PHYSIOLOGY OF THE

ADRENAL GLAND
 Adrenal Gland
• cortex
– zona glomerulosa
• mineralocorticoids-
aldosterone
– zona fasciculata
• glucocorticoids- cortisol
– zona reticularis
• androgens- estrogen,
progesterone,
testosterone
• medulla
– norepinephrine, epinephrine
 Adrenal Gland - Physiology
• zona glomerulosa
– angiotensin II potent pressor > aldosterone
– hyperkalemia promotes independently
– hypokalemia inhibits
– ACTH
 Adrenal Gland - Physiology

• zona fasciculata
– ACTH as discussed
– cortisol actions
• zona reticularis
– ACTH controls
– no feedback
 MEKANISME KERJA
Mekanisme Tak Tergantung Reseptor
(TERMASUK GEN ACTIVE HORMONES)

11-a Hidroksisterol
KORTISON dehidrogenase KORTISOL ALDOSTERON

RESEPTOR
Reseptor MINERALOKORTIKOID
Mineralokortikoid
Increase granulocite
Decrease eosinophil,
Limphocite & monocite

Increase
gluconeogenesis
 Hyperadrenocorticism

• cushing’s sydndrome
• 3rd - 6th decade, 4 to1 females
• causes
– pharmocologic
– pituitary adenoma 75-90%
– adrenal adenoma, carcinoma
– ectopic ACTH
• treatment based on cause
 Adrenocortical insufficiency
• primary causes, ie. Addison’s disease
– autoimmune disease, tumors, infection,
hemorrhage, metabolic failure,
• secondary causes
– hypopituitarism, suppression exogenous
steroids