4. SALT
• Mineralocorticoids (F & E balance)
– Aldosterone (renin from kidneys controls adrenal
cortex production of aldosterone)
• Na retention
• Water retention
• K excretion
5. SUGAR
• GLUCOCORTICOIDS
(regulate metabolism & are critical in stress
response)
– CORTISOL responsible for control and &
metabolism of:
a. CHO (carbohydrates)
– glucose formed
– glucose released
6. CORTISOL
FATS-control of fat metabolism
• stimulates fatty acid mobilization from
adipose tissue
PROTEINS-control of protein metabolism
– stimulates protein synthesis in liver
– protein breakdown in tissues
7. • Other fxs of Cortisol
– inflammatory and allergic
response
– immune system therefore prone to
infection
8. SEX
• ANDROGENS
– hormones which male characteristics
• release of testosterone
• Clear more in women than men
10. The Adrenal Gland
The adrenal glands (also known as suprarenal
glands) are endocrine glands that sit atop the
kidneys; in humans, the right suprarenal gland is
triangular shaped, while the left suprarenal gland is
semilunar shaped.
It is pyramidal in structure and weights about four
grams.
14. Each adrenal gland has two distinct
structures, the adrenal cortex and the
medulla, both of which produce
hormones.
The cortex mainly produces cortisol,
aldosterone and androgens, while the
medulla chiefly produces epinephrine
and norepinephrine.
Parts Of Adrenal Gland
16. The Adrenal Gland
In General
These hormones control many important functions in the
body, such as:
1. Maintaining metabolic processes, such as managing
blood sugar levels and regulating inflammation
2. Regulating the balance of salt and water
3. Controlling the "fight or flight" response to stress
4. Maintaining pregnancy
5. Initiating and controlling sexual maturation during
childhood and puberty
17. Adrenal Cortex
• It is divided into 3 zones in the adult gland:
1. Zona Glomerulosa,
2. Zona Fasciculata,
3. Zona Rericularis.
• Is divided onto 4 zones in the fetal gland.
• The three zones of the permanent cortex constitutes
only 20% of the fetal gland’s size. The remaining zone
(fetal cortex) comprises up to 80% of gland’s size during
fetal life.
18. – The outermost layer, the zona glomerulosa is the
main site for production of mineralocorticoids,
mainly aldosterone,
– Aldosterone is largely responsible for the long-term
regulation of blood pressure.
• Complete failure to secrete aldosterone leads to death
(dehydration, low blood volume).
• Hyperalsdosterone states: Contribute to hypertension
associated with increased blood volume.
Glomerulosa,
22. – Situated between the glomerulosa and
reticularis, the zona fasciculata is responsible
for producing glucocorticoids, chiefly cortisol in
humans.
– The zona fasciculata secretes a basal level of
cortisol but can also produce bursts of the
hormone in response to adrenocorticotropic
hormone (ACTH) from the anterior pituitary.
Fasciculata
23. • The inner most cortical layer, the zona reticularis
produces androgens, mainly
dehydroepiandrosterone (DHEA) and DHEA
sulfate (DHEA-S) in humans.
Reticularis
25. • Use as immunosuppressant
– Hyperimmune reactions (bee stings)
– Serious side effects
• Hypercortisolism (Cushing's syndrome)
– Tumors (pituitary or adrenal)
– Iatrogenic (physician caused)
• Hypocortisolism (Addison's disease)
Cortisol: Role in Diseases and
Medication
26. Adrenal Gland Disorders
Adrenal gland disorders occur when the
adrenal glands don’t work properly.
Sometimes, the cause is a problem in another
gland that helps to regulate the adrenal
gland.
In other cases, the adrenal gland itself may
have the problem.
36. Treatment
Congenital adrenal hyperplasia
Congenital adrenal hyperplasia can’t be cured,
but it can be treated and controlled. People
with congenital adrenal hyperplasia can take
medication to help replace the hormones their
bodies are not making.
Some people with congenital adrenal
hyperplasia only need these medications when
they are sick, but others may need to take
them every day.
39. TREATMENT
Addisonian Crisis
• Rapid infusion of IV fluids
• Check VS and urine output frequently
• Monitor EKG
• Give solu-cortef IV Q6 hours until S & S
disappear
41. ETIOLOGY AND RISK FACTORS
• Tuberculosis (TB) :TB is an infection which
usually affects the lungs. In some cases the
infection can spread to, and gradually
destroy, the adrenals
• Other infections can sometimes affect both
adrenals.
• Cancers of other parts of the body can spread
and destroy the adrenals.
• Rare hereditary conditions.
• adrenalectomy
• Auto immune diseases: auto-immune
diseases the immune system makes
antibodies against part or parts of the body.
In auto-immune Addison's disease, you make
antibodies which attach to cells in the adrenal
cortex
42. CLINICAL MANIFESTATION
• General weakness and becoming easily
tired.
• Darkened areas of skin ('pigmentation').
• Blood pressure is low and falls further
when you stand which can make you
dizzy.
• Being off your food and weight loss.
• Feeling sick and vomiting from time to
time.
• Abdominal pains which may come and go.
• Diarrhoea or constipation which may
come and go.
• Cramps and pains in muscles.
• Craving for salt, or salty foods and drinks.
• Menstrual periods in women may become
irregular, or stop.