 The adrenal medulla occupies a little over a

quarter of the inner mass and is composed of

modified sympathetic ganglia that secrete
catecholamines (mostly epinephrine) to mediate
rapid responses in fight-or- flight situations

 The adrenal cortex forms the outer three-

quarters of the gland and secretes a variety of
steroid hormones.
 Stimulation gluconeogenesis
◦ Increase protein catabolism
◦ Decrease glucose utilization and insulin sensitivity
◦ Increase lipolysis
 Anti-inflammatory effect
◦ induce the synthesis of lipocortin (an inhibitor of
phospholipase A2)
◦ inhibit the release of histamine and serotonin
 Maintenance of vascular responsiveness to
cathecolamines
◦ up-regulates alpha1 receptors on arterioles
 ↑renal Na+ reabsorption (action on the
principal cells of the late distal tubule and
collecting duct)

 ↑renal K+ secretion (action on the principal

cells of the late distal tubule and collecting
duct)

 ↑renal H+ secretion (action on the α-

intercalated cells of the late distal tubule and
collecting duct)
 Adrenal medulla is a specialized ganglion of
the sympathetic nervous system.
◦ Preganglionic fibers synapse directly on chromaffin
cells in the adrenal medulla.
◦ The chromaffin cells secrete epinephrine (80%) and
norepinephrine (20%) into the circulation
◦ Pheochromocytoma is a tumor of the adrenal
medulla that secretes excessive amounts of
catecholamines and is associated with increased
excretion of 3-methoxy- 4-hydroxymandelic acid
(VMA).
 Secretory product and action

 Control pathway

 Pathophysiology