ADRENAL MEDULLA

The adrenal medulla is the inner part of the adrenal gland. It is made up of neural tissue called chromaffin
cells. These cells are essentially postganglionic motor neurons of the sympathetic nervous system.
Stimulus of the Adrenal Medulla
The adrenal medulla is stimulated during short-term stress or "fight-or-flight" situations. The primary
stimulus is acute stress, which triggers the sympathetic nervous system.
Activation Pathway

 The hypothalamus, a regulator of the autonomic nervous system, sends signals to the spinal cord.
 These signals reach the thoracolumbar outflow (T1 to L2) in the spinal cord.
 The lateral gray horn of the spinal cord contains preganglionic motor neurons of the sympathetic
nervous system.
 Axons from these preganglionic neurons travel through the ventrolateral rami and bypass
sympathetic chain ganglia.
 The axons reach the adrenal medulla and stimulate the chromaffin cells.
 Preganglionic motor neurons from the thoracolumbar spinal cord (T1-L2) send axons.
 These axons bypass sympathetic chain ganglia and directly reach the adrenal medulla.
 Acetylcholine released from the axons binds to nicotinic receptors on chromaffin cells.

Neurotransmitter Synthesis:

 Tyrosine (amino acid) is converted to L-DOPA by tyrosine hydroxylase.

 L-DOPA is converted to dopamine by dopa decarboxylase.
 Dopamine is converted to norepinephrine by dopamine beta-hydroxylase.
 Norepinephrine is converted to epinephrine by phenyl ethanolamine N-methyltransferase.
Secretion:
 Chromaffin cells store epinephrine and norepinephrine in synaptic vesicles.
 Action potentials trigger calcium influx into the terminal bulb.
 Calcium triggers vesicle fusion with the cell membrane.
 Epinephrine (80%) and norepinephrine (20%) are released into the bloodstream.

Epinephrine and Norepinephrine Release:

 Action potentials trigger calcium influx into the chromaffin cell terminal bulb.
 Calcium triggers exocytosis of norepinephrine and epinephrine (80% epinephrine, 20%
norepinephrine) into the bloodstream.

EFFECTS OF EPINEPHRINE AND NOREPINEPHRINE

EYES
 Dilation of pupils: Improves visual perception.

MUSCLES
 Increased blood sugar levels: Provides readily available energy for muscles.
 Increased blood flow to skeletal muscles: Delivers oxygen and nutrients to muscles for
movement.
LIVER
 Mechanism of Blood Sugar Increase:
 Epinephrine binds to adrenergic receptors on liver cells.
 This activates a G protein pathway, leading to the production of cyclic AMP (cAMP).
 cAMP activates protein kinase A, which stimulates glycogenolysis (breakdown of glycogen) in
the liver.
 Glycogenolysis releases glucose molecules into the bloodstream, raising blood sugar levels.
 Cortisol, another hormone released during stress, increases the sensitivity of liver cells to
glucagon, promoting glycogenolysis (breakdown of glycogen) for glucose release.
 Epinephrine stimulates gluconeogenesis in the liver, which converts amino acids, glycerol, and
lactic acid into glucose.
 The combined effects of epinephrine and cortisol lead to increased blood glucose levels
(hyperglycemia).
 Increased blood glucose provides readily available energy for muscles during fight-or-flight
situations.

ADIPOSE TISSUE
 Lipolysis:
 Epinephrine binds to G protein-coupled receptors on fat tissue.
 This activates hormone-sensitive lipase, an enzyme that breaks down triglycerides into glycerol
and fatty acids.
 Glycerol can be used in gluconeogenesis for further glucose production.
 Fatty acids are released into the bloodstream and can be taken up by muscles for energy
production through beta-oxidation.
 Increased fatty acid utilization by muscles spares glucose for other tissues like the brain.

CARDIOVASCULAR SYSTEM

 Effects of Epinephrine on the Cardiovascular System (continued)

 Epinephrine and norepinephrine bind to beta-adrenergic receptors on heart cells.
 This increases the rate and force of contraction of the heart muscle, leading to increased cardiac
output (blood pumped per minute).
 Increased cardiac output delivers more oxygen and nutrients to tissues throughout the body.
 Epinephrine can also cause vasoconstriction in some blood vessels in some areas, such as the skin
and intestines, via alpha-1 adrenergic receptors.
 Vasoconstriction decreases blood vessel diameter, increasing blood pressure.
 This helps to prioritize blood flow to vital organs like the heart, brain, and skeletal muscles
during fight-or-flight situations.
 Blood flow is diverted away from non-essential organs like the skin and digestive system.

RESPIRATORY SYSTEM
 Epinephrine binds to beta-2 adrenergic receptors in the smooth muscle surrounding the bronchi in
the lungs.
 This binding causes relaxation of the smooth muscle, a process called bronchodilation.
 Bronchodilation increases the diameter of the airways, allowing for more air to flow in and out of
the lungs.
 Increased airflow facilitates greater oxygen intake and carbon dioxide removal during exercise or
stressful situations.