DISORDERS OF ADRENAL GLAND

INTRODUCTION

• The two adrenal glands are pyramid shaped organs that sit on top of the kidney.
• Each gland consists of two parts : inner medulla, outer cortex.
• The adrenal medulla produces two hormones which are also known as catecholamines : epinephrine (adrenaline) and norepinephrine (noradrenline) 

• These hormones are similar to substances released by the sympathetic nervous system, therefore not essential to life. 
• Control the "Fight or Flight" situation.

• Epinephrine (80%) - increases blood glucose levels, increases rate and cardiac contractions, constricts blood vessels, and stimulates the release of ACTH from the pituitary : ACTH will stimulate adrenal cortex to release glucocorticoids.
• Norepinephrine (20%) - increases both heart rate and force of cardiac contractions, vasoconstricts blood vessels throughout the body. 

• The adrenal cortex secretes corticosteroids (mineralocorticoids and glucocorticoids) and androgens which are essential to life.
• The release of mineralocorticoids is controlled by renin (enzyme).
• Mineralocorticoids play a vital role in body fluid regulation. (renin-angiotensin-aldosterone system)
• The glucocorticoids include cortisol and cortisone.
• Glucocorticoids are released in time of stress.
• These hormones affect carbohydrate metabolism by regulating glucose use in body tissues, mobilizing fatty acids from fatty tissues. 

NORMAL VS FLIGHT & FIGHT RESPONSE

DISORDERS OF ADRENAL CORTEX

TYPES OF DISORDERS

• Disorders of adrenal cortex can result in excessive/reduced production of glucocorticoids, mineralocorticoids and androgens.
• 1 major condition of hyposecretion/adrenal insufficiency : Addison's Disease
• 3 major conditions of adrenocorticol hyperfuntion are :

         a) Cushing's Syndrome (glucocorticoid excess)

         b) Conn's Syndrome or aldosteronism (aldosterone excess)

         c) Congenital Adrenal Hyperplasia (adrenogenital syndrome, androgen excess) 

REFERENCES

• http://www.nlm.nih.gov/medlineplus/adrenalglanddisorders.html
• http://www.clevelandclinicmeded.com/medicalpubs/diseasemanagement/endocrinology/diseases-of-the-adrenal-gland/
• Brunner & Suddarth's (2010). Assessment and Management of Patients With Endocrine Disorders,Medical-Surgical Nursing Text Book. 42(8), 1275-1287