PHYSIOLOGY OF THE

ADRENAL MEDULLA

By
Nazia Uzma

Nomad:Adrenals 1
 ADRENAL GLANDS
 ALSO CALLED AS SUPRARENAL
GLANDS.
 EACH IS A TWO-IN-ONE GLAND.
 ADRENAL CORTEX & ADRENAL
MEDULLA.

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 Adrenal Medulla

Lecture Objectives:

• What are the adrenal medulla hormones?

• What are their endocrine effects?

• What is pheochromocytoma?
 ADRENAL MEDULLA
 WEIGHT – 1g
 FORMS 28% OF THE GLAND.
 IS CENTRALLY PLACED.
 THIS PART OF THE GLAND IS NOT ESSENTIAL
FOR LIFE.
 HORMONES HELP IN

DEALING WITH

EMERGENCIES.
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 Anatomy and Origin

• Embryologically derived from

pheochromoblasts

• Differentiate into modified neuronal

cells • More gland than nerve

• Acts like sympathetic ganglion

 Function of the Adrenal Medulla
• An extension of the sympathetic nervous
system

• Acts as a peripheral amplifier

• Activated by same stimuli as the

sympathetic nervous system

(examples – exercise, cold, stress, hemorrhage,

etc.)
 CELLS
CHROMAFFIN CELLS
ADRENOMEDULLARY HORMONES
(CATECHOLAMINES)
1)Epinephrine secreting type (80%)

2)Norepinephrine-secreting
1)EPINEPHRINE (30pg/mL)type (20%)

2)NOREPINEPHRINE (300pg/mL)

3)DOPAMINE (35pg/mL)

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 Mechanism of Action

• Receptor mediated – adrenergic receptors

• Peripheral effects dependent on type

receptors

Receptor  
Norepinephrine +++++ ++
Epinephrine ++ +++++
Catecholamine Synthesis
Tyrosine
tyrosine hydroxylase

Dihydroxyphenylalanine

L-aromatic amino acid decarboxylase

Dopamine
dopamine-b-hydroxylase

Norepinephrine
phenylethanolamine-N-methyltransferase

Epinephrine
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SECRETION OF ADRENOMEDULLARY HORMONES

1)EXERCISE

2)HYPOGLYCEMIA

3)TRAUMA

4)ANGER AND ANXIETY

5)PAIN

6)COLD

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PHYSIOLOGICAL ACTIONS

1)METABOLISM

2)FIGHT AND FLIGHT

3)CONTROL OVER DIFFERENT

SYSTEMS

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 METABOLISM

1)CARBOHYDRATE METABOLISM
Catecholamines act on liver to increase the glucose

2) FAT METABOLISM
Catecholamines increases the FFA in the plasma

3) BASAL METABOLIC RATE (BMR)

Increases the body temperature (Calorigenic Hormone)

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 FIGHT OR FLIGHT

EXCLUSIVELY BY SYMPATHETIC STIMULATION AND

ADRENAL MEDULLAR RELEASE OF CATECHOLAMINES

Increases the cardiac output promote blood

flow to different organs

Increase Ventilation

Stimulate energy supply

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EFFECT ON DIFFERENT SYSTEM

EFFECT ON CVS
Increases the force and rate of contraction of heart

Epinephrine causes arteriolar constriction

at renal and cutaneous bed

But Epinephrine produces vasodilation in

Skeletal and Hepatic circulation via b -receptors

So total peripheral resistance remain constant or

it will falls

Norepinephrine increases vasoconstriction through

a- receptors
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 EFFECT ON GI SYSTEM

Inhibit gastric secretion and motility

EFFECT ON RESPITATORY SYSTEM

Increases the broncial dilation

EFFECTS ON EYES
Pupillary dilation

EFFECT ON KIDNEY
Increases Na+ reabsorption

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EFFECTS OF DOPAMINE

Produce renal vasodilation

Other part it produces vasoconstriction

It increases systolic pressure

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 Pheochromocytoma
APPLIED ASPECT

• A catecholamine-secreting tumour of
chromaffin cells of the adrenal medulla
Signs & Symptoms of Pheochromocytoma

• Treatment resistant hypertension

• Headache
• Sweating Classic triad
• Palpitations

• Chest pain
• Anxiety
• Glucose intolerance
• Increased metabolic rate
 Diagnosis and Treatment

• Diagnosed by high plasma catecholamines

and increased metabolites in urine
• Vanilyl mandelic acid

• Treatment is surgical resection

• Catecholamines are the choice in the

treatment of Bronchial asthma
THANK
YOU