C5 -- The Adrenal Medulla and Adrenal Cortex
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
