Phys 2- Test 2

• zona glomerulosa
• zona fasiculata
• zona reticularis
• medulla

zona glomerulosa

zona fasiculata

zona reticularis

adrenal medulla

• at the 12th throacic level
• above the kidney

• ACTH from anterior pituitary
• reninangiotensin

sympathetic nervous system

• located in the adrenal medulla
• secrete norepi and epi

from cholesterol from LDL

• increase LDL receptors on adenocortical cells
• increases cholesterol from LDL

cholesterol causes pregenvlolone causes cortisol, sex hormones, and aldosterone

• can bind to cortisol r/c
• agonist

• glucocorticoid
• produced during stress
• r/cs in almost all cells

• ACTH: stimulated by CRH, secreted by stress and circadian rhythm
• CRH: diurnal, highest before waking

• inhibits CRH from hypothalamus
• inhibits ACTH from anterior pituitary
• OVERRIDEN BY STRESS

• mostly bound to CBG (corticosteroid binding globulin) and albumin
• slow elimination
• resovior

• occurs in the liver
• 25%- bile/feces
• 75%- kidneys/urine

• cells, organs, systems cant respond to signals and stress
• causes death

• supresses immune and inflammatory responses
• breakdown of CT and bone
• increase diabetes mellitus

• increase liver gluconeogenesis (glu from AAs and lipids)
• increase mobilization of AAs
• decrease glucose uptake
• lipolysis in adipose (FA for energy)

• increase gluconeogenesis
• increase glycogen storage in liver
• decrease glucose utilization

• increase in circulating glucose causing insulin secretion
• causes decrease in insulin effectiveness and sensetivity
• DIABETOGENIC

• EXCEPT in the liver
• decrease protein catabolism causing muscle weakness
• decrease protein synthesis causing decrease immunity

• increase free FA (better for FA oxidation)
• use of FA for energy instead of glucose

• increase appetite
• increase leptin
• increase visceral fat deposition

cortisol weakens immunity

• blocks inflammatory process
• rapid resolution
• speedy healing
• stabalizes lysosomal membranes
• inhibits tissue destruction
• decreases capillary permeability
• attenuates fever

• binds to aldosterone r/c in kidney
• normally converted to cortison, which doesnt bind
• -inhibited by liquorice

• decreases bone formation
• creates memories from short term exposure
• fetal maturation- surfactant

• theraputic uses
• anti-inflammatory
• chronic use may impair anabolic process (cushing's syndrome)

hypercortisolism, adrenalism, and adenocorticism

• truncal weight gain
• moon-like face
• acne and hiruitism
• hypertension
• high blood glucose
• weakness
• purple stria
• osteoporosis
• menstral irregularities

adenomas of anterior pituitary

• labs
• primary- high cortisol, low ACTH
• secondary- high cortisol, high ACTH

• failure of adrenals to produce hormones
• usually autoimmune problem
• low aldosterone
• low cortisol
• steroid treatment

• low fluid
• high RBCs, low plasma
• decreased cardiac output

• decreased metabolic functions
• sluggish, weakness
• increase ACTH
• increase melanin

• mineralocorticoid
• from zona glomerulosa
• from cholesterol stimulated by ACTH
• stimulated by the concentration of angiotensisn 2 and K+

• in the collecting ducts and tubules
• atrial natriuetic peptide inhibits aldosterone

• increased [K]
• increase renin-angiotensin system
• ACTH

decreased [Na]

• death
• renal Na wasting causing decreased blood volume and cardiac output

• adrenal tumor
• increased Na/H2O retention
• hypertension
• muscle weakness

• confusion
• twitching
• nausea
• light-headed

• primary aldosteronism
• from zona glomerulosa tumor
• excess aldosterone production

• important during fetal development and puberty
• DHEA, androstendine (precursor to testosterone)
• progesterone and estrogen

• increases:
• contraction/cardiac output
• breathing rate
• sweating
• anxiety
• metabolism

• chromaffin cell tumor
• overproduction of norepi and epi
• usually benign
• treatment to nromalize blood pressure

• multiple endocrine neoplasia 2
• pheochromocytoma with meduallary thyroid cancer or hyperparathyroidism= MEN 2A
• pheochromocytoma wiht tumors of Ns in lips, mouth and eyes = MEN 2B

• labs show:
• increased epi, norepi and metanephrines
• abnromal CT/MRI

• MI
• heart failure
• stroke
• kidney failure
• vison impairment
• death

• release of excess catecholamines causing HR 250/150
• causes stroke, congestive heart failure
• increased risk of diabetes

• islets of langerhans
• beta cells
• alpha cells
• delta cells
• polypeptide cells

• insulin
• amylin (inhibits insulin)

glucagon

somatastatins (inhibit glucagon and insulin

pancreatic polypeptide

• the dominant hormone in regulating blood sugar
• increases when engery's abundant
• increases energy storage
• increases to reduce blood sugar

• storage of CHOs as glycogen in liver and MS
• stores protein as AAs

• translated/synthesiszed as preprohormone
• cleaved in ER to proinsulin
• cleaved in golgi to insulin
• packaged and secreted into blood
• cleared in 10-15 minutes
• degredaded by insulinase

• binds to r/c, initiates enzymatic cascade
• increases cells glucose uptake to adipose and Ms
• phosphorylates glucose for CHO metabolism
• increases membrane permeability to AA, K, and Phosphate

• noninsulin regulated GKUT-2 r/c
• increased glycogen synthetase
• decreased glycogen phosphylation

• increase glucose uptake
• increase glucogenesis
• decreased gluconeogenesis

• increased tri-g synthesis
• decreased tri-g breakdown

• increased synthesis
• decreased breakdown

• Glu-6-P causes Ca+ influx causing insulin secretion from beta cells
• primary factor is increased blood Glu sensed by GLUT-2 r/c on beta cells
• increased glucagon, AA, GI hormones after a meal, ACh, and sulfonurea drugs

• increased glucose= increased insulin= increased uptake and storage of Glu
• b/t meals insulin needs to be low so glucose can go to the brain

the brain

• promotes in liver
• glucose to pyruvate to acetal-CoA to FAs
• packaged in VLDL to the blood, stored as fat

• during exercise without insulin
• after meals with increased Glu

insulin + GH causes dramatic growth

• hyperglycemic hormone
• increases with low blood glucose
• opposes insulin (causes high blood glucose to correct hypoglycemia)

• glycogenolysis- breakdown of liver glucose
• gluconeogenesis- in liver, uptake of AA
• increased adipose breakdown
• decreased tri-g storage in liver

• decreased blood glucose
• exercising
• increased serum AA after high protein meal

• high blood glucose
• somatostatin

• secreted from delta cells
• inhibits insulin and glucagon

• ingestion of food
• blood glucose
• AA
• FA
• GI hormones

• extend time for nutrients to get into blood
• decrease use of absorbed nutrients by tissues

low blood glucose causing shock, coma, death

protein wasting causing wakness and organ dysfunction

• more fat used for energy
• atherosclerosis from increased free FAs
• formation of ketone bodies in the liver
• death

• impaired CHO, PRO, and fat metabolism
• caused by:
• -lack of insulin secretion (IDDM, type 1)
• -decreased insulin sensetivity of tissues (NIDDM, type 2)

• beta cell failure/destruction
• 5% of cases
• genetic predistposition
• onset usually during childhood
• developes abruptly
• increased blood glucose to urine
• polyol pathway

• genetic
• auto-immune
• viral infection

• glycated protein/ frosted
• loss of normal function
• s/sx: polyuria, increased thirst

• causes tissue damage
• polyol pathway

• altherosclerosis
• blindness
• gangrene
• peripheral neuropathey
• hypertension
• fat metabolism leading to death

• loss of insulin sensetivity, later loss of beta cells
• 95% of cases
• usual onset >30
• develops gradually
• associated with high insulin causing decreased sensetivity and more insulin secretion

over eating

• obesity
• abdominal fat
• reactive hypoglycemia
• insulin resistance
• fasting hyperglycemia
• increased tri-g, decreased HDL
• hypertension

• chronic inculin exposure causing r/c down regulation
• obesity
• excess cortisol/GH
• pregnancy
• polycystic ovarian syndrome
• hemochromatosis

IDDM

• deit
• excersize
• weightloss
• drugs

low/undetectable insulin

high insulin early, low late

• tumor of beta cells causing hypersecretion of insulin
• can lead to insulin shock (hypoglycemia-coma)

• drugs
• hormone deficiencies
• liver failure
• critical illness
• endogenous hyperinsulinism
• auto-immune disease

• congenital deficiency of enzyme of CHO metabolism
• GI

determined by chromosomes

determined by testes/ovaries

determined by hormones and secondary sex characteristics

• mullerian inhibiting hormone- inhibits growth of paramesonephric ducts
• testosterone- causes deveolopemnt of mesonephric ducts

• ovaries secrete estrogen and progesterone
• no testosterone so mesonephric ducts wither

• hypothalamus
• anterior pituitary
• gonads

• gametogenesis
• hormone secretion

• hypothalamus- GnRH
• anterior pituitary- LH and FSH

• from hypothalamus
• released in pulsatile fashion
• binds to r/c on gonadotropes
• feedback by LH and FSH
• also controlled by stress, pheramones, light/dark cycles

• from anterior pituitary
• bind and activate G-protein and cAMP
• promotes gametogenesis and gonadal hormone secretion

• week 4- GnRH secretion (low till puberty)
• week 10-12- LH and FSH secretion (peak at mid-gestation, low until puberty)

LH and FSH levels rise slowly

• pulsitile secretion of GnRH
• increased LH and FSH secretion

• increase in LH and FSH due to down regulation of r/cs (no negative feedback)
• more gradual in males

• plasma levels increase (estrogen, testosterone, and inhibin)
• r/cs become more responsive resulting in the development of secondary sex characteristics

• ovaries produce estradiol
• budding of breasts
• hair growth
• menarche
• growth spurts

• leydig cell proliferation
• lowering of voice
• spermatogenesis begins
• growth spurt

• regulation, synthesis, and secretion of hormones
• spermatogenesis
• sex

• leydig cells
• sertoli cells

• located in CT
• secrete testosterone
• stimulated by LH

• in seminiferous tubules
• stimulated by FSH
• produce sperm
• testosterone r/cs
• secrete inhibin (inhibits GnRH and FSH)

• testes to vas deferens
• maturation of sperm
• lined by cilia

• secretes 70% of semen fluid
• energy

• 5 lobes
• produces seminal fluid
• contracts during emission

• pH 7.5
• clotting enzymes
• fibrinolysis

• head- acrosome
• tail- glagellum

• mature in epididymis
• stored in vas deferense

• increased temp causes decreased spermatogenesis
• cryptorchidism- failure of testes to descend
• <20 million= infertility

androgens (testosterone, dihydrotestosterone, androstenedione)

FSH and testosterone

• produced by sertoli cells
• supresses FSH via negative feedback

via FSH

spermatogonia -> primary spermatocyte -> secondary spermatocyte -> spermatid -> spermatozoa

• stimulated at puberty by FSH
• GH controls metabolic function of testes
• sertoli cells produce androgen binding protein

• = steroid promoting growth and decvelopment of genital tract
• 95% from leydig cells
• 5% from adrenals

most abundant androgen

from testosterone

precurosor to testosterone

• diurnal
• low at night, high in the morning

• fetal- high
• childhood- low
• puberty- high
• adulthood- high, decreases after 60

• most circulate bound to proteins (sex-hormone binding globumin and albumin)
• 2% free and active
• converted in liver to dehydroepiandosterone for excretion

• binds to cytoplasmic r/cs
• enters nucleus (transcription and translation)
• production of proteins everywhere in the body
• androgen actions

• estradios via aromatase
• dehydrotestosterone via 5-alpha-reductase

• stimulated by hCG
• supresses female genetalia
• makes hypothalamus more male

developement of primary and secondary sex characteristics

• secretions
• libido
• sperm materation
• semen production

• prepares for conception
• pregnancy

• FSH and LH stimulate estrogen and progesterone from ovary
• FSH and LH inactve until puberty

• oogonia formed in fetus by hCG, Gh, and gonadotropins
• granulosa cells surround ovun- primordial follicle
• gransulosa cells secrete oocyte inhibiting factor until puberty
• FSH stimulates 6-12 follicles
• outer granulosa cells form thecal cells

• have LH receptors
• produce androstenediaon and testosterone

• have FSH receptors
• have aromatase to convert androstenedion to estradiol

• theca internaa produces estrogen, progesterone, and theca externa
• growth via estrogen
• LH and estrogen cause increased theca secretions
• 1 mature follicle per month

LH

low levels of LH and FSH when unfertilized

• influenced by estrogen and progesterone
• if corpus albicans form, menstral phase occurs, sloughing off of endometrium
• high estrogen prior to ovulation causes endometrial proliferation
• high progesterone after ovulation causes secretory development

estrogen levels become high and cyclic

• ovarian burn-out
• estradiol secretion ceases
• FSH and LH levels rise b/c of no negative feedback

estradiol

progesterone

• proliferation
• promote growth and development of reproductive tract
• secondary sex characteristics

• secretory
• prepare uterus for pregnancy
• prepare breasts for lactation

progesterone and testosterone synthesized but then converted to estrogen by aromatase in granulosa cells

progesterone levels high

• 98% bound to sex hormone binding protein or albumin
• loose binding, hormones easily released

• mainly in liver
• converts E1 and E2 to E3 (inactive)

• E2- beta estradiol- most potent/common- non pregnant
• E1- estrone- from conversion of testosterone to estrogen
• E3- estriol- from oxidation of others in liver

• ovaries: follicular growth
• uterus: proliferation of endometrium
• vagina: growth, reduces pH
• fallopian tube: growth , ciliary action to uterus
• external genetalia: growth
• breasts: growth, development
• cervical mucus: thinner, increased pH, sperm transport

• anabolic
• stimulates bone growth
• increased skin thickness
• sodium and water retention

• cramps
• nausea
• edema
• enlarged uterus
• fibrocystic breasts
• menorrhagia

• scant menses
• small uterus
• small breasts
• spotting

• progesterone- most inportant
• 17-alpha-hydroxyprogesterone- aganist to progesterone

• endometrial secretory changes
• decreased contraction of uterus
• secretion of fallopian tubes
• breast enlargement
• maintains pregnancy

• thermogenic effect (increased basal body temp)
• CNS effects

• edema
• bloating
• headach
• depression
• weight gain
• tiredness
• varicose veins

• prolonged menses
• heavey menses
• cramps
• luteal spotting

• fertilized secondary oocyte completes meiosis 2 -> ovum
• chromosomes align

• 3-5 days after fertilization
• progesterone relaxes smooth muscle
• implantation of blastocyst
• requires low estrogen and high progesterone levels

placenta: hCG, estrogens, progesterone, hCS

• human chorionic gonadotropin
• prevents involution of corpus luterum
• development of alveoli in breasts
• development of male fetus

• from syncytiotrophoblasts 2-3 days post plantation
• detection used for pregnancy tests
• maximum secretion wekk 10-12
• low levels weeks 16-20

• human chorionic somatomammotropin
• secreted around week 5 in proportion to fetal weight

• development of breasts
• decreased insulin sensetivity for more blood glucose for baby
• release of free FA for moms energy

• secreted by corpus luteum
• week 12- secreted by syncytiotrophoblast
• increased 10X during pregnancy
• produced from cholesterol by placenta

• develupment of decidual cells
• decreases contractility of myometrium
• cleaveage of embryo
• prepares breasts for lactation

• from syncytiotrophoblast cells
• requires dehydroepiantrosterone- from fetal adrenals

• enlargement of uterus
• enlargement of breasts
• enlargement of external genitalia
• relaxation for parturition

• increased CRH, TRH, and prolactin
• increased clucocorticoids
• increased aldosterone
• thyroid enlargement
• PTH- Ca absorption and lactation
• relaxin- softens cervix
• oxytocin- increases in uterine contraction reflex

• weight gain
• increase metabolic rate (increased temperature)
• anemia from deficiency
• increased cardiac output
• increased blood volume
• increased respiratory rate
• increased urination
• preclampsia

• hypertension with proteinuria
• -salt and water retention
• -low blood flow
• caused by: aldosterone, autoimmune, low blood to placenta

• fetal nutrition
• diffusion of oxygen
• removal of CO2
• steroid hormone secretion

• maternal PO2= 50
• fetal PO2= 30
• fetal hemoglobin has high binding affinity
• Borr effect

• progesterone- inhibits contractions
• increased estrogen- causes uterine contractions, increased gap junctions
• oxytocin- positive feedback for contractions

• estrogen develops ducts
• progesterone develops secretory characteristics
• prolactin promates secretion of milk
• oxytocin promotes ejection of milk into ducts

hypothalamus inhibits prolactin - dopamine