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