Dilranjan Kaur, Nursing Tutor 1

THE ENDOCRINE SYSTEM, Bsc Nursing 1st year

By- Dilranjan Kaur, Nusing Tutor

ADRENAL GLANDS
LOCATION- The paired adrenal or suprarenal glands (supra-above; renalkidney), one of which lies
superior to each kidney in the retroperitoneal space, have a flattened pyramidal shape. There are
two adrenal glands, one situated on the upper pole of each kidney enclosed within the renal
fascia. They are about 4 cm long and 3 cm thick it weighs 3.5–5 g.

STRUCTURE- Although the adrenal gland looks like a single organ, it is structurally and functionally
two endocrine organs in one. The glands are composed of two parts which have different
structures and functions. The outer part is the cortex and the inner part the medulla. The adrenal
cortex is essential to life but the medulla is not.

BLOOD SUPPLY-
The main arteries that supply the adrenal glands are
 the several superior suprarenal arteries arising from the inferior phrenic artery
 the right and left middle suprarenal arteries from the aorta, and
 the inferior suprarenal arteries from the renal arteries.

BLOOD DRAINS-
 The suprarenal vein of the right adrenal gland drains directly into the inferior vena cava
 the suprarenal vein of the left adrenal gland empties into the left renal vein
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The principal nerve supply to the adrenal glands is from preganglionic fibers from the thoracic
splanchnic nerves, which pass through the celiac and associated sympathetic plexuses. These
myelinated fibers innervate the secretory cells of the gland found in a region of the medulla.

Adrenal gland

Adrenal cortex Adrenal medulla

Glucocorticoids Norepinephrine

Mineralocorticoids Epinephrine

Androgens

Fig 2- which hormones are

Fig 3 how hormones are
released by adrenal gland
released by adrenal gland
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ADRENAL CORTEX
The adrenal cortex is subdivided into three zones, each of which secretes different hormones.
1. The outer zone, just deep to the connective tissue capsule, is called the zona glomerulosa-
secrete hormones called mineralocorticoids because they affect metabolism of the
minerals sodium and potassium. Aldosterone is a mineralocorticoid.
2. The middle zone, or zona fasciculata, is the widest - secrete mainly glucocorticoids,
primarily cortisol. The glucocorticoids are so named because they affect glucose
metabolism.
3. The cells of the inner zone, the zona reticularis- synthesize small amounts of weak
androgens, hormones that have masculinizing effects.

The adrenal cortex produces hormones that are essential for life. Complete loss of adrenocortical
hormones leads to death in a few days to a week due to dehydration and electrolyte imbalances,
unless hormone replacement therapy begins promptly.

Hormones of the Adrenal Cortex

The adrenal cortex produces three groups of steroid hormones from cholesterol. They are
collectively called adrenocorticocoids (corticosteroids, corticoids). They are:
 Glucocorticoids
 Mineralocorticoids
 Sex hormones (androgens).
The hormones in each group have different characteristic actions but due to their structural
similarity their actions may overlap.
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1. GLUCOCORTICOIDS
The middle cortical layer mainly produces glucocorticoids, which
include cortisone and cortisol
Its Functions -
 It promote normal cell metabolism and help the body to resist long-term stressors by
increasing blood glucose levels, thus it is said to be a hyperglycemic hormone.
 It also reduces pain and inflammation by inhibiting some pain-causing molecules
called prostaglandins.
 It regulating metabolism and responses to stress.
Glucocorticoids have widespread effects and these include:
 Gluconeogenesis (formation of new sugar from, for example, protein) and
hyperglycaemia (raised blood glucose level)
 Lipolysis (breakdown of triglycerides into fatty acids and glycerol for energy
production)
 Stimulating breakdown of protein, releasing amino acids, which can be used for
synthesis of other proteins, e.g. Enzymes, or for energy (atp) production
 Promoting absorption of sodium and water from renal tubules (a weak
mineralocorticoid effect).
In pathological and pharmacological quantities glucocorticoids:
 Have an anti-inflammatory action
 Suppress the immune response
 Suppress the response of tissues to injury
 Delay wound healing.
When the sleeping and waking pattern is changed it takes several days for adjustment of the
ACTH/cortisol secretion to take place.
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How secretion is stimulated by ACTH and by stress.

2. MINERALOCORTICOIDS
The mineralocorticoids, primarily aldosterone, are produced by the outermost adrenal cortex cell
layer and is the main mineralocorticoid.
Its functions are:-
 Maintenance of water and electrolyte balance in the body.
 It stimulates the reabsorption of sodium (Na+) by the renal tubules and excretion of
potassium (K+) in the urine.
 Sodium reabsorption is also accompanied by retention of water and therefore aldosterone
is involved in the regulation of blood volume and blood pressure too.
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How secretions are regulated?

The blood potassium level regulates the amount of aldosterone produced by the adrenal
cortex. When the blood potassium level rises, more aldosterone is secreted. Low blood
potassium has the opposite effect. Angiotensin also stimulates the release of aldosterone.
Renin-angiotensin-aldosterone system-
 When renal blood flow is reduced or blood sodium levels fall the enzyme renin is secreted
by kidney cells.
 Renin converts the plasma protein angiotensinogen, produced by the liver, to angiotensin
1.
 Angiotensin converting enzyme (ACE), formed in small quantities in the lungs, proximal
kidney tubules and other tissues converts angiotensin 1 to angiotensin 2, which stimulates
secretion of aldosterone.
 It also causes vasoconstriction and increases blood pressure.
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3. Sex hormones. Both male and female sex hormones are produced by the adrenal cortex
throughout life in relatively small amounts; although the bulk of sex hormones produced
by the innermost cortex layer are androgens (male sex hormones), some estrogens
(female sex hormones), are also formed.
 Sex hormones secreted by the adrenal cortex are mainly androgens (male sex hormones)
and the amounts produced are insignificant compared with those secreted by the testes
and ovaries in late puberty and adulthood.
 Their role is unclear but it is thought that they contribute to the onset of puberty. An
elevated level in females causes masculinisation. Control of secretion is poorly understood.

ADRENAL MEDULLA
The inner region of the adrenal gland, the adrenal medulla, is0 completely surrounded by the
cortex. It develops from nervous tissue in the embryo and is part of the sympathetic division of the
autonomic nervous system. It is stimulated by its extensive sympathetic nerve supply to produce
the hormones adrenaline and nor adrenaline. The adrenal medulla, like the posterior pituitary,
develops from a knot of nervous tissue.
The hormone producing cells, called chromaffin cell, are innervated by sympathetic preganglionic
neurons of the greater splanchnic nerve from lower thoracic spinal levels. Because the ANS
controls the chromaffin cells directly, hormone release can occur very quickly.

The adrenal medulla produces two hormones: norepinephrine and epinephrine.

o The two principal hormones synthesized by the adrenal medulla are epinephrine and
norepinephrine (NE), also called adrenaline and noradrenaline, respectively.
o Adrenaline and noradrenaline Noradrenaline collectively, these hormones are referred to
as catecholamines.
o They are structurally very similar and this explains their similar effects.
o Epinephrine constitutes about 80 percent of the total secretion of the gland.
o Both hormones are sympathomimetic their effects mimic those brought about by the
sympathetic division of the ANS.
Together they potentiate the fight or flight response after initial sympathetic stimulation by:
 Increasing heart rate
 Increasing blood pressure
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 Dilate the small passageways of the lungs

 Diverting blood to essential organs including the heart, brain and skeletal muscles by
dilating their blood vessels and constricting those of less essential organs, such as the skin
 Increasing metabolic rate (Adrenaline has a greater effect on the heart and metabolic
processes whereas noradrenaline has more influence on blood vessels)
 Dilating the pupils.
 The catecholamines prepare the body to cope with a brief or short-term stressful situation
and cause the so-called alarm stage of the stress response.

Response to stress
When the body is under stress homeostasis is disturbed. To restore it and, in some cases, to
maintain life there are immediate and, if necessary, longer-term responses. Stressors include
exercise, fasting, fright, temperature changes, infection, disease and emotional disturbances/
situations. The immediate response is sometimes described as preparing for 'fight or flight'. This is
mediated by the sympathetic part of the autonomic nervous system and the principal effects. In
the longer term, ACTH from the anterior pituitary stimulates the release of glucocorticoids and
mineralocorticoids from the adrenal cortex and a more prolonged response to stress occurs.
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THYMUS GLAND
The thymus gland is large in infants and children and decreases in size throughout adulthood.
 Location. The thymus gland is located in the upper thorax, posterior to the sternum.
 Thymosin is the hormone secreted by the thymus gland and is required for the
development of special group of white blood cells (T-lymphocytes, or T cells) for cell
mediated immunity and the immune response.