Adrenal Medulla

Adrenal Cortex
Zona Glomerulosa
Zona Faciculata
Zona Reticularis

Adrenal Glands

suprarenal they sit on top of the

kidneys

each is composed of 2 distinct regions:

A. Adrenal Medulla
- the inner region
- comprises 20% of the gland
- secretes epinephrine and
norepinephrine
- derived from ectoderm
B. Adrenal Cortex
-the outer region
-comprises 80% of the gland
-secretes corticosteroids
-derived from mesoderm

1) Zona Glomerulosa (outermost region)

- produces mineralocorticoids
(aldosterone)
2) Zona Fasiculata (middle region)
- produces glucocorticoids (cortisol) as well as
estrogens and androgens
3) Zona Reticularis (innermost region)
- adrenal androgens
DHEA dehydroepiandrosterone

an adrenal androgen in females

responsible for growth of pubic and axillary hair

Cortex (steroids)
Cholesterol

Pregnenolone

Progesterone

DHEAS

170H PROG
*21
Hydroxylase

Aldosterone

Cortisol

(Mineralocorticoid)

(Glucocorticoid)

Testosterone

A. Functions
promotes reabsorption of Na+ and secretion of
K+ from the distal portion of the nephron
B. Regulation of Secretion
1. Renin Angiotensin
- Angiotensin II stimulates aldosterone secretion
2. Potassium
- high levels of K+ induce aldosterone secretion
3. ACTH
- no direct role

A. Metabolic Effects
- overall effect: increase plasma glucose levels, often at
the expense of proteins and fats
1. CHO Metabolism
a. gluconeogenesis
cortisol helps convert skeletal muscle protein to CHOs
and eventually glycogen
b. decrease glucose utilization(anti-insulin effect)

- proteins are mobilized by cortisol to be converted to

CHOs in a fasting state
- lean body mass decreases
3. Fat Metabolism
- cortisol causes lipolysis (enhances catecholamines)
- person will be thin, but if excessive cortisol see
unusual fat distribution (i.e. buffalo hump)

4. Increases Hunger

1. Fetal Development

Cortisol aids in maturation of the lungs, especially with

the production of surfactant

Maturation of g.i. enzymes

1. Stress
- Hans Selye: experimented by stressing

animals

- results: stress is associated with

of glucocorticoids

increased levels

- explanation: glucocorticoids activate a pool of amino acids to

construct needed proteins or enzymes to face the stress

2. Anti-inflammatory
- during tissue damage, phospholipase A2
activity increases releasing arachadonic acid
to aid in
synthesis of prostaglandins &
leukotrienes
3. Immune Response
- glucocorticoids suppress the immune system
decreasing the number of T lymphocytes

- used frequently after organ transports

by

4. Vasoconstriction
- Glucocorticoids necessary for vasocontriction effects of the
catecholamines
5. Stimulates Erythropoietin
6. Increases Bone Resorption
7. Decreases REM Sleep

- its a classic negative feedback system

(CRH)

- low glucocorticoid stimulate

hypothalamus to secrete corticotropin hormone
- There will be release of ACTH

- Stimulates glucocorticoid production at the

adrenal
cortex

Stress and hypoglycemia can also activate the release of

CRH

Cushings Syndrome

Caused by excess cortisol.

State of "hypercortisolism,"
1-2 PER 1 lakh population.
More common in female

ETIOLOGY

EXOGENOUS

When the body's tissues exposed to excessive

levels of cortisol for long periods
Glucocorticoid hormones therapy- Prednisone
Asthma,
Rheumatoid arthritis,
Lupus and other inflammatory diseases,
Or immunosuppression .

ENDOGENOUS

Pituitary adenomas -"Cushing's disease

Ectopic ACTH Syndrome

Adrenal Tumors

Familial Cushing's Syndrome

Pituitary adenomas cause most cases of

Cushing's syndrome.

secrete increased amounts of ACTH.

Most patients have a single adenoma.

This form of the syndrome, known as

"Cushing's disease," affects women more
frequently than men.

Ectopic ACTH Syndrome

Benign or malignant tumors arise outside the

pituitary can produce ACTH.

Lung tumors-CARCINOID cause over 50% of

these cases.

Men are affected more frequently than

women.

Common ACTH-producing tumors are oat

cell, or small cell lung cancer - 25% of all
lung cancer cases
Others - thymomas, pancreatic islet cell
tumors, and medullary carcinomas of the
thyroid,pheochromocytoma.

Thank you