Endocrine2- Adrenal Part 2

  1. Describe the blood supply to the adrenal gland.
    small arteries penetrate the capsule; they are sinusoidal and bathe the cells in blood
  2. ______________ nerve fibers synapse on ___________ of the adrenal medulla.
    Preganglionic myelinated sympathetic; secretory cells
  3. Exogenous cortisol causes ___________ of the __(2)__.
    trophic atrophy; zona fasiculata and reticularis
  4. Treatment with glucocorticoids reduces...
    endogenous ACTH and glucocorticoid production.
  5. Exogenous corticosteroids inhibit __________; long term use leads to lesions in the adrenal that include increased ________ because...
    ACTH secretion; lipid; ACTH is necessary to convert cholesterol to glucocorticoids.
  6. 2 metabolic syndromes associated with atrophy of the adrenal cortex.
    peracute- Waterhouse-Fredrickson Syndrome, chronic- Addison's Disease
  7. Why do we not often diagnose and treat peracute adrenocortical insufficiency?
    very high mortality- patients (usually young animals) die quickly
  8. What are causes of peracute adrenocortical insufficiency (Waterhouse-Fredrickson Syndrome)? (4)
    diffuse cortical necrosis/hemorrhage (trauma/septicemia), thrombosis of adrenal vessels, toxemia
  9. Chronic hypoadrenocorticism causes loss of _________.
    all 3 layers of the cortex
  10. What is the most common cause of chronic hypoadrenocorticism? What are 2 less common causes?
    inflammation (adrenalitis); less commonly: necrosis, mineralization of adrenal cortex
  11. Why is the adrenal so sensitive to fungal and protozoal insults?
    high levels of glucocorticoids, which are immunosuppressive
  12. Addison's disease is caused by ____________ that is comprised of ___________, causing secondary __(2)__.
    idiopathic autoimmune adrenalitis; lymphoplasmacytic inflammation; atrophy and fibrosis
  13. How does autoimmune adrenalitis affect the pituitary gland?
    pituitary corticotroph hyperplasia because it is trying to stimulate the adrenal (which isn't functioning)
  14. Patients with Addison's have _______ ACTH and ________ glucocorticoids.
    high; low
  15. Sub-clinical, age-related change in the adrenal cortex of dogs.
    extracoritcal nodular hyperplasia
  16. Sub-clinical, nodular adrenal change with a variable zone of origin.
    multinodular hyperplasia
  17. __________ animals have lower glucocorticoid stimulation because of...
    Older; normal degeneration and mineralization of the adrenal cortex that is associated with age.
  18. Degeneration and mineralization of the adrenal cortex with age usually affects the __(2)__.
    zona fasiculata and reticularis
  19. Functional adenomas of the adrenal cortex can cause... (2)
    hyperadrenocorticism, hyperestrogenism (ferrets)
  20. Carcinomas of the adrenal cortex invade the ________, and ultimately _________.
    blood vessels (esp. the vena cava); metastasize
  21. How can you identify a functional tumor of the adrenal cortex on necropsy?
    the rest of the cortex/contralateral adrenal is atrophied (trophic atrophy- tumor is secreting all the hormone)
  22. Almost all ferrets are gonadectomized at a young age; this leads to increased levels of _______ and secondarily increased __(2)__; in ferrets, this stimulates the adrenal cortex, and the tumor the develops produces _________.
    GnRH; LH and FSH; estrogen
  23. How can you differentiate adrenal cortex hyperplasia from tumors in ferrets?
    hyperplasia is bilateral; tumors are unilateral
  24. What are clinical signs of hyperestrogenism in ferrets? (2)
    vulvular enlargement, bilaterally symmetrical alopecia of abdomen and rear legs
  25. In ferrets, hyperestrogenism causes... (4)
    anemia, thrombocytopenia, pyometra, prostate enlargement
  26. Ferrets with hyperestrogenism get pyometra secondary to ___________.
    endometrial hyperplasia
  27. The adrenal medulla derived from __________ from __________.
    neuroectoderm; neural crest
  28. Why do neural crest cell migrate ventrally to form the adrenal medulla?
    the adrenal cortex has glucocorticoids--> chromaffin cells of the medulla want to be in an environment of high glucocorticoid conc
  29. Hormones of the adrenal medulla.
    catecholamines- epinephrine and norepinephrine
  30. Describe the gross appearance of the adrenal cortex and medulla and why they appear this way.
    • cortex- fatty- lipid is precursor for corticosteroids
    • medulla- darker- uses AAs as precursors for catecholamines
  31. What are the contents of the adrenal medulla secretory granules? (5)
    catecholamines, ATP, chromogranin A, Dopamine beta-hydroxylase, ascorbate
  32. What component of the adrenal medulla secretory granules is used as a diagnostic tool for endocrine tumors? What is a con to using this tool?
    Chromogranin A- does not localize the tumor to a specific endocrine organ (adrenal, parathyroid, etc)
  33. Enzyme that converts NE to Epi; only present in epinephrine-producing cells.
    phenylethanolamine N-methyl transferase (PNMT)
  34. The enzyme PMNT is induced by _________.
  35. Clinically, which catecholamine is more potent?
  36. Biologically, which catecholamine has a greater effect on end organs in the body?
  37. Response of an organ to sympathomimetic amines depends upon the...
    proportion and density of alpha and beta receptors.
  38. Effects of NE on the body. (3)
    generalized vasoconstriction,pupillary dilation, decreased GI motility
  39. Effects of Epi on the body. (5)
    selective vasoconstriction of skin and kidney, selective vasodilation of skeletal m. and coronary aa., increased cardiac activity, increased metabolism, bronchiolar dilation
  40. What organs does Epi vasoconstrict? Which ones does it vasodilate?
    • Vasoconstriction- organs not necessary for fleeing danger (skin, kidneys)
    • Vasodilation- organs necessary for flight (skeletal muscle, coronary aa.)
  41. What effects does Epi have on metabolism? (4)
    increase basal metabolic rate, glycogenolysis, lipolysis, increased blood glucose
  42. The adrenal medulla provides _________ response to stress; the adrenal cortex provides _________ response to stress.
    rapid, short-term; long-term
  43. How are catecholamines recycled locally?
    local nerve ending- enzymatic degradation, physical diffusion, re-uptake into nerves
  44. How are catecholamines recycled systemically?
    enzymatic degradation in the liver
  45. What happens with absence of the adrenal medulla?
    not essential for life- may not react as quickly to stressful situations (oh well...)
  46. Why must the adrenal medulla be examined soon after death to be a reliable indicator of disease?
    undergoes rapid post-mortem autolysis (may over-diagnose hemorrhage and necrosis)
  47. 4 types of adrenal medullary hyperfunction/neoplasms.
    hyperplasia, neuroblastoma, ganglioneuroma, pheochromocytoma
  48. Hyperplasia of the adrenal medulla occurs in __(2)__ due to _________.
    rats and cows; chronic stress
  49. Proliferative, aggressive, malignant tumor of the adrenal medulla that occurs in young animals; consists of poorly differentiated round cells.
  50. Benign tumor of the adrenal medulla; composed of neurons and axons.
  51. Tumor of secretory cells of the adrenal medulla that may start as hyperplasia and progresses to a benign space-occupying mass, and sometimes to a malignant tumor.
  52. Malignant pheochromocytoma invades the _________.
    caudal vena cava
  53. Tumor that appears in the adrenal medulla in animals that are especially susceptible to endocrine neoplasia.
    multiple endocrine neoplasia (MEN)
  54. Functional effects of neoplasms in the adrenal medulla. (4)
    space-occupying mass, hormone secretion, vascular invasion, necrosis and hemorrhage
  55. Effects of hormone-secreting adrenal tumors. (5)
    tachycardia, hypertension, sweating, hyperglycemia, vasoconstriction
  56. Describe the Chromaffin reaction.
    used to differentiate cortical and medullary neoplasms- brown staining means medullary neoplasm
  57. Metastatic neoplasms from other Morgans that end up in the adrenal medulla are usually __________; this is more/less common than to the adrenal cortex.
    bilateral; more
  58. Neoplasms in cats and cows that metastasize to the adrenal medulla.
  59. Neoplasms in dogs that metastasize to the adrenal medulla.
    lung, mammary, prostate
Card Set
Endocrine2- Adrenal Part 2
vetmed endocrinology