AP 2 Endocrine system part II

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AP 2 Endocrine system part II
2013-10-19 21:31:15
AP2 Endocrine

Adrenals, GAS, Pancreas,
Show Answers:

  1. What is the location of the adrenals?
    Superior to the kidneys, about the level of the 12th rib
  2. What is the color of the adrenals? Why?
    Yellowish - Due to the presence of stored lipids, especially cholesterol and fatty acids
  3. What is the shape of the adrenals?
    Flattened pyramidal shape
  4. What is the size and weight of the adrenals?
    Size: 3-5 cm high, 2-3 cm width, 1 cm thick

    Weight: 3.5-5 grams (0.18 oz)
  5. What surrounds the adrenals?
    Encased in a fibrous capsule and surrounded by adipose
  6. What are the regions of the adrenals?
    1. Cortex - Outer portion of the adrenals

    2. Medulla - Inner portion of adrenals
  7. What are the zones of the adrenal cortex?
    1. Zona glomerulosa

    2. Zona fasciculata

    3. Zona reticularis
  8. Which zone of the adrenal cortex is the widest middle part?
    Zona fasciculata
  9. The zona glomerulosa manufactures what hormone group?
  10. What is the main hormone the zona glomerulosa produces?
  11. The zona fasciculata manufactures what hormone group?
  12. What is the main hormone the zona fasciculata produces?
  13. The zona reticularis manufactures what hormonal group?
  14. What is the main hormone the zona reticularis produces?
    Mostly testosterone with a small amount of estrogen
  15. What is the composition of the zona glomerulosa?
    Composed of clusters of round cells
  16. What is the composition of the zona fasciculata?
    Comprised of chains of round cells
  17. What is the composition of the zona reticularis?
    Composed of round cells in branches
  18. The adrenal medulla houses what type of cells?
    Chromaffin cells
  19. What are chromaffin cells?
    Modified post-ganglionic neurons associated with sympathetic division
  20. What hormone do the chromaffin cells produce?
    Epinephrin and norepinephrin
  21. Where are the chromaffin cells located? Why?
    Near blood sinuses in order quickly secrete hormones into the blood stream
  22. How are chromaffin cells stimulated?
    Nerve impulses leave the T9 cord (preganglionic fibers), slip through celiac ganglion, and innervate the chromaffin cells directly
  23. What is the hormone classification of E and NE?
    Amine (tyrosine)
  24. Is E and NE lipid or water soluble?
    Water soluble
  25. Where do E and NE interact on target cell receptors?
    Interacts with cell membrane receptors
  26. How much E and NE does each chromaffin cell secrete?
    80%E and 20% NE
  27. E stimulates what?
    Heart and metabolic activities
  28. NE stimulates what?
    Peripheral vasoconstriction and BP
  29. What is a pheochromocytoma?
    A benign tumor of chromaffin cells
  30. What are the signs/symptoms of a pheochromocytoma?
    • 1. Increased heart rate and BP
    • 2. Increased respiratory rate
    • 3. Increased sweating
    • 4. Increased glucose levels
    • 5. Increased VMA (vanyllamendallic acid) in urine
  31. What is the treatment for a pheochromocytoma?
    Tumor removal
  32. What hormone classification is aldosterone?
  33. Is aldosterone water or lipid soluble?
    lipid soluble
  34. Where does aldosterone interact on target cells?
    Intracellular receptors
  35. What is the function of aldosterone?
    Stimulates the sodium reabsorption and elimination of potassium - mineral balance - regulation of BP
  36. What structures does aldosterone act on?
    • 1. Principal cells of DCT and collecting tubules of nephron of kidney
    • 2. Sweat glands
    • 3. Salivary glands
    • 4. Gastric juice secretion
  37. How is aldosterone secretion regulated?
    • 1. Renin-angiotensin pathway
    • 2. Stress
    • 3. Humeral blood levels of Na+ and K+
  38. What causes humeral stimulation of aldosterone secretion?
    Low Na+, High K+ levels
  39. What causes humeral inhibition of aldosterone secretion?
    High Na+, Low K+ levels
  40. What is the hormone classification of Angiotensin II?
    Protein and peptide
  41. Is angiotensin II water or lipid soluble?
    Water soluble
  42. Where does angiotensin II interact on target cells?
    Interacts on cell membrane receptors
  43. What is the function of angiotensin II?
    • 1. Increase thirst
    • 2. Stimulate ADH secretion
    • 3. Stimulate aldosterone secretion
    • 4. Enhances vasoconstriction
  44. What is the main action of angiotensin II?
    Increase blood volume and increase blood pressure for better blood delivery to tissues
  45. How is glucose beneficial during stress?
    Increased glucose is used as an energy source to ward off stress
  46. What is the hormone classification of ANF (Atrial natriuretic factor)?
    Protein and peptide
  47. Is ANF water or lipid soluble?
    Water soluble
  48. Where does ANF interact on target cells?
    Interacts on cell membrane receptors
  49. Where is ANF secreted from?
    In the atria
  50. What stimulates the secretion of ANF?
    Stretch receptors sense atrial stretch in response to increased blood volume
  51. What is the function of ANF?
    Inhibits ADH and aldosterone secretion, which decreases blood volume and decreases BP
  52. Conn's syndrome results in hyperaldosteonism or hypoaldosteronism?
  53. What causes Conn's syndrome?
    A benign tumor of the zona glomerulosa resulting in high aldosterone
  54. What are the signs/symptoms of Conn's syndrome?
    • 1. Increased BP
    • 2. Increased edema
    • 3. Decreased Potassium
    • 4. Arrhythmia/Possible cardiac arrest
    • 5. Increased sodium
    • 6. Decreased calcium
  55. Addison's disease results in hyperaldosteronism or hypoaldosteronism?
  56. Addison's disease is associated with what?
    Decrease in mineralcorticoids and glucocorticoids
  57. Hormonal classification of cortisol
  58. What is the function of cortisol?
    Increase glucose levels in the blood to combat stress
  59. What is the action of cortisol?
    • 1. Enhances metabolism
    • 2. Maintains glucose levels to ward off stress
    • 3. Prevents the shift of water in tissues
    • 4. Depresses immune system
  60. What is the main metabolic process of cortisol?
  61. What is gluconeogenesis?
    Metabolic process that uses non-carbohydrate sources for glucose - fat and protein
  62. Cortisol secretion is controlled by what?
    • 1. Stress
    • 2. Eating and activity patterns
    • 3. CRH
  63. How does cortisol act on the immune system?
    1. Prevents the release of histamines and eicosanoids - anti-inflammatory

    2. Decreases white blood cell lymphocytic activity and lysosomal enzyme release
  64. When is cortisol levels highest? Lowest?
    Highest in the morning upon waking, lowest at night before sleeping (Diurnal cycle - CRH is secreted as we sleep)
  65. Due to it's ability to decrease immune response, cortisol is used to treat what?
    1. Anti-inflammatory: arthritis, asthma, allergies

    2. Anti-rejection drug for transplants
  66. Cushing's syndrome is from a hypersecretion or hyposecretion of cortisol?
  67. Causes of Cushing's syndrome?
    • 1. Over administration of glucocorticoid drugs (most common)
    • 2. ACTH producing tumor of the anterior pituitary
    • 3. Tumor on adrenal cortex (Rare)
  68. Signs/symptoms of Cushing's syndrome?
    • 1. Hyperglycemia
    • 2. Buffalo hump and pedunculated abdomen due to increased fat mobilization and redistribution
    • 3. Spindle legs and arms (breakdown of muscle proteins)
    • 4. Joint/cartilage deterioration
    • 5. Slow wound healing and easy bruising
    • 6. Increased BP
    • 7. Increased Na+, decreased K+ and Ca+ due to aldosterone secretion during stress
    • 8. Edema - moon-shaped face due to increased Na+
  69. Addison's disease results in hypersecretion or hyposecretion of cortisol?
    Hyposecretion of cortisol and aldosterone
  70. What is Addison's disease?
    Autoimmune disease that attacks the adrenals - adrenal insufficiency
  71. Signs and symptoms of Addison's disease?
    • 1. Skin bronzing from increased MSH
    • 2. Hypoglycemia
    • 3. Low BP
    • 4. Dehydration
    • 5. Mentally and physically lethargic from decreased glucose
    • 6. Low sodium, high potassium levels causing arrhythmia
    • 7. Depression
  72. What is the hormonal classification of gonadocorticoids?
  73. Function of gonadocorticoids?
    • 1. Maintains sex characteristics prior to puberty and after menopause
    • 2. Possibly contributes to onset of puberty
    • 3. Contributes to sex drive in females
  74. What is the result of a virilizing tumor?
    Increased testosterone secretion
  75. What are the symptoms of a virilizing tumor in males/females?
    Males: Adult males - none, young males - early sexual development

    Females: Hirsutism - development of male physical tendencies
  76. What is the result of a feminizing tumor?
    Increased estrogen secretion
  77. What are the symptoms of a feminizing tumor in males/females?
    Males: Feminism - gynecomastia (breast development)

    Females: none
  78. What is GAS?
    General adaptation syndrome - hormonal response to stress
  79. Physiologist who studied GAS?
    Hans Selye
  80. What is a stressor?
    Any circumstance that threatens homeostasis, imbalances body chemistry, or affects the structure/function of organs
  81. What is eustress? Example?
    Good stress - exercise, sex
  82. What is distress? Example?
    Bad stress - psychological (death, divorce, money, abuse), drastic temp changes, disease, pregnancy
  83. What are the stages of GAS?
    • 1. Alarm phase
    • 2. Resistance phase
    • 3. Exhaustion phase
  84. What happens during the alarm phase of GAS?
    • FFF response initiated, NE/E secreted
    • Remedies short term stress
  85. What happens during the resistance phase of GAS?
    • 1. Intervenes during persistent stress (few hours)
    • 2. Stimulates hypothalamic hormones CRH, TRH, hGHRH - increase gluconeogenesis, glycogenolysis, and lipolysis
    • 3. Increased glucose for increased energy
    • 4. Increased BP through vasoconstriction
  86. What happens during the exhaustion phase of GAS?
    • Decreased cortisol, ATP production, potassium
    • Increased water loss
  87. Location of the pancreas
    Just underneath the stomach in 'C' curve of duodenum
  88. The pancreas is a heterocrine gland - What does heterocrine mean?
    • Has both endocrine and exocrine secretions
    • Pancreas - 99% exocrine 1%endocrine
  89. 3 parts of pancreas
    • 1. Head
    • 2. Body
    • 3. Tail
  90. Two visible ducts of pancreas
    • 1. Pancreatic duct (longest, exocrine)
    • 2. Accessory duct (exocrine)
  91. Function of pancreatic duct and accessory duct
    Lead pancreatic juice into the duodenum
  92. Two cells of pancreas
    • 1. Acini cells (99% of gland)
    • 2. Islets of Langerhans (1% of gland)
  93. Function of acini cells of pancreas
    Exocrine, manufactures pancreatic juice that contains digestive enzymes
  94. Four cell types housed by Islets of Langerhans
    • 1. Alpha cell
    • 2. Beta cell
    • 3. Delta cell
    • 4. F cell
  95. Secreted by Alpha cell
  96. Secreted by Beta cell
  97. Secreted by Delta cell
    hGHIH or Somatostatin
  98. Secreted by F cell
    Pancreatic polypeptide
  99. Hormone classification of Glucagon
    Protein and peptide
  100. Function of glucagon
    Raises blood glucose levels primarily by glycogenolysis
  101. Stimulation of glucagon release
    Decreased glucose level detected by chemoreceptors
  102. Inhibition of glucagon release
    • 1. High glucose release
    • 2. Somatostatin (secreted from delta cells)
  103. Hormone classification of Insulin
    Protein and peptide
  104. Function of insulin
    • -Works in antagony with glucagon
    • -Decreases glucose blood levels
    • -Primes cell to encourage cellular uptake of glucose
    • -Stimulates the absorption of amino acids and protein synthesis
    • -Stimulates the absorption of glucose and fatty acids by adipocytes
  105. Stimulation of insulin release
    Increased glucose levels
  106. Inhibition of insulin release
    • 1. Decreased glucose levels
    • 2. Somatostatin (secreted from delta cells)
  107. Hormone classification of Somatostatin
    Protein and peptide
  108. Function of somatostatin / hGHIH
    • Inhibits glucagon and insulin, creating balance
    • Slows the rate of nutrient absorption and enzyme secretion along GI tract
  109. Hormone classification of Pancreatic polypeptide
    Protein and peptide
  110. Function of pancreatic polypeptide
    • 1. Stimulates the production of pancreatic juice
    • 2. Increases the rate of nutrient absorption by GI tract
  111. Two types of diabetes mellitus
    1. Type I - IDDM (insulin dependent diabetes) Juvenile onset before age 20

    2. Type II - NIDDM (non-insulin dependant diabetes) Maturity onset after age 35
  112. Three cardinal signs of diabetes mellitis
    • 1. Polyphagia - increased hunger/eating
    • 2. Polydipsia - increased thirst/drinking
    • 3. Polyuria - increased urination
  113. Possible causes of Type I diabetes
    1. Genetic - decreased number of functioning beta cells (least common)

    2. Viruses - viruses damage beta cells decreasing insulin production (2nd most common)

    3. Auto-immune response - antibodies attack beta cells (most common)
  114. Results of Type I diabetes
    -Decreased beta cell activity: high BP, retinopathy, dialating heart, kidney damage

    -Increased lypolysis: weight loss, mobilization of fat, ischemia, increased risk of stroke

    -Increased ketone body formation: electrolyte imbalance, acidosis, neuropathy
  115. Possible treatment for Type I diabetes
    • 1. Cyclosporin - suppresses immune system
    • 2. Insulin infusion - insulin pump
    • 3. Islet transplant (rare)
  116. Contributing factors of Type II diabetes
    1. Genetic predisposition - down-regulation of insulin receptors -> impairing glucose uptake -> high blood glucose

    2. Obesity - adipose tissue produces "tumor necrosis factor alpha" -> blocks Glut 4 protein carriers -> impairs glucose uptake -> high blood glucose
  117. Treatment for type II diabetes
    • 1. Increase exercise
    • 2. Monitor diet
    • 3. Oral anti-diabetic medication
  118. Causes of Hyperinsulinism
    • 1. Benign tumor on beta cells (very rare)
    • 2. Overdose of insulin
  119. Signs/symptoms of hyperinsulinism
    Anxiety, nervousness, tremors, weakness, disorientation, possible unconsciousness due to low glucose to the brain
  120. Treatment for hyperinsulinism
    Remove tumor