their cortisol/ACTH peaks reverse, or stay the same?

the peaks are reversed

The skin and subcutaneous tissue of individuals with Cushing's syndrome are ___.

thin

The adrenal cortex is comprised of ____ layers.

three

The result of norepinephrine's vasoconstriction and epinephrine's vasodilation combined is that the _______.

total peripheral resistance drops

The steroid-receptor complexes of glucocorticoids act as ____ that ____, which leads via the appropriate ____ to synthesis of ____ that ____.

transcription factors; turn on segments of DNA; mRNAs; enzymes; alter cell function

People with Cushing's can develop ____ because of resultant ____.

type 2 diabetes mellitus; hyperglycemia

The reasons an elevated circulating ACTH and elevated glucocorticoid levels are essential for resisting stress are ___.

unknown

Norepinephrine produces _____ via ____ receptors.

vasoconstriction; alpha-1

Epinephrine produces ____ in skeletal muscle and liver via ____.

vasodilation; beta-2

Cortisol and sex hormones are derived from ____ layer(s) of the adrenal cortex.

zona fasciculata and zona reticularis

Sex hormones are derived from ____ layer(s) of the adrenal cortex, but come primarily from the ____.

zona fasciculata and zona reticularis; zona reticularis

The _____ is the middle layer of the adrenal cortex, comprising ___% of the adrenal cortex.

zona fasciculata; 50%

Aldosterone is derived from ____ layer(s) of the adrenal cortex.

zona glomerulosa

The ____ forms new cortical cells for the adrenal cortex.

zona glomerulosa

The _____ is the outer layer of the adrenal cortex, comprising ___% of the adrenal cortex.

zona glomerulosa; 15%

What are the three layers of the adrenal cortex?

zona glomerulosa; zona fasciculata; zona reticularis

The ____ is the deepest layer of the adrenal cortex, comprising ___% of the adrenal cortex.

zona reticularis; 7%

Epinephrine secreting cells in the adrenal medulla make up __% of the mass, and norepinephrine secreting cells make up __%.

90%; 10%

______ can occur from adrenal tumors, prolonged administration of exogenous glucocorticoids, tumors in the anterior pituitary gland, or even from tumors (usually in the lungs) that secrete ACTH.

Cushing's syndrome

The long-term changes of androgens is due to changes in _____, not changes in ____.

17 alpha-hydroxylase; ACTH secretion

Put the following events in order for the control of glucocorticoid release. 1. Stress and diurnal/circadian rhythms stimulate the hypothalamus to release corticotropin-releasing hormone (CRH) 2. Adrenocorticotropic hormone acts on the adrenal cortex to release glucocorticoids 3. Corticotropin-releasing hormone stimulates the anterior pituitary gland to release adrenocorticotropic hormone (corticotropin, ACTH) 4. Glucocorticoids inhibit the hypothalamus and the anterior pituitary gland

1; 3; 2; 4

The medulla make up ___% of the mass of the adrenal gland.

28%

Upon stimulation, the circulation is flooded with as much as ____ times the normal concentration of epinephrine.

300

The half-life of cortisol is approximately ____.

60-90 minutes

___% of daily production of cortisol occurs between _____.

75%; 4-10AM

Secretion of adrenal androgens is controlled by ____, not by ____.

ACTH; gonadotropins

Are hormones from the adrenal medulla essential for life?

NO

T/F: Stress can be a positive event.

TRUE

T/F: The adrenal cortex is essential to life.

TRUE

____ is the most active androgen, and comes from the ____.

Testosterone; testes


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