Relaxes smooth muscle of blood vessels supplying

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relaxes smooth muscle of blood vessels supplying skeletal muscles dilation of airways in lungs induces liver to release glucose via glycogenolysis (major) and/or gluconeogenesis (minor) Induces fat cells to release fatty acids (lipolysis) for fuel The adrenal medulla releases catecholamines , primarily in response to sympathetic signals arising in the hypothalamus and brainstem.
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Adrenal gland is a key player in the integrated response to stress
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1. Adrenocortical insufficiency Most common form of primary adrenocortical deficiency is Addison’s disease, which includes: – Aldosterone deficiency » Hyperkalemia (high K+) and hyponatremia (Low Na+) (most acutely dangerous) – Cortisol deficiency » Poor response to stress » Hypoglycemia » Impaired sympathetic/catecholamine induced vasoconstriction The Adrenal Glands: Disorders of Adrenocortical Function
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What is the location of the defect in Addison’s disease– adrenal, pituitary, or hypothalamus?
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• Diagnosis of adrenocortical insufficiency typically involves an ACTH stimulation test. 0 2 0 100 200 300 400 500 ACTH stimulation test Hours past injection Cortisol (nmol/L) Adrenal insufficiency Normal
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• Adrenocortical insufficiency may also occur due to defects at the level of the pituitary or of the hypothalamus. • How would a clinician discriminate between primary adrenocortical insufficiency and secondary/ tertiary insufficiency? The Adrenal Glands: Disorders of Adrenocortical Function
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CRH stimulation test Individual is given an injection of synthetic CRH and blood draws are taken over the course of 2h. Site of defect [ACTH] response to CRH stim [Cortisol] response to CRH stim Adrenal gland Pituitary Hypothalamus
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The Adrenal Glands: Disorders of Adrenocortical Function 2. Cortisol hypersecretion: Cushing ± s syndrome – Causes • Adrenal tumors secreting cortisol [email protected] tumor – Signs and symptoms • Hyperglycemia and glucosuria (adrenal diabetes) • Abnormal fat distributions • Muscle, connective tissue loss • Hirsutism in females (also elevates DHEA secretion) • Infertiliity
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Ask the class… My other dog, Honey, was prescribed a synthetic form of cortisol to treat skin inflammation (remember, cortisol is anti: inflammatory). At the end of her dosing regimen, I was cautioned to taper the withdrawal of medication. Why? What might be the consequence of suddenly removing the high dose of cortisol?
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  • Spring '08
  • Fuller,Charles/Goldberg,Jack
  • Physiology, ACTH, Cortisol, Anterior pituitary

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