...

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(Adreal Glands)

(endocrine glands)
2
1. (adrenal cortex) coelomic mesoderm
3
1.1 zona glomerulosa
(mineralocorticoids)
(aldosterone)
1.2 zona fasciculata
(glucocorticoids) (metabolism)
(cortisol) (corticosterone)
(cortisone)
1.3 zona reticularis
(androgen)
(estrogen) (progesterone)
2. (adrenal medulla) ectodermal neural crest
(cathecolamines) (epinephrine)
(norepinephrine)



(capsule)

(acetate) (cholesterol) (precursor)

( 1 )

CHOLESTEROL ACETATE

ACTH, NADPH, O2 17-HYDROXYLASE

NADPH, O2 17-HYDROXY DEHYDROEPI
PREGNENOLONE
PREGNENOLONE ANDROSTERONE
3-DEHYDROGENASE
5,4 ISOMERASE,
NAD+

17-HYDROXY 4-ANDROSTENE
PROGESTERONE
PROGESTERONE -3-17 DIONE
21-HYDROXYLASE
NADPH, O2

DEOXY DEOXY
TESTOSTERONE
CORTICOSTERONE CORTISOL
11-HYDROXYLASE
NADPH, O2

CORTICOSTERONE CORTISOL ESTRADIOL

18-HYDROXY
CORTICOSTERONE
18-HYDROXY
DEOXY ALDOSTERONE
CORTICOSTERONE

1.
 3

(adrenocorticotrophic hormone) ACTH
11 (11 hydroxylase)

ACTH
(corticotrophic releasing factor) CRF (hypothalamus)

CRF ACTH
zona glomerulosa -
(renin-angiotensin system) R-A system ACTH ( 2)

1.
1.1 Na+ K+ H+

1.2 Na+
1.3 Na+
 4

HYPOTHALAMUS

CRF

ANTERIOR PITUITARY

ACTH

ADRENAL CORTEX FEED BACK

?

ZONA ZONA ZONA

GLOMERULOSA FASCICULATA RETICULARIS

R-A
SYSTEM

MINERALOCORTICOIDS GLUCOCORTICOIDS SEX HORMONES

2.

2.

2.1 R-A system
(extracellular fluid)
(renal arterial mean pressure)
(juxta glomerular apparatus)
(renin)
(angiotensinogen)
 5

(angiotensin I) (converting
enzyme) (angiotensin II)
Na+

2.2 K+
2.3 Na+
2.4 ACTH
2.5 (adrenoglomerulotropin)

zona fasciculata

compound F compound B
compound E
1.
1.1
1.1.1

(glycogenolysis) (gluconeogenesis)
1.1.2
(amino acid)
(gluconeogenesis fron protein)
1.1.3
(gluconeogenesis from fat)
1.1.4


1.2 (water diuresis)
(glomerular filtration rate) GFR

 6

1.3 (anti inflammatory action)

1.4 (antiallergic reaction)
(histaminase enzyme) (histamine)

1.5

1.6
(neutrophil) (basophil) (eosinophil)
(lymphocyte)
1.7 ---
(catecholamine-o-methyl transferase) COMT

1.8
(euphoria)
(psychosis)
1.9 (stress)


2.
ACTH

ACTH 20


 7

zona reticularis 2

1.

2.
5




ACTH

(sympathetic ganglion cells)
(chromaffin cells) (pheochromatocytes)
(preganglionic fiber) (splanchnic nerve)

(phenylalanine)
(tyrosine) (dopa) (dopamine)

--- (phenylethanolamine-N-methyltransferase)

1.

2. (alert)
3.
3.1

3.2 (lipolysis)
3.3
3.4 (calorigenic effect)



1



(cardiac output)



(baroreceptor reflex)

 9

1.

( reflex
bradycardia

)

(peripheral resistance)
++++ ++
++++ +++
++++ ++++
+++ ++++
+ ++++
 10

2
(hyperfunction) (hypofunction)

(primary cause)
(secondary cause)

1. (Cushings syndrome)

(moon face) (buffalo hump) (trunkal
obesity)
(centripetal redistribution of
fat) (purple abdominal striae)


(osteoporosis)

 11

(hirsutism)

2. (Conns syndrome)
(hyperaldosteronism)

(polyuria)
(polydipsia) (hypernatremia)
(alkalosis) (tetany)
3. (adrenogenital syndrome)


ACTH



3
3.1 (precoccious pseudopuberty)

7-8
(sperm)

 12

3.2 (female pseudohermaphroditism)

(sex
differentiation) (primary
sex organs) (secondary sex
organs)

3.3 (adrenal virilism)

1.
1.1 Addisons disease chronic primary adrenocortical insufficiency

(autoimmune disease) (atrophy)



(hyperpigmentation)

ACTH MSH (melanocyte stimulating hormone)

(Addisons crisis)
1.2 Acute primary adrenocortical insufficiency

Waterhouse-Friderichsen syndrome
(meningococcemia)

 13

2.

2.1 Sheehans syndrome
(panhypopituitarism)
(postpartum hemorrhage) FSH
(follicle stimulating hormone) LH (luteinizing hormone)
TSH (thyroid stimulating hormone) ACTH
2.2 Simmonds disease

(pheochromocytoma)
(chromaffinoma)

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 14

1. Longo, D.L., Fauci, A., Kasper D., Hauser S., Jameson J.L. and Loscalzo, J. Harrisons
Principles of Internal Medicine, 18th edition, Mcgraw Hill Book Company, New
York, 2011.
2. Ganong, W.F. Review of Medical Physiology, 22nd edition, McGraw-Hill Medica Book
Company, New York, 2005.
3. Guyton, A.C., J.E. Hall. Textbook of Medical Physiology, 11th edition, W.B. Saunders
Company, Philadelphia, 2005.

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