Adrenal Gland

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Study Tools For Adrenal Gland

Cross Section of Adrenal Gland (Image)
Adrenal Gland location (Image)
Adrenal Gland Hormones (Mnemonic)
Adrenal Gland (Basic) (Picmonic)
Adrenal Gland (Advanced) (Picmonic)
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Outline

Overview

  1. Adrenal Gland
    1. Location: on top  of kidney
    2. Tissues/structure
      1. Inner = adrenal medulla
        1. Catecholamines
      2. Outer = adrenal cortex
        1. Adrenocorticosteroid hormones
          1. Mineralocorticoids
          2. Glucocorticoids
          3. Androgens

Nursing Points

General

  1. Adrenal medulla
    1. Location – internal aspect of gland
    2. Composition
      1. Specialized sympathetic neurons – chromaffin cells
        1. No axons and dendrites
    3. When stimulated, chromaffin cells secrete catecholamines
      1. Norepinephrine = neurotransmitter
      2. Epinephrine (aka Adrenaline)
      3. Effects (fight or flight response)
        1. Increased BP, HR, circulation to skeletal muscles, lung ventilation
        2. Inhibits less important functions (digestion/excretion)
        3. Hyperglycemic effect:
          1. Glycogenolysis, gluconeogenesis →  increase glucose in blood
          2. Inhibits insulin
            1. Ensures glucose to brain
            2. Decreased uptake of glucose
          3. Glucose-sparing
    4. Association w/ adrenal cortex
      1. Stress stimulates medullary cells to secrete catecholamines which stimulate the cortex to secrete corticosterone
  2. Adrenal cortex
    1. Location – around outside border of gland
    2. Secretions → steroid hormones (corticosteroids or corticoids)
      1. Mineralocorticoids
        1. Act on kidneys to control electrolyte balance
        2. Aldosterone
          1. Sodium retention
            1. Water follows
          2. Potassium excretion
      2. Glucocorticoids
        1. Cortisol, hydrocortisone
        2. Stimulate
          1. Fat & Protein breakdown
          2. Gluconeogenesis
          3. Release of fatty acids and glucose into blood
        3. Anti-inflammatory effect
        4. Long term secretion suppresses immune system
          1. See lesson on Cushing’s Syndrome
        5. Lack of secretion leads to fluid and electrolyte imbalances
          1. See lesson on Addison’s Disease
      3. Sex steroids
        1. Androgens – control aspects of male development and reproductive anatomy
          1. Male
            1. Dehydroepiandrosterone (DHEA)
              1. Naturally weak
              2. Converted to testosterone in other tissues
              3. This source is minor – testes make most of testosterone
          2. Female
            1. Adrenal androgens comprise 50% of androgen needs
          3. Both
            1. Stimulate development of pubic and axillary hair
            2. Apocrine scent glands at puberty
            3. Sustain libido

References:

Betts, J.G., et al. (2017). Anatomy and physiology. Houston, TX: OpenStax, Rice University. Retrieved from https://openstax.org/details/books/anatomy-and-physiology?Book%20details

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Transcript

Alright we’re gonna talk about the adrenal gland. The adrenal glad is incredibly important to our body. It’s a very small gland that sits on top of either kidney that you probably don’t think about every day. But we’re gonna talk about it and help give you a better understanding of what it is, what it does, and why it really matters. The adrenal glad is this triangular-shaped gland sitting on top of either kidney. And it’s made up of two different elements. We have our adrenal medulla that’s in the center, this kinda horseshoe-shaped piece in the center. And then we have the adrenal cortex, which is the outer portion that surrounds the adrenal medulla. The adrenal medulla again is the inner layer. It’s responsible for excreting catecholamines, things like norepinephrine, epinephrine. And we’ll talk about that in just a second. The adrenal cortex, or the outer layer, is responsible for excreting mineralocorticoids, glucocorticoids, and androgens. So the adrenal medulla, again the adrenal medulla is the center layer, this horseshoe-shaped center layer of the adrenal glad. It’s made of the specialized sympathetic neurons called chromaffin cells. They don’t have any axons, they don’t have any dendrites. And what they do is when it’s stimulated, epinephrine and norepinephrine are released. Now you’ve probably heard of epinephrine and norepinephrine before. Norepinephrine is a neurotransmitter. Epinephrine, aka adrenaline, plays a role in this fight-or-flight response. So it’s gonna do things like increase our heart rate, increase our blood pressure. It’s going to shift circulation to the skeletal muscle, increase ventilation in the lungs, and it’s going to inhibit some of these quote unquote less important functions. Things like digestion and excretion. The whole purpose of this is to prepare our body for this fight-or-flight response, to get us ready to move. Stop all these things that don’t need to be going on for us to fight or for us to run, and those things would be digestion and excretion. Imagine you’re being chased by a lion. The last thing you want is to be going through the digestive process or the excretion process. You need your heart to be going faster, you need your blood pressure, you need your lungs going. And that’s what is really important in this fight-or-flight response, and epinephrine plays a huge role in that. It also creates this hyperglycemic effect through gluconeogenesis and glycogenolysis. Both of those kinda leading to increasing glucose in our blood. Now why would we want that? It’s going to inhibit insulin, increase glucose in our blood, all for the purpose of increasing the amount of glucose that can get to our brain. We want our brain to be able to function. It’s a massive consumer of glucose, and so we’re really trying to create more glucose, get it all up into the brain. Alright, now how is this associated with the adrenal cortex? So, stress stimulates this medullary cells to secrete all these catecholamines, epinephrine, norepinephrine. And this stimulates the cortex, the adrenal cortex, to release corticosterone. So with that, let’s get into what the adrenal cortex does. Again, the adrenal cortex is this outer layer of the adrenal gland. It’s main purpose is to excrete or release steroid hormones, corticosteroids and corticoids. Now, we have a couple of different kinds of these. We have mineralocorticoids, glucocorticoids, and androgens. Mineralocorticoids act on the kidneys to control electrolyte balance. So aldosterone, what it does is it leads to sodium retention. Now water follows sodium, and so we’re retaining sodium, we’re retaining H20, retaining water. At the same time, this leads to potassium excretion. Retain sodium, water follows sodium, potassium leaves. So that’s kinda the big role of aldosterone with electrolyte balance. Then we also have our glucocorticoids. We have cortisol and hydrocortisone. The main role of these is fat and protein breakdown. It also plays a role in gluconeogenesis which is the creation of glucose. And it has a huge anti-inflammatory effect. Now what you’re gonna see with this is long-term secretion of glucocorticoids, of cortisol and hydrocortisone, is going to lead to a suppression of our immune system. And now if we have this long-term suppression of our immune system, it can lead to something called Cushing’s syndrome. Now we have a whole lesson on that. I invite you to go watch that. Now the lack of secretion over long-term can lead to fluid and electrolyte imbalances. And it can also lead to Addison’s disease. Again we have a whole lesson on that, and I invite you to go watch that. Now we also have the sex steroids, called androgens. They play a role in reproductive anatomy. For males, it plays a role in DHEA which is naturally weak, but it’s converted to testosterone in other tissues. Now the testes are the main source of testosterone and make most of the testosterone in the male body. For females, the adrenal androgens comprise about 50% of all the female needs for androgen. For both male and females, it stimulates the development of secondary sex characteristics like pubic and axillary hair, and it plays a role in sustained libido. So let’s review some of the key points really quick. The… Adrenal glad sits on top of the kidneys. It’s this triangular-shaped gland with two pieces. You have your adrenal medulla in the middle. And you have your adrenal cortex as the outer layer. The adrenal medulla plays a role in catecholamine release, epinephrine, norepinephrine, that plays a role in fight-or-flight. And then we also have our adrenal cortex which plays a role in mineralocorticoids, glucocorticoids, and androgen release. We talked about how those play a role in the body. A big thing to keep in mind here is that the adrenal gland is a main source of our flight-or-fight response. It’s the result of this catecholamine release, again this norepinephrine and epinephrine release, that creates this fight-or-flight response. This is an incredibly important gland. I hope this helps make it a little bit more clear for you guys, and kinda get those key points. Now, like we always say here at NRSNG, go out and be your best self today. Happy nursing.

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Med surg 2 (Endocrine, Gastro, Neuro and musculoskeletal)

Concepts Covered:

  • Disorders of the Posterior Pituitary Gland
  • Disorders of the Thyroid & Parathyroid Glands
  • Disorders of Pancreas
  • Prenatal Concepts
  • Tissues and Glands
  • Pregnancy Risks
  • Health & Stress
  • Emergency Care of the Cardiac Patient
  • Vascular Disorders
  • Terminology
  • Studying
  • Female Reproductive Disorders
  • Disorders of the Adrenal Gland
  • Endocrine System
  • Oncology Disorders
  • Eating Disorders
  • Substance Abuse Disorders
  • Shock
  • Respiratory Disorders
  • Male Reproductive Disorders
  • Gastrointestinal Disorders
  • Upper GI Disorders
  • Liver & Gallbladder Disorders
  • Digestive System
  • Newborn Complications
  • Neurologic and Cognitive Disorders
  • Emergency Care of the Trauma Patient
  • Disorders of Thermoregulation
  • Hematologic Disorders
  • Lower GI Disorders
  • Immunological Disorders
  • Anxiety Disorders
  • Endocrine and Metabolic Disorders
  • Urinary Disorders
  • Cardiac Disorders
  • Central Nervous System Disorders – Brain
  • Nervous System
  • Intraoperative Nursing
  • Medication Administration
  • Urinary System
  • Musculoskeletal Trauma
  • Cognitive Disorders
  • Acute & Chronic Renal Disorders
  • Noninfectious Respiratory Disorder
  • Somatoform Disorders
  • Microbiology
  • Adult
  • Multisystem
  • Neurological
  • Emergency Care of the Neurological Patient
  • Peripheral Nervous System Disorders
  • Neurological Trauma
  • Central Nervous System Disorders – Spinal Cord
  • Neurological Emergencies
  • Musculoskeletal Disorders
  • Preoperative Nursing
  • Skeletal System
  • Musculoskeletal Disorders
  • Communication
  • Learning Pharmacology

Study Plan Lessons

03.05 Endocrine Practice Questions for CCRN Review
Diabetes Mellitus for Progressive Care Certified Nurse (PCCN)
Factors That Can Put a Pregnancy at Risk Nursing Mnemonic (RIBCAGE)
Glands
Glucose Tolerance Test (GTT) Lab Values
Health & Stress
Hypertension (Uncontrolled) and Hypertensive Crisis for Progressive Care Certified Nurse (PCCN)
Hypoglycemia for Progressive Care Certified Nurse (PCCN)
Metabolic & Endocrine Module Intro
Metabolic & Endocrine Terminology
Metabolic/Endocrine Course Introduction
Mnemonic for Organ Systems (MR DICE RUNS)
Nursing Care and Pathophysiology for Menopause
Nursing Care Plan (NCP) for Addison’s Disease (Primary Adrenal Insufficiency)
Nursing Care Plan (NCP) for Hyperthyroidism
Nursing Care Plan (NCP) for Osteoporosis
Nutritional Requirements
Pancreas
Pharmacology Terminology
Pituitary Adenoma
Potassium-K (Hyperkalemia, Hypokalemia)
Thyroid Cancer
Urinalysis (UA)
Anti-Infective – Carbapenems
Anti-Infective – Macrolides
Anti-Infective – Sulfonamides
Appendicitis
Bariatric Surgeries
Celiac Disease
Cirrhosis for Certified Emergency Nursing (CEN)
Colonoscopy
Colorectal Cancer (colon rectal cancer)
Constipation and Encopresis (Incontinence)
Cystic Fibrosis (CF)
Digestion & Absorption
Digestive Terminology
Discomforts of Pregnancy
Endoscopy & EGD
Erythroblastosis Fetalis
Famotidine (Pepcid) Nursing Considerations
Gastritis
Gastrointestinal (GI) Bleed Concept Map
Gastrointestinal (GI) Course Introduction
Gastrointestinal Trauma for Certified Emergency Nursing (CEN)
Hemorrhagic Fevers for Certified Emergency Nursing (CEN)
Hyperbilirubinemia (Jaundice)
Imperforate Anus
Intussusception
Iron (Fe) Lab Values
Liver Function Tests
Lower Gastrointestinal (GI) Module Intro
Nursing Care Plan (NCP) for Abdominal Pain
Nursing Care Plan (NCP) for Acquired Immune Deficiency Syndrome (AIDS)
Nursing Care Plan (NCP) for Addison’s Disease (Primary Adrenal Insufficiency)
Nursing Care Plan (NCP) for Anemia
Nursing Care Plan (NCP) for Anxiety
Nursing Care Plan (NCP) for Appendicitis
Nursing Care Plan (NCP) for Bowel Obstruction
Nursing Care Plan (NCP) for Cholecystitis
Nursing Care Plan (NCP) for Colorectal Cancer (Colon Cancer)
Nursing Care Plan (NCP) for Constipation / Encopresis
Nursing Care Plan (NCP) for Cystic Fibrosis
Nursing Care Plan (NCP) for Dehydration & Fever
Nursing Care Plan (NCP) for Diverticulosis / Diverticulitis
Nursing Care Plan (NCP) for GI (Gastrointestinal) Bleed
Nursing Care Plan (NCP) for Hyperemesis Gravidarum
Nursing Care Plan (NCP) for Imperforate Anus
Nursing Care Plan (NCP) for Inflammatory Bowel Disease (Ulcerative Colitis / Crohn’s Disease)
Nursing Care Plan (NCP) for Intussusception
Nursing Care Plan (NCP) for Nutrition Imbalance
Nursing Care Plan (NCP) for Ovarian Cancer
Nursing Care Plan (NCP) for Pancreatitis
Nursing Care Plan (NCP) for Peptic Ulcer Disease (PUD)
Nursing Care Plan (NCP) for Sepsis
Nursing Care Plan (NCP) for Stomach Cancer (Gastric Cancer)
Nursing Care Plan (NCP) for Urinary Tract Infection (UTI)
Nursing Care Plan for Hiatal Hernia
Nursing Care Plan for Liver Cancer
Nursing Care Plan for Scleroderma
Nursing Case Study for Colon Cancer
Nutrition (Diet) in Disease
Omphalocele
Pediatric Gastrointestinal Dysfunction – Diarrhea
Pharmacology Terminology
Physiological Changes
Thromboembolic Disease- Deep Vein Thrombosis (DVT) for Certified Emergency Nursing (CEN)
Total Bilirubin (T. Billi) Lab Values
Umbilical Hernia
Upper Gastrointestinal (GI) Module Intro
Nursing Care Plan (NCP) for Eating Disorders (Anorexia Nervosa, Bulimia Nervosa, Binge-Eating Disorder)
Nursing Care Plan (NCP) for Hashimoto’s Thyroiditis
Nursing Care Plan (NCP) for Hyperparathyroidism
Nutrition Assessments
Alcohol Withdrawal (Addiction)
Altered Mental Status Nursing Mnemonic (AEIOU TIPS)
Ammonia (NH3) Lab Values
Autonomic Nervous System (ANS)
Barbiturates
Bowel Perforation for Certified Emergency Nursing (CEN)
Calcium and Magnesium Imbalance for Certified Emergency Nursing (CEN)
Chemotherapy Patients
Complications of Immobility
Day in the Life of a Med-surg Nurse
Dementia Nursing Mnemonic (DEMENTIA)
Fibromyalgia
Head to Toe Nursing Assessment (Physical Exam)
Meds for Alzheimers
Nuclear Medicine
Nursing Care and Pathophysiology for Hypothyroidism
Nursing Care and Pathophysiology of Chronic Kidney (Renal) Disease (CKD)
Nursing Care Plan (NCP) for Anaphylaxis
Nursing Care Plan (NCP) for Aspiration
Nursing Care Plan (NCP) for Celiac Disease
Nursing Care Plan (NCP) for Eating Disorders (Anorexia Nervosa, Bulimia Nervosa, Binge-Eating Disorder)
Nursing Care Plan (NCP) for Encephalopathy
Nursing Care Plan (NCP) for Endocarditis
Nursing Care Plan (NCP) for Hashimoto’s Thyroiditis
Nursing Care Plan (NCP) for Hyperparathyroidism
Nursing Care Plan (NCP) for Hypoparathyroidism
Nursing Care Plan (NCP) for Hypothyroidism
Nursing Care Plan (NCP) for Hypovolemic Shock
Nursing Care Plan (NCP) for Omphalocele
Nursing Care Plan (NCP) for Reye’s Syndrome
Nursing Care Plan (NCP) for Somatic Symptom Disorder (SSD)
Nursing Care Plan (NCP) for Vomiting / Diarrhea
Nursing Care Plan (NCP) for West Nile Virus
Nursing Care Plan for Distributive Shock
Nutrition Assessments
Pituitary Gland
Stomach Cancer (Gastric Cancer)
Vomiting
Adrenal Gland
Advanced Cardiovascular Life Support (ACLS)
Anti-Infective – Antifungals
07.01 CVA (Cerebrovascular Accident/Stroke) for CCRN Review
07.10 Neurologic Review questions for CCRN Review
Acute Confusion
Altered Mental Status Nursing Mnemonic (AEIOU TIPS)
Altered Mental Status- Delirium and Dementia for Progressive Care Certified Nurse (PCCN)
Assessment of Guillain-Barre Syndrome Nursing Mnemonic (GBS=PAID)
Blood Brain Barrier (BBB)
Brain Tumors
Brain Tumors
Cerebral Metabolism
Cerebral Palsy (CP)
Cerebral Perfusion Pressure Case Study (60 min)
Electroencephalography (EEG)
Encephalopathies
Encephalopathy Case Study (45 min)
Head and Spinal Cord Trauma for Certified Emergency Nursing (CEN)
Hydrocephalus
Increased Intracranial Pressure
Impulse Transmission
Increased Intracranial Pressure (ICP) for Certified Emergency Nursing (CEN)
Intracranial Hemorrhage
Intracranial Pressure ICP
Levels of Consciousness (LOC)
Mannitol (Osmitrol) Nursing Considerations
Meningitis
Membrane Potentials
Meningitis Assessment Findings Nursing Mnemonic (FAN LIPS)
Meningitis for Certified Emergency Nursing (CEN)
Migraines
Nerve Transmission
Nervous System Anatomy
Neuro A&P Module Intro
Neuro Anatomy
Neuro Assessment
Neuro Assessment Module Intro
Neuro Course Introduction
Neuro Disorders Module Intro
Neuro Terminology
Neuro Trauma Module Intro
Neurogenic Shock for Certified Emergency Nursing (CEN)
Neurological Disorders (Multiple Sclerosis, Myasthenia Gravis, Guillain-Barré Syndrome) for Certified Emergency Nursing (CEN)
Neurological Fractures
Nursing Care Plan (NCP) for Brain Tumors
Nursing Care Plan (NCP) for Encephalopathy
Nursing Care Plan (NCP) for Meningitis
Nursing Care Plan (NCP) for Migraines
Nursing Care Plan (NCP) for Multiple Sclerosis (MS)
Nursing Care Plan (NCP) for Seizures
Nursing Care Plan (NCP) for Spinal Cord Injury
Nursing Care Plan (NCP) for Stroke (CVA)
Nursing Case Study for Head Injury
Parasympatholytics (Anticholinergics) Nursing Considerations
Parasympathomimetics (Cholinergics) Nursing Considerations
Seizure Causes (Epilepsy, Generalized)
Seizure Disorder for Progressive Care Certified Nurse (PCCN)
Seizure Disorders for Certified Emergency Nursing (CEN)
Seizure Management in the ER
Seizures Case Study (45 min)
Spina Bifida – Neural Tube Defect (NTD)
Spinal Cord Injury
Spinal Cord Injury Case Study (60 min)
Stroke (CVA) Management in the ER
Stroke Assessment (CVA)
Stroke Case Study (45 min)
Stroke Concept Map
Stroke for Certified Emergency Nursing (CEN)
Stroke for Progressive Care Certified Nurse (PCCN)
Stroke Nursing Care (CVA)
Casting & Splinting
Complications of Immobility
Head to Toe Nursing Assessment (Physical Exam)
Health & Stress
Intro to Health Assessment
Introduction to Health Assessment
Joints
Marfan Syndrome
Musculoskeletal Assessment
Musculoskeletal Course Introduction
Musculoskeletal Module Intro
Musculoskeletal Terminology
Nursing Care Plan (NCP) for Abdominal Pain
Nursing Care Plan (NCP) for Activity Intolerance
Nursing Care Plan (NCP) for Cerebral Palsy (CP)
Nursing Care Plan (NCP) for Clubfoot
Nursing Care Plan (NCP) for Lyme Disease
Nursing Care Plan (NCP) for Marfan Syndrome
Nursing Care Plan (NCP) for Neural Tube Defect, Spina Bifida
Nursing Care Plan (NCP) for Osteoporosis
Nursing Care Plan (NCP) for Scoliosis
Nursing Care Plan (NCP) for Spinal Cord Injury
Nursing Care Plan (NCP) for Systemic Lupus Erythematosus (SLE)
Nursing Care Plan for Fibromyalgia
Nursing Care Plan for Scleroderma
Nutrition Assessments
Osteosarcoma
Physiological Changes
Positioning (Pressure Injury Prevention and Tourniquet Safety) for Certified Perioperative Nurse (CNOR)
Report For Transferring To a Higher Level of Care
The SOCK Method – O