Discusses in detail adrenal physiology, then discusses common conditions that arise due to adrenal gland pathology. Talks about clinical features, investigations and management.
left adrenal vein> renal vein > inferior vena
cava (organs on left have longer course as
they have to cross over to the vena cava
found on the right side of the body.)
right adrenal vein > inferior vena cava
Cortex and medulla:
Medulla:
secretes adrenaline and noradrenaline
sympathetic nervous system control -
sympathetic nervous system activation
releases ACh at synapse, which causes
adrenal medulla to release adrenaline and
noradrenaline
Cortex: produces three different hormones
Mineralocorticoids (aldosterone) —> Zona
glomerulosa G
Adrenals 1
, Made from cholesterol, ACTH activates
enzyme needed in first step
Glucocorticoids (cortisol) —> Zona
fasciculata F
Uses precursors from Zona glomerulosa to
make Glucocorticoids
Androgens (testosterone) —> Zona
reticularis R
Uses precursors from Zona fasciculata to
make androgens
Adrenal cortex
1. Mineralocorticoids (aldosterone)
Affects kidney function, and its release is controlled
by the Renin-angiotensin-aldosterone (RAA)
Increases Na/Water resorption
Promotes K/H excretion
2. Androgens (testosterone and DHEA)
Small contribution to androgen production in males
(due to testes)
produces ~50% of androgens for females
Relevant in congenital adrenal hyperplasia where there
is an over/underproduction —> abnormal sex
development
3. Glucocorticoids (cortisol)
Cortisol is a major glucocorticoid that binds to
intracellular receptors
Exerts affect by activating/supressing gene
transcription
Production is stimulated by ACTH
Adrenals 2
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