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Adrenal gland

Abira Rajasingam

Adrenal gland

Also known as suprarenal glands


Endocrine glands that are retroperitoneal
and are attached to the superior border of
each kidney by a dense fibrous capsule
The right adrenal gland is triangular
shaped whereas the left is semi-lunar
shaped
Found at the level of the 12th rib
A typical adrenal gland weighs about 5.0
g but its size can greatly vary according
to its secretory demands

Adrenal gland

Divided into 2 parts: a superficial cortex and


an inner medulla
Embryologically, the cortex develops from
mesodermal tissue whereas the medulla
develops from neuronal tissue
Adrenal cortex has 3 distinct regions:
. Zona Glomerulosa
. Zona Fasciculata
. Zona Reticularis

Adrenal gland layers

Zona Glomerulosa

Accounts for 15% of the volume of the adrenal cortex


Produces mineralocorticoids of which aldosterone is the
main hormone
This hormone is released in response to a rise in
potassium level and it also occurs in response to
Angiotensin 2
Aldosterone causes the retention of sodium ions at the
kidneys, sweat glands, salivary glands and pancreas
and is also involved in elimination of K+
As a secondary effect, the reabsorption of Na+
enhances the osmotic reabsorption of water at the
kidneys, sweat glands, salivary glands and pancreas

Renin-AAS pathway

RAA pathway

Stimuli that initiate the renin-angiotensin-aldosterone pathway include dehydration, Na+ deficiency, or
haemorrhage
These conditions cause a decrease in blood volume
Decreased blood volume leads to a decreased blood pressure
Lowered blood pressure stimulate certain cells of the kidneys, called juxtaglomerular cells, to secrete the enzyme
renin
The level of renin in the blood increases
Renin converts angiotensinogen into angiotensin I
Blood containing increased levels of Angiotensin I circulates in the body
ACE converts angiotensin I into the hormone angiotensin II
Blood level of angiotensin II increase
Angiotensin II stimulates the adrenal cortex to secrete aldosterone
Blood containing increased levels of aldosterone circulates to the kidney
Aldosterone increases reabsorption of Na+, which in turn causes reabsorption of water by osmosis. As a result, less
water is lost in the urine. Aldosterone stimulates the kidney to increase secretion of K+ and H+ into the urine
With increased water reabsorption by the kidneys, blood volume increases
As blood volume increases, blood pressure increases to normal
Angiotensin II also stimulate contraction of smooth muscle in the walls of arterioles. The resulting vasoconstriction
of the arterioles increases blood pressure and thus helps raise blood pressure to normal.
Besides angiotensin II, a second stimulator of aldosterone secretion is an increase in the K concentration of blood
(or interstitial fluid). A decrease in the blood K level has the opposite effect.

Zona Fasciculata

Secretes glucocorticoids- which regulates metabolism and


resistance to stress
Cortisol, corticosterone and cortisone
95% of glucocorticoid activity
Low levels of glucocorticoids- mainly cortisol- stimulate
neurosecretory cells in the hypothalamus to secrete
corticotropin-releasing hormone (CRH)
CRH promotes the release of ACTH from the anterior
pituarity
ACTH flows in the blood to the adrenal cortex, where it
stimulates glucocorticoid secretion
ACTH also stimulates secretion of aldosterone

Glucocorticoids

Protein breakdown:

GCs increase the rate of protein breakdown- mainly in muscle fibersincreases the liberation of amino acids into the bloodstream.

Glucose formation:
Liver cells may convert certain amino acids or lactic acid to glucose,
which neurons and other cells can use for ATP production =
gluconeogenesis

Lipolysis:
Depression of immune response:
Given for organ transplant

Resistance to stress:
Additional glucose supplied by the liver cells provides tissues with a
ready source of ATP to combat a range of stresses, including exercise,
fasting, fright, temperature extremes, high altitude, bleeding,
infection, surgery, trauma, and disease
High doses can cause severe mental disturbances

Androgens

The major androgen secreted by the adrenal gland is


dehydroepiandrosterone
After puberty in males, the androgen testosterone is also released in
much greater quantity by the testes. Thus, the amount of androgens
secreted by the adrenal gland in males is usually so low that their
effects are insignificant.
In females, however, adrenal androgens play important roles.
They promote libido (sex drive) and are converted into oestrogens
(feminizing sex steroids) by other body tissues. After menopause,
when ovarian secretion of oestrogens ceases, all female oestrogens
come from conversion of adrenal androgens.
Adrenal androgens also stimulate growth of axillary and pubic hair in
boys and girls and contribute to the prepubertal growth spurt.
Although control of adrenal androgen secretion is not fully
understood, the main hormone that stimulates its secretion is ACTH.

Adrenal medulla

Inner region of the adrenal gland


Modified sympathetic ganglion of the ANS
Develops from the same embryonic tissue as all
other sympathetic ganglia, but its cells, which lack
axons, form clusters around large blood vessel
Instead of releasing neurotransmitters- they
secrete hormones- from Chromaffin cells
Innervated by sympathetic preganglionic neurons
of the ANS. Because the ANS exerts direct control
over the Chromaffin cells, hormone release can
occur very quickly.

Adrenal medulla

Epinephrine- 80%
Norepinephrine- 20%
Hormones of the adrenal medulla intensify sympathetic responses
that occurs in other parts of the body
In stressful situations and during exercise, impulses from the
hypothalamus stimulate sympathetic preganglionic neurons
stimulate the Chromaffin cells to secrete epinephrine and
norepinephrine.
By increasing heart rate and force of contraction, epinephrine and
norepinephrine increase the output of the heart, which increases
blood pressure.
They increase blood flow to the heart, liver, skeletal muscle, and
adipose tissue, dilate airways to the lungs; and increase blood levels
of glucose and fatty acids.

Blood supply

Blood supply

Like other endocrine glands, the adrenal glands are highly


vascularised.
There are usually 3 arteries that supply each adrenal gland:
Superior adrenal artery provided by the inferior phrenic
artery
The middle adrenal artery is provided by the abdominal aorta
The inferior adrenal artery is provided by the renal artery

Venous drainage of the adrenal glands is achieved by the


adrenal veins:
The right adrenal vein drains into the IVC
The left adrenal vein drains into the left renal vein or the left
inferior phrenic vein

The adrenal glands and the thyroid gland are the organs that
have the greatest blood supply per gram of tissue.

Nerve supply

Innervated by sympathetic nervous system


The nerves supplying the adrenal glands are
derived from the coeliac plexus and thoracic
splanchnic nerves
Adrenal medullary cells are modified
postganglionic neurons, where preganglionic
fibers synapse on neuroendocrine cells that
secrete epinephrine, norepinephrine into the
bloodstream