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Questions and Answers
What is the blood supply source for the middle adrenal artery?
What is the blood supply source for the middle adrenal artery?
- Superior adrenal artery
- Abdominal aorta (correct)
- Renal arteries
- Inferior phrenic artery
Which artery gives rise to the superior adrenal artery?
Which artery gives rise to the superior adrenal artery?
- Renal arteries
- Middle adrenal artery
- Inferior phrenic artery (correct)
- Abdominal aorta
What is the source of the inferior adrenal artery?
What is the source of the inferior adrenal artery?
- Inferior phrenic artery
- Renal arteries (correct)
- Middle adrenal artery
- Abdominal aorta
Which artery supplies blood to the adrenal gland from the abdominal aorta?
Which artery supplies blood to the adrenal gland from the abdominal aorta?
From which artery does the superior adrenal artery arise?
From which artery does the superior adrenal artery arise?
What is the origin of the middle adrenal artery?
What is the origin of the middle adrenal artery?
Where does the inferior adrenal artery arise from?
Where does the inferior adrenal artery arise from?
Which enzyme prevents the breakdown of sodium channels in renal collecting duct epithelial cells?
Which enzyme prevents the breakdown of sodium channels in renal collecting duct epithelial cells?
What is the main aim of the renin-angiotensin-aldosterone system (RAAS)?
What is the main aim of the renin-angiotensin-aldosterone system (RAAS)?
Which hormone is primarily responsible for promoting sodium retention in the kidney?
Which hormone is primarily responsible for promoting sodium retention in the kidney?
What is the only therapeutic use of mineralocorticoids?
What is the only therapeutic use of mineralocorticoids?
What is the main function of 11β-hydroxysteroid dehydrogenase (HSD) in aldosterone sensitive tissues?
What is the main function of 11β-hydroxysteroid dehydrogenase (HSD) in aldosterone sensitive tissues?
Which component of the RAAS system triggers the secretion of aldosterone from the adrenal cortex?
Which component of the RAAS system triggers the secretion of aldosterone from the adrenal cortex?
What is the enzyme that prevents the breakdown of sodium channels in renal collecting duct epithelial cells?
What is the enzyme that prevents the breakdown of sodium channels in renal collecting duct epithelial cells?
What is the main usage of inhaled glucocorticoids?
What is the main usage of inhaled glucocorticoids?
What is the main adverse effect of over-dosing on glucocorticoids?
What is the main adverse effect of over-dosing on glucocorticoids?
What is the immediate emergency treatment for Addisonian crisis?
What is the immediate emergency treatment for Addisonian crisis?
What is the most serious consequence of prolonged glucocorticoid delivery?
What is the most serious consequence of prolonged glucocorticoid delivery?
What can cause Addisonian crisis?
What can cause Addisonian crisis?
What is the role of 17α-hydroxylase in adrenal hormone synthesis?
What is the role of 17α-hydroxylase in adrenal hormone synthesis?
Where can additional in-depth information about glucocorticoids and mineralocorticoids be found?
Where can additional in-depth information about glucocorticoids and mineralocorticoids be found?
What does HPA stand for in 'Normal HPA function'?
What does HPA stand for in 'Normal HPA function'?
What is the main usage of topical glucocorticoids?
What is the main usage of topical glucocorticoids?
What determines whether mineralocorticoids or glucocorticoids are produced in the adrenal gland?
What determines whether mineralocorticoids or glucocorticoids are produced in the adrenal gland?
What controls cortisol secretion in the adrenal gland?
What controls cortisol secretion in the adrenal gland?
What is the primary function of cortisol under normal circumstances?
What is the primary function of cortisol under normal circumstances?
What is the diurnal rhythm of cortisol secretion?
What is the diurnal rhythm of cortisol secretion?
What percentage of cortisol is free and active in the blood?
What percentage of cortisol is free and active in the blood?
What does cortisol primarily affect during stress or injury?
What does cortisol primarily affect during stress or injury?
What role does cortisol play in the fight or flight response?
What role does cortisol play in the fight or flight response?
Which layer of the adrenal gland is primarily responsible for producing glucocorticoids?
Which layer of the adrenal gland is primarily responsible for producing glucocorticoids?
What is the primary mineralocorticoid produced by the adrenal cortex?
What is the primary mineralocorticoid produced by the adrenal cortex?
Which enzyme is primarily responsible for the conversion of cholesterol to pregnenolone in the adrenal cortex?
Which enzyme is primarily responsible for the conversion of cholesterol to pregnenolone in the adrenal cortex?
Which of the following is a characteristic of Cushing's syndrome?
Which of the following is a characteristic of Cushing's syndrome?
What is the primary physiological action of glucocorticoids in the body?
What is the primary physiological action of glucocorticoids in the body?
Which of the following is a potential effect of prolonged exposure to high levels of glucocorticoids?
Which of the following is a potential effect of prolonged exposure to high levels of glucocorticoids?
What is the primary source of cortisol production in the body?
What is the primary source of cortisol production in the body?
Which factor can disrupt the normal circadian rhythm of cortisol secretion?
Which factor can disrupt the normal circadian rhythm of cortisol secretion?
What is the primary function of cortisol in the liver?
What is the primary function of cortisol in the liver?
How does cortisol affect protein synthesis in muscles?
How does cortisol affect protein synthesis in muscles?
What is the main consequence of cortisol's interaction with catecholamines?
What is the main consequence of cortisol's interaction with catecholamines?
How is cortisol primarily transported in the blood?
How is cortisol primarily transported in the blood?
What is the primary effect of cortisol on wound healing processes?
What is the primary effect of cortisol on wound healing processes?
Which enzyme determines the effect of cortisol on the mineralocorticoid pathway?
Which enzyme determines the effect of cortisol on the mineralocorticoid pathway?
What role does cortisol play in the fight or flight response?
What role does cortisol play in the fight or flight response?
What is the primary consequence of prolonged heightened stress related to cortisol?
What is the primary consequence of prolonged heightened stress related to cortisol?
What does cortisol primarily affect in the brain?
What does cortisol primarily affect in the brain?
What is the primary role of cortisol in regulating blood pressure?
What is the primary role of cortisol in regulating blood pressure?
Which layer of the adrenal cortex primarily produces glucocorticoids?
Which layer of the adrenal cortex primarily produces glucocorticoids?
What determines the production of mineralocorticoids or glucocorticoids in the adrenal cortex?
What determines the production of mineralocorticoids or glucocorticoids in the adrenal cortex?
What triggers the synthesis of cortisol in the adrenal cortex?
What triggers the synthesis of cortisol in the adrenal cortex?
What is the primary drainage route from the adrenal glands?
What is the primary drainage route from the adrenal glands?
What is the primary function of the enzyme 17 alpha hydroxylase in adrenal hormone synthesis?
What is the primary function of the enzyme 17 alpha hydroxylase in adrenal hormone synthesis?
What is the primary role of the adrenal medulla?
What is the primary role of the adrenal medulla?
What is the primary function of aldosterone in the renin-angiotensin-aldosterone system?
What is the primary function of aldosterone in the renin-angiotensin-aldosterone system?
What is the role of glucocorticoids in relation to mineralocorticoid receptors?
What is the role of glucocorticoids in relation to mineralocorticoid receptors?
What enzyme inactivates cortisol in glucocorticoid-sensitive cells and tissues?
What enzyme inactivates cortisol in glucocorticoid-sensitive cells and tissues?
In what condition would mineralocorticoid replacement therapy, such as fludrocortisone, be used?
In what condition would mineralocorticoid replacement therapy, such as fludrocortisone, be used?
What are the potential consequences of aldosterone deficiency?
What are the potential consequences of aldosterone deficiency?
What triggers the production of aldosterone from the adrenal cortex?
What triggers the production of aldosterone from the adrenal cortex?
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Study Notes
Adrenal Gland and Cortisol: Key Points
- The adrenal gland has different regions: capsule, zona glomerulosa, zona fasciculata, zona reticularis, and medulla
- The gland produces mineralocorticoids in the zona glomerulosa, glucocorticoids in the zona fasciculata, and androgens in the zona reticularis
- The enzyme 17α-hydroxylase determines whether mineralocorticoids or glucocorticoids are produced
- Cortisol, a glucocorticoid, follows a diurnal rhythm, with peak secretion in the morning and lowest levels at night
- Cortisol secretion is controlled by ACTH, which is regulated by CRH from the hypothalamus
- Cortisol is transported in the blood, with only 10% being free and active
- Cortisol acts as a transcription factor and affects gene expression
- Under normal circumstances, cortisol affects liver function, skeletal muscle, blood vessels, and cognition
- During stress or injury, cortisol affects immune response, inflammation, pain, and wound healing
- Cortisol prolongs the effects of the fight or flight response by decreasing the inflammatory response
- Glucocorticoids like cortisol may act against a person's best interests in certain situations
- Cortisol enables individuals to perform despite extreme physical or emotional stressors, with both short-term benefits and long-term detriments
Aldosterone and Mineralocorticoid Pathway Overview
- Aldosterone is the end product of the mineralocorticoid pathway and plays a major role in the renin-angiotensin-aldosterone system to regulate blood pressure.
- Low blood pressure detected by the kidneys triggers the release of renin, eventually leading to the production of Angiotensin II, which increases blood pressure through vasoconstriction and release of antidiuretic hormone.
- Aldosterone secretion from the adrenal cortex increases sodium retention in the kidneys, leading to water retention and higher blood pressure.
- Aldosterone binds to mineralocorticoid receptors, leading to the expression of S.G.K.1, preventing the breakdown of sodium channels and increasing sodium retention.
- Glucocorticoids can affect mineralocorticoid receptors, but it is rare and generally occurs during periods of heightened stress.
- Glucocorticoid-sensitive cells and tissues contain an enzyme called 11-beta hydroxysteroid dehydrogenase, which inactivates cortisol, the inactive form of cortisol.
- During heightened stress, some cortisol may not be converted to cortisone and can have an effect on mineralocorticoid receptors.
- Glucocorticoids do not have a mineralocorticoid effect during normal physiology, only during periods of massively heightened circulating levels of glucocorticoid.
- Aldosterone production is stimulated by the renin-angiotensin-aldosterone system, which involves the conversion of angiotensin I to angiotensin II by the angiotensin converting enzyme, leading to aldosterone production.
- Mineralocorticoid replacement therapy, such as fludrocortisone, is used when a patient is not producing enough of their own mineralocorticoid, as in Addison's disease, an autoimmune disease that destroys the adrenal cortex.
- Addison's disease patients may also require cortisol replacement, but the focus on aldosterone is on water retention in the kidneys and preventing low sodium and high potassium levels.
- Impaired sodium balance and high potassium levels due to aldosterone deficiency can lead to conditions such as hyponatremia and hypokalemia, which can be severe if left untreated.
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