Você está na página 1de 27

Adrenal Cortex

Suprarenal gland
Inner medulla catecholamines Epinephrine Norepinephrine Dopamine Outer cortex steroid hormones

Cortical Zones
Medulla 28% Glomerulosa 15% Fasciculata 50% Reticularis 7%

Structure
Derived from cholesterol C21, C19 and C18 steroids C21 - Mineralocorticoids or glucocorticoids C19 - Androgens

Synthesis

Aldosterone

Synthesis

Synthesis

Adrenogenital syndrome

Transport

Synthetic steroids
Prednisolone Dexamethasone Fluorocortisol

Catabolism

Metabolic actions
Carbohydrate metabolism Gluconeogenesis Hepatic glycogenesis Anti-insulin effect

Actions
Protein catabolism Mobilization of free fatty acids from adipocytes

Stress
Any change in external environment that changes or threatens to change an optimal steady state Trauma, surgery Increase in ACTH and glucocorticoids

Immune system
Anti-inflammatory Inhibition of phospholipase A2 Anti-allergic Decreases eosinophils, basophils and lymphocytes

Other actions
Permissive action Accelerates maturation of GIT and lungs of the fetus Inhibits growth CNS and renal effects

Regulation

Cushing syndrome
ACTH dependent and ACTH independent Facial hair and acne Hypertension Diabetes Psychiatric disorders

Aldosterone
Re-absorption of sodium by the principal cells of the collecting duct Also cause re-absorption from sweat, saliva and colon Sodium is exchanged for potassium or hydrogen

Mechanism of action
Cytoplasmic receptor Increased insertion of ENaCs Increase synthesis of ENaCs Increases sodium potassium exchange

Aldosterone action

Regulation
ACTH Angiotensin II Potassium

Renin-angiotensin system

Primary adrenal insufficiency


Addisons disease Autoimmune destruction of adrenal gland Hypotension, shock (addisonian crisis) Fasting hypoglycemia

Addisons disease

Hyperaldosteronism
Primary Conn syndrome adenoma of glomerulosa or carcinoma of the adrenal Sodium retention - hypertension Potassium loss weakness Reduced secretion of renin