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Adrenal Gland

and Cortisol
Renz Jethro M. Ortega III BS in Medical Technology Emilio Aguinaldo College Manila

Objectives
De ine the adrenal gland Di!cu!! the anatomy and "hy!iology o adrenal gland Identi y the hormone! and location! they are "roduced in the adrenal gland E#"lain corte# !teroidogene!i! and $io!ynthe!i! o catecholamine E#"lain the hormone corti!ol

Adrenal Gland
A multi unctional endocrine organ that "roduce! !teroid hormone! and neuro"e"tide! e!!ential or li e. Su"rarenal gland% ound ato" the &idney!. A "yramidal !tructure 'eighing a""ro#. ( gram!.

Functions of the Adrenal Gland


The!e unction! re lect to the hormone! "roduced $y the gland Maintaining meta$olic "roce!!e!) !uch a! managing $lood !ugar le*el!) regulating in lammation and $lood "re!!ure. Regulating the $alance o !alt and 'ater Controlling the + ight or light, re!"on!e to !tre!! Maintaining "regnancy Initiating and controlling !e#ual maturation during childhood and "u$erty.

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Anatomy of Adrenal Gland


In human!) the right adrenal gland i! triangular !ha"ed% le t i! !emilunar !ha"ed. Each adrenal gland i! com"o!ed o t'o em$ryologically di!tinct $ut con1oined) gland!- the outer adrenal corte# and the inner adrenal medulla. Surrounded $y adi"o!e ca"!ule and renal a!cia.

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Anatomy of Adrenal Cortex


It i! deri*ed rom me!enchymal cell! that di erentiate! into three di!tinct zone!- zona glomerulo!a) zona a!cuculata and zona reticulari!. Contri$ute! to 345 o the gland6! 'eight. A""ear! yello' in gro!! !ectioning.

Anatomy of Adrenal Medulla


It ari!e! rom the neural cre!t cell! that in*ade the corte# in the 7nd month o etal de*elo"ment. Contri$ute! to 845 o the total adrenal 'eight. On gro!! !ectioning) the medulla i! dar& mahogany.

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Adrenal Glands Blood Supply


Arterie! that !u""ly $lood to the adrenal gland. Su"erior !u"rarenal artery i! "ro*ided $y the in erior "hrenic artery. Middle !u"rarenal artery i! "ro*ided $y the a$dominal aorta. In erior !u"rarenal artery i! "ro*ided $y the renal artery.

Adrenal Glands Blood Supply


;enou! drainage o achie*ed *iathe adrenal gland i!

Right !u"rarenal *ein drain! into the in erior *ena ca*a. :e t !u"rarenal *ein drain! into the le t renal canal o the le t "hrenic *ein.

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hysiolo!y of Adrenal Cortex


The ma1or corte# hormone!) aldo!terone) corti!ol and dehydroe"iandro!terone !ul ate <D=EAS> are !ynthe!ized rom a common "recur!or) chole!terol $y each zonal layer!.

?ona 2lomerulo!a ?ona /a!ciculata ?ona Reticulari!

Clinical Chemistry @Michael :. Bi!ho" MS MT <ASCA> C:S <BCA>) Ed'ard A. /ody MD) :arry E. Schoe MS MT <ASCA>C Dth edition

"ona Glomerulosa
Synthe!ize aldo!terone <mineralocorticoid!>. Critical or !odium retention <*olume>) "ota!!ium and acidE$a!e $alance. =a*e lo' cyto"la!micEtoEnuclear ratio and !mall nuclei 'ith den!e chromatin 'ith intermediate li"id inclu!ion!. 2 cell! con*ert chole!terol to "regnenolone.

"ona Fasciculata
Synthe!ize glucocorticoid! !uch a! corti!ol and corti!one) critical or $lood gluco!e homeo!ta!i! and $lood "re!!ure. Cord! o clear cell!) 'ith high cyto"la!micE toEnuclear ratio and li"id! laden 'ith oamy cyto"la!m. 2enerate androgen "recur!or D=EA <dehydroe"iandro!terone>

"ona #eticularis
Sul ate D=EA to D=EAS) the main adrenal androgen. Andro!tenedione and dehydroe"iandro!terone Shar"ly demarcated 'ith li"idEde icient cord! o irregular) den!e cell! 'ith li"o u!cin de"o!it!.

Cortex Steroido!enesis
Bio!ynthe!i! o hormone! occur *ia !u$!trate a*aila$ility) enzyme acti*itie! and inhi$itory eed$ac& loo"!.
Stored LDL Use Acetyl-CoA Cortisol Primary !eedbac" #egulator$

Circadian signals Serum cortisol Stress

6 Carbons removed by Cytochrome P450

C#$ % Corticotropin&#eleasin! $ormone AC'$ % Adrenocorticotropic $ormone

Clinical Chemistry @Michael :. Bi!ho" MS MT <ASCA> C:S <BCA>) Ed'ard A. /ody MD) :arry E. Schoe MS MT <ASCA>C Dth edition

hysiolo!y of Adrenal Medulla


In re!"on!e to !ym"athetic !timulation) it !ecrete! catecholamine) the ir!t re!"onder! to !tre!!. Aromote! the ight or light re!"on!e 'hich increa!e! cardiac out"ut and $lood "re!!ure) di*ert! $lood to'ard mu!cle and $rain and mo$ilize! uel !torage.

Biosynthesis and Stora!e of Catecholamine

(O A % )&*+,&dihydroxyphenylalanine -MA' % -esicle Monoamine 'ransporters .M' % henylethanolamine N&methyltransferase

/ 0 % /pinephrine ./ % .orepinephrine

Clinical Chemistry @Michael :. Bi!ho" MS MT <ASCA> C:S <BCA>) Ed'ard A. /ody MD) :arry E. Schoe MS MT <ASCA>C Dth edition

Cortisol
A glucocorticoid "roduced $y zona a!ciculata o the adrenal corte#. Main unction i! to control hemodynamic! <$lood "re!!ure> and gluco!e homeo!ta!i! <antiEin!ulin e ect>. Regulated $y ACT=% only hormone inhi$iting ACT= Diurnal% high le*el! in morning <DEF am> and lo'e!t at night <84 "mE87 am> 345 in inacti*e and $ound to "rotein <tran!cortin> Re erence *alue- FE8G mg.d:

Biolo!ical /ffects of Cortisol


Arotein nitrogen cata$oli!m increa!ed 2luconeogene!i! Increa!ed $lood gluco!e concentration Decrea!ed gluco!e tolerance Increa!ed li*er glycogen Increa!ed li*er glycogenoly!i! Decrea!ed "eri"heral u"ta&e and utilization o gluco!e Decrea!ed !ynthe!i! o acidE!ul ated muco"oly!accharide!

Biolo!ical /ffects of Cortisol


/at !ynthe!i! and redi!tri$ution Cellular or ti!!ue e ect! Antiin lammatory Di!!olution o lym"hoid ti!!ue :ym"ho"enia Eo!ino"enia Increa!ed erythro"oie!i! Alteration o cellular "ermea$ility) e!"ecially decrea!ed mem$rane "ermea$ility to 'ater Increa!ed ga!tric <=Cl and "e"!in> !ecretion

1rinary Metabolites of Cortisol


The li*er degrade! all glucocorticoid! meta$olite! e#creted in urine. 23&hydroxycorticosteroid Te!t- Poster-Silber %ethod & ' yello($ Reagent- Phenyl )ydra*ine in )+S,4 & alcohol 23&4eto!enic Steroids Te!t- -immermann #eaction & ' reddish .ur.le$ Reagent- %eta-dinitroben*ene O#idation Arocedure- /orymbers"i /a& bismuthate$

#eferences5
Clinical Chemistry @Michael :. Bi!ho" MS MT <ASCA> C:S <BCA>) Ed'ard A. /ody MD) :arry E. Schoe MS MT <ASCA>C 6th edition #evie7er for Clinical Chemistry @Maria Tere!a RodriguezC 8nd edition $enry9s Clinical (ia!nosis and Mana!ement by )aboratory Methods @Richard A. McAher!on) MD and Matthe' R. Aincu!) MD) AhDC 88nd /dition htt"-..'''.ouh!c.edu.hi!tology.2la!! 574!lide!.93049.1"g

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