ADRENAL GLAND

Dr. Anis Irmawati, drg., MKes

Physiology II

Dental Medicine Faculty

Universitas Airlangga
Maret 13, 2018
Anatomy
Anatomy
 Adrenal gland structure

There are 2 layers

1. Cortex

2. Medulla
Cortex :
produces hormone that are vital to life
for long term stress
cortisol : regulate metabolism and help to response stress
aldosterone : control blood pressure

Medulla :
produces non essential hormone
for acute term stress
adrenaline : help to react to stress
 Adrenal Cortex

*consist of multiple layers of lipid storing cell

*devide into 3 structural distinc region :
1. zona glomerulosa
2. zona fasciculate
3. zona reticularis
*component of HPA axis (hypothalamic pituitary adrenal)
*HPA axis :
involves the stimulation hypothalamus  CRH  HA 
ACTH  adrenal gland  cortisol
 Zona glomerulosa

most superficial region

produces group hormone :
mineralocorticoids  effect on body minerals,
especially sodium and potassium 
essential for fluid and electrolyte balance
aldosterone : major mineralocorticoid
released : stimulates by kidney
 Zona fasciculata

intermediate region
produce hormone :
glucocorticoid  role in glucose metabolism
glucocorticoid produces :
1. hydrocortisone = cortisol
2. corticosterone
released by : hypothal & HA stimulation
 Zona fasciculata

1. hydrocortisone = cortisol :
*regulate how the body convert C, L, P to form energy
*help regulate blood pressure, cardiovascular

2. corticosterone :
with hydrocortisone regulate :
*immune respon
*suppress inflamatory reaction
 Zona reticularis

deepest region
produces steroid sex hormone : androgen (not puberty)
remember :
during puberty and most adulthood 
androgen produced by gonads
stimulus  CRH  ACTH  zona reticularis  
testosterone >>> & estrogen  sex drive
 Medulla andrenal

Medulla :
*synthesis epinephrine (E) = adrenaline : 80%,
and nor epinephrine (NE) = noadrenaline : 20%
*released after symphatetic nervous system (SNS)
is stimulated  acute term stress
*stressfull situation : fight or flight response
 Medulla adrenal

Epinephrine :
*one part of the molecule has a hydrogen atom
*heart rate 
*rushing blood to the muscle and brain
*blood glucose  (liver : glycogen  glucose)

NE :
*one part of the molecule has a methyl group (CH3)
*works with E in responding to stress
*vasoconstriction blood vessel  blood pressure 
*also : act as neurotransmitter
Synthesis
 Adrenal Hormone

1. Cortex 2. Medulla

Aldosteron
Epinephrine
Glucocorticoid
Norepinephrine
Androgen
 Physiology

major function : respond to stress

physical or psychological stress or both
physical stress : injury, malnutrition, cold or hot condition
psychic : mal perseption, negative thinking

the body respond to stress : short term n long term 

different  general adaptation syndrome (GAS) 
3 steps
 GAS step

1. Alarm reaction
*short term stress
*fight or flight respond
*mediated : epinephrine n nor epinephrine hormone
via SAM (sympathomedullary) pathway
*function : prepare the body for extreme physical exertion
*once stress is relieved : body return to normal
*adrenal medulla cover this reaction
2. Stage of resistant :
*if the stress is not soon relieved
*person is starving : body send signal to the GIT for longer
term  to max the absorption of nutrient from food

3. Stage of exhaustions :
*longer term
*individu begin suffer depression, immune response 
severe fatigue, or even a fatal heart attack
*these symptom : mediated by hormon adrenal cortex,
especially : cortisol (result of signal from HPA axis)
 Aldosterone

major mineralocorticoid
regulation concentration Na + , K+ : urine, sweat, saliva
respond to : K+ >>>; Na+ <<<, blood pressue /low blood
volume  CRH   ACTH   stimulates cortex
adrenal  aldosterone   K+ <<<; Na+ >>>;
blood volume n blood pressure 
key component of RAAS (renin-angiotensin-aldosteron
system )
 Cortisol

released by : CRH  ACTH  cortex adrenal  cortisol

hormone stress :
stress  need energy   BMR   glucose demand 
 cortisol help to supply glucose by :
mobilize glucagon , gluconeogenesis , catabolism
muscle protein  blood glucose level 
neuron sensitivity 
physiology apoptosis 
absorption of Ca2+ from GIT n renal tubules 
bone resorption 
 Epinephrine and NE

has a role to :
*fight or flight response
*physical n psychic stimulation
E & NE have important effect :
bloodflow to the muscle   muscle cell use oxygen
to produce energy from digest food
stress : need more oxygen & nutrient !!!
 Disorder

1. Cushing’s disease

2. Addison’s disease
 Cushing’s disease

*caused by : hypersecretion ACTH or cortisol

(pituitary tumor)
*a moon face
*a buffalo hump on the back of the neck
*rapid weight gain
*hair loss
*chronic blood glucose   DM risk (type 2)
compromise immunity
resistant to infection
 Addison’s disease

*caused by : hyposecretion ACTH or cortisol

*low blood glucose level
*low blood sodium level
*general weakness
*abdominal pain
*weight loss
*nausea
*vomiting
*sweating
ALHAMDULILLAH