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Adrenal gland - Coggle Diagram

- - - - no clinical use
  - - - fludrocortisone
        
        replace aldosterone
        
        used in Addison disease
    - - low-potency, short-acting
        
        cortisol (hydrocortisone)
        
        cortisone
      - medium-potency, intermediate-acting
        
        prednisone
        
        prednisolone
        
        methylprednisolone
        
        triamcinolone
      - high-potency, long-acting
        
        budesonide
        
        long-acting
        
        administered by inhalation
        
        dexamethasone
        
        used in diagnostic dexamethasone suppression tests
        
        betamethasone
        
        systemic use
        
        topical treatment
        
        skin disorders
        
        atopic dermatitis
        
        neurodermatitis
        
        psoriasis
      - indications
        
        respiratory distress syndrome
        
        adrenal insufficiency
        
        cancer
        
        congenital adrenal hyperplasia
        
        inflammation, allergy, autoimmune disorders
        
        Cushing syndrome
        
        dermatologic conditions
        
        other disorders
- - - - using ACTH injection
- - - - lie on the supero - medial part (upper pole) of each kidney
        
        the suprarenal and the kidney are enclosed in a common fascial sheath (renal fascia), separated from the kidney by perinephric fat
        
        renal fascia attached to the crura of the diaphragm
        
        adrenal gland histology
        
        zona fasciculata
        
        glucocorticoids
        
        1 more item...
        
        polyhedral cells arranged in one or two cell thick vertical columns with capillaries between them
        
        zona reticularis
        
        gonadocorticoids
        
        1 more item...
        
        irregularly arranged clusters of cells
        
        zona glomerulosa
        
        adrenal cortex
        
        mineralocorticoids
        
        1 more item...
        
        columnar cells, pyramidal cells, inverted columns surrounded with capillaries
        
        adrenal medulla
        
        chromaffin cells, profuse capillaries
        
        epinephrine, adrenaline
        
        1 more item...
        
        norepinephrine, noradrenaline
        
        1 more item...
        
        capsule
    - - posteriorly
        
        diaphragm
      - medially
        
        IVC
      - anteriorly
        
        liver
    - - arteries
        
        superiorly
        
        inferior phrenic artery
        
        middle
        
        aorta
        
        inferiorly
        
        renal artery
      - veins
        
        a single vein emerges from the hilum of each gland and drains into the IVC on the right and into the renal vein on the left
    - - adrenal medulla
        
        preganglionic sympathetic fibers arise from the lateral horn of gray matter of spinal segments T10-L1
        
        pass through the sympathetic chain
        
        celiac ganglion
        
        celiac plexus
        
        medulla (chromaffin cells)
      - adrenal cortex
        
        vasomotor innervation
  - - - posteriorly
        
        diaphragm
      - medially
        
        abdominal aorta
      - anteriorly
        
        superior
        
        stomach
        
        inferior
        
        pancreas and splenic vessel
- - - - glucocorticoids
        
        cortisol
        
        stimulated by ACTH to be secreted
        
        corticosterone
    - - adrenal androgen
        
        androstenedione
        
        DHEA (Dehydroepiandrosterone)
        
        stimulated by ACTH to be secreted
    - - mineralocorticoids
        
        aldosterone
        
        stimulated by angiotensin 2 and potassium to be secreted
    - - catecholamines
        
        epinephrine
        
        stimulated by acetylcholine release from preganglionic sympathetic fibers innervating the medulla
        
        norepinephrine
        
        dopamine
  - - - increase Na+ absorption
        
        it has an effect on blood pressure
      - increase K+ secretion
      - increase H+ secretion
      - acts on principal cells of late distal tubule and collecting ducts
    - - masculinizing effects
      - protein anabolism
      - growth
    - - gluconeogenesis
      - immunosuppression
      - protein catabolism
      - lipolysis
      - anti-inflammatory
      - anti-allergic
- - - - L-DOPA
        
        dopamine
        
        norepinephrine
        
        epinephrine
  - - - 27 carbon atoms
        
        arranged in 4 conjoined rings
        
        3 benzene rings
        
        1 cyclopentane ring
        
        2 methyl groups at C10 and C13
        
        8 carbon side chain
      - cholesterol (not esterified) transported to the mitochondrion by StAR
        
        in the mitochondrion, cytochrome P450 side chain cleavage enzyme (P450scc) converts cholesterol (C27) to pregnenolone (C21)
        
        pregnanolone
        
        Pregnene-series
        
        progesterone
        
        18-hydroxylase
        
        1 more item...
        
        17-hydroxylase
        
        1 more item...
        
        androstene-series
        
        17-hydroxylase
        
        DHEA (dehydroepiandrosterone) (C19)
        
        1 more item...
- - - - anxiety disorder that causes a person to have a distorted view of how they look and to spend a lot of time worrying about their appearance
- - - - exogenous corticosteroids
      - paraneoplastic ACTH secretion (e.g. small cell lung carcinoma)
      - ACTH secreting pituitary adenoma
      - primary adrenal adenoma
    - - moon face (fat, round)
      - buffalo hump (fat deposition on abdomen and back of neck)
      - red face
      - hyperglycemia
      - purple striae
      - gynecomastia
      - susceptibility to infections
      - amenorrhea
      - hirsutism
      - thin skin, due to the breakdown of dermal proteins
      - osteoporosis
      - fluid retention (edema)
      - CNS irritability
      - bruises and petechiae
      - hypertension
- - - - infections
        
        TB
        
        fungi
      - autoimmune adrenalitis
        
        60-70% of cases
      - metastatic diseases
        
        carcinoma of the lung and breast are the source of the majority of metastases in the adrenals
      - systemic amyloidosis
      - sarcoidosis and hemochromatosis
    - - hyperpigmentation
        
        bronze tone on the skin
      - low blood pressure
      - hypoglycemia
      - hyperkalemia
      - anorexia
      - nausea and vomiting
      - weight loss
      - diarrhea
      - progressive weakness and easy fatigability
      - suppression of the immune system