Anatomy and Physiology of Adrenal glands

Gross Structure of the Adrenal Glands

The adrenal glands are on top of each kidney. Each gland has a cortex (outer
region) and a medulla (inner region). The cortex secretes glucocorticoids such as
cortisol, mineralocorticoids, and small amounts of androgens and estrogens responsible
for some secondary sex characteristics. Glucocorticoids raise blood sugar levels by
increasing gluconeogenesis (synthesis of glucose from amino acid). This action ensures
glucose supplies for the body when it is under stress. Mineralocorticoids such as
aldosterone promote sodium (salt) reabsorption by stimulating the kidneys to absorb
more sodium from the blood.

The adrenal glands which are also called the suprarenal glands, are small,
triangular glands located on top of both kidneys. An adrenal gland is made of two parts:
the outer region is called the adrenal cortex and the inner region is called the adrenal
medulla. Both parts of the adrenal glands -- the adrenal cortex and the adrenal medulla
-- perform very separate functions.
 The adrenal glands work interactively with the hypothalamus and pituitary gland in
the following process:

• the hypothalamus produces corticotropin-releasing hormones, which stimulate

the pituitary gland.
• the pituitary gland, in turn, produces corticotropin hormones, which stimulate the
adrenal glands to produce corticosteroid hormones.

Internal Structure of the Adrenal Cortex

The outer covering (adrenal cortex) is derived from the fetal mesodermal ridge, a
structure that also gives rise to the kidneys so that the juxtaposition of the two organs is
not surprising. Within the adrenal cortex are three zones known as the outer (zona
glomerulosa), the middle (zona fasciculata), and the inner (zona reticularis). Under the
microscope the cells are rather typical endocrine cells; the distinction between zones is
made by differing staining characteristics.
Adrenal Cortex Functions

The adrenal cortex, the outer portion of the adrenal gland, secretes hormones that
have an effect on the body's metabolism, on chemicals in the blood, and on certain
body characteristics. The adrenal cortex secretes corticosteroids and other hormones
directly into the bloodstream. The hormones produced by the adrenal cortex include:

• corticosteroid hormones

• hydrocortisone hormone - this hormone, also known as cortisol, controls the

body's use of fats, proteins, and carbohydrates.
• corticosterone - this hormone, together with hydrocortisone hormones,
suppresses inflammatory reactions in the body and also affects the immune
system.

• aldosterone hormone - this hormone inhibits the level of sodium excreted into
the urine, maintaining blood volume and blood pressure.
• androgenic steroids (androgen hormones) - these hormones have minimal
effect on the development of male characteristics

Hormones

Adrenocortical cells synthesize and secrete chemical derivatives (steroids) from

cholesterol, the major animal sterol. While cholesterol can be synthesized in many body
tissues, further differentiation into steroid hormones takes place only in the adrenal
cortex and in its embryological cousins, the ovaries and the testes.

Aldosterone

The biologic effect of aldosterone, the principal mineralocorticoid, is to set in motion a

set of reactions at the cell surface of all body tissues in order to enhance the uptake and
retention of sodium in all cells and the extrusion of potassium from them. It also has a
major impact on kidney function, to retain sodium within the circulation while increasing
the excretion of potassium into the urine. At the same time, aldosterone tends to
decrease the acidity of body fluids.

Cortisol

Cortisol (hydrocortisone) is the major human glucocorticoid. It exerts multiple and varied
effects. It also serves as a mineralocorticoid but is considerably less effective than
aldosterone. Cortisol plays a major role in the body's response to stress. In fasting, for
example, it sustains the blood sugar concentration by blocking the egress of glucose
into all tissues other than the critically important brain and spinal cord, while it
simultaneously increases the breakdown of protein from muscle and other organs and
hastens the conversion of newly generated amino acids to glucose to replenish the
supply constantly being consumed by the brain.

Adrenal androgens

Adrenal androgens are not as potent as testosterone, the major steroid secreted by the
testis, but a number of them, including androstenedione, dehydroepiandrosterone
(DHEA), and its sulfate (DHEAS) may be converted to stronger androgens such as
testosterone. Although little androgen is secreted before puberty, the output increases
dramatically at puberty so that the adrenal cortex makes a significant contribution,
known as the adrenarche, to developmental changes in both sexes.