Advanced Adrenal Cortex Quiz

Q1. What is the relationship between the definitive adult cortex and the fetal adrenal cortex during development?

• The fetal zone largely regresses while the definitive cortex forms the adult cortex
• The fetal zone becomes the adrenal medulla
• Both zones become renal cortex
• The definitive cortex disappears at birth

Q2. Which enzyme distribution helps explain why the zona glomerulosa produces aldosterone rather than cortisol?

• Absence of cholesterol in the cells
• Presence of aldosterone synthase with lack of significant 17-alpha-hydroxylase activity
• Lack of mitochondria
• Exclusive expression of catecholamine enzymes

Q3. Why is the zona fasciculata particularly rich in smooth endoplasmic reticulum and mitochondria with tubular cristae?

• They support steroidogenesis
• They generate collagen fibers for the capsule
• They synthesize catecholamines
• They store glycogen for skeletal muscle contraction

Q4. How does cortical blood flow influence the adrenal medulla?

• Cortical blood carries urine into the medulla
• Cortical blood delivers glucocorticoids to medullary chromaffin cells
• Cortical blood prevents all medullary hormone synthesis
• The cortex and medulla have completely separate circulations

Q5. Which medullary enzyme is promoted by high local glucocorticoid concentrations from cortical blood?

• Acetylcholinesterase
• Phenylethanolamine N-methyltransferase
• Aldosterone synthase
• Renin

Q6. Why can prolonged suppression of ACTH lead to adrenal cortical atrophy?

• ACTH directly supplies blood to the cortex
• ACTH normally suppresses cortical growth
• Loss of ACTH trophic stimulation causes fasciculata and reticularis atrophy
• The zona glomerulosa is the only ACTH-dependent zone

Q7. Which cortical zones are most likely to enlarge during chronic ACTH excess?

• Zona glomerulosa only
• Renal cortex and renal medulla
• Adrenal medulla and capsule
• Zona fasciculata and zona reticularis

Q8. Why is the zona glomerulosa relatively preserved when ACTH is chronically suppressed?

• It is primarily regulated by angiotensin II and potassium
• It is supplied only by parasympathetic nerves
• It has no endocrine function
• It is part of the adrenal medulla

Q9. What structural feature allows steroid hormones to enter the circulation efficiently after synthesis?

• Direct ducts opening into the renal pelvis
• Large cartilage plates between cells and vessels
• Thick keratinized barriers around each cell
• Close association with fenestrated sinusoidal capillaries

Q10. Which statement best integrates adrenal cortex anatomy and function?

• It is a uniform cortical layer without functional zonation
• It is an exocrine gland whose ducts empty into the renal pelvis
• It is a zonated mesodermal steroidogenic tissue whose histology, blood flow, and regulation correspond to distinct hormone outputs
• It is neural crest-derived tissue composed entirely of chromaffin cells