Adrenal gland

? What is the adrenal gland The adrenal glands (also known as suprarenal glands) are the triangle-shaped and orange- colored endocrine glands and measure about one-half inch in height and 3 inches in length located on the top of both kidneys at the level of the 12th thoracic vertebra.

LOCATION: one above each kidney. Consisting of Bone marrow, and the crust.

Function 1- the medulla synthesized adrenaline and noradrenaline. 2- the cortex produced cortisol,pre-androgens,and aldosterone.

Structure Each adrenal gland consists of : 1-Adrenal medulla. 2-Adrenal cortex.

Adrenal medulla adrenal medulla is the inner part of the adrenal gland and surrounded by the adrenal cortex and helps a person in coping with physical and emotional stress.

Adrenal medulla hormones: 1- Epinephrine : adrenaline and Epinephrine, or adrenaline hormone sometimes fear he is working to increase the heart and strength and also may help the liver to convert glycogen to glucose to feed the cells.

- 2- Norepinephrine - helps to constrict blood vessels and control blood pressure. this hormone has little effect on smooth muscle, metabolic processes, and cardiac output, but has strong vasoconstriction effects, thus increasing blood pressure

The Adrenal Cortex The adrenal cortex is the outer portion of the adrenal gland consists of three different regions, with each region producing a different group or type of hormones that carry out specific functions throughout your body.

Adrenal Cortex hormones The adrenal cortex produces three major groups of steroid hormones collectively called ( corticosteroids): 1) Mineralocorticoids (outermost ) 2) Glucocorticoids (middle ) 3) sex hormones (innermost )

MINERALOCORTICOIDS Mineralocorticoids are secreted by the outermost region of the adrenal cortex. The principal mineralocorticoid is aldosterone, which is the major hormone controlling the sodium and potassium levels, Aldosterone responsible for the reabsorption of sodium and stimulates the excretion of potassiumand thus fluid balance, within your bloodstream.

GLUCOCORTICOIDS Glucocorticoids are secreted by the middle region of the adrenal cortex.which include cortisone and cortisol.Cortisol controls or greatly influences the metabolism of fats, proteins to maintain blood glucose within a narrow optimal range and keep it there even under stressful conditions.

SEX HORMONES sex hormones are secreted by the innermost region of the adrenal cortex. Androgens (Male hormones) Estrogens (female hormones)

Cushing's Syndrome Cushing’s syndrome is a hormonal disorder caused by prolonged exposure of the body’s tissues to high levels of the hormone cortisol. Sometimes called hypercortisolism, Cushing’s syndrome is relatively rare and most commonly affects adults aged 20 to 50. People who are obese and have type 2 diabetes, along with poorly controlled blood glucose—also called blood sugar—and high blood pressure, have an increased risk of developing the disorder

Causes of Cushing's syndrome The most common cause is taking cortisone-like medicines orally (by mouth) every day for weeks to months. Prednisone for asthma, rheumatoid arthritis is the most common medicine that's taken this way. Cushing's disease is common cause of Cushing syndrome because excessive production of the hormone ACTH (Adreno - Corticotrophic Hormone) by the pituitary gland. ACTH stimulates the adrenal glands to produce cortisol.

symptoms of Cushing's syndrome severe fatigue weak muscles high blood pressure high blood glucose increased thirst and urination irritability, anxiety, or depression

Treatment Tumor treatments - various treatments aim at treating the underlying tumor causing the disease: Surgery Transsphenoidal adenomectomy - remove pituitary tumor Radiation Pituitary gland irradiation

DIAGNOSIS 1-24 hour urinary free cortisol level 2- x-rays to locate any tumors  Reference range of cortisol:  In morning: nmol/L  At night: nmol/L Reference range of ACTH: 7 – 40 m IU/L

Addison disease Addison disease is adrenocortical insufficiency due to the destruction or dysfunction of the entire adrenal cortex. It affects both glucocorticoid and mineralocorticoid function. The onset of disease usually occurs when 90% or more of both adrenal cortices are dysfunctional or destroyed.

Causes of Addison's Disease  Disorder of the adrenal glands.  Tuberculosis.  Adrenal cancer.  surgical removal of the adrenal glands  Autoimmune disorders.

Symptoms of Addison's Disease  weight loss.  loss of appetite.  muscle weakness.  nausea.  vomiting.  Diarrhea

Diagnosis  Determine the levels of cortisol.  Reference range of Aldosterone :  In blood : 4 – 9 microgram/100mL  In urine : 2 – 18 microgram/24 hours

How is it treated? Treatment focuses on replacing the insufficient hormones. Daily replacement medication is taken for the rest of the person's life. Regular checkups to monitor the disease are important. Aldosterone is also replaced with oral doses of a fludrocortisone

BY: ABDULRHMAN MOHAMMED TWHARI