Advanced Adrenal Cortex Quiz

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

• It is supplied only by parasympathetic nerves
• It is primarily regulated by angiotensin II and potassium
• 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?

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

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

• It is neural crest-derived tissue composed entirely of chromaffin cells
• 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 a uniform cortical layer without functional zonation